WorldWideScience

Sample records for cancer indirect comparison

  1. Total, direct, and indirect effects of paan on oral cancer.

    Science.gov (United States)

    Merchant, Anwar T; Pitiphat, Waranuch

    2015-03-01

    Paan (betel leaf and betel nut quid) used with or without tobacco has been positively associated with oral cancer. Oral submucous fibrosis (OSMF), a precancerous condition caused by paan, lies on the causal pathway between paan use and oral cancer. The purpose of this analysis was to estimate the effect of paan consumption on oral cancer risk when it is mediated by OSMF. We used mediation methods proposed by VanderWeele, which are based on causal inference principles, to characterize the total, direct, and indirect effects of paan, consumed with and without tobacco, on oral cancer mediated by OSMF. We reanalyzed case-control data collected from three hospitals in Karachi, Pakistan, between July 1996 and March 1998. For paan without tobacco, the total effect on oral cancer was OR 7.39, 95 % CI 1.01, 38.11, the natural indirect effect (due to OSMF among paan users) was OR 2.48, 95 % CI 0.99, 10.44, and the natural direct effect (due to paan with OSMF absent) was OR 3.32, 95 % CI 0.68, 10.07. For paan with tobacco, the total direct effect was OR 15.68, 95 % CI 3.00, 54.90, the natural indirect effect was OR 2.18, 95 % CI 0.82, 5.52, and the natural direct effect was OR 7.27, 95 % CI 2.15, 20.43. Paan, whether or not it contained tobacco, raised oral cancer risk irrespective of OSMF. Oral cancer risk was higher among those who used paan with tobacco.

  2. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study.

    Science.gov (United States)

    Song, Fujian; Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

    2011-08-16

    To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included 112 independent trial networks (including 1552 trials with 478,775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence.

  3. [Development of an Excel spreadsheet for meta-analysis of indirect and mixed treatment comparisons].

    Science.gov (United States)

    Tobías, Aurelio; Catalá-López, Ferrán; Roqué, Marta

    2014-01-01

    Meta-analyses in clinical research usually aimed to evaluate treatment efficacy and safety in direct comparison with a unique comparator. Indirect comparisons, using the Bucher's method, can summarize primary data when information from direct comparisons is limited or nonexistent. Mixed comparisons allow combining estimates from direct and indirect comparisons, increasing statistical power. There is a need for simple applications for meta-analysis of indirect and mixed comparisons. These can easily be conducted using a Microsoft Office Excel spreadsheet. We developed a spreadsheet for indirect and mixed effects comparisons of friendly use for clinical researchers interested in systematic reviews, but non-familiarized with the use of more advanced statistical packages. The use of the proposed Excel spreadsheet for indirect and mixed comparisons can be of great use in clinical epidemiology to extend the knowledge provided by traditional meta-analysis when evidence from direct comparisons is limited or nonexistent.

  4. Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies : Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 2

    NARCIS (Netherlands)

    Hoaglin, David C.; Hawkins, Neil; Jansen, Jeroen P.; Scott, David A.; Itzler, Robbin; Cappelleri, Joseph C.; Boersma, Cornelis; Thompson, David; Larholt, Kay M.; Diaz, Mireya; Barrett, Annabel

    Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for

  5. Performance comparison of direct and indirect lighting systems

    International Nuclear Information System (INIS)

    Rubinstein, F.; Morse, O.; Clark, T.

    1993-01-01

    The performance of a retrofitted indirect lighting system was compared to the performance of a typical de-lamped direct lighting system in a partitioned office space. Power, illuminance and luminance measurements were made for the de-lamped direct lighting system and after installation of the indirect lighting system with various lamp and ballast combinations. Using the same lamps and ballasts, average workplace illuminance was slightly higher with indirect lighting than with direct lighting. With indirect lighting, workplace lumen efficacy was 4.5% lower due to the higher power draw of the lamps in the more open and cooler indirect fixtures. Indirect lighting with 36 watt T-8 lamps and electronic ballasts achieved an initial average workplace illuminance of 45 foot-candles in the partitioned office space at only 1.1 w/ft 2

  6. A comparison of microhardness of indirect composite restorative materials

    DEFF Research Database (Denmark)

    Miranda, Carolina Baptista; Pagani, Clóvis; Bottino, Marco Cícero

    2003-01-01

    The purpose of this study was to compare the microhardness of four indirect composite resins. Forty cylindrical samples were prepared according to the manufacturer’s recommendations using a Teflon mold. Ten specimens were produced from each tested material, constituting four groups (n=10) as foll...... esthetics and adequate mechanical properties may be considered as substitutes of natural teeth....

  7. In vitro and in vivo Comparison of Orthodontic Indirect Bonding ...

    African Journals Online (AJOL)

    2018-05-22

    May 22, 2018 ... 2018 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer ‑ Medknow. Objective: The aim of this study was to evaluate in vitro shear bond strength ... with indirect bonding resins that were either chemically or light-cured. ...... strength of composite, glass ionomer, and acidic primer adhesive.

  8. Resting energy expenditure and body composition in children with cancer: indirect calorimetry and bioimpedance analysis

    Directory of Open Access Journals (Sweden)

    M. V. Konovalova

    2014-07-01

    Full Text Available Resting energy expenditure (REE by indirect calorimetry and body composition by bioimpedance analysis are studied in three groups of children aged 5–18 years. Group 1 (n = 181 – patients in remission of cancer, group 2 (n = 55 – children with oncology diseases receiving chemotherapy or who are in the early period after hematopoietic stem cell transplantation, group 3 (n = 63 – children with non-malignant diseases of the gastrointestinal tract. To eliminate the influence of age and gender on the intergroup comparisons, body composition parameters were expressed as standardized values (z-scores relative to a reference group of healthy Russian children (n = 138,191. Group 1 was characterized by excess fat content with intact lean body mass, and groups 2 and 3 by protein depletion, more pronounced in Group 2 with a higher percentage of body fat. All used conventional formulas (WHO, Harris–Benedict and others in groups 1 and 3 underestimated REE as compared with indirect calorimetry. A new formula for REE, giving an unbiased estimate in the group 1 was proposed: REE (kcal/day = 28.7 × BCM (kg +10.5 × Height (cm – 38.6 × Age (years – 134, where BCM – body cell mass according to bioimpedance analysis (R2 = 0.67, the standard deviation of 196 kcal/day.

  9. A Dominant Social Comparison Heuristic Unites Alternative Mechanisms for the Evolution of Indirect Reciprocity

    Science.gov (United States)

    Whitaker, Roger M.; Colombo, Gualtiero B.; Allen, Stuart M.; Dunbar, Robin I. M.

    2016-08-01

    Cooperation is a fundamental human trait but our understanding of how it functions remains incomplete. Indirect reciprocity is a particular case in point, where one-shot donations are made to unrelated beneficiaries without any guarantee of payback. Existing insights are largely from two independent perspectives: i) individual-level cognitive behaviour in decision making, and ii) identification of conditions that favour evolution of cooperation. We identify a fundamental connection between these two areas by examining social comparison as a means through which indirect reciprocity can evolve. Social comparison is well established as an inherent human disposition through which humans navigate the social world by self-referential evaluation of others. Donating to those that are at least as reputable as oneself emerges as a dominant heuristic, which represents aspirational homophily. This heuristic is found to be implicitly present in the current knowledge of conditions that favour indirect reciprocity. The effective social norms for updating reputation are also observed to support this heuristic. We hypothesise that the cognitive challenge associated with social comparison has contributed to cerebral expansion and the disproportionate human brain size, consistent with the social complexity hypothesis. The findings have relevance for the evolution of autonomous systems that are characterised by one-shot interactions.

  10. Materials used for indirect pulp treatment in primary teeth: a mixed treatment comparisons meta-analysis

    Directory of Open Access Journals (Sweden)

    Pablo Silveira dos Santos

    2017-12-01

    Full Text Available Abstract: This study aimed to systematically review the literature to address the question regarding the influence of different materials in the clinical and radiographic success of indirect pulp treatment in primary teeth. A literature search was carried out for articles published prior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIP and ClinicalTrials databases; relevant articles included randomized clinical trials that compared materials used for indirect pulp treatment in primary teeth. Two reviewers independently selected the studies and extracted the data. The effects of each material on the outcome (clinical and radiographic failures were analyzed using a mixed treatment comparisons meta-analysis. The ranking of treatments according to their probability of being the best choice was also calculated. From 1,088 potentially eligible studies, 11 were selected for full-text analysis, and 4 were included in the meta-analysis. In all papers, calcium hydroxide liner was used as the control group versus an adhesive system, resin-modified glass ionomer cement or placebo. The follow-up period ranged from 24 to 48 months, with dropout rates of 0-25.7%. The material type did not significantly affect the risk of failure of the indirect pulp treatment. However, calcium hydroxide presented a higher probability of failure. In conclusion, there is no scientific evidence showing the superiority of any material used for indirect pulp treatment in primary teeth.

  11. Duloxetine compared with fluoxetine and venlafaxine: use of meta-regression analysis for indirect comparisons

    Directory of Open Access Journals (Sweden)

    Lançon Christophe

    2006-07-01

    Full Text Available Abstract Background Data comparing duloxetine with existing antidepressant treatments is limited. A comparison of duloxetine with fluoxetine has been performed but no comparison with venlafaxine, the other antidepressant in the same therapeutic class with a significant market share, has been undertaken. In the absence of relevant data to assess the place that duloxetine should occupy in the therapeutic arsenal, indirect comparisons are the most rigorous way to go. We conducted a systematic review of the efficacy of duloxetine, fluoxetine and venlafaxine versus placebo in the treatment of Major Depressive Disorder (MDD, and performed indirect comparisons through meta-regressions. Methods The bibliography of the Agency for Health Care Policy and Research and the CENTRAL, Medline, and Embase databases were interrogated using advanced search strategies based on a combination of text and index terms. The search focused on randomized placebo-controlled clinical trials involving adult patients treated for acute phase Major Depressive Disorder. All outcomes were derived to take account for varying placebo responses throughout studies. Primary outcome was treatment efficacy as measured by Hedge's g effect size. Secondary outcomes were response and dropout rates as measured by log odds ratios. Meta-regressions were run to indirectly compare the drugs. Sensitivity analysis, assessing the influence of individual studies over the results, and the influence of patients' characteristics were run. Results 22 studies involving fluoxetine, 9 involving duloxetine and 8 involving venlafaxine were selected. Using indirect comparison methodology, estimated effect sizes for efficacy compared with duloxetine were 0.11 [-0.14;0.36] for fluoxetine and 0.22 [0.06;0.38] for venlafaxine. Response log odds ratios were -0.21 [-0.44;0.03], 0.70 [0.26;1.14]. Dropout log odds ratios were -0.02 [-0.33;0.29], 0.21 [-0.13;0.55]. Sensitivity analyses showed that results were

  12. Chromosome 15q25 (CHRNA3-CHRNA5 variation impacts indirectly on lung cancer risk.

    Directory of Open Access Journals (Sweden)

    Yufei Wang

    2011-04-01

    Full Text Available Genetic variants at the 15q25 CHRNA5-CHRNA3 locus have been shown to influence lung cancer risk however there is controversy as to whether variants have a direct carcinogenic effect on lung cancer risk or impact indirectly through smoking behavior. We have performed a detailed analysis of the 15q25 risk variants rs12914385 and rs8042374 with smoking behavior and lung cancer risk in 4,343 lung cancer cases and 1,479 controls from the Genetic Lung Cancer Predisposition Study (GELCAPS. A strong association between rs12914385 and rs8042374, and lung cancer risk was shown, odds ratios (OR were 1.44, (95% confidence interval (CI: 1.29-1.62, P = 3.69×10(-10 and 1.35 (95% CI: 1.18-1.55, P = 9.99×10(-6 respectively. Each copy of risk alleles at rs12914385 and rs8042374 was associated with increased cigarette consumption of 1.0 and 0.9 cigarettes per day (CPD (P = 5.18×10(-5 and P = 5.65×10(-3. These genetically determined modest differences in smoking behavior can be shown to be sufficient to account for the 15q25 association with lung cancer risk. To further verify the indirect effect of 15q25 on the risk, we restricted our analysis of lung cancer risk to never-smokers and conducted a meta-analysis of previously published studies of lung cancer risk in never-smokers. Never-smoker studies published in English were ascertained from PubMed stipulating--lung cancer, risk, genome-wide association, candidate genes. Our study and five previously published studies provided data on 2,405 never-smoker lung cancer cases and 7,622 controls. In the pooled analysis no association has been found between the 15q25 variation and lung cancer risk (OR = 1.09, 95% CI: 0.94-1.28. This study affirms the 15q25 association with smoking and is consistent with an indirect link between genotype and lung cancer risk.

  13. A performance comparison of direct- and indirect-detection flat-panel imagers

    International Nuclear Information System (INIS)

    Partridge, M.; Hesse, B.-M.; Mueller, L.

    2002-01-01

    A comparison of the performance of a direct- and an indirect-detection amorphous silicon flat-panel X-ray imager is presented for a 6 MV beam. Experimental measurements of the noise characteristics, image lag, spectral response, spatial resolution and quantum efficiency are described, compared and discussed. The two systems are comprised of 512x512 pixel, 400 μm pitch, arrays of a-Si:H p-i-n photodiodes and thin-film transistors. In the direct-detection system, X-rays interact to produce electron/hole pairs directly in the silicon photodiodes. For the indirect-detection system, a phosphor screen converts energy from the incident X-rays into visible light, which is then detected by the photodiodes. Both systems are shown to be quantum noise limited, with the total electronic noise in the detector 10-15 times smaller than the Poisson noise level in detected signal. The measured lag for both systems is 1.0±0.1% or less in the first frame with subsequent signals decaying exponentially with frame read-out, with a half-life of between 3.3 and 3.8 frames. Both systems are demonstrated to have a pronounced sensitivity to low-energy multiply scattered photons, although this is shown to be effectively filtered out using a 2 mm copper build-up plate. The direct-detection system, with the 2 mm Cu build-up, shows greater sensitivity to scattered radiation than the indirect system. The spatial resolutions of both systems were effectively equal with an f 50 of 0.25 mm -1 when pixels are binned 2x2, although a slight contribution from optical scattering in the phosphor screen is seen for the indirect-detection system. The quantum efficiency of the direct-detection system is a factor of 0.45 lower than that of the indirect-detection system. The application of these detectors to megavoltage CT is discussed, with the conclusion that the indirect-detection system is to be preferred

  14. Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

    Science.gov (United States)

    Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

    2009-07-22

    Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

  15. Network meta-analysis: a technique to gather evidence from direct and indirect comparisons

    Science.gov (United States)

    2017-01-01

    Systematic reviews and pairwise meta-analyses of randomized controlled trials, at the intersection of clinical medicine, epidemiology and statistics, are positioned at the top of evidence-based practice hierarchy. These are important tools to base drugs approval, clinical protocols and guidelines formulation and for decision-making. However, this traditional technique only partially yield information that clinicians, patients and policy-makers need to make informed decisions, since it usually compares only two interventions at the time. In the market, regardless the clinical condition under evaluation, usually many interventions are available and few of them have been studied in head-to-head studies. This scenario precludes conclusions to be drawn from comparisons of all interventions profile (e.g. efficacy and safety). The recent development and introduction of a new technique – usually referred as network meta-analysis, indirect meta-analysis, multiple or mixed treatment comparisons – has allowed the estimation of metrics for all possible comparisons in the same model, simultaneously gathering direct and indirect evidence. Over the last years this statistical tool has matured as technique with models available for all types of raw data, producing different pooled effect measures, using both Frequentist and Bayesian frameworks, with different software packages. However, the conduction, report and interpretation of network meta-analysis still poses multiple challenges that should be carefully considered, especially because this technique inherits all assumptions from pairwise meta-analysis but with increased complexity. Thus, we aim to provide a basic explanation of network meta-analysis conduction, highlighting its risks and benefits for evidence-based practice, including information on statistical methods evolution, assumptions and steps for performing the analysis. PMID:28503228

  16. The indirect costs of cancer-related absenteeism in the workplace in Poland.

    Science.gov (United States)

    Macioch, Tomasz; Hermanowski, Tomasz

    2011-12-01

    The aim of this study was to evaluate cancer-related absenteeism costs in Poland. Data on sickness absences and disability were retrieved from the Department of Statistics of the Social Insurance Institution. The cost of lost productivity owing to premature death was estimated from data retrieved from the Polish National Cancer Registry. Absenteeism costs were estimated on the basis of the measure of gross value added per employee. The costs of lost productivity owing to sick leave, disability, and premature death were estimated to be 1.572 billion EUR, 0.504 billion EUR, and 0.535 billion EUR, respectively, in 2009. The indirect costs of lost productivity owing to cancer-related sick leave, disability, and premature death have a substantial effect on the Polish economy. In 2009, they accounted for more than 0.8% of GDP.

  17. A performance comparison of direct- and indirect-detection flat-panel imagers

    CERN Document Server

    Partridge, M; Müller, L

    2002-01-01

    A comparison of the performance of a direct- and an indirect-detection amorphous silicon flat-panel X-ray imager is presented for a 6 MV beam. Experimental measurements of the noise characteristics, image lag, spectral response, spatial resolution and quantum efficiency are described, compared and discussed. The two systems are comprised of 512x512 pixel, 400 mu m pitch, arrays of a-Si:H p-i-n photodiodes and thin-film transistors. In the direct-detection system, X-rays interact to produce electron/hole pairs directly in the silicon photodiodes. For the indirect-detection system, a phosphor screen converts energy from the incident X-rays into visible light, which is then detected by the photodiodes. Both systems are shown to be quantum noise limited, with the total electronic noise in the detector 10-15 times smaller than the Poisson noise level in detected signal. The measured lag for both systems is 1.0+-0.1% or less in the first frame with subsequent signals decaying exponentially with frame read-out, with...

  18. THE POSSIBILITIES AND RESULTS OF INDIRECT COMPARISON OF BIOLOGICAL AGENTS IN ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2016-01-01

    Full Text Available The paper analyzes two matching-adjusted indirect comparison-based investigations of the efficacy of adalimumab (ADA and secukinumab (SCM in active ankylosing spondylitis, which have been recently reported at the EULAR Congress (London, 2016. One study sponsored by AbbVie was conducted to determine the short-term (16-week comparative clinical and economic efficacy of the test drugs and the other was supported by Novartis to reveal long-term (52-week, only clinical efficacy. Both studies have shown that the short-term efficacy ofADAand SCM is practically similar; however, the latter has a better long-term clinical efficacy. A pharmacoeconomic analysis of both drugs used during the first 12 weeks has demonstrated some advantage ofADA. 

  19. Comparison of ammonia and methanol applied indirectly in a hydrogen fuel cell

    International Nuclear Information System (INIS)

    Metkemeijer, R.; Achard, P.

    1993-01-01

    A comparison is presented between ammonia and methanol, applied indirectly in a hydrogen/air fuel cell. The calculations concentrate on specific energy of the fuels (amount of electricity produced per mass of fuel), specific energy of the fuels corrected for the mass and volume of the tank, and the overall energy efficiency (amount of electricity produced by one kg of fuel divided by the amount of energy needed for the production of one kg of this fuel). Taking into consideration the differences in efficiencies between the acid fuel cell and the alkaline fuel cells, the reformer temperatures, the reforming efficiencies, and some ecological and economical considerations, it appears that ammonia is a more interesting fuel than methanol for certain applications. 6 figs., 2 tabs

  20. [Assessing the economic impact of cancer in Chile: a direct and indirect cost measurement based on 2009 registries].

    Science.gov (United States)

    Cid, Camilo; Herrera, Cristian; Rodríguez, Rodrigo; Bastías, Gabriel; Jiménez, Jorge

    2016-08-02

    This paper aims to determine the economic impact that cancer represents to Chile, exploring the share of costs for the most important cancers and the differences between the public and private sector. We used the cost of illness methodology, through the assessment of the direct and indirect costs associated with cancer treatment. Data was obtained from 2009 registries of the Chilean Ministry of Health and the Superintendence of Health. Indirect costs were calculated by days of job absenteeism and potential years of life lost. Over US$ 2.1 billion were spent on cancer in 2009, which represents almost 1% of Chile’s Gross Domestic Product. The direct per capita cost was US$ 47. Indirect costs were 1.92 times more than direct costs. The three types of cancer that embody the highest share of costs were gastric cancer (17.6%), breast cancer (7%) and prostate cancer (4.2%) in the public sector, and breast cancer (14%), lung cancer (7.5%) and prostate cancer (4.1%) in the private sector. On average men spent 30.33% more than women. There are few studies of this kind in Chile and the region. The country can be classified as having a cancer economic impact below the average of those in European Union countries. We expect that this information can be used to develop access policies and resource allocation decision making, and as a first step into further cancer-costing studies in Chile and the Latin American and Caribbean region.

  1. Quantifying the indirect impacts of climate on agriculture: an inter-method comparison

    Science.gov (United States)

    Calvin, Kate; Fisher-Vanden, Karen

    2017-11-01

    Climate change and increases in CO2 concentration affect the productivity of land, with implications for land use, land cover, and agricultural production. Much of the literature on the effect of climate on agriculture has focused on linking projections of changes in climate to process-based or statistical crop models. However, the changes in productivity have broader economic implications that cannot be quantified in crop models alone. How important are these socio-economic feedbacks to a comprehensive assessment of the impacts of climate change on agriculture? In this paper, we attempt to measure the importance of these interaction effects through an inter-method comparison between process models, statistical models, and integrated assessment model (IAMs). We find the impacts on crop yields vary widely between these three modeling approaches. Yield impacts generated by the IAMs are 20%-40% higher than the yield impacts generated by process-based or statistical crop models, with indirect climate effects adjusting yields by between -12% and +15% (e.g. input substitution and crop switching). The remaining effects are due to technological change.

  2. Comparison of plastic, high density carbon, and beryllium as indirect drive NIF ablators

    Science.gov (United States)

    Kritcher, A. L.; Clark, D.; Haan, S.; Yi, S. A.; Zylstra, A. B.; Callahan, D. A.; Hinkel, D. E.; Berzak Hopkins, L. F.; Hurricane, O. A.; Landen, O. L.; MacLaren, S. A.; Meezan, N. B.; Patel, P. K.; Ralph, J.; Thomas, C. A.; Town, R.; Edwards, M. J.

    2018-05-01

    Detailed radiation hydrodynamic simulations calibrated to experimental data have been used to compare the relative strengths and weaknesses of three candidate indirect drive ablator materials now tested at the NIF: plastic, high density carbon or diamond, and beryllium. We apply a common simulation methodology to several currently fielded ablator platforms to benchmark the model and extrapolate designs to the full NIF envelope to compare on a more equal footing. This paper focuses on modeling of the hohlraum energetics which accurately reproduced measured changes in symmetry when changes to the hohlraum environment were made within a given platform. Calculations suggest that all three ablator materials can achieve a symmetric implosion at a capsule outer radius of ˜1100 μm, a laser energy of 1.8 MJ, and a DT ice mass of 185 μg. However, there is more uncertainty in the symmetry predictions for the plastic and beryllium designs. Scaled diamond designs had the most calculated margin for achieving symmetry and the highest fuel absorbed energy at the same scale compared to plastic or beryllium. A comparison of the relative hydrodynamic stability was made using ultra-high resolution capsule simulations and the two dimensional radiation fluxes described in this work [Clark et al., Phys. Plasmas 25, 032703 (2018)]. These simulations, which include low and high mode perturbations, suggest that diamond is currently the most promising for achieving higher yields in the near future followed by plastic, and more data are required to understand beryllium.

  3. Methodological challenges in indirect treatment comparisons: spotlight on a recent comparison of long-acting injectable aripiprazole versus paliperidone palmitate in the treatment of schizophrenia.

    Science.gov (United States)

    Singh, Arun; Gopal, Srihari; Kim, Edward; Mathews, Maju; Kern-Sliwa, Jennifer; Turkoz, Ibrahim; Wooller, Annette; Berlin, Jesse

    2018-03-01

    In a recent study, an indirect treatment comparison was performed to examine the relative efficacy and tolerability of aripiprazole once monthly and paliperidone palmitate once monthly. The authors concluded that the results may suggest relative advantages for aripiprazole once monthly over paliperidone palmitate once monthly in the short-term treatment of schizophrenia. However, the validity of the study is compromised as an indirect treatment comparison using extant data may violate important assumptions. Other methodological issues identified further highlight the challenges of performing indirect treatment comparisons.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

  4. Comparison of direct and indirect plasma oxidation of NO combined with oxidation by catalyst

    DEFF Research Database (Denmark)

    Jogi, Indrek; Stamate, Eugen; Irimiea, Cornelia

    2015-01-01

    of the DBD reactor decreased the long-term efficiency of direct plasma oxidation. At the same time, the efficiency of indirect oxidation increased at elevated reactor temperatures. Additional experiments were carried out to investigate the improvement of indirect oxidation by the introduction of catalyst...

  5. Indirect comparison for Anti-TNF drugs in moderate to severe ulcerative colitis

    Directory of Open Access Journals (Sweden)

    M. Galván-Banqueri

    2015-01-01

    Full Text Available Objective: To compare the relative efficacy of infliximab, adalimumab and golimumab through adjusted indirect treatment comparisons (ITCs. Methods: An exhaustive search was performed until October 2013. Databases consulted were MEDLINE, EMBASE, the Cochrane Library, the Centre for Reviews and Dissemination and the Web of Science. Randomized control trials (RCTs comparing the efficacy of infliximab, adalimumab or golimumab versus placebo, in terms of clinical remission, clinical response and mucosal healing, were included. In the case that more than one RCT fulfilled the inclusion criteria for the same drug, a metanalysis was undertaken using a fixed effects model. ITCs were carried out using the method proposed by Bucher et al. Results: 6 RCTs published in 5 papers were included: 2 for infliximab (ACT 1 and ACT 2, 2 for adalimumab (ULTRA 1 y ULTRA 2 and 2 for golimumab (PURSUIT-SC y PURSUIT-M.In these RTCs, each biological agent was superior in efficacy to placebo. The results of the adjusted ITC are the following. In relation to the clinical remission, in the induction and maintenance period, there are no statistically significant differences between the three anti-TNF drugs. In relation to the clinical response and mucosal healing, in the induction period, there are statistically significant differences between infliximab and adalimumab. Conclusion: In view of the results obtained, infliximab, adalimumab and golimumab appear to be similarly effective therapeutic alternatives. Therefore, other considerations such as safety, tolerance and cost-effectiveness should be taken into account in order to select the most appropriate treatment

  6. Comparative effectiveness of mepolizumab and omalizumab in severe asthma: An indirect treatment comparison.

    Science.gov (United States)

    Cockle, Sarah M; Stynes, Gillian; Gunsoy, Necdet B; Parks, Daniel; Alfonso-Cristancho, Rafael; Wex, Jaro; Bradford, Eric S; Albers, Frank C; Willson, Jenny

    2017-02-01

    Severe asthma is a heterogeneous disease. Patients with both eosinophilic and allergic asthma phenotypes may be eligible for treatment with mepolizumab and omalizumab. Evidence on the relative effectiveness of these treatments in this 'overlap' population would be informative for clinical and payer decision making. A systematic literature review and indirect treatment comparison (Bayesian framework) were performed to assess the comparative effectiveness and tolerability of mepolizumab and omalizumab, as add-ons to standard of care. Studies included in the primary analysis were double-blind, randomized controlled trials, ≥12 weeks' duration enrolling patients with severe asthma with a documented exacerbation history and receiving high-dose inhaled corticosteroids plus ≥1 additional controller. Two populations were examined: patients potentially eligible for 1) both treatments (Overlap population) and 2) either treatment (Trial population). In the Overlap population, no differences between treatments in clinically significant exacerbations and exacerbations requiring hospitalization were found, although trends favored mepolizumab (rate ratio [RR]:0.66 [95% credible intervals (Crl):0.37,1.19]; 0.19[0.02,2.32], respectively). In the Trial population, mepolizumab treatment produced greater reductions in clinically significant exacerbations (RR:0.63 [95% CrI:0.45,0.89]) but not exacerbations requiring hospitalization compared with omalizumab (RR:0.58 [95% Crl: 0.16,2.13]), although the trend favored mepolizumab. Both treatments had broadly comparable effects on lung function, and similar tolerability profiles. Whilst this analysis has limitations due to a restricted evidence base and residual heterogeneity, it showed that in patients with severe asthma, mepolizumab seems to be at least as effective as omalizumab and that the tolerability profiles of the two treatments did not meaningfully differentiate. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Measurement of the optical density of packable composites: comparison between direct and indirect digital systems

    Directory of Open Access Journals (Sweden)

    Graziottin Luiz Felipe Rodrigues

    2002-01-01

    Full Text Available The aim of this study was to measure the optical density of four packable composite resins with widths of 1, 2, 3 and 4 mm, by means of Digora® (direct and DentScan DentView® (indirect digital imaging systems, in order to compare both methods. Twenty acrylic plates, with the proposed thicknesses, were used, each one containing a sample of each resin. Each acrylic plate was radiographed three times, under a standardized technique. For the Digora® system, an optical plate was used under each resin sample, and, for the DentScan DentView® system, occlusal films were employed, totalizing 60 exposures for each system. Optical plates and films were scanned and three consecutive optical readouts were carried out, totalizing 1,440 readouts. The results were submitted to statistical analysis and revealed that the average optical density of the four resins always increased as thickness increased. Regarding the comparisons between the composite resins, in both analysis the resin with the greater optical density was SurefilTM followed by ProdigyTM Condensable, AlertTM and Solitaire®. The correlations between the results of Digora® and DentScan DentView® were significant for the different thicknesses and materials. The observed tendency is that as the values obtained with the Digora® system increase, so do the values obtained with DentScan DentView®. While thickness increased, the values of optical density in both Digora® and DentScan DentView® tended to approach each other. The Digora® system presented smaller amplitude between the results obtained in adjacent thicknesses.

  8. Effectiveness comparison of inferior alveolar nerve block anesthesia using direct and indirect technique

    Directory of Open Access Journals (Sweden)

    Rehatta Yongki

    2016-12-01

    Full Text Available Local anesthesia is important to do prior to tooth extraction procedure to control the patient's pain. Local anesthetic technique in dentistry consists of topical, infiltration, and anesthetic blocks. For molar tooth extraction, mandibular block technique is used either direct or indirect. This study aimed to see if there are differences in effectiveness of inferior alveolar nerve block anesthesia techniques between direct and indirect. This clinical experimental design study used 20 patients as samples during February-April. 10 patients were taken as a group that carried out direct technique while 10 others group conducted indirect techniques. The sample selection using purposive sampling method. Pain level were measured using objective assessments (pain experienced by the patient after a given stimulus and subjective evaluation (thick taste perceived by the patient. The average time of onset in direct and indirect techniques in each sample was 16.88 ± 5.30 and 102.00 ± 19.56 seconds (subjectively and 22.50 ± 8.02 and 159.00 ± 25.10 (objectively. These results indicated direct techniques onset faster than indirect techniques. The average duration of direct and indirect techniques respectively was 121.63 ± 8.80 and 87.80 ± 9.96 minutes (subjectively and 91.88 ± 8.37 and 60.20 ± 10.40 minutes (objectively. These results indicated the duration of direct technique is longer than indirect technique. There was no significant difference when viewed from anesthesia depth and aspiration level. This study indicated that direct technique had better effect than indirect technique in terms of onset and duration, while in terms of anesthesia depth and aspiration level was relatively equal. Insignificant differences were obtained when assessing anesthetic technique successful rate based on gender, age and extracted tooth.

  9. Microsomal aryl hydrocarbon hydroxylase comparison of the direct, indirect and radiometric assays

    International Nuclear Information System (INIS)

    Denison, M.S.; Murray, M.; Wilkinson, C.F.

    1983-01-01

    The direct fluorometric assay of aryl hydrocarbon hydroxlyase has been compared to the more commonly used indirect fluorometric and radiometric assays. Although rat hepatic microsomal activities measured by the direct assay were consistently higher than those obtained by the other assays, the relative changes in activity following enzyme induction and/or inhibition were similar. The direct assay provides an accurate and rapid measure of aryl hydrocarbon hydroxylase activity and avoids several problems inherent in the indirect and radiometric assays. 2 tables

  10. Comparison of viral RNA electrophoresis and indirect ELISA methods in the diagnosis of human rotavirus infection

    Energy Technology Data Exchange (ETDEWEB)

    Avendano, L F; Dubinovsky, S; James, Jr, H D

    1984-01-01

    A total of 177 stool samples from Chilean diarrhea patients under two years of age were tested for rotavirus by two methods - the indirect enzyme-linked immunosorbent assay (indirect ELISA) and viral RNA electrophoresis in agarose gels (v RNA EPH). Fifty of the specimens came from patients with acute diarrhea and 127 came from patients with protracted diarrhea. The indirect ELISA testing was performed at the National Institutes of Health in the United States: the electrophoretic testing was carried out in Santiago, Chile by the authors. The electrophoretic method detected rotavirus in 36% of the acute samples and 25% of the samples from protracted cases, while the indirect ELISA method detected rotavirus in higher percentages of samples - 46% and 38%, respectively. These results support the conclusion that v RNA EPH is a less sensitive method for detecting rotavirus than the indirect ELISA. Nevertheless, the former method's high specificity, ease of application, and low cost make it a worthwhile alternative to indirect ELISA. Thus, considering the important role played by rotavirus in infant diarrhea and the need for a diagnostic technique that can be incorporated into the routines of medical center laboratories in developing countries, there is good reason to conclude that v RNA EPH is a useful tool for studying rotavirus diarrhea. 18 refs, 3 tabs. Also published in the Bol. Oficina Sanit. Panam. (1984) v. 97(1), p. 1-7 (In Spanish).

  11. Comparison of viral RNA electrophoresis and indirect ELISA methods in the diagnosis of human rotavirus infection

    International Nuclear Information System (INIS)

    Avendano, L.F.; Dubinovsky, S.

    1984-01-01

    A total of 177 stool samples from Chilean diarrhea patients under two years of age were tested for rotavirus by two methods - the indirect enzyme-linked immunosorbent assay (indirect ELISA) and viral RNA electrophoresis in agarose gels (v RNA EPH). Fifty of the specimens came from patients with acute diarrhea and 127 came from patients with protracted diarrhea. The indirect ELISA testing was performed at the National Institutes of Health in the United States: the electrophoretic testing was carried out in Santiago, Chile by the authors. The electrophoretic method detected rotavirus in 36% of the acute samples and 25% of the samples from protracted cases, while the indirect ELISA method detected rotavirus in higher percentages of samples - 46% and 38%, respectively. These results support the conclusion that v RNA EPH is a less sensitive method for detecting rotavirus than the indirect ELISA. Nevertheless, the former method's high specificity, ease of application, and low cost make it a worthwhile alternative to indirect ELISA. Thus, considering the important role played by rotavirus in infant diarrhea and the need for a diagnostic technique that can be incorporated into the routines of medical center laboratories in developing countries, there is good reason to conclude that v RNA EPH is a useful tool for studying rotavirus diarrhea. (author)

  12. Comparison of a direct and indirect ELISA for quantitating antisperm antibody in semen.

    Science.gov (United States)

    Lynch, D M; Howe, S E

    1987-01-01

    A direct and an indirect quantitative ELISA for antisperm antibody were compared using the spermatozoa and cell-free seminal fluid of 66 infertile males. The normal concentration of sperm binding immunoglobulin was less than or equal to 1.5 fg Ig per spermatozoon for the indirect seminal plasma assay and less than or equal to 1.5 fg Ig per spermatozoon by the direct assay. Of the 66 infertile males, 21% (14/66) had elevated levels of antisperm antibody in their seminal plasma and 26% (17/66) had elevated levels bound directly to their spermatozoa. The direct correlation between the results of these assays was 94%. A simple linear regression analysis between the indirect and direct measurements of antisperm antibody resulted in a correlation coefficient of r = 0.907. There was no statistically significant difference between results from the direct and indirect methods of the patients as a group. However, there was evidence of autospecificity in a small percentage of males who had elevated levels of antisperm antibody by the direct assay that was not detected by the indirect assay using pooled donor spermatozoa.

  13. Comparison of stabilities in translucency, fluorescence and opalescence of direct and indirect composite resins.

    Science.gov (United States)

    Yu, Bin; Lee, Young-Keun

    2013-01-01

    To evaluate translucency, fluorescence and opalescence stabilities of direct and indirect composite resins after aging. One direct (16 shades) and two indirect composite resins (16 and 26 shades) were investigated. Resins were filled in a mold (1 mm thick) and light cured; post-curings were performed for indirect resins. Color was measured before and after 5,000 cycles of thermocycling on a reflection spectrophotometer in reflectance and transmittance modes to calculate parameters for translucency (TP), fluorescence (FL) and opalescence (OP). Differences in the changes of TP, FL and OP after aging by the type of resin were determined by t test, and those were also determined by one-way ANOVA with the factor of the brand or the shade group (P resins; and were -2.0 to 1.8, -0.9 to 0.4 and -2.9 to 3.7, respectively, for indirect resins. Changes in TP were not significantly different by the type of resin, but those in FL and OP were different (P = 0.05). Changes in optical parameters were influenced by the brand or the shade group of the resins (P resins varied depending on type, brand or shade group. Aging significantly affected fluorescence and opalescence, but not translucency, of indirect resins compared to those of direct resins.

  14. Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography.

    Science.gov (United States)

    Türk, Ayşe Gözde; Sabuncu, Metin; Ünal, Sena; Önal, Banu; Ulusoy, Mübin

    2016-01-01

    The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (pmarginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation.

  15. Indirect Evolution Versus Strategic Delegation : A Comparison of Two Approaches to Explaining Economic Institutions

    NARCIS (Netherlands)

    Dufwenberg, M.; Güth, W.

    1997-01-01

    The two major methods of explaining economic institutions, namely by strategic choices or by (indirect) evolution, are compared for the case of a homogenous quadratic duopoly market. Sellers either can provide incentives for their agents to care for sales (amounts) or evolve as sellers who care for

  16. Comparison of Indirect Assessments of Association as Predictors of Marijuana Use Among At-Risk Adolescents

    NARCIS (Netherlands)

    Ames, S.L.; Grenard, J.L.; Thush, C.; Sussman, S.Y.; Wiers, R.W.H.J.; Stacy, A.W.

    2007-01-01

    In this study, the authors compared indirect measures that attempt to quantify the level of marijuana associations among adolescents. They also evaluated whether these various methods overlap or tap different aspects of associative processes that may act in concert to influence marijuana use.

  17. Inter-comparison of different direct and indirect methods to determine radon flux from soil

    International Nuclear Information System (INIS)

    Grossi, C.; Vargas, A.; Camacho, A.; Lopez-Coto, I.; Bolivar, J.P.; Xia Yu; Conen, F.

    2011-01-01

    The physical and chemical characteristics of radon gas make it a good tracer for use in the application of atmospheric transport models. For this purpose the radon source needs to be known on a global scale and this is difficult to achieve by only direct experimental methods. However, indirect methods can provide radon flux maps on larger scales, but their reliability has to be carefully checked. It is the aim of this work to compare radon flux values obtained by direct and indirect methods in a measurement campaign performed in the summer of 2008. Different systems to directly measure radon flux from the soil surface and to measure the related parameters terrestrial γ dose and 226 Ra activity in soil, for indirect estimation of radon flux, were tested. Four eastern Spanish sites with different geological and soil characteristics were selected: Teruel, Los Pedrones, Quintanar de la Orden and Madrid. The study shows the usefulness of both direct and indirect methods for obtaining radon flux data. Direct radon flux measurements by continuous and integrated monitors showed a coefficient of variation between 10% and 23%. At the same time, indirect methods based on correlations between 222 Rn and terrestrial γ dose rate, or 226 Ra activity in soil, provided results similar to the direct measurements, when these proxies were directly measured at the site. Larger discrepancies were found when proxy values were extracted from existing data bases. The participating members involved in the campaign study were the Institute of Energy Technology (INTE) of the Technical University of Catalonia (UPC), Huelva University (UHU), and Basel University (BASEL).

  18. Hepatitis B Core Antigen in Hepatocytes of Chronic Hepatitis B: Comparison between Indirect Immunofluorescence and Immunoperoxidase Method

    Science.gov (United States)

    Tabassum, Shahina; Al-Mahtab, Mamun; Nessa, Afzalun; Jahan, Munira; Shamim Kabir, Chowdhury Mohammad; Kamal, Mohammad; Cesar Aguilar, Julio

    2015-01-01

    Background Hepatitis B virus (HBV) infection has many faces. Precore and core promoter mutants resemble inactive carrier status. The identification of hepatitis B core antigen (HBcAg) in hepatocytes may have variable clinical significance. The present study was undertaken to detect HBcAg in chronic hepatitis B (CHB) patients and to assess the efficacy of detection system by indirect immunofluorescence (IIF) and indirect immunoperoxidase (IIP). Materials and methods The study was done in 70 chronic HBV-infected patients. Out of 70 patients, eight (11.4%) were hepatitis B e antigen (HBeAg) positive and 62 (88.57%) were HBeAg negative. Hepatitis B core antigen was detected by indirect immunofluorescence (IIF) and indirect immunoperoxidase (IIP) methods in liver tissue. Results All HBeAg positive patients expressed HBcAg by both IIF and IIP methods. Out of 62 patients with HBeAg-negative CHB, HBcAg was detected by IIF in 55 (88.7%) patients and by IIP in 51 (82.26%) patients. A positive relation among viral load and HBcAg detection was also found. This was more evident in the case of HBeAg negative patients and showed a positive relation with HBV DNA levels. Conclusion Hepatitis B core antigen can be detected using the IIF from formalin fixed paraffin block preparation and also by IIP method. This seems to reflect the magnitudes of HBV replication in CHB. How to cite this article Raihan R, Tabassum S, Al-Mahtab M, Nessa A, Jahan M, Kabir CMS, Kamal M, Aguilar JC. Hepatitis B Core Antigen in Hepatocytes of Chronic Hepatitis B: Comparison between Indirect Immunofluorescence and Immunoperoxidase Method. Euroasian J Hepato-Gastroenterol 2015;5(1):7-10. PMID:29201677

  19. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison.

    Directory of Open Access Journals (Sweden)

    Gláucia F Cota

    Full Text Available We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL therapy among HIV infected individuals.The outcomes of interest were clinical and parasitological cure, mortality, and adverse events.PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available.Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3-25%, indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9-9.4%. It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sb(v. The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was

  20. Annual national direct and indirect cost estimates of the prevention and treatment of cervical cancer in Brazil

    Science.gov (United States)

    Novaes, Hillegonda Maria Dutilh; Itria, Alexander; Silva, Gulnar Azevedo e; Sartori, Ana Marli Christovam; Rama, Cristina Helena; de Soárez, Patrícia Coelho

    2015-01-01

    OBJECTIVE: To estimate the annual direct and indirect costs of the prevention and treatment of cervical cancer in Brazil. METHODS: This cost description study used a "gross-costing" methodology and adopted the health system and societal perspectives. The estimates were grouped into sets of procedures performed in phases of cervical cancer care: the screening, diagnosis and treatment of precancerous lesions and the treatment of cervical cancer. The costs were estimated for the public and private health systems, using data from national health information systems, population surveys, and literature reviews. The cost estimates are presented in 2006 USD. RESULTS: From the societal perspective, the estimated total costs of the prevention and treatment of cervical cancer amounted to USD $1,321,683,034, which was categorized as follows: procedures (USD $213,199,490), visits (USD $325,509,842), transportation (USD $106,521,537) and productivity losses (USD $676,452,166). Indirect costs represented 51% of the total costs, followed by direct medical costs (visits and procedures) at 41% and direct non-medical costs (transportation) at 8%. The public system represented 46% of the total costs, and the private system represented 54%. CONCLUSION: Our national cost estimates of cervical cancer prevention and treatment, indicating the economic importance of cervical cancer screening and care, will be useful in monitoring the effect of the HPV vaccine introduction and are of interest in research and health care management. PMID:26017797

  1. Comparison of mechanisms for DNA strand break formation by the direct and indirect effect of radiation

    International Nuclear Information System (INIS)

    Schulte-Frohlinde, D.

    1986-01-01

    Irradiation of cells may lead to mutations, reproductive cell death and the disappearance of some or all cell activities. These effects, especially reproductive cell death, are believed to be the result of damage to DNA. Two kinds of formation of DNA damage are often distinguished, the so-called ''direct'' and the ''indirect'' effect of irradiation. The direct effect is due to ionization or electronic excitation of the DNA, and the indirect effect is caused by reactive species, in most cases free radicals, which are produced in the vicinity of the DNA. These radicals may be primary radicals produced by energy absorption in water, i.e., the solvated electron, the H-atom and the OH radical, or organic radicals produced from organic material other than DNA either by interaction with radiation or by reaction with the primary radicals generated from water. 36 refs., 2 figs., 2 tabs

  2. Indirect comparisons of second-generation tyrosine kinase inhibitors in CML: case study using baseline population characteristics

    Directory of Open Access Journals (Sweden)

    Kimbach Tran Carpiuc

    2010-10-01

    Full Text Available Kimbach Tran Carpiuc1, Gianantonio Rosti2, Fausto Castagnetti2, Maarten Treur3, Jennifer Stephens11Pharmerit North America LLC, Bethesda, MD, USA; 2Department of Hematology and Oncology, S Orsola-Malpighi University Hospital, Bologna, Italy; 3Pharmerit Europe, Rotterdam, The NetherlandsAbstract: The use of indirect comparisons to evaluate the relative effectiveness between two or more treatments is widespread in the literature and continues to grow each year. Appropriate methodologies will be essential for integrating data from various published clinical trials into a systematic framework as part of the increasing emphasis on comparative effectiveness research. This article provides a case study example for clinicians using the baseline study population characteristics and response rates of the tyrosine kinase inhibitors in imatinib-resistant or imatinib-intolerant chronic myelogenous leukemia followed by a discussion of indirect comparison methods that are being increasingly implemented to address challenges with these types of comparisons.Keywords: comparative effectiveness research, meta-analysis, BCR–ABL-positive chronic myelogenous leukemia, imatinib mesylate, nilotinib, dasatinib 

  3. Comparison of indirect and direct quantification of esters of monochloropropanediol in vegetable oil.

    Science.gov (United States)

    Dubois, Mathieu; Tarres, Adrienne; Goldmann, Till; Empl, Anna Maria; Donaubauer, Alfred; Seefelder, Walburga

    2012-05-04

    The presence of fatty acid esters of monochloropropanediol (MEs) in food is a recent concern raised due to the carcinogenicity of their hydrolysable moieties 2- and 3-monochloropropanediol (2- and 3-MCPD). Several indirect methods for the quantification of MEs have been developed and are commonly in use until today, however significant discrepancies among analytical results obtained are challenging their reliability. The aim of the present study was therefore to test the trueness of an indirect method by comparing it to a newly developed direct method using palm oil and palm olein as examples. The indirect method was based on ester cleavage under acidic conditions, derivatization of the liberated 2- and 3-MCPD with heptafluorobutyryl imidazole and GC-MS determination. The direct method was comprised of two extraction procedures targeting 2-and 3-MCPD mono esters (co-extracting as well glycidyl esters) by the use of double solid phase extraction (SPE), and 2- and 3-MCPD di-esters by the use of silica gel column, respectively. Detection was carried out by liquid chromatography coupled to time of flight mass spectrometry (LC-ToF-MS). Accurate quantification of the intact compounds was assured by means of matrix matched standard addition on extracts. Analysis of 22 palm oil and 7 palm olein samples (2- plus 3-MCPD contamination ranged from 0.3 to 8.8 μg/g) by both methods revealed no significant bias. Both methods were therefore considered as comparable in terms of results; however the indirect method was shown to require less analytical standards, being less tedious and furthermore applicable to all type of different vegetable oils and hence recommended for routine application. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Anti-tumor necrosis factor (TNF drugs for the treatment of psoriatic arthritis: an indirect comparison meta-analysis

    Directory of Open Access Journals (Sweden)

    Thorlund K

    2012-12-01

    Full Text Available Kristian Thorlund,1 Eric Druyts,2 J Antonio Aviña-Zubieta,3,4 Edward J Mills1,21Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; 2Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; 3Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; 4Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaObjective: To evaluate the comparative effectiveness of available tumor necrosis factor-a inhibitors (anti-TNFs for the management of psoriatic arthritis (PsA in patients with an inadequate response to disease-modifying antirheumatic drugs (DMARDs.Methods: We used an exhaustive search strategy covering randomized clinical trials, systematic reviews and health technology assessments (HTA published on anti-TNFs for PsA. We performed indirect comparisons of the available anti-TNFs (adalimumab, etanercept, golimumab, and infliximab measuring relative risks (RR for the psoriatic arthritis response criteria (PsARC, mean differences (MDs for improvements from baseline for the Health Assessment Questionnaire (HAQ by PsARC responders and non-responders, and MD for the improvements from baseline for the psoriasis area and severity index (PASI. When the reporting of data on intervention group response rates and improvements were incomplete, we used straightforward conversions based on the available data.Results: We retrieved data from 20 publications representing seven trials, as well as two HTAs. All anti-TNFs were significantly better than control, but the indirect comparison did not reveal any statistically significant difference between the anti-TNFs. For PsARC response, golimumab yielded the highest RR and etanercept the second highest; adalimumab and infliximab both yielded notably smaller RRs. For HAQ improvement, etanercept and infliximab yielded the largest MD among PsARC responders

  5. The reciprocal and indirect relationships between passive Facebook use, comparison on Facebook, and adolescents’ body dissatisfaction

    OpenAIRE

    Rousseau, Ann; Eggermont, Steven; Frison, Eline

    2017-01-01

    Facebook has been found to provide a fertile ground for social comparison. Emerging evidence indicates that social comparison may mediate the relationship between Facebook use and young people’s body dissatisfaction. Yet, little work has been done on how these relationships evolve over time in adolescence and no study has examined the reciprocal relationships between passive Facebook use, social comparison, and adolescents’ body dissatisfaction. To examine these reciprocal relationships, t...

  6. Regional comparison of cancer incidence

    International Nuclear Information System (INIS)

    Obralic, N.; Gavrankapetanovic, F.; Dizdarevic, Z.; Duric, O.; Sisic, F.; Selak, I.; Balta, S.; Nakas, B.

    2004-01-01

    Background. Due to specific war and post-war situation in Balkan region, differences in the number, type, development, biological course, treatment of malignant tumours and its outcome are possible. In order to perceive the situation realistically, it is necessary to gather continuously exact data about malignant tumours and compare them with the data from other European and world countries.The aim of the study was to collect and analyse the data on cancer incidence in the region of Sarajevo city, which represents a symbol of difficult times in the recent past, and to compare it to the incidence in the neighbouring countries. Patients and methods. Data on all newly diagnosed cancer cases, permanent residents of Sarajevo Canton, in the years 1999 and 2000 were collected. Crude incidence rate has been calculated according to the years observed, gender and localizations of the disease The data were compared to the cancer registries of Slovenia and Croatia and were observed in the light of specific local situation. Results. The crude cancer incidence of all sites but skin was the highest in both years and by both genders in Croatia. The incidence of the most common tumours (lung and breast cancer) was similar in all three countries. The differences in the incidence between both genders in the Sarajevo canton were registered in laryngeal and urinary bladder cancer, as well as in bone and cartilage sarcoma. Cervical cancer had extremely high incidence and was high up on the incidence list in the Sarajevo canton, which correlates with the data in developing countries. The incidence of other tumours in the post-war period is reaching expected numbers. Conclusions. It is difficult to identify whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city of Sarajevo or some other factor influenced the cancer incidence among exposed population. The prevalence of smoking in the whole region is extremely high, in Bosnia and

  7. Comparison of digital imaging screening and indirect ophthalmoscopy for retinopathy of prematurity.

    Science.gov (United States)

    Ezz El Din, Zahraa Mohamed; El Sada, Mohamed Ahmed; Ali, Aliaa Adel; Al Husseiny, Khalid; Yousef, Aly Abdel Rahman

    2015-01-01

    The aims of this study were to determine the incidence and severity of retinopathy of prematurity (ROP) using digital imaging screening, confirm findings by indirect opthalmoscopy, and document risk factors of ROP in the neonatal intensive care unit (NICU) of a large tertiary hospital in a developing country. This prospective cohort study included infants with gestational age (GA) ≤ 32 wk, birth weight (BW) ≤ 1,500 g, or older and heavier neonates who were critically ill. Two hundred twenty two eyes (111 infants) were screened with digital imaging (Ret-Cam) and indirect ophthalmoscopy until retinal vascularization was complete or the disease regressed. Perinatal risk factors for ROP were analyzed. The overall incidence of ROP was 18.9 %. The incidence of ROP requiring treatment was 5.4 % (12/222) of the total eyes screened. Lower GA and blood transfusion were independent risk factors associated with ROP by multivariate analysis (p = 0.001, OR = 0.562, 95 % CI = 0.395-0.802, and p = 0.027, OR = 6.11, 95 % CI = 1.22-30.44, respectively). Digital imaging facilitated timely screening and detection of ROP, and enabled transfer of images, allowing early intervention for patients who required treatment.

  8. Comparison of desiccant air conditioning systems with different indirect evaporative air coolers

    International Nuclear Information System (INIS)

    Pandelidis, Demis; Anisimov, Sergey; Worek, William M.; Drąg, Paweł

    2016-01-01

    Highlights: • A numerical study of desiccant air conditioning systems is presented. • The ε-NTU model is used for the analysis. • Different arrangements of the desiccant systems were compared. • The systems were compared under different operating conditions. - Abstract: This paper presents a numerical analysis of three desiccant air-conditioning systems equipped with different indirect evaporative air coolers: (1) the cross-flow Maisotsenko cycle heat and mass exchanger (HMX), (2) the regenerative counter-flow Maisotsenko cycle heat and mass exchanger and (3) the standard cross-flow evaporative air cooler. To analyze the desiccant wheel and the indirect evaporative air coolers, the modified ε-NTU-model was used. The simulations were performed under assumption that the desiccant wheel is regenerated with air heated to relatively low temperature values (50–60 °C), which can be produced with solar panels in typical moderate climatic conditions. It was established that the main advantage of the presented solutions is that they can provide comfort conditions even with less effective dehumidification. The different systems were compared under variable selected operational factors (i.e. inlet air temperature, humidity and regeneration air temperature). The analysis allowed establishing the advantages and disadvantages of presented solutions and allowed estimating their application potential.

  9. Educational differences in postmenopausal breast cancer--quantifying indirect effects through health behaviors, body mass index and reproductive patterns.

    Directory of Open Access Journals (Sweden)

    Ulla Arthur Hvidtfeldt

    Full Text Available Studying mechanisms underlying social inequality in postmenopausal breast cancer is important in order to develop prevention strategies. Standard methods for investigating indirect effects, by comparing crude models to adjusted, are often biased. We applied a new method enabling the decomposition of the effect of educational level on breast cancer incidence into indirect effects through reproductive patterns (parity and age at first birth, body mass index and health behavior (alcohol consumption, physical inactivity, and hormone therapy use. The study was based on a pooled cohort of 6 studies from the Copenhagen area including 33,562 women (1,733 breast cancer cases aged 50-70 years at baseline. The crude absolute rate of breast cancer was 399 cases per 100,000 person-years. A high educational level compared to low was associated with 74 (95% CI 22-125 extra breast cancer cases per 100,000 person-years at risk. Of these, 26% (95% CI 14%-69% could be attributed to alcohol consumption. Similar effects were observed for age at first birth (32%; 95% CI 10%-257%, parity (19%; 95%CI 10%-45%, and hormone therapy use (10%; 95% CI 6%-18%. Educational level modified the effect of physical activity on breast cancer. In conclusion, this analysis suggests that a substantial number of the excess postmenopausal breast cancer events among women with a high educational level compared to a low can be attributed to differences in alcohol consumption, use of hormone therapy, and reproductive patterns. Women of high educational level may be more vulnerable to physical inactivity compared to women of low educational level.

  10. Educational Differences in Postmenopausal Breast Cancer – Quantifying Indirect Effects through Health Behaviors, Body Mass Index and Reproductive Patterns

    Science.gov (United States)

    Hvidtfeldt, Ulla Arthur; Lange, Theis; Andersen, Ingelise; Diderichsen, Finn; Keiding, Niels; Prescott, Eva; Sørensen, Thorkild I. A.; Tjønneland, Anne; Rod, Naja Hulvej

    2013-01-01

    Studying mechanisms underlying social inequality in postmenopausal breast cancer is important in order to develop prevention strategies. Standard methods for investigating indirect effects, by comparing crude models to adjusted, are often biased. We applied a new method enabling the decomposition of the effect of educational level on breast cancer incidence into indirect effects through reproductive patterns (parity and age at first birth), body mass index and health behavior (alcohol consumption, physical inactivity, and hormone therapy use). The study was based on a pooled cohort of 6 studies from the Copenhagen area including 33,562 women (1,733 breast cancer cases) aged 50–70 years at baseline. The crude absolute rate of breast cancer was 399 cases per 100,000 person-years. A high educational level compared to low was associated with 74 (95% CI 22–125) extra breast cancer cases per 100,000 person-years at risk. Of these, 26% (95% CI 14%–69%) could be attributed to alcohol consumption. Similar effects were observed for age at first birth (32%; 95% CI 10%–257%), parity (19%; 95%CI 10%–45%), and hormone therapy use (10%; 95% CI 6%–18%). Educational level modified the effect of physical activity on breast cancer. In conclusion, this analysis suggests that a substantial number of the excess postmenopausal breast cancer events among women with a high educational level compared to a low can be attributed to differences in alcohol consumption, use of hormone therapy, and reproductive patterns. Women of high educational level may be more vulnerable to physical inactivity compared to women of low educational level. PMID:24205296

  11. Design of different types of indirect cooling systems in supermarkets - Comparison of energy use and costs

    Energy Technology Data Exchange (ETDEWEB)

    Haglund Stignor, Caroline

    2007-08-15

    A case study has been performed comparing 11 different cases of indirect cooling systems in supermarkets. The influence of the selection of cooling-coil/heat exchanger design, display cabinets, type of secondary refrigerant, types of valves, types of pumps and type of system design has been investigated. The cases have been selected to be representative for a large number of supermarkets in Sweden. However, some of the cases are only hypothetical and do no not exist in reality so far. The results show that savings of both energy and money can be significant, by the selection of efficient components and system design. An iterative procedure, for finding the optimal operating point (liquid inlet temperature and liquid flow rate) is suggested. This procedure has been evaluated with good results

  12. A comparison between indirect and objective wear-time assessment of removable orthodontic appliances.

    Science.gov (United States)

    Schott, Timm C; Meyer-Gutknecht, Hannes; Mayer, Nicolai; Weber, Joachim; Weimer, Katja

    2017-04-01

    Patients do not always adhere to the wear times prescribed for removable orthodontic appliances. We evaluated the validity and usability of indirect wear-time assessment methods by comparing wear-time estimates with microelectronically measured wear times in patients with removable orthodontic appliances. Wear times of 33 expansion plates, 34 functional appliances, and 42 retention plates of patients aged 6-20 years (12.3±2.9 years, 50.5% female) were indirectly determined by practitioners using a questionnaire assessing five parameters on a 5-point Likert scale: appliance handling, appliance appearance, bite shift, tooth movement, and appliance fit. The perceived difficulty in assessing each parameter was rated. Actual wear times were evaluated with microelectronic sensors in the appliances. Regression analyses revealed that practitioners' decisions about wear times varied depending on the type of appliance and criteria used, with only one standard criterion best predicting estimated wear time for each appliance. Different standard criteria were better predictors of measured wear time: 22.3% of wear-time variability was explained by expansion plate appearance, 31.2% by functional appliance handling, and 18.8% by retainer fitting. However, practitioners rated the difficulty of assessment in most cases as 'easy'. The study was not double blinded for technical reasons, and practitioners may have considered the evaluation criteria more carefully than in normal daily practice. Practitioners' decisions about wear times based on standard criteria strongly vary depending on the type of appliance and criteria used. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  13. Comparison of a Handheld Indirect Calorimetry Device and Predictive Energy Equations Among Individuals on Maintenance Hemodialysis.

    Science.gov (United States)

    Morrow, Ellis A; Marcus, Andrea; Byham-Gray, Laura

    2017-11-01

    Practical methods for determining resting energy expenditure (REE) among individuals on maintenance hemodialysis (MHD) are needed because of the limitations of indirect calorimetry. Two disease-specific predictive energy equations (PEEs) have been developed for this metabolically complex population. The aim of this study was to compare estimated REE (eREE) by PEEs to measured REE (mREE) with a handheld indirect calorimetry device (HICD). A prospective pilot study of adults on MHD (N = 40) was conducted at 2 dialysis clinics in Houston and Texas City, Texas. mREE by an HICD was compared with eREE determined by 6 PEEs using Bland-Altman analysis with a band of acceptable agreement of ±10% of the group mean mREE. Paired t-test and the intraclass correlation coefficient were also used to compare the alternate methods of measuring REE. A priori alpha was set at P Maintenance Hemodialysis Equation-Creatinine version (MHCD-CR) was the most accurate PEE with 52.5% of values within the band of acceptable agreement, followed by the Mifflin-St. Jeor Equation and the Vilar et al. Equation at 45.0% and 42.5%, respectively. When compared with mREE by the HICD, the MHDE-CR was more accurate and precise than other PEEs evaluated; however, this must be interpreted with caution as mREE was consistently lower than eREE from all PEEs. Further research is needed to validate the MHDE-CR and other practical methods for determining REE among individuals on MHD. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Diagnosis of superior labral lesions: comparison of noncontrast MRI with indirect MR arthrography in unexercised shoulders

    International Nuclear Information System (INIS)

    Dinauer, Philip A.; Flemming, Donald J.; Murphy, Kevin P.; Doukas, William C.

    2007-01-01

    To prospectively compare the accuracy of noncontrast magnetic resonance imaging (MRI) with indirect MR arthrography (I-MRa) of unexercised shoulders for diagnosis of superior glenoid labral lesions. Institutional Review Board approval and patient informed consent were obtained for this prospective study. Superior labral findings on shoulder MRI and unexercised I-MRa studies of 104 patients were correlated with findings at arthroscopic shoulder surgery. Two musculoskeletal radiologists independently reviewed the two sets of MR images while blinded to arthroscopic results. For each radiologist, the McNemar test was used to detect statistically significant differences between techniques. The superior labrum was intact in 24 and abnormal in 80 subjects. For detection of superior labral lesions by each radiologist, I-MRa was more sensitive (84-91%) than MRI (66-85%), with statistically significant improvement in sensitivity for one reader (p = 0.003). However, I-MRa was less specific (58-71%) than MRI (75-83%). Overall, accuracy was slightly improved on I-MRa (78-86%) compared with MRI (70-83%), but this difference was not statistically significant for either reader. Compared with noncontrast MRI, I-MRa was more sensitive for diagnosis of superior glenoid labral lesions. However, the diagnostic value of I-MRa in shoulders remaining at rest is potentially limited by decreased specificity of the technique. (orig.)

  15. Direct contra naïve-indirect comparison of clinical failure rates between high-viscosity GIC and conventional amalgam restorations: an empirical study.

    Science.gov (United States)

    Mickenautsch, Steffen; Yengopal, Veerasamy

    2013-01-01

    Naïve-indirect comparisons are comparisons between competing clinical interventions' evidence from separate (uncontrolled) trials. Direct comparisons are comparisons within randomised control trials (RCTs). The objective of this empirical study is to test the null-hypothesis that trends and performance differences inferred from naïve-indirect comparisons and from direct comparisons/RCTs regarding the failure rates of amalgam and direct high-viscosity glass-ionomer cement (HVGIC) restorations in permanent posterior teeth have similar direction and magnitude. A total of 896 citations were identified through systematic literature search. From these, ten and two uncontrolled clinical longitudinal studies for HVGIC and amalgam, respectively, were included for naïve-indirect comparison and could be matched with three out twenty RCTs. Summary effects sizes were computed as Odds ratios (OR; 95% Confidence intervals) and compared with those from RCTs. Trend directions were inferred from 95% Confidence interval overlaps and direction of point estimates; magnitudes of performance differences were inferred from the median point estimates (OR) with 25% and 75% percentile range, for both types of comparison. Mann-Whitney U test was applied to test for statistically significant differences between point estimates of both comparison types. Trends and performance differences inferred from naïve-indirect comparison based on evidence from uncontrolled clinical longitudinal studies and from direct comparisons based on RCT evidence are not the same. The distributions of the point estimates differed significantly for both comparison types (Mann-Whitney U  =  25, n(indirect)  =  26; n(direct)  =  8; p  =  0.0013, two-tailed). The null-hypothesis was rejected. Trends and performance differences inferred from either comparison between HVGIC and amalgam restorations failure rates in permanent posterior teeth are not the same. It is recommended that clinical practice

  16. Educational Differences in Postmenopausal Breast Cancer - Quantifying Indirect Effects through Health Behaviors, Body Mass Index and Reproductive Patterns

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Lange, Theis; Andersen, Ingelise

    2013-01-01

    Studying mechanisms underlying social inequality in postmenopausal breast cancer is important in order to develop prevention strategies. Standard methods for investigating indirect effects, by comparing crude models to adjusted, are often biased. We applied a new method enabling the decomposition......-years at risk. Of these, 26% (95% CI 14%-69%) could be attributed to alcohol consumption. Similar effects were observed for age at first birth (32%; 95% CI 10%-257%), parity (19%; 95%CI 10%-45%), and hormone therapy use (10%; 95% CI 6%-18%). Educational level modified the effect of physical activity on breast...

  17. Comparison of Direct and Indirect Gas Reactor Brayton Systems for Nuclear Electric Space Propulsion

    International Nuclear Information System (INIS)

    M Postlehwait; P DiLorenzo; S Belanger; J Ashcroft

    2005-01-01

    Gas reactor systems are being considered as candidates for use in generating power for the Prometheus-1 spacecraft, along with other NASA missions as part of the Prometheus program. Gas reactors offer a benign coolant, which increases core and structural materials options. However, the gas coolant has inferior thermal transport properties, relative to other coolant candidates such as liquid metals. This leads to concerns for providing effective heat transfer and for minimizing pressure drop within the reactor core. In direct gas Brayton systems, i.e. those with one or more Brayton turbines in the reactor cooling loop, the ability to provide effective core cooling and low pressure drop is further constrained by the need for a low pressure, high molecular weight gas, typically a mixture of helium and xenon. Use of separate primary and secondary gas loops, one for the reactor and one or more for the Brayton system(s) separated by heat exchanger(s), allows for independent optimization of the pressure and gas composition of each loop. The reactor loop can use higher pressure pure helium, which provides improved heat transfer and heat transport properties, while the Brayton loop can utilize lower pressure He-Xe. However, this approach requires a separate primary gas circulator and also requires gas to gas heat exchangers. This paper focuses on the trade-offs between the direct gas reactor Brayton system and the indirect gas Brayton system. It discusses heat exchanger arrangement and materials options and projects heat exchanger mass based on heat transfer area and structural design needs. Analysis indicates that these heat exchangers add considerable mass, but result in reactor cooling and system resiliency improvements

  18. Comparison study of indirect MR arthrography and direct MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    Jung, Jee Young; Yoon, Young Cheol; Yi, Sang-Kyu; Yoo, Jaechul; Choe, Bong-Keun

    2009-01-01

    To compare the diagnostic value of indirect magnetic resonance arthrography (I-MRA) with that of direct MR arthrography (D-MRA) for labral tears, rotator cuff tears, and long head of biceps tendon (LHBT) tears using a 3-T MR unit. Institutional review board approval was given; written informed consent was obtained from all patients. From November 2005 to June 2006, 19 patients (eight men and 11 women; mean age, 51 years) who had undergone both I-MRA and D-MRA underwent arthroscopic surgery. Both methods were performed in fat-saturated axial, coronal oblique, and sagittal oblique T1-weighted sequences, as well as axial and coronal oblique T2-weighted sequences. Two radiologists independently and retrospectively evaluated two sets of MRA for the diagnosis of superior and anterior labral tears, subscapularis tendon (SSC), and supraspinatus-infraspinatus tendon (SSP-ISP) tears, and LHBT tears. With the arthroscopic finding as a gold standard, we analyzed statistical differences of sensitivities and specificities between two sets of MRA and inter-observer agreement was evaluated using the kappa value. The sensitivity and specificity of I-MRA and D-MRA for reader 1 were 79/80% and 71/80%, respectively, for superior labral tears; 100/100% and 100/100%, respectively, for anterior labral tears; 64/75% and 64/100%, respectively, for SSC tears; 100/86% and 100/100%, respectively, for SSP-ISP tears; and 67/100% and 78/100%, respectively, for LHBT tears. Those of I-MRA and D-MRA for reader 2 were 86/80% and 71/100%, respectively, for superior labral tears; 100/83% and 100/100%, respectively, for anterior labral tears; 64/88% and 82/100%, respectively, for SSC tears; 92/86% and 100/100%, respectively, for SSP-ISP tears; and 78/90% and 89/100%, respectively, for LHBT tears. No significant differences were found between the methods. Inter-observer agreements were higher than moderate (κ > 0.41) with both methods. Based on a relatively small number of patients, no significant

  19. Comparison study of indirect MR arthrography and direct MR arthrography of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jee Young; Yoon, Young Cheol [Sungkyunkwan University, Department of Radiology, Samsung Medical Center, School of Medicine, Seoul (Korea); Yi, Sang-Kyu [Sungkyunkwan University, Department of Radiology, Samsung Medical Center, School of Medicine, Seoul (Korea); Sekye Radiologic Clinic, Daejeon (Korea); Yoo, Jaechul [Sungkyunkwan University, Department of Orthopedic Surgery, School of Medicine, Seoul (Korea); Choe, Bong-Keun [Kyung Hee University, Department of Preventive Medicine, School of Medicine, Seoul (Korea)

    2009-07-15

    To compare the diagnostic value of indirect magnetic resonance arthrography (I-MRA) with that of direct MR arthrography (D-MRA) for labral tears, rotator cuff tears, and long head of biceps tendon (LHBT) tears using a 3-T MR unit. Institutional review board approval was given; written informed consent was obtained from all patients. From November 2005 to June 2006, 19 patients (eight men and 11 women; mean age, 51 years) who had undergone both I-MRA and D-MRA underwent arthroscopic surgery. Both methods were performed in fat-saturated axial, coronal oblique, and sagittal oblique T1-weighted sequences, as well as axial and coronal oblique T2-weighted sequences. Two radiologists independently and retrospectively evaluated two sets of MRA for the diagnosis of superior and anterior labral tears, subscapularis tendon (SSC), and supraspinatus-infraspinatus tendon (SSP-ISP) tears, and LHBT tears. With the arthroscopic finding as a gold standard, we analyzed statistical differences of sensitivities and specificities between two sets of MRA and inter-observer agreement was evaluated using the kappa value. The sensitivity and specificity of I-MRA and D-MRA for reader 1 were 79/80% and 71/80%, respectively, for superior labral tears; 100/100% and 100/100%, respectively, for anterior labral tears; 64/75% and 64/100%, respectively, for SSC tears; 100/86% and 100/100%, respectively, for SSP-ISP tears; and 67/100% and 78/100%, respectively, for LHBT tears. Those of I-MRA and D-MRA for reader 2 were 86/80% and 71/100%, respectively, for superior labral tears; 100/83% and 100/100%, respectively, for anterior labral tears; 64/88% and 82/100%, respectively, for SSC tears; 92/86% and 100/100%, respectively, for SSP-ISP tears; and 78/90% and 89/100%, respectively, for LHBT tears. No significant differences were found between the methods. Inter-observer agreements were higher than moderate ({kappa} > 0.41) with both methods. Based on a relatively small number of patients, no significant

  20. A finite and stable exponential growth-adjusted indirect cost of cancer associated with discounted years of life lost in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Omar B. Da'ar

    2018-05-01

    Conclusion: Our findings reveal evidence of indirect cost associated with cancer premature deaths in Saudi Arabia. In order to develop cancer control actions, the results of this study can inform health system policymakers not only of the extent of the enormous economic burden but also drawing attention to epidemiological and economic factors that explain the variability of the burden.

  1. Antitumor effects of metformin via indirect inhibition of protein phosphatase 2A in patients with endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Shinsuke Hanawa

    Full Text Available Metformin, an antidiabetic drug, inhibits the endometrial cancer cell growth in vivo by improving the insulin resistance; however, its mechanism of action is not completely understood. Protein phosphatase 2A (PP2A is a serine/threonine phosphatase associated with insulin resistance and type 2 diabetes, and its inhibition restores the insulin resistance. This study investigated the antitumor effect of metformin on endometrial cancer with a focus on PP2A.Metformin (1,500-2,250 mg/day was preoperatively administered to patients with endometrial cancer for 4 to 6 weeks. Expression of the PP2A regulatory subunits, 4 (PPP2R4 and B (PP2A-B, was evaluated using real-time polymerase chain reaction (RT-PCR and immunohistochemistry (IHC using paired specimens obtained before and after metformin treatment. The effect of PPP2R4 inhibition with small interfering RNA was evaluated in the endometrial cancer cell lines HEC265 and HEC1B. P values of < .05 were considered statistically significant.Preoperative metformin treatment significantly reduced the expression of PP2A-B, as determined using IHC, and the mRNA expression of PPP2R4, as determined using RT-PCR, in the patients with endometrial cancer. However, metformin could not directly alter the PPP2R4 mRNA levels in the endometrial cancer cell lines in vitro. PPP2R4 knockdown reduced the proliferation and induced the apoptosis by activating caspases 3/7 in HEC265 and HEC1B cells.Downregulation of the PP2A-B subunit, including PPP2R4, is an important indirect target of metformin. Inhibition of PP2A may be an option for the treatment of endometrial cancer patients with insulin resistance.This trial is registered with UMIN-CTR (number UMIN000004852.

  2. Lipophilic versus hydrophilic statin therapy for heart failure: a protocol for an adjusted indirect comparison meta-analysis

    Science.gov (United States)

    2013-01-01

    Background Statins are known to reduce cardiovascular morbidity and mortality in primary and secondary prevention studies. Subsequently, a number of nonrandomised studies have shown statins improve clinical outcomes in patients with heart failure (HF). Small randomised controlled trials (RCT) also show improved cardiac function, reduced inflammation and mortality with statins in HF. However, the findings of two large RCTs do not support the evidence provided by previous studies and suggest statins lack beneficial effects in HF. Two meta-analyses have shown statins do not improve survival, whereas two others showed improved cardiac function and reduced inflammation in HF. It appears lipophilic statins produce better survival and other outcome benefits compared to hydrophilic statins. But the two types have not been compared in direct comparison trials in HF. Methods/design We will conduct a systematic review and meta-analysis of lipophilic and hydrophilic statin therapy in patients with HF. Our objectives are: 1. To determine the effects of lipophilic statins on (1) mortality, (2) hospitalisation for worsening HF, (3) cardiac function and (4) inflammation. 2. To determine the effects of hydrophilic statins on (1) mortality, (2) hospitalisation for worsening HF, (3) cardiac function and (4) inflammation. 3. To compare the efficacy of lipophilic and hydrophilic statins on HF outcomes with an adjusted indirect comparison meta-analysis. We will conduct an electronic search of databases for RCTs that evaluate statins in patients with HF. The reference lists of all identified studies will be reviewed. Two independent reviewers will conduct the search. The inclusion criteria include: 1. RCTs comparing statins with placebo or no statin in patients with symptomatic HF. 2. RCTs that employed the intention-to-treat (ITT) principle in data analysis. 3. Symptomatic HF patients of all aetiologies and on standard treatment. 4. Statin of any dose as intervention. 5. Placebo or no

  3. If psychosis were cancer: a speculative comparison

    Science.gov (United States)

    Boden, Zoë; Newton, Elizabeth

    2017-01-01

    Recently, health policy in the UK has begun to engage with the concept of ‘parity of esteem’ between physical and mental healthcare. This has led one recent initiative to improve service provision for first episode psychosis, which aims to bring it into line with some of the principles underpinning good practice in cancer care. In this paper, we consider some of the metaphorical consequences of likening psychosis to cancer. While we find the comparison unhelpful for clinical purposes, we argue that it can be a helpful lens through which to examine service provision for psychosis in young people. Through this lens, specialist community-based services would appear to compare reasonably well. Inpatient care for young people with psychosis, on the other hand, suffers very badly by comparison with inpatient facilities for teenage cancer care. We note some of the many positive features of inpatient cancer care for young adults, and—drawing upon previous research on inpatient psychiatric care—observe that many of these are usually absent from mental health facilities. We conclude that this metaphor may be a helpful rhetorical device for communicating the lack of ‘parity of esteem’ between mental and physical healthcare. This inequity must be made visible in health policy, in commissioning, and in service provision. PMID:28559369

  4. Comparison between SGLT2 inhibitors and DPP4 inhibitors added to insulin therapy in type 2 diabetes: a systematic review with indirect comparison meta-analysis.

    Science.gov (United States)

    Min, Se Hee; Yoon, Jeong-Hwa; Hahn, Seokyung; Cho, Young Min

    2017-01-01

    Both sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors can be used to treat patients with type 2 diabetes mellitus (T2DM) that is inadequately controlled with insulin therapy, and yet there has been no direct comparison of these two inhibitors. We searched MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov through June 2015. Randomized controlled trials published in English that compare SGLT2 inhibitor plus insulin (SGLT2i/INS) with placebo plus insulin or DPP4 inhibitor plus insulin (DPP4i/INS) with placebo plus insulin in patients with T2DM were selected. Data on the study characteristics, efficacy and safety outcomes were extracted. We compared the efficacy and safety between SGLT2i/INS and DPP4i/INS indirectly with covariates adjustment. Risk of potential bias was assessed. Fourteen eligible randomized controlled trials comprising 6980 patients were included (five SGLT2 inhibitor studies and nine DPP4 inhibitor studies). Covariate-adjusted indirect comparison using meta-regression analyses revealed that SGLT2i/INS achieved greater reduction in HbA 1c [weighted mean difference (WMD) -0.24%, 95% confidence interval (CI) -0.43 to -0.05%], fasting plasma glucose (WMD -18.0 mg/dL, 95% CI -28.5 to -7.6 mg/dL) and body weight (WMD -2.38 kg, 95% CI -3.18 to -1.58 kg) from baseline than DPP4i/INS without increasing the risk of hypoglycaemia (relative risks 1.19, 95% CI 0.78 to 1.82). Sodium glucose cotransporter 2 inhibitors achieved better glycaemic control and greater weight reduction than DPP4 inhibitors without increasing the risk of hypoglycaemia in patients with T2DM that is inadequately controlled with insulin. There has been no direct comparison of SGLT2 inhibitors and DPP4 inhibitors in patients with T2DM inadequately controlled with insulin therapy. In this study, we performed indirect meta-analysis comparing SGLT2 inhibitors and DPP4 inhibitors added to insulin

  5. Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review

    International Nuclear Information System (INIS)

    Lee, Peter N; Forey, Barbara A

    2013-01-01

    National smoking-specific lung cancer mortality rates are unavailable, and studies presenting estimates are limited, particularly by histology. This hinders interpretation. We attempted to rectify this by deriving estimates indirectly, combining data from national rates and epidemiological studies. We estimated study-specific absolute mortality rates and variances by histology and smoking habit (never/ever/current/former) based on relative risk estimates derived from studies published in the 20 th century, coupled with WHO mortality data for age 70–74 for the relevant country and period. Studies with populations grossly unrepresentative nationally were excluded. 70–74 was chosen based on analyses of large cohort studies presenting rates by smoking and age. Variations by sex, period and region were assessed by meta-analysis and meta-regression. 148 studies provided estimates (Europe 59, America 54, China 22, other Asia 13), 54 providing estimates by histology (squamous cell carcinoma, adenocarcinoma). For all smoking habits and lung cancer types, mortality rates were higher in males, the excess less evident for never smokers. Never smoker rates were clearly highest in China, and showed some increasing time trend, particularly for adenocarcinoma. Ever smoker rates were higher in parts of Europe and America than in China, with the time trend very clear, especially for adenocarcinoma. Variations by time trend and continent were clear for current smokers (rates being higher in Europe and America than Asia), but less clear for former smokers. Models involving continent and trend explained much variability, but non-linearity was sometimes seen (with rates lower in 1991–99 than 1981–90), and there was regional variation within continent (with rates in Europe often high in UK and low in Scandinavia, and higher in North than South America). The indirect method may be questioned, because of variations in definition of smoking and lung cancer type in the

  6. Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review

    Science.gov (United States)

    2013-01-01

    Background National smoking-specific lung cancer mortality rates are unavailable, and studies presenting estimates are limited, particularly by histology. This hinders interpretation. We attempted to rectify this by deriving estimates indirectly, combining data from national rates and epidemiological studies. Methods We estimated study-specific absolute mortality rates and variances by histology and smoking habit (never/ever/current/former) based on relative risk estimates derived from studies published in the 20th century, coupled with WHO mortality data for age 70–74 for the relevant country and period. Studies with populations grossly unrepresentative nationally were excluded. 70–74 was chosen based on analyses of large cohort studies presenting rates by smoking and age. Variations by sex, period and region were assessed by meta-analysis and meta-regression. Results 148 studies provided estimates (Europe 59, America 54, China 22, other Asia 13), 54 providing estimates by histology (squamous cell carcinoma, adenocarcinoma). For all smoking habits and lung cancer types, mortality rates were higher in males, the excess less evident for never smokers. Never smoker rates were clearly highest in China, and showed some increasing time trend, particularly for adenocarcinoma. Ever smoker rates were higher in parts of Europe and America than in China, with the time trend very clear, especially for adenocarcinoma. Variations by time trend and continent were clear for current smokers (rates being higher in Europe and America than Asia), but less clear for former smokers. Models involving continent and trend explained much variability, but non-linearity was sometimes seen (with rates lower in 1991–99 than 1981–90), and there was regional variation within continent (with rates in Europe often high in UK and low in Scandinavia, and higher in North than South America). Conclusions The indirect method may be questioned, because of variations in definition of smoking and

  7. [Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].

    Science.gov (United States)

    Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B

    1995-09-01

    Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly

  8. Mechanical endovascular therapy for acute ischemic stroke: An indirect treatment comparison between Solitaire and Penumbra thrombectomy devices.

    Directory of Open Access Journals (Sweden)

    Jonathan T Caranfa

    Full Text Available Randomized controlled trials (RCTs have compared mechanical endovascular therapy (MET in addition to intravenous tissue plasminogen activator (IVtPA to IVtPA alone for the management of acute ischemic stroke (AIS. Direct comparative studies between individual METs are not available. In lieu of head-to-head randomized control trials, we performed an adjusted indirect treatment comparison (ITC meta-analysis to assess the comparative efficacy and safety of different METs, Solitaire+IVtPA and Penumbra+IVtPA in AIS patients.We searched MEDLINE, the Cochrane Central Register of Controlled Trials and Embase from January 1, 2005 through April 1, 2017 for RCTs in AIS patients, comparing a single MET+IVtPA to IVtPA alone and reporting shift in ordinal modified Rankin Scale (mRS score at 90 days. Secondary endpoints included 90 day mortality and symptomatic intracranial hemorrhage (sICH. Endpoints were pooled using traditional random effects meta-analysis methods, producing odds ratios and 95% confidence intervals. Adjusted ITCs using pooled estimates were then performed. Three studies (SWIFT PRIME, EXTEND-IA, THERAPY were included; two evaluating the Solitaire stent retriever and one the Penumbra system. Traditional meta-analysis demonstrated that each MET+IVtPA resulted in increased odds of improving ordinal mRS score vs. IVtPA alone, but did not alter the odds of death or sICH. Adjusted ITC showed no significant difference between the METs for any outcome.No significant difference in efficacy or safety between the Solitaire and Penumbra devices was observed.

  9. The Impact on Pupils' Altruistic Attitudes : a Comparison of the Effects of Direct Activity and Indirect Interventions.

    OpenAIRE

    Miyasato, Tomoe

    2008-01-01

    The purpose of this study was to identify the impact on pupils' altruistic attitudes of participating in either direct experiential activity or indirect interventions. In the direct condition, 4th grade pupils interacted experientially with kindergarten children in naturalistic social settings; in the indirect condition, the older pupils read a story about social interaction to the kindergarten children and discussed it with them afterwards. Seventy 4th-graders took part. After they participa...

  10. A comparison of microhardness of indirect composite restorative materials Estudo comparativo da microdureza de materiais resinosos indiretos

    Directory of Open Access Journals (Sweden)

    Carolina Baptista Miranda

    2003-06-01

    Full Text Available The purpose of this study was to compare the microhardness of four indirect composite resins. Forty cylindrical samples were prepared according to the manufacturer’s recommendations using a Teflon mold. Ten specimens were produced from each tested material, constituting four groups (n=10 as follows: G1 - Artglass; G2 - Sinfony; G3 - Solidex; G4 - Targis. Microhardness was determined by the Vickers indentation technique with a load of 300g for 10 seconds. Four indentations were made on each sample, determining the mean microhardness values for each specimen. Descriptive statistics data for the experimental conditions were: G1 - Artglass (mean ±standard deviation: 55.26 ± 1.15HVN; median: 52.6; G2 - Sinfony (31.22 ± 0.65HVN; 31.30; G3 - Solidex (52.25 ± 1.55HVN; 52.60; G4 - Targis (72.14 ± 2.82HVN; 73.30. An exploratory data analysis was performed to determine the most appropriate statistical test through: (I Levene's for homogeneity of variances; (II ANOVA on ranks (Kruskal-Wallis; (III Dunn's multiple comparison test (0.05. Targis presented the highest microhardness values while Sinfony presented the lowest. Artglass and Solidex were found as intermediate materials. These results indicate that distinct mechanical properties may be observed at specific materials. The composition of each material as well as variations on polymerization methods are possibly responsibles for the difference found in microhardness. Therefore, indirect composite resin materials that guarantee both good esthetics and adequate mechanical properties may be considered as substitutes of natural teeth.O objetivo deste estudo foi comparar a microdureza de 4 resinas compostas indiretas. Quarenta amostras cilíndricas foram obtidas com o auxílio de uma matriz de teflon, seguindo-se as recomendações dos fabricantes. Foram obtidas 10 amostras para cada material testado, contituindo-se 4 grupos (n=10 como se segue: G1-Artglass; G2-Sinfony; G3-Solidex; G4-Targis. A

  11. Treatment of Adults With Treatment-Resistant Depression: Electroconvulsive Therapy Plus Antidepressant or Electroconvulsive Therapy Alone? Evidence From an Indirect Comparison Meta-Analysis

    OpenAIRE

    Song, Guo-Min; Tian, Xu; Shuai, Ting; Yi, Li-Juan; Zeng, Zi; Liu, Shuang; Zhou, Jian-Guo; Wang, Yan

    2015-01-01

    Abstract Electroconvulsive therapy (ECT) and antidepressant are the effective treatment alternatives for patients with treatment-resistant depression (TRD); however, the effects and safety of the ECT plus antidepressant relative to ECT alone remain controversial. We decide to assess the potential of ECT plus antidepressant compared with ECT alone by undertaking an indirect comparison meta-analysis. Databases from PubMed, ISI Web of Science, CENTRAL, Clinicaltrials.gov, EMBASE, CBM (China Biom...

  12. Boceprevir and telaprevir for the treatment of chronic hepatitis C genotype 1 infection: an indirect comparison meta-analysis

    Directory of Open Access Journals (Sweden)

    Cooper CL

    2012-03-01

    Full Text Available Curtis L Cooper1, Eric Druyts2, Kristian Thorlund3, Jean B Nachega4, Antoine C El Khoury5, Christopher O'Regan6, Edward J Mills2,31Division of Infectious Diseases, Faculty of Medicine, 2Faculty of Health Sciences, University of Ottawa, Ottawa, 3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; 4Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 5Merck and Co, Inc, Whitehouse Station, NJ, 6Merck Sharp and Dohme Ltd, Hoddesdon, Hertfordshire, United KingdomBackground: The aim of this study was to examine the relative efficacy and safety of boceprevir and telaprevir, when used in combination with pegylated interferon alpha and ribavirin, using an indirect comparison meta-analysis.Methods: Published phase II and phase III randomized placebo-controlled trials examining the efficacy of boceprevir and telaprevir in chronic hepatitis C virus genotype 1 infected adult populations were included. The primary outcomes were sustained virologic response, relapse, and discontinuation of all study drugs. Secondary outcomes included the adverse events of anemia, neutropenia, rash, and pruritus. Results: Four boceprevir trials and six telaprevir trials were included. No significant differences were observed for sustained virologic response among either naïve (relative risk [RR] 1.14, 95% confidence interval [CI] 0.93–1.37, P = 0.20 or experienced patients (RR 0.81, 95% CI 0.52–1.23, P = 0.30. Similarly, for relapse among naïve (RR 0.80, 95% CI 0.18–3.45, P = 0.77 and experienced patients (RR 1.71, 95% CI 0.90–3.24, P = 0.10, or discontinuation of therapy for naïve (RR 0.80, 95% CI 0.28–2.29, P = 0.72 and experienced patients (RR 0.88, 95% CI 0.69–1.12, P = 0.30. Telaprevir was more likely to be associated with rash and pruritus, and boceprevir was more likely to be associated with neutropenia in certain patient populations.Conclusion: Boceprevir and telaprevir appear

  13. Aquaporin-4 autoantibodies in neuromyelitis optica spectrum disorders: comparison between tissue-based and cell-based indirect immunofluorescence assays

    Directory of Open Access Journals (Sweden)

    Chan Koon H

    2010-09-01

    Full Text Available Abstract Background Neuromyelitis optica spectrum disorders (NMOSD are severe central nervous system inflammatory demyelinating disorders (CNS IDD characterized by monophasic or relapsing, longitudinally extensive transverse myelitis (LETM and/or optic neuritis (ON. A significant proportion of NMOSD patients are seropositive for aquaporin-4 (AQP4 autoantibodies. We compared the AQP4 autoantibody detection rates of tissue-based indirect immunofluorescence assay (IIFA and cell-based IIFA. Methods Serum of Chinese CNS IDD patients were assayed for AQP4 autoantibodies by tissue-based IIFA using monkey cerebellum and cell-based IIFA using transfected HEK293 cells which express human AQP4 on their cell membranes. Results In total, 128 CNS IDD patients were studied. We found that 78% of NMO patients were seropositive for AQP4 autoantibodies by cell-based IIFA versus 61% by tissue-based IFA (p = 0.250, 75% of patients having relapsing myelitis (RM with LETM were seropositive by cell-based IIFA versus 50% by tissue-based IIFA (p = 0.250, and 33% of relapsing ON patients were seropositive by cell-based IIFA versus 22% by tissue-based IIFA (p = 1.000; however the differences were not statistically significant. All patients seropositive by tissue-based IIFA were also seropositive for AQP4 autoantibodies by cell-based IIFA. Among 29 NMOSD patients seropositive for AQP4 autoantibodies by cell-based IIFA, 20 (69% were seropositive by tissue-based IIFA. The 9 patients seropositive by cell-based IIFA while seronegative by tissue-based IIFA had NMO (3, RM with LETM (3, a single attack of LETM (1, relapsing ON (1 and a single ON attack (1. Among 23 NMO or RM patients seropositive for AQP4 autoantibodies by cell-based IIFA, comparison between those seropositive (n = 17 and seronegative (n = 6 by tissue-based IIFA revealed no differences in clinical and neuroradiological characteristics between the two groups. Conclusion Cell-based IIFA is slightly more sensitive

  14. Indirect treatment comparison of bevacizumab + interferon-α-2a vs tyrosine kinase inhibitors in first-line metastatic renal cell carcinoma therapy

    Directory of Open Access Journals (Sweden)

    Gerald HJ Mickisch

    2011-01-01

    Full Text Available Gerald HJ Mickisch1, Björn Schwander2, Bernard Escudier3, Joaquim Bellmunt4, José P Maroto5, Camillo Porta6, Stefan Walzer7, Uwe Siebert8,91Department of Urology, Center of Operative Urology Bremen, Bremen, Germany; 2Department of Outcomes Research, AiM GmbH Assessment-in-Medicine, Lörrach, Germany; 3Immunotherapy Unit, Institut Gustave Roussy, Villejuif, France; 4Department of Medical Oncology, University Hospital del Mar UPF, Barcelona, Spain; 5Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 6Department of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy; 7Global Health Economics, F Hoffmann-La Roche Pharmaceuticals AG, Basel, Switzerland; 8Department of Public Health, Medical Decision Making and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria; 9Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USABackground: The vascular endothelial growth factor inhibitor bevacizumab (BEV given in combination with interferon-α-2a (IFN, and the tyrosine kinase inhibitors (TKIs sunitinib (SUN and pazopanib (PAZ, have all shown significant increase in progression-free survival (PFS in first-line metastatic renal-cell carcinoma (mRCC therapy. These targeted therapies are currently competing to be primary choice; hence, in the absence of direct head-to-head comparison, there is a need for valid indirect comparison assessment.Methods: Standard indirect comparison methods were applied to independent review PFS data of the pivotal Phase III trials, to determine indirect treatment comparison hazard-ratios (HR with 95% confidence intervals (95% CI. As BEV+IFN and SUN have been compared to IFN, indirect comparison was enabled by the common IFN comparator arms. As PAZ was compared to placebo (PLA, a connector trial (IFN vs PLA was required for the indirect comparison to BEV

  15. Comparison of Direct and Indirect Methods of Teaching Breast Self-Examination – Influence on Knowledge and Attitudes of Iranian Nursing and Midwifery Personnel

    Science.gov (United States)

    Shahbazi, Sara; Heidari, Mohammad; Ghafourifard, Mansour

    2017-04-01

    Background: Breast cancer is the most common cancer in women. Monthly breast self-examination (BSE) has been presented as one of the best screening methods available. The aim of this study was to compare effects of both direct and indirect methods of teaching of BSE on knowledge and attitudes of nursing and midwifery personnel. Materials and Methods: The present study was performed on 89 nursing and midwifery personnel in Valiasr hospital of Borujen city. Participants were randomly divided into a direct and an indirect training group. Researcher-designed BSE knowledge and attitude and demographic information questionnaires were used for data collection. Results: Before the education intervention, the mean levels of knowledge and attitude were 9.82±2.79 and 56.5±6.21 in the direct training group and 9.59±2.71 and 54.5±4.51 in the indirect training group; after the intervention, they reached 19.2±0.96 and 62.9±4.21, and 11.0±2.58 and 59.0±3.44, respectively. The difference in the mean levels of knowledge and attitude were significantly higher in the direct training group post intervention (Pdirect training methods. Creative Commons Attribution License

  16. Comparison of Cancer Incidence between China and the USA.

    Science.gov (United States)

    Wang, Yong-Chuan; Wei, Li-Juan; Liu, Jun-Tian; Li, Shi-Xia; Wang, Qing-Sheng

    2012-06-01

    The incidence of cancer varies around the globe, especially between less-developed and developed regions. The aim of this study is to explore differences in cancer incidence between China and the USA. Data were obtained from the GLOBOCAN 2008 database. Estimated numbers of new cancer cases in the USA were obtained from the American Cancer Society, while the numbers of cases in China, including those in urban and rural areas, were obtained from 36 cancer registries (2003-2005). Cancer incidence for major sites between China and the USA were analyzed. In China, lung cancer was the predominant type of cancer detected in males; in females, breast cancer was the main type of cancer. Gastrointestinal cancers, such as those of the liver, stomach, and esophagus, were more commonly seen in China than in the USA. A significant difference in the incidence of melanoma of the skin was observed between China and the USA. During comparison of differences in the age-standardized rates by world population (ASRWs) of major cancer sites between the two countries, 4 sites in males (i.e., nasopharynx, esophagus, stomach, and liver) and 6 sites in females (i.e., nasopharynx, esophagus, stomach, liver, gallbladder, and cervix uteri) showed higher cancer incidence rates in China than in the USA. Significant differences in cancer incidence sites were found between the two countries. Cancer may be prevented through public education and awareness. Programs to promote cancer prevention in China, especially those of the lung, breast, and gastrointestinal region, must also be implemented.

  17. A comparison of average wages with age-specific wages for assessing indirect productivity losses : Analytic simplicity versus analytic precision

    NARCIS (Netherlands)

    Connolly, Mark P; Tashjian, Cole; Kotsopoulos, Nikolaos; Bhatt, Aomesh; Postma, Maarten J

    Objectives: Numerous approaches are used to estimate indirect productivity losses using various wage estimates applied to poor health in working aged adults. Considering the different wage estimation approaches observed in the published literature, we sought to assess variation in productivity loss

  18. A comparison of the impact of direct and indirect benefits of mating decisions in the rose bitterling (Rhodeus ocellatus)

    Czech Academy of Sciences Publication Activity Database

    Agbali, M.; Spence, R.; Reichard, Martin; Smith, C.

    2012-01-01

    Roč. 58, č. 4 (2012), s. 279-288 ISSN 1565-9801 R&D Projects: GA ČR GA206/09/1163 Institutional support: RVO:68081766 Keywords : bitterling * direct selection * indirect selection * mate choice * oviposition * Rhodeus ocellatus Subject RIV: EG - Zoology Impact factor: 0.444, year: 2012 http://www.tandfonline.com/doi/abs/10.1560/IJEE.58.4.279

  19. Comparison of three dimensional isotropic and two dimensional conventional indirect MR arthrography for the diagnosis of rotator cuff tears

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Yoon, Young Cheol; Kwon, Jong Won; Yoo, Jae Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Cha, Jang Kyu [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Jee, Suk Kyoung [Joeun Madi Hospital, Seoul (Korea, Republic of)

    2014-12-15

    To compare the accuracy between a three-dimensional (3D) indirect isotropic T1-weighted fast spin-echo (FSE) magnetic resonance (MR) arthrography and a conventional two-dimensional (2D) T1-weighted sequences of indirect MR arthrography for diagnosing rotator cuff tears. The study was approved by our Institutional Review Board. In total, 205 patients who had undergone indirect shoulder MR arthrography followed by arthroscopic surgery for 206 shoulders were included in this study. Both conventional 2D T1-weighted FSE sequences and 3D isotropic T1-weighted FSE sequence were performed in all patients. Two radiologists evaluated the images for the presence of full- or partial-thickness tears in the supraspinatus-infraspinatus (SSP-ISP) tendons and tears in the subscapularis (SSC) tendons. Using the arthroscopic findings as the reference standard, the diagnostic performances of both methods were analyzed by the area under the receiver operating characteristic curve (AUC). Arthroscopy confirmed 165 SSP-ISP tendon tears and 103 SSC tendon tears. For diagnosing SSP-ISP tendon tears, the AUC values were 0.964 and 0.989 for the 2D sequences and 3D T1-weighted FSE sequence, respectively, in reader I and 0.947 and 0.963, respectively, in reader II. The AUC values for diagnosing SSC tendon tears were 0.921 and 0.925, respectively, for reader I and 0.856 and 0.860, respectively, for reader II. There was no significant difference between the AUC values of the 2D and 3D sequences in either reader for either type of tear. 3D indirect isotropic MR arthrography with FSE sequence and the conventional 2D arthrography are not significantly different in terms of accuracy for diagnosing rotator cuff tears.

  20. Comparison of three dimensional isotropic and two dimensional conventional indirect MR arthrography for the diagnosis of rotator cuff tears

    International Nuclear Information System (INIS)

    Lee, Ji Hyun; Yoon, Young Cheol; Kwon, Jong Won; Yoo, Jae Chul; Cha, Jang Kyu; Jee, Suk Kyoung

    2014-01-01

    To compare the accuracy between a three-dimensional (3D) indirect isotropic T1-weighted fast spin-echo (FSE) magnetic resonance (MR) arthrography and a conventional two-dimensional (2D) T1-weighted sequences of indirect MR arthrography for diagnosing rotator cuff tears. The study was approved by our Institutional Review Board. In total, 205 patients who had undergone indirect shoulder MR arthrography followed by arthroscopic surgery for 206 shoulders were included in this study. Both conventional 2D T1-weighted FSE sequences and 3D isotropic T1-weighted FSE sequence were performed in all patients. Two radiologists evaluated the images for the presence of full- or partial-thickness tears in the supraspinatus-infraspinatus (SSP-ISP) tendons and tears in the subscapularis (SSC) tendons. Using the arthroscopic findings as the reference standard, the diagnostic performances of both methods were analyzed by the area under the receiver operating characteristic curve (AUC). Arthroscopy confirmed 165 SSP-ISP tendon tears and 103 SSC tendon tears. For diagnosing SSP-ISP tendon tears, the AUC values were 0.964 and 0.989 for the 2D sequences and 3D T1-weighted FSE sequence, respectively, in reader I and 0.947 and 0.963, respectively, in reader II. The AUC values for diagnosing SSC tendon tears were 0.921 and 0.925, respectively, for reader I and 0.856 and 0.860, respectively, for reader II. There was no significant difference between the AUC values of the 2D and 3D sequences in either reader for either type of tear. 3D indirect isotropic MR arthrography with FSE sequence and the conventional 2D arthrography are not significantly different in terms of accuracy for diagnosing rotator cuff tears.

  1. Comparative Efficacy of Daratumumab Monotherapy and Pomalidomide Plus Low-Dose Dexamethasone in the Treatment of Multiple Myeloma: A Matching Adjusted Indirect Comparison.

    Science.gov (United States)

    Van Sanden, Suzy; Ito, Tetsuro; Diels, Joris; Vogel, Martin; Belch, Andrew; Oriol, Albert

    2018-03-01

    Daratumumab (a human CD38-directed monoclonal antibody) and pomalidomide (an immunomodulatory drug) plus dexamethasone are both relatively new treatment options for patients with heavily pretreated multiple myeloma. A matching adjusted indirect comparison (MAIC) was used to compare absolute treatment effects of daratumumab versus pomalidomide + low-dose dexamethasone (LoDex; 40 mg) on overall survival (OS), while adjusting for differences between the trial populations. The MAIC method reduces the risk of bias associated with naïve indirect comparisons. Data from 148 patients receiving daratumumab (16 mg/kg), pooled from the GEN501 and SIRIUS studies, were compared separately with data from patients receiving pomalidomide + LoDex in the MM-003 and STRATUS studies. The MAIC-adjusted hazard ratio (HR) for OS of daratumumab versus pomalidomide + LoDex was 0.56 (95% confidence interval [CI], 0.38-0.83; p  = .0041) for MM-003 and 0.51 (95% CI, 0.37-0.69; p  < .0001) for STRATUS. The treatment benefit was even more pronounced when the daratumumab population was restricted to pomalidomide-naïve patients (MM-003: HR, 0.33; 95% CI, 0.17-0.66; p  = .0017; STRATUS: HR, 0.41; 95% CI, 0.21-0.79; p  = .0082). An additional analysis indicated a consistent trend of the OS benefit across subgroups based on M-protein level reduction (≥50%, ≥25%, and <25%). The MAIC results suggest that daratumumab improves OS compared with pomalidomide + LoDex in patients with heavily pretreated multiple myeloma. This matching adjusted indirect comparison of clinical trial data from four studies analyzes the survival outcomes of patients with heavily pretreated, relapsed/refractory multiple myeloma who received either daratumumab monotherapy or pomalidomide plus low-dose dexamethasone. Using this method, daratumumab conferred a significant overall survival benefit compared with pomalidomide plus low-dose dexamethasone. In the absence of head-to-head trials, these

  2. Efficacy of α-blocker in improving ureteral stent-related symptoms: a meta-analysis of both direct and indirect comparison

    Directory of Open Access Journals (Sweden)

    He F

    2016-05-01

    Full Text Available Feng He, Li-bo Man, Gui-zhong Li, Ning Liu Department of Urinary Surgery, Beijing Jishuitan Hospital, Beijing, People’s Republic of China Objective: To critically evaluate the efficacy of an α-blocker in improving ureteral-stent-related symptoms and preliminarily investigate the difference between different types of α-blockers. Methods: Relevant randomized controlled trials were identified through searching PubMed, the Cochrane Library, Embase, and other sources. After quality assessment and data abstraction, direct comparison based on the Ureteral Stent-related Symptom Questionnaire (USSQ between α-blockers and control was performed by RevMan 5.3. Indirect comparison between different types of α-blockers was performed by ITC 1.0. Sensitive and subgroup analyses were used to handle important clinical factors. Results: Sixteen randomized controlled trials containing 1,489 cases were included. Compared with control, α-blockers significantly reduced the overall urinary symptom, pain index, general health index, and scores related to sexual matters, while no significant difference was found in work performance and additional problem scores. Subgroup analysis showed that the duration of stent insertion, patient’s age, stent size, and the type of α-blocker had the potential to influence the outcomes. Through indirect comparison, we found alfuzosin and terazosin to be better than tamsulosin in pain relief and general health improvement. Conclusion: α-Blocker was effective in treating ureteral stent-related symptoms, as it improved the major indexes of USSQ post-insertion or post-removal. Alfuzosin and terazosin seemed to be better than tamsulosin, which needs further verification because of the lack of direct comparison currently. Keywords: α-blocker, tamsulosin, alfuzosin, terazosin, ureteral stent-related discomfort

  3. Comparison of imaging properties of direct-type and indirect-type of flat-panel detector

    International Nuclear Information System (INIS)

    Matsumoto, Masao; Suekane, Koji; Ichimaru, Yasunobu; Ogata, Yuji; Inamura, Kiyonari; Kanai, Kouzou; Kanamori, Hitoshi

    2002-01-01

    A Flat-Panel Detector (FPD) has many advantages such as eliminating cassette handling and being able to display a preview image immediately in addition to the digital image processing and the networking. Thus, the FPD has ability to innovate the radiology department. We measured and evaluated the digital and over-all imaging properties (characteristic curves, modulation Transfer Functions, Wiener spectra and Noise Equivalent Quanta (NEQ) for the direct-type and indirect-type of FPD. The pre-sampling and overall NEQ of the indirect-type of FPD were better than the NEQ of the direct-type of FPD at lower spatial frequencies, but were worse at higher spatial frequencies. The FPD can take image data at real-time and be easy to digitalize. From these results, Screen/Film system and Computed Radiography system will be replaced by the FPD system, together with diffusion of CAD, cone beam Computed Tomography (CT) system and open-type Magnetic Resonance Imagining (MRI) system. (T. Tanaka)

  4. Extraction of indirectly captured information for use in a comparison of offline pH measurement technologies.

    Science.gov (United States)

    Ritchie, Elspeth K; Martin, Elaine B; Racher, Andy; Jaques, Colin

    2017-06-10

    Understanding the causes of discrepancies in pH readings of a sample can allow more robust pH control strategies to be implemented. It was found that 59.4% of differences between two offline pH measurement technologies for an historical dataset lay outside an expected instrument error range of ±0.02pH. A new variable, Osmo Res , was created using multiple linear regression (MLR) to extract information indirectly captured in the recorded measurements for osmolality. Principal component analysis and time series analysis were used to validate the expansion of the historical dataset with the new variable Osmo Res . MLR was used to identify variables strongly correlated (p<0.05) with differences in pH readings by the two offline pH measurement technologies. These included concentrations of specific chemicals (e.g. glucose) and Osmo Res, indicating culture medium and bolus feed additions as possible causes of discrepancies between the offline pH measurement technologies. Temperature was also identified as statistically significant. It is suggested that this was a result of differences in pH-temperature compensations employed by the pH measurement technologies. In summary, a method for extracting indirectly captured information has been demonstrated, and it has been shown that competing pH measurement technologies were not necessarily interchangeable at the desired level of control (±0.02pH). Copyright © 2017 Elsevier B.V. All rights reserved.

  5. A comparison of indirect immunofluorescence and electron microscopy for the diagnosis of some haemorrhagic viruses in cell cultures.

    Science.gov (United States)

    El Mekki, A A; van der Groen, G

    1981-09-01

    Yellow fever, dengue (types 1, 2 and 4), Chikungunya, Rift Valley fever, Ebola, Marburg, and Lassa viruses were inoculated into susceptible cell cultures and daily investigated by indirect immunofluorescence (IFA) and electron microscopy (EM) with a view to achieve an early detection-identification of these agents. Compared to the other cell lines tested (Vero, BHK-21 and Aedes albopictus), CV-1 cells were found to be more sensitive. Viral antigens were detected by IFA from a few hours post inoculation (CHIK and RVF) to a maximum of 3 days (YF and EBO). For most of the viruses studied, the cytopathic effect (CPE) commenced 2-3 days after the detection of viral antigens. Virus particles were detected by EM only in the case of EBO, MBG and LAS, before any CPE was observed in cell cultures.

  6. Detection of Candida albicans Sap2 in cancer patient serum samples by an indirect competitive enzyme-linked immunosorbent assay for the diagnosis of candidiasis

    Directory of Open Access Journals (Sweden)

    Yicun Wang

    2013-01-01

    Full Text Available Background: The secreted aspartyl proteinases 2 (Sap2 of Candida albicans (C. albicans is a potential marker of candididasis. It is a virulence factor associated with adherence and tissue invasion. Aim: In order to detect Sap2 in clinical sera, we developed an indirect competitive enzyme-linked immunosorbent assay (ELISA. Materials and Methods: Polyclonal antibodies were produced for Sap2 by injecting Sap2 into a New Zealand White inbred rabbit. They could be used at a dilution exceeding 1:1200 in an indirect ELISA, and detected Sap2 concentration up to 1 ng/mL. Results: Of the 286 cancer serum samples tested, 16.8% were found as candidiasis. The test was simple and economical to perform and had a level of sensitivity for detection of low-titer positive sera; thus, it may be proven to be of value in epidemiological studies on candidiasis.

  7. Detection of Candida albicans Sap2 in cancer patient serum samples by an indirect competitive enzyme-linked immunosorbent assay for the diagnosis of candidiasis.

    Science.gov (United States)

    Wang, Yicun; Gao, Xiang; Zhi Gang, J U; Liu, Jingyuan; Dong, Shuai; Wang, Li

    2013-01-01

    The secreted aspartyl proteinases 2 (Sap2) of Candida albicans (C. albicans) is a potential marker of candididasis. It is a virulence factor associated with adherence and tissue invasion. In order to detect Sap2 in clinical sera, we developed an indirect competitive enzyme-linked immunosorbent assay (ELISA). Polyclonal antibodies were produced for Sap2 by injecting Sap2 into a New Zealand White inbred rabbit. They could be used at a dilution exceeding 1:1200 in an indirect ELISA, and detected Sap2 concentration up to 1 ng/mL. Of the 286 cancer serum samples tested, 16.8% were found as candidiasis. The test was simple and economical to perform and had a level of sensitivity for detection of low-titer positive sera; thus, it may be proven to be of value in epidemiological studies on candidiasis.

  8. Comparison of direct and indirect radiation effects on osteoclast formation from progenitor cells derived from different hemopoietic sources.

    Science.gov (United States)

    Scheven, B A; Wassenaar, A M; Kawilarang-de Haas, E W; Nijweide, P J

    1987-07-01

    Hemopoietic stem and progenitor cells from different sources differ in radiosensitivity. Recently, we have demonstrated that the multinucleated cell responsible for bone resorption and marrow cavity formation, the osteoclast, is in fact of hemopoietic lineage. In this investigation we have studied the radiosensitivity of osteoclast formation from two different hemopoietic tissues: fetal liver and adult bone marrow. Development of osteoclasts from hemopoietic progenitors was induced by coculture of hemopoietic cell populations with fetal mouse long bones depleted of their own osteoclast precursor pool. During culture, osteoclasts developed from the exogenous cell population and invaded the calcified hypertrophic cartilage of the long bone model, thereby giving rise to the formation of a primitive marrow cavity. To analyze the radiosensitivity of osteoclast formation, either the hemopoietic cells or the bone rudiments were irradiated before coculture. Fetal liver cells were found to be less radiosensitive than bone marrow cells. The D0, Dq values and extrapolation numbers were 1.69 Gy, 5.30 Gy, and 24.40 for fetal liver cells and 1.01 Gy, 1.85 Gy, and 6.02 for bone marrow cells. Irradiation of the (pre)osteoclast-free long bone rudiments instead of the hemopoietic sources resulted in a significant inhibition of osteoclast formation at doses of 4 Gy or more. This indirect effect appeared to be more prominent in the cocultures with fetal than with adult hemopoietic cells. Furthermore, radiation doses of 8.0-10.0 Gy indirectly affected the appearance of other cell types (e.g., granulocytes) in the newly formed but underdeveloped marrow cavity. The results indicate that osteoclast progenitors from different hemopoietic sources exhibit a distinct sensitivity to ionizing irradiation. Radiation injury to long bone rudiments disturbs the osteoclast-forming capacity as well as the hemopoietic microenvironment.

  9. A comparison of average wages with age-specific wages for assessing indirect productivity losses: analytic simplicity versus analytic precision.

    Science.gov (United States)

    Connolly, Mark P; Tashjian, Cole; Kotsopoulos, Nikolaos; Bhatt, Aomesh; Postma, Maarten J

    2017-07-01

    Numerous approaches are used to estimate indirect productivity losses using various wage estimates applied to poor health in working aged adults. Considering the different wage estimation approaches observed in the published literature, we sought to assess variation in productivity loss estimates when using average wages compared with age-specific wages. Published estimates for average and age-specific wages for combined male/female wages were obtained from the UK Office of National Statistics. A polynomial interpolation was used to convert 5-year age-banded wage data into annual age-specific wages estimates. To compare indirect cost estimates, average wages and age-specific wages were used to project productivity losses at various stages of life based on the human capital approach. Discount rates of 0, 3, and 6 % were applied to projected age-specific and average wage losses. Using average wages was found to overestimate lifetime wages in conditions afflicting those aged 1-27 and 57-67, while underestimating lifetime wages in those aged 27-57. The difference was most significant for children where average wage overestimated wages by 15 % and for 40-year-olds where it underestimated wages by 14 %. Large differences in projecting productivity losses exist when using the average wage applied over a lifetime. Specifically, use of average wages overestimates productivity losses between 8 and 15 % for childhood illnesses. Furthermore, during prime working years, use of average wages will underestimate productivity losses by 14 %. We suggest that to achieve more precise estimates of productivity losses, age-specific wages should become the standard analytic approach.

  10. A METHOD OF INTEGRATED ASSESSMENT OF LIVER FIBROSIS DEGREE: A COMPARISON OF THE OPTICAL METHOD FOR THE STUDY OF RED BLOOD CELLS AND INDIRECT ELASTOGRAPHY OF THE LIVER

    Directory of Open Access Journals (Sweden)

    M. V. Kruchinina

    2017-01-01

    Full Text Available The presented  method  of integrated  assessment of liver fibrosis degree based on the comparison of the data obtained in the study of electric and viscoelastic parameters of erythrocytes by the dielectrophoresis  method  using the electro-optical system  of the detection  cells and method  for indirect elastometry. A high degree of comparability of the results of the above-described  methods  was established  when the degree of fibrosis F 2-4  in the  absence  of marked  cytolysis, cholestasis,  inflammatory  syndrome,  metal  overload. It is shown that  parallel using the methods  of dielectrophoresis and indirect elastography is needed in the presence of a rise of transaminases, gammaglutamyltranspeptidase more than 5 norms, expressed dysproteinemia,  syndromes of iron overload, copper to increase the accuracy in determining the degree of liver fibrosis. The evaluation of dynamics of changes of the degree of fibrosis during antiviral therapy is more accurate by the method  of indirect elastometry, and the method of dielectrophoresis  is preferable in the treatment of nonalcoholic fatty liver disease. In cases of restrictions on the use of the method  for indirect elastography (marked obesity, ascites, cholelithiasis, pregnancy, presence of pacemaker, prosthesis to determine  the degree of fibrosis the method of dielectrophoresis  of red blood cells can be used. Simultaneous use of both methods  (using the identified discriminatory values allows to reduce or to neutralize their disadvantages, dependence on associated syndromes, to expand the possibilities of their application, to improve the diagnostic accuracy in determining each of the degrees of liver fibrosis. Integrated application of both methods — indirect elastography and dielectrophoresis of red blood cells — for determining the degree of liver fibrosis allows to achieve high levels of sensitivity (88.9 percent and specificity (100 percent compared to

  11. Western lowland gorilla diet and resource availability: new evidence, cross-site comparisons, and reflections on indirect sampling methods.

    Science.gov (United States)

    Doran, Diane M; McNeilage, Alastair; Greer, David; Bocian, Carolyn; Mehlman, Patrick; Shah, Natasha

    2002-11-01

    We describe the resource availability and diet of western lowland gorillas (Gorilla gorilla gorilla) from a new study site in the Central African Republic and Republic of Congo based on 3 years of study. The results, based on 715 fecal samples and 617 days of feeding trails, were similar to those reported from three other sites, in spite of differences in herb and fruit availability. Staple foods (consumed year-round) included high-quality herbs (Haumania), swamp herbs (when present), and a minimal diversity of fruit. A variety of fruits (average of 3.5 species per day and 10 per month) were selectively consumed; gorillas ignored some common fruits and incorporated rare fruits to a degree higher than predicted based on availability. During periods of fruit abundance, fruit constituted most of the diet. When succulent fruits were unavailable, gorillas used low-quality herbs (i.e., low-protein), bark, and more fibrous fruits as fallback foods. Fibrous fruit species, such as Duboscia macrocarpa and Klainedoxa gabonensis, were particularly important to gorillas at Mondika and other sites as fallbacks. The densities of these two species are similar across sites for which data are available, in spite of major differences in forest structure, suggesting they may be key species in determining gorilla density. No sex difference in diet was detected. Such little variation in western lowland gorilla diet across sites and between sexes was unexpected and may partly reflect limitations of indirect sampling. Copyright 2002 Wiley-Liss, Inc.

  12. Diagnostic performance of CT and MRI on the detection of symptomatic intracranial dural arteriovenous fistula: a meta-analysis with indirect comparison

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Heng [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China); Lin, Hsien-Ho [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); Liu, Hon-Man; Lee, Chung-Wei; Chen, Ya-Fang [National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China)

    2016-08-15

    This study aims to review the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) in symptomatic dural arteriovenous fistula (DAVF). EMBASE, PubMed, and Cochrane Library were searched until April 2015 for studies which compared CT, MRI, or both with angiography for the detection of DAVF. The diagnostic performances of MRI and CT were indirectly compared using modality as a covariate in the analysis. Thirteen studies met our inclusion criteria. MRI had a sensitivity of 0.90 (95 % confidence interval (CI) = 0.83-0.94) and specificity of 0.94 (95 % CI = 0.90-0.96). CT had a sensitivity of 0.80 (95 % CI = 0.62-0.90) and specificity of 0.87 (95 % CI = 0.74-0.94). MRI showed better diagnostic performance than CT (p = 0.02). Contrast medium use and time-resolved MR angiography did not improve MRI diagnostic performance (p = 0.31 and 0.44, respectively). Both CT and MRI had good diagnostic performance. MRI was better than CT on the detection of symptomatic intracranial dural arteriovenous fistula in the indirect comparison. (orig.)

  13. Screening for retinopathy of prematurity-a comparison between binocular indirect ophthalmoscopy and RetCam 120

    Directory of Open Access Journals (Sweden)

    Shah Parag

    2006-01-01

    Full Text Available Aim: To compare the photographic screening for retinopathy of prematurity (ROP using RetCam 120 with binocular indirect ophthalmoscope (BIO, which is the current gold standard. Setting and Design: Prospective, comparative study. Materials and Methods: A total of 87 RetCam examinations were performed on 27 premature babies. They were stored in a separate file after deleting the identifying information. At the same visit using the BIO with scleral depression, an experienced vitreoretinal surgeon evaluated the fundus in detail. A masked examiner then evaluated the RetCam photographs for presence or absence of ROP, the stage and zone of the disease, and the presence or absence of plus disease. These data were then compared with the BIO findings to determine the sensitivity, specificity, and the positive and negative predictive values of the method. Results: ROP was detected in 63 of 87 examinations by BIO and in 56 of 87 RetCam examinations. Nine RetCam examinations were false-negative and two were false-positive. Sensitivity of RetCam was 85.71% (54/63 and specificity was 91.66% (22/24. The positive and negative predictive values were 96.43% and 70.97% respectively. Conclusion: Nine cases having ROP were missed by the RetCam. All these cases were either in zone 3 or the outer part of zone 2, which later regressed. These were missed mostly because of the restricted mobility of the camera head caused by its size and the barrier caused by the lid speculum arms. No case of threshold ROP was missed. RetCam may replace BIO for screening of ROP.

  14. Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact

    Directory of Open Access Journals (Sweden)

    S. R. Zeissig

    2017-11-01

    Full Text Available Abstract Background There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in registry-based studies are discussed. Methods In a cross-sectional cancer-registry-based study, long-term melanoma patients were contacted by dermatologists rather than directly by the registry on the basis of the legal situation. Logistic regression models and generalized estimating equations were used to assess effects of various patient and physician characteristics on participation and data quality. Especially differences between hospital-based versus office-based dermatologists are evaluated. Results Seventy two out of 112 contacted dermatologists took part in the study (64.3%. The cooperation proportion was 52.2% (689 participants/1320 contacted patients. Participants and non-participants differed regarding age and sex, but not regarding other social demographic factors and cancer stage. We did not observe a difference in patient participation between hospital-based versus office-based dermatologists (OR 1.08 [CI 0.84–1.39]; p = 0.57. However, medical data provided by the cancer registry were better for participants registered and recruited by hospitals. Conclusions In cohort studies with epidemiological cancer registries, recruitment via physicians has potential disadvantages and is more complex. If this indirect way of contact is mandatory, we recommend recruitment procedures including hospital-based rather than office-based physicians. However, physician characteristics were not associated with outcome.

  15. Neuroticism and responses to social comparison among cancer patients

    NARCIS (Netherlands)

    Buunk, A.P.; Brakel, T.M.; Bennenbroek, F.T.C.; Stiegelis, H.E.; Sanderman, R.; Bergh, A.C.M. van den; Hagedoorn, M.

    2009-01-01

    The present study examined how the effects of three audiotapes containing different types of social comparison information on the mood of cancer patients depended on the level of neuroticism. On the procedural tape, a man and woman discussed the process of radiation therapy, on the emotion tape,

  16. A Comparison of Carbon Dioxide Elimination Measurements Between a Portable Indirect Calorimeter and Volumetric Capnography Monitor: An In Vitro Simulation.

    Science.gov (United States)

    Smallwood, Craig D; Martinez, Enid E; Mehta, Nilesh M

    2016-03-01

    Gas exchange measurements for carbon dioxide elimination (V̇CO2 ) and oxygen consumption (V̇O2 ) have been used to derive resting energy expenditure and guide energy prescription. Volumetric capnography is used in intensive care units and provides V̇CO2 measurements that could be used for titrating respiratory and nutritional support. We have recently suggested that measuring V̇CO2 may be sufficient to obtain a reasonable estimate of energy expenditure. However, data describing the accuracy of gas exchange measurement devices are limited. We used an in vitro simulation model to test the accuracy of gas exchange measurements by 2 devices: the CCM Express indirect calorimeter and the NM3, a volumetric capnography monitor. A Huszczuk gas injection system combined with a high-fidelity lung simulator was used to simulate V̇O2 and V̇CO2 values in the pediatric and adult range. Bland-Altman analysis was used to examine the agreement between the measured and simulated values across a range of tidal volumes and gas exchange values. Additionally, agreement between the 2 devices was examined. During the adult simulation with the CCM Express, the mean bias (95% CI) for V̇CO2 values was -12.6% (-16.4 to -8.8%) and -17.5% (-19.9 to -15.1%) for V̇O2 values. For the pediatric simulation with the CCM Express, mean bias for V̇O2 was -14.7% (-16.4 to -13.0%) and V̇CO2 was -10.9% (-13.5 to -8.3%). For the adult and pediatric simulations with the NM3, the bias for V̇CO2 was -8.2% (-15.7 to -0.7%) and -8.3% (-19.4 to -2.8%), respectively. Between the 2 devices, the mean bias was -4.4% (-10.2 to 1.3%) and -2.3% (-11.4 to 6.8%) for the adult and pediatric V̇CO2 simulations, respectively. Currently available portable gas exchange monitors demonstrated acceptable agreement with reference V̇O2 and V̇CO2 values in an in vitro simulation. The devices demonstrated good agreement with each other. Copyright © 2016 by Daedalus Enterprises.

  17. Comparison of two non-invasive methods of microbial analysis in surgery practice: incision swabbing and the indirect imprint technique.

    Science.gov (United States)

    Chovanec, Zdenek; Veverkova, Lenka; Votava, Miroslav; Svoboda, Jiri; Jedlicka, Vaclav; Capov, Ivan

    2014-12-01

    A variety of methods exist to take samples from surgical site infections for cultivation; however, an unambiguous and suitable method has not yet been defined. The aim of our retrospective non-randomized study was to compare two non-invasive techniques of sampling material for microbiologic analysis in surgical practice. We compared bacteria cultured from samples obtained with the use of the swab technique, defined in our study as the gold standard, with the indirect imprint technique. A cotton-tipped swab (Copan, Brescia, Italy) was used; the imprints were taken using Whatman no. 4 filter paper (Macherey-Nagal, Duren, Germany) cut into 5×5 cm pieces placed on blood agar in a Petri dish. To culture the microorganisms in the microbiology laboratory, we used blood agar, UriSelect 4 medium (Bio-Rad, Marnes-la-Coquette, France), and a medium with sodium chloride (blood agar with salt). After careful debridement, a sample was taken from the incision surface by swab and subsequently the same area of the surface was imprinted onto filter paper. The samples were analyzed in the microbiology laboratory under standard safety precautions. The cultivation results of the two techniques were processed statistically using contingency tables and the McNemar test. Those samples that were simultaneously cultivation-positive by imprint and -negative by swabbing were processed in greater detail. Over the period between October 2008 and March 2013, 177 samples from 70 patients were analyzed. Sampling was carried out from 42 males and 28 females. One hundred forty-six samples were from incisions after operations (21 samples from six patients after operation on the thoracic cavity, 73 samples from 35 patients after operation on the abdominal cavity combined with the gastrointestinal tract, 52 samples from 19 patients with other surgical site infections not included above) and 31 samples from 11 patients with no post-operative infection. One patient had a sample taken both from a post

  18. Clinical and radiographic comparison of indirect pulp treatment using light-cured calcium silicate and mineral trioxide aggregate in primary molars: A randomized clinical trial.

    Science.gov (United States)

    Menon, Navya P; Varma, Balagopal R; Janardhanan, Sureshkumar; Kumaran, Parvathy; Xavier, Arun Mamachan; Govinda, Bhat Sangeetha

    2016-01-01

    To clinically and radiographically evaluate the reparative dentin formation in indirect pulp treatment (IPT) using mineral trioxide aggregate (MTA) and light cured calcium silicate (TheraCal) in primary molars over a period of 6 months. A clinical trial on IPT on 43 primary molars in 21 patients between the age of 4-7 years, divided into two groups: 22 teeth in MTA group and 21 in TheraCal group. Measurement of the variation in dentin thickness was done on the digitalized radiograph at baseline, 3 months and 6 months using CorelDRAW X3 software. Statistical analysis using an independent t -test for intragroup and intergroup comparison showed a significant increase in dentin thickness in both the MTA and TheraCal group (intragroup comparison [ P 0.05). Clinically and radiographically, both MTA and TheraCal are good IPT materials. The better handling characteristics and comparable reparative dentin-forming ability of TheraCal make this material an alternative to MTA in pediatric restorative procedures.

  19. Clinical and radiographic comparison of indirect pulp treatment using light-cured calcium silicate and mineral trioxide aggregate in primary molars: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Navya P Menon

    2016-01-01

    Full Text Available Aim: To clinically and radiographically evaluate the reparative dentin formation in indirect pulp treatment (IPT using mineral trioxide aggregate (MTA and light cured calcium silicate (TheraCal in primary molars over a period of 6 months. Materials and Methods: A clinical trial on IPT on 43 primary molars in 21 patients between the age of 4–7 years, divided into two groups: 22 teeth in MTA group and 21 in TheraCal group. Measurement of the variation in dentin thickness was done on the digitalized radiograph at baseline, 3 months and 6 months using CorelDRAW X3 software. Results: Statistical analysis using an independent t-test for intragroup and intergroup comparison showed a significant increase in dentin thickness in both the MTA and TheraCal group (intragroup comparison [P 0.05. Conclusion: Clinically and radiographically, both MTA and TheraCal are good IPT materials. The better handling characteristics and comparable reparative dentin-forming ability of TheraCal make this material an alternative to MTA in pediatric restorative procedures.

  20. Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis.

    Science.gov (United States)

    Kono, Yutaka; Gen, Hogaku; Sakuma, Yoshio; Koshika, Yasuhide

    2018-04-01

    Retrospective study. In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis. There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF. Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery. There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss ( p X group ( p <0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group ( p <0.001). Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater correction of DH were observed in XLIF.

  1. Once-daily long-acting beta-agonists for chronic obstructive pulmonary disease: an indirect comparison of olodaterol and indacaterol

    Directory of Open Access Journals (Sweden)

    Roskell NS

    2014-07-01

    Full Text Available Neil S Roskell,1 Antonio Anzueto,2 Alan Hamilton,3 Bernd Disse,4 Karin Becker5 1Statistics, Bresmed Health Solutions Ltd, Sheffield, UK; 2School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA; 3Medical Department, Boehringer Ingelheim (Canada Ltd, Burlington, ON, Canada; 4Medical Department, Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany; 5Global Health Economics and Outcomes Research, Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany Purpose: In the absence of head-to-head clinical trials comparing the once-daily, long-acting beta2-agonists olodaterol and indacaterol for the treatment of chronic obstructive pulmonary disease (COPD, an indirect treatment comparison by systematic review and synthesis of the available clinical evidence was conducted. Methods: A systematic literature review of randomized, controlled clinical trials in patients with COPD was performed to evaluate the efficacy and safety of olodaterol and indacaterol. Network meta-analysis and adjusted indirect comparison methods were employed to evaluate treatment efficacy, using outcomes based on trough forced expiratory volume in 1 second (FEV1, Transition Dyspnea Index, St George’s Respiratory Questionnaire total score and response, rescue medication use, and proportion of patients with exacerbations. Results: Eighteen trials were identified for meta-analysis (eight, olodaterol; ten, indacaterol. Olodaterol trials included patients of all severities, whilst indacaterol trials excluded patients with very severe COPD. Concomitant maintenance bronchodilator use was allowed in most olodaterol trials, but not in indacaterol trials. When similarly designed trials/data were analyzed for change from baseline in trough FEV1 (liters, the following mean differences (95% confidence interval were observed: trials excluding concomitant bronchodilator: indacaterol 75 mcg versus olodaterol 5 mcg, –0.005 (–0.077 to 0.067, and indacaterol 150 mcg

  2. Meta-analysis: adjusted indirect comparison of drug-eluting bead transarterial chemoembolization versus 90Y-radioembolization for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Ludwig, Johannes M.; Xing, Minzhi; Zhang, Di; Kim, Hyun S.

    2017-01-01

    To investigate comparative effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) versus Yttrium-90 ( 90 Y)-radioembolization for hepatocellular carcinoma (HCC). Studies comparing conventional (c)TACE versus 90 Y-radioembolization or DEB-TACE for HCC treatment were identified using PubMed/Medline, Embase, and Cochrane databases. The adjusted indirect meta-analytic method for effectiveness comparison of DEB-TACE versus 90 Y-radioembolization was used. Wilcoxon rank-sum test was used to compare baseline characteristics. A priori defined sensitivity analysis of stratified study subgroups was performed for primary outcome analyses. Publication bias was tested by Egger's and Begg's tests. Fourteen studies comparing DEB-TACE or 90 Y-radioembolization with cTACE were included. Analysis revealed a 1-year overall survival benefit for DEB-TACE over 90 Y-radioembolization (79 % vs. 54.8 %; OR: 0.57; 95 %CI: 0.355-0.915; p = 0.02; I-squared: 0 %; p > 0.5), but not for the 2-year (61 % vs. 34 %; OR: 0.65; 95%CI: 0.294-1.437; p = 0.29) and 3-year survival (56.4 % vs. 20.9 %; OR: 0.713; 95 % CI: 0.21-2.548; p = 0.62). There was significant heterogeneity in the 2- and 3-year survival analyses. The pooled median overall survival was longer for DEB-TACE (22.6 vs. 14.7 months). There was no significant difference in tumour response rate. DEB-TACE and 90 Y-radioembolization are efficacious treatments for patients suffering from HCC; DEB-TACE demonstrated survival benefit at 1-year compared to 90 Y-radioembolization but direct comparison is warranted for further evaluation. (orig.)

  3. Meta-analysis: adjusted indirect comparison of drug-eluting bead transarterial chemoembolization versus {sup 90}Y-radioembolization for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, Johannes M.; Xing, Minzhi [Yale School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Zhang, Di [University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA (United States); Kim, Hyun S. [Yale School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Yale School of Medicine, Yale Cancer Center, New Haven, CT (United States)

    2017-05-15

    To investigate comparative effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) versus Yttrium-90 ({sup 90}Y)-radioembolization for hepatocellular carcinoma (HCC). Studies comparing conventional (c)TACE versus {sup 90}Y-radioembolization or DEB-TACE for HCC treatment were identified using PubMed/Medline, Embase, and Cochrane databases. The adjusted indirect meta-analytic method for effectiveness comparison of DEB-TACE versus {sup 90}Y-radioembolization was used. Wilcoxon rank-sum test was used to compare baseline characteristics. A priori defined sensitivity analysis of stratified study subgroups was performed for primary outcome analyses. Publication bias was tested by Egger's and Begg's tests. Fourteen studies comparing DEB-TACE or {sup 90}Y-radioembolization with cTACE were included. Analysis revealed a 1-year overall survival benefit for DEB-TACE over {sup 90}Y-radioembolization (79 % vs. 54.8 %; OR: 0.57; 95 %CI: 0.355-0.915; p = 0.02; I-squared: 0 %; p > 0.5), but not for the 2-year (61 % vs. 34 %; OR: 0.65; 95%CI: 0.294-1.437; p = 0.29) and 3-year survival (56.4 % vs. 20.9 %; OR: 0.713; 95 % CI: 0.21-2.548; p = 0.62). There was significant heterogeneity in the 2- and 3-year survival analyses. The pooled median overall survival was longer for DEB-TACE (22.6 vs. 14.7 months). There was no significant difference in tumour response rate. DEB-TACE and {sup 90}Y-radioembolization are efficacious treatments for patients suffering from HCC; DEB-TACE demonstrated survival benefit at 1-year compared to {sup 90}Y-radioembolization but direct comparison is warranted for further evaluation. (orig.)

  4. A Comparison of Regorafenib and TAS-102 for Metastatic Colorectal Cancer: A Systematic Review and Network Meta-analysis.

    Science.gov (United States)

    Abrahao, Ana B K; Ko, Yoo-Joung; Berry, Scott; Chan, Kelvin K W

    2017-11-21

    Regorafenib and TAS-102 have shown to be superior to placebo in refractory metastatic colorectal cancer. However, no studies have directly compared both drugs. Giving the lack of standard options in this scenario, a systematic review to compare the efficacy and safety of regorafenib and TAS-102 was performed. A systematic review using the PubMed, Medline, Embase, Scopus, and Cochrane databases to identify published and unpublished studies up to November 2015 for randomized controlled trials for patients with metastatic colorectal cancer, involving regorafenib or TAS-102, was performed. Data including overall survival, progression-free survival, and toxicity were extracted. Pairwise direct meta-analyses (regorafenib vs. placebo and TAS-102 vs. placebo) and indirect comparison (regorafenib vs. TAS-102) using network meta-analyses methods to preserve randomization were performed using random effects. Three randomized controlled trials fulfilled eligibility criteria (regorafenib monotherapy for previously treated metastatic colorectal cancer [CORRECT]: an international, multicentre, randomised, pacebo-controlled, phase 3 trial, regorafenib plus best supportive care versus placebo plus best supportive care in Asian patients with previously treated metastatic colorectal cancer [CONCUR]: a randomised, double-blind, placebo-controlled, phase 3 trial, and randomized trial of TAS-102 for refractory metastatic colorectal cancer [RECOURSE] trials) involving 1764 patients (regorafenib, 641; TAS-102, 534; placebo, 589). Subgroups of patients (1659) who had not received prior regorafenib or TAS-102 were used to perform meta-analyses for efficacy. In the indirect comparison, no statistically significant differences were observed between regorafenib and TAS-102 in overall survival (hazard ratio, 0.96; 95% confidence interval [CI], 0.57-1.66; P = .91) or progression-free survival (hazard ratio, 0.85; 95% CI, 0.40-1.81; P = .67). However, regorafenib has statistically more all

  5. Indirect comparison of the antiviral efficacy of peginterferon alpha 2a plus ribavirin used with or without simeprevir in genotype 4 hepatitis C virus infection, where common comparator study arms are lacking: a special application of the matching adjusted indirect comparison methodology.

    Science.gov (United States)

    Van Sanden, Suzy; Pisini, Marta; Duchesne, Inge; Mehnert, Angelika; Belsey, Jonathan

    2016-01-01

    The need to assess relative efficacy in the absence of comparative clinical trials is a problem that is often encountered in economic modeling. The use of matching adjusted indirect comparison (MAIC) in this situation has been suggested. We present the results of a MAIC used to evaluate the incremental benefit offered by adding simeprevir (SMV) to standard therapy in the treatment of patients infected with genotype 4 hepatitis C virus (HCV). Individual patient data for a single arm study evaluating the use of SMV with peginterferon alfa 2a + ribavirin (PR) in genotype 4 HCV were available (RESTORE study). A systematic literature review was used to identify studies of PR alone used in the same patient group. By applying the inclusion criteria for each study in turn to the RESTORE dataset and then applying the published MAIC covariate matching algorithm, a series of pseudosamples from RESTORE were generated. After assessment of the matching outcomes, the best matched comparisons were used to derive estimates of efficacy for SMV + PR in patients equivalent to those participating in the PR trial. Five potential comparator studies were identified. After applying the matching process, two emerged as offering the greatest equivalence with the generated RESTORE pseudosamples and were used to estimate SMV + PR efficacy, expressed as the percentage of patients achieving sustained viral response (SVR). In one comparison, SVR in the SMV + PR group was 85% versus 63% for PR alone. In the second comparison, the corresponding SVRs were 77% and 44% respectively. After matching for varying baseline characteristics, both comparisons of RESTORE versus studies of PR alone yielded a benefit for SMV + PR vs PR alone in genotype 4 HCV-infected patients. The incremental gain in SVR associated with use of SMV ranged from 22% to 33%. In the absence of direct comparative studies, the MAIC gives a better perspective than simple comparison of absolute SVR from individual

  6. Cancer Drugs: An International Comparison of Postlicensing Price Inflation.

    Science.gov (United States)

    Savage, Philip; Mahmoud, Sarah; Patel, Yogin; Kantarjian, Hagop

    2017-06-01

    The cost of cancer drugs forms a rising proportion of health care budgets worldwide. A number of studies have examined international comparisons of initial cost, but there is little work on postlicensing price increases. To examine this, we compared cancer drug prices at initial sale and subsequent price inflation in the United States and United Kingdom and also reviewed relevant price control mechanisms. The 10 top-selling cancer drugs were selected, and their prices at initial launch and in 2015 were compared. Standard nondiscounted prices were obtained from the relevant annual copies of the RED BOOK and the British National Formulary. At initial marketing, prices were on average 42% higher in the United States than in the United Kingdom. After licensing in the United States, all 10 drugs had price rises averaging an overall annual 8.8% (range, 1.4% to 24.1%) increase. In comparison, in the United Kingdom, six drugs had unchanged prices, two had decreased prices, and two had modest price increases. The overall annual increase in the United Kingdom was 0.24%. Cancer drug prices are rising substantially, both at their initial marketing price and, in the United States, at postlicensing prices. In the United Kingdom, the Pharmaceutical Price Regulation Scheme, an agreement between the government and the pharmaceutical industry, controls health care costs while allowing a return on investment and funds for research. The increasing costs of cancer drugs are approaching the limits of sustainability, and a similar government-industry agreement may allow stability for both health care provision and the pharmaceutical industry in the United States.

  7. Efficacy of bendamustine and rituximab as first salvage treatment in chronic lymphocytic leukemia and indirect comparison with ibrutinib: a GIMEMA, ERIC and UK CLL FORUM study.

    Science.gov (United States)

    Cuneo, Antonio; Follows, George; Rigolin, Gian Matteo; Piciocchi, Alfonso; Tedeschi, Alessandra; Trentin, Livio; Medina Perez, Angeles; Coscia, Marta; Laurenti, Luca; Musuraca, Gerardo; Farina, Lucia; Rivas Delgado, Alfredo; Orlandi, Ester Maria; Galieni, Piero; Mauro, Francesca Romana; Visco, Carlo; Amendola, Angela; Billio, Atto; Marasca, Roberto; Chiarenza, Annalisa; Meneghini, Vittorio; Ilariucci, Fiorella; Marchetti, Monia; Molica, Stefano; Re, Francesca; Gaidano, Gianluca; Gonzalez, Marcos; Forconi, Francesco; Ciolli, Stefania; Cortelezzi, Agostino; Montillo, Marco; Smolej, Lukas; Schuh, Anna; Eyre, Toby A; Kennedy, Ben; Bowles, Kris M; Vignetti, Marco; de la Serna, Javier; Moreno, Carol; Foà, Robin; Ghia, Paolo

    2018-04-19

    We performed an observational study on the efficacy of bendamustine and rituximab as first salvage regimen in chronic lymphocytic leukemia. In an intention-to-treat analysis including 237 patients, the median progression free survival was 25 months. The presence of del(17p), unmutated IGHV and advanced stage were associated with a shorter progression free survival at multivariate analysis. The median time-to-next treatment was 31.3 months. Front-line treatment with a chemoimmunotherapy regimen was the only predictive factor for a shorter time to next treatment at multivariate analysis. The median overall survival was 74.5 months. Advanced Binet stage (i.e. III-IV or C) and resistant disease were the only parameters significantly associated with a shorter OS. Grade 3-5 infections were recorded in 6.3% of patients. A matched-adjusted indirect comparison with ibrutinib given second-line within named patient programs in the United Kingdom and in Italy was carried out with overall survival as objective endpoint. When restricting the analysis to patients with intact 17p who had received chemoimmunotherapy in first line, the overall survival did not differ between patients treated with ibrutinib (63% alive at 36 months) and patients treated with BR (74.4% alive at 36 months). BR is an efficacious first salvage regimen in chronic lymphocytic leukemia in a real-life population, including the elderly and unfit patients. BR and ibrutinib may be equally effective in terms of overall survival when used as first salvage treatment in patients without 17p deletion. ClinicalTrials.gov identifier: NCT02491398. Copyright © 2018, Ferrata Storti Foundation.

  8. Effects of Statin Treatment on Inflammation and Cardiac Function in Heart Failure: An Adjusted Indirect Comparison Meta-Analysis of Randomized Trials.

    Science.gov (United States)

    Bonsu, Kwadwo Osei; Reidpath, Daniel Diamond; Kadirvelu, Amudha

    2015-12-01

    Statins are known to prevent heart failure (HF). However, it is unclear whether statins as class or type (lipophilic or hydrophilic) improve outcomes of established HF. The current meta-analysis was performed to compare the treatment effects of lipophilic and hydrophilic statins on inflammation and cardiac function in HF. Outcomes were indicators of cardiac function [changes in left ventricular ejection fraction (LVEF) and B-type natriuretic peptide (BNP)] and inflammation [changes in highly sensitive C-reactive protein (hsCRP) and interluekin-6 (IL-6)]. We conducted a search of PubMed, EMBASE, and the Cochrane databases until December 31, 2014 for randomized control trials (RCTs) of statin versus placebo in patients with HF. RCTs with their respective extracted information were dichotomized into statin type evaluated and analyzed separately. Outcomes were pooled with random effect approach, producing standardized mean differences (SMD) for each statin type. Using these pooled estimates, we performed adjusted indirect comparisons for each outcome. Data from 6214 patients from 19 trials were analyzed. Lipophilic statin was superior to hydrophilic statin treatment regarding follow-up LVEF (SMD, 4.54; 95% CI, 4.16-4.91; P statin produces greater treatment effects on cardiac function and inflammation compared with hydrophilic statin in patients with HF. Until data from adequately powered head-to-head trial of the statin types are available, our meta-analysis brings clinicians and researchers a step closer to the quest on which statin--lipophilic or hydrophilic--is associated with better outcomes in HF. © 2015 John Wiley & Sons Ltd.

  9. Comparison of antibody titer against the infectious bursal disease virus following the disease with that obtained from live intermediate vaccines using indirect hemagglutination (IHA test in broiler chicks

    Directory of Open Access Journals (Sweden)

    A Feizi

    2009-02-01

    Full Text Available In this study, antibody titer obtained from the outbreak of the infection bursal disease (IBD was compared with the titer obtained from live intermediate vaccines by indirect haemagglutination (IHA test in broiler chicks. A total of 450 one day old Cobb chicks were divided into 3 groups each containing 150 chicks and were kept for 42 days in the same rearing conditions. Chicks in groups 1 and 2 received Bursin-2 and D-78 vaccines respectively via drinking water n days 14 and 21. The rest of the chicks were kept as the controls (group 4 and did not receive any vaccine against the IBD. Serum samples were collected from all birds 2 weeks after the second IBD vaccination. Additional 150 serum samples were also collected from 3 broiler flocks that were affected by IBD and had a history of vaccination by the previously mentioned method, two weeks after the last clinical sings were observed (group 3. Antibody titer of the samples against the IBD virus were determined by the IHA test and the results were evaluated using ANOVA and SPSS software. The mean antibody titer obtained from Bursin-2 and D-78 vaccines were 3.19 and 3.21 respectively which is less than the titer of 6 needed for protection against the disease. The antibody titer in affected flocks was 7.19. comparison of the mean titer of the two vaccines did not show any significant difference but there was significant difference between the titer obtained from each vaccine and that of the effected flock (p

  10. VAGINAL PROGESTERONE VERSUS CERVICAL CERCLAGE FOR THE PREVENTION OF PRETERM BIRTH IN WOMEN WITH A SONOGRAPHIC SHORT CERVIX, SINGLETON GESTATION, AND PREVIOUS PRETERM BIRTH: A SYSTEMATIC REVIEW AND INDIRECT COMPARISON META-ANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustin; ROMERO, Roberto; NICOLAIDES, Kypros; CHAIWORAPONGSA, Tinnakorn; O'BRIEN, John M.; CETINGOZ, Elcin; DA FONSECA, Eduardo; CREASY, George; SOMA-PILLAY, Priya; FUSEY, Shalini; CAM, Cetin; ALFIREVIC, Zarko; HASSAN, Sonia S.

    2012-01-01

    OBJECTIVE No randomized controlled trial has directly compared vaginal progesterone and cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone versus cerclage, using placebo/no cerclage as the common comparator. STUDY DESIGN Adjusted indirect meta-analysis of randomized controlled trials. RESULTS Four studies evaluating vaginal progesterone versus placebo (158 patients) and five evaluating cerclage versus no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect meta-analyses did not show statistically significant differences between vaginal progesterone and cerclage in reducing preterm birth or adverse perinatal outcomes. CONCLUSION Based on state-of-the-art methodology for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous preterm birth. The selection of the optimal treatment may depend upon adverse events, cost and patient/clinician preferences. PMID:23157855

  11. A comparison of titers of anti-Brucella antibodies of naturally infected and healthy vaccinated cattle by standard tube agglutination test, microtiter plate agglutination test, indirect hemagglutination assay, and indirect enzyme-linked immunosorbent assay

    Directory of Open Access Journals (Sweden)

    Anju Mohan

    2016-07-01

    Full Text Available Aim: We determined the antibody response in cattle naturally infected with brucellosis and normal healthy adult cattle vaccinated during calf hood with strain 19. Materials and Methods: The antibody titers were measured by standard tube agglutination test (STAT, microtiter plate agglutination test (MAT, indirect hemagglutination assay (IHA, and indirect enzyme-linked immunosorbent assay (iELISA as per standard protocols. Results: The mean STAT titers were 1.963±0.345 in infected cattle and 1.200±0.155 in healthy vaccinated cattle. The difference was extremely significant (p<0.0001. The mean MAT titers were 2.244±0.727 in infected cattle and 1.200±0.155 in healthy vaccinated cattle. The difference was very significant (p<0.005. The mean IHA titers in infected cattle were 2.284±0.574, and those in healthy vaccinated cattle were 1.200±0.155. The difference was extremely significant (p=0.0002. However, the difference in mean iELISA titers of infected cattle (1.3678±0.014 and healthy vaccinated cattle (1.367±0.014 was non-significant. The infected animals showed very high titers of agglutinating antibodies compared to the vaccinated animals. However, it cannot be ascertained whether these antibodies are due to vaccine or response to infection. Since the infected animals had been vaccinated earlier, the current infection may suggest that vaccination was unable to induce protective levels of antibody. The heightened antibody response after infection may also indicate a secondary immune response to the antigens common to the vaccine strain and wild Brucella organisms. Conclusion: The brucellosis infected animals showed very high titers of agglutinating antibodies compared to the vaccinated animals.

  12. [Comparison of the Pressure on the Larynx and Tongue Using McGRATH® MAC Video Laryngoscope--Direct Vision versus Indirect Vision].

    Science.gov (United States)

    Tanaka, Yasutomo; Miyazaki, Yukiko; Kitakata, Hidenori; Shibuya, Hiromi; Okada, Toshiki

    2015-12-01

    Studies show that McGRATH® MAC (McG) is useful during direct laryngoscopy. However, no study has examined whether McG re- duces pressure on the upper airway tract We compared direct vision with indirect vision concerning pressure on the larynx and tongue. Twenty two anesthesiologists and 16 junior residents attempted direct laryngoscopy of airway management simulator using McG with direct vision and indirect vision. Pressure was measured using pressure measurement film. In anesthesiologists group, pressure on larynx was 14.8 ± 2.7 kgf · cm(-2) with direct vision and 12.7 ± 2.7 kgf · cm(-2) with indirect vision (P vision and 7.6 ± 2.8 kgf · cm(-2) with indirect vision (P = 0.18). In junior residents group, pressure on larynx was 19.0 ± 1.3 kgf · cm(-2) with direct vision and 14.1 ± 3.1 kgf · cm(-2) with indirect vision (P vision and 11.2 ± 4.7 kgf · cm(-2) with indirect vision (P vision can reduce pressure on the upper airway tract.

  13. Thermoacoustic imaging of prostate cancer: comparison to histology

    Science.gov (United States)

    Patch, S. K.; Griep, S. K.; Jacobsohn, K.; See, W. A.; Hull, D.

    2014-03-01

    Ex vivo imaging of fresh prostate specimens was performed to test the hypothesis that the thermoacoustic (TA) contrast mechanism generated with very high frequency electromagnetic (EM) irradiation is sensitive to prostate cancer. Ex vivo imaging was performed immediately after radical prostatectomy, performed as part of normal care. Irradiation pulsewidth was 700 ns and duty cycle was extremely low. Typical specific absorption rate (SAR) throughout the prostate was 70-90 kW/kg during pulsing, but time-averaged SAR was below 2 W/kg. TA pressure pulses generated by rapid heating due to EM energy deposition were detected using single element transducers. 15g/L glycine powder mixed into DI water served as acoustic couplant, which was chilled to prevent autolysis. Spatial encoding was performed by scanning in tomographic "step-and-shoot" mode, with 3 mm translation between slices and 1.8-degree rotation between tomographic views. Histology slides for 3 cases scanned with 2.25 MHz transducers were marked for comparison to TA reconstructions. These three cases showed little, moderate, and severe involvement in the histology levels surrounding the verumontanum. TA signal strength decreased with percent cancerous involvement. When VHF is used for tissue heating, the TA contrast mechanism is driven by ionic content and we observed suppressed TA signal from diseased prostate tissue in the peripheral zone. For the 45 regions of interest analyzed, a reconstruction value of 0.4 mV provides 100% sensitivity but only 29% specificity.

  14. Follow-up effects of social comparison information on the quality of life of cancer patients : The moderating role of social comparison orientation

    NARCIS (Netherlands)

    Buunk, Abraham P.; Bennenbroek, Femke T. C.; Stiegelis, Heidi E.; van den Bergh, Alfons C. M.; Sanderman, Robbert; Hagedoorn, Mariet

    2012-01-01

    Objective: To examine how social comparison orientation (SCO) moderates the effects of three types of social comparison information on the global quality of life of cancer patients 2 weeks and 3 months later. Design: Cancer patients (n=226) were provided with social comparison information just prior

  15. Follow-up effects of social comparison information on the quality of life of cancer patients: The moderating role of social comparison orientation

    NARCIS (Netherlands)

    Buunk, A.P.; Bennenbroek, F.T.C.; Stiegelis, H.E.; Bergh, A.C.M. van den; Sanderman, R.; Hagedoorn, M.

    2012-01-01

    Objective: To examine how social comparison orientation (SCO) moderates the effects of three types of social comparison information on the global quality of life of cancer patients 2 weeks and 3 months later. Design: Cancer patients (n = 226) were provided with social comparison information just

  16. Indirection and computer security.

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Michael J.

    2011-09-01

    The discipline of computer science is built on indirection. David Wheeler famously said, 'All problems in computer science can be solved by another layer of indirection. But that usually will create another problem'. We propose that every computer security vulnerability is yet another problem created by the indirections in system designs and that focusing on the indirections involved is a better way to design, evaluate, and compare security solutions. We are not proposing that indirection be avoided when solving problems, but that understanding the relationships between indirections and vulnerabilities is key to securing computer systems. Using this perspective, we analyze common vulnerabilities that plague our computer systems, consider the effectiveness of currently available security solutions, and propose several new security solutions.

  17. The comparison between presenting symptoms of ovarian cancer ...

    African Journals Online (AJOL)

    The sensation of abdominal mass was more common in women with ovarian cancer than other abdominalpelvic cancers (P=0.00l). Constipation was documented in the patients with colon cancer more than women with ovarian cancer (P=0.012), whereas urinary symptoms were more common in patients with ovarian ...

  18. Heavy Reliance on the Indirect Financing as Sources of Funds for Business Firms in Japan: As a Comparison for Indonesian Financial Crisis

    Directory of Open Access Journals (Sweden)

    Yulius Yulius

    2001-09-01

    Full Text Available The purpose of this article is to study the implication of financial liberalization to the heavy reliance of firms to the indirect finance in Japanese experience. In order to analyze the goal of this article, we start to examine the causes of the main bank system in Japan before and the pre-war period. Then, this article discusses the impacts of financial liberalization to the to the heavy reliance on the indirect-financing for business firms in the light with Japan’s financial market, particularly the main bank system. Finally, this article also discusses the implication of loose relationship of big firms and major banks (main bank system to the recent financial condition in starting from the early of 1990s until now. This article discovered that financial liberalization, which started at the latter half of 1970s, has shaken the foundation of the main bank system. The major firms started to less dependent on the major banks and they issued the securities in domestic and international market. As a consequence, the SMBS still depend on the banks as their source of indirect financing. However, the competitiveness in the SMBS market turned to erode the bank profits that induced them to enter the risk activities, such as real estate. In addition, the bubble burst economy also triggered the boom in real estate. Naturally, as a nature of risk asset, loan to the real estate became the potential of bad loans that also was exacerbated the bubble burst in economy. Then, the financial crisis has revealed in 1990s.

  19. Endorectal 3D T2-weighted 1 mm-slice thickness MRI for prostate cancer staging at 1.5 Tesla: Should we reconsider the indirects signs of extracapsular extension according to the D’Amico tumor risk criteria?

    International Nuclear Information System (INIS)

    Cornud, F.; Rouanne, M.; Beuvon, F.; Eiss, D.; Flam, T.; Liberatore, M.; Zerbib, M.; Delongchamps, N.B.

    2012-01-01

    Purpose: To evaluate the accuracy of a 3D-endorectal 1 mm-thick slices MRI acquisition for local staging of low, intermediate and high D’Amico risk prostate cancer (PCa). Materials and methods: 178 consecutive patients underwent a multiparametric MRI protocol prior to radical prostatectomy (RP). T2W images were acquired with the 3D sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) sequence (5 mn acquisition time). Direct and indirect MRI signs of extracapsular extension (ECE) were evaluated to predict the pT stage. The likelihood of SVI (seminal vesicle invasion) was also assessed. Results: Histology showed ECE and SVI in 38 (21%) and 12 (7%) cases, respectively. MRI sensitivity and specificity to detect ECE were 55 and 96% if direct signs of ECE were used and 84 and 89% (p < 0.05), if both direct and indirect signs were combined. D’Amico criteria did not influence MRI performance. Sensitivity and specificity for SVI detection were 83% and 99%. Conclusions: 3D data sets acquired with the SPACE sequence provides a high accuracy for local staging of prostate cancer. The use of indirect signs of ECE may be recommended in low D’Amico risk tumors to optimise patient selection for active surveillance or focal therapy.

  20. Comparison of electron microscopy, enzyme-linked immunosorbent assay, solid-phase radioimmunoassay, and indirect immunofluorescence for detection of human rotavirus antigen in faeces

    Energy Technology Data Exchange (ETDEWEB)

    Birch, C J; Lehmann, N I; Hawker, A J; Marshall, J A; Gust, I D [Fairfield Hospital for Communicable Diseases, Victoria (Australia). Virology Dept.

    1979-07-01

    Four techniques were compared for their practicability, speed, and sensitivity for the detection of human rotavirus. Radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) were found to be the most sensitive means of identifying rotavirus and, once processed, up to 40 specimens could be examined daily. Electron microscopy, although less sensitive than these techniques, had the advantage of being able to detect other viral agents present in faecal extracts. Indirect immunofluorescence failed to detect rotavirus as often as the other three methods. In laboratories where routine examination of faecal specimens from patients with gastroenteritis is required, ELISA and RIA are useful alternatives to electron microscopy.

  1. Comparison of electron microscopy, enzyme-linked immunosorbent assay, solid-phase radioimmunoassay, and indirect immunofluorescence for detection of human rotavirus antigen in faeces

    International Nuclear Information System (INIS)

    Birch, C.J.; Lehmann, N.I.; Hawker, A.J.; Marshall, J.A.; Gust, I.D.

    1979-01-01

    Four techniques were compared for their practicability, speed, and sensitivity for the detection of human rotavirus. Radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) were found to be the most sensitive means of identifying rotavirus and, once processed, up to 40 specimens could be examined daily. Electron microscopy, although less sensitive than these techniques, had the advantage of being able to detect other viral agents present in faecal extracts. Indirect immunofluorescence failed to detect rotavirus as often as the other three methods. In laboratories where routine examination of faecal specimens from patients with gastroenteritis is required, ELISA and RIA are useful alternatives to electron microscopy. (author)

  2. Comparison of colorectal and gastric cancer: Survival and prognostic factors

    International Nuclear Information System (INIS)

    Moghimi-Dehkordi, Bijan; Safaee, Azadeh; Zali, Mohammad R

    2009-01-01

    Gastric and colorectal cancers are the most common gastrointestinal malignancies in Iran. We aim to compare the survival rates and prognostic factors between these two cancers. We studied 1873 patients with either gastric or colorectal cancer who were registered in one referral cancer registry center in Tehran, Iran. All patients were followed from their time of diagnosis until December 2006 (as failure time). Survival curves were calculated according to the Kaplan-Meier Method and compared by the Log-rank test. Multivariate analysis of prognostic factors was carried out using the Cox proportional hazard model. Of 1873 patients, there were 746 with gastric cancer and 1138 with colorectal cancer. According to the Kaplan-Meier method 1, 3, 5, and 7-year survival rates were 71.2, 37.8, 25.3, and 19.5%, respectively, in gastric cancer patients and 91.1, 73.1, 61, and 54.9%, respectively, in patients with colorectal cancer. Also, univariate analysis showed that age at diagnosis, sex, grade of tumor, and distant metastasis were of prognostic significance in both cancers ( P < 0.0001). However, in multivariate analysis, only distant metastasis in colorectal cancer and age at diagnosis, grade of tumor, and distant metastasis in colorectal cancer were identified as independent prognostic factors influencing survival. According to our findings, survival is significantly related to histological differentiation of tumor and distant metastasis in colorectal cancer patients and only to distant metastasis in gastric cancer patients. (author)

  3. Comparison of various models on cancer rate and forecasting ...

    African Journals Online (AJOL)

    ADOWIE PERE

    model and the quadratic trend model and the results of the work compared. Data collected ... Keywords: Cancer, Tumor, Leukemia, Linear Regression, Mean Percentage Error. Cancer is a .... by a simple mathematical method. The quadratic ...

  4. The big five and identification-contrast processes in social comparison in adjustment to cancer treatment

    NARCIS (Netherlands)

    van der Zee, KI; Buunk, BP; Sanderman, R; Botke, G; van den Bergh, F

    1999-01-01

    The present study examined the relationship between social comparison processes and the Big Five personality factors. In a sample of 112 patients with various forms of cancer it was found that Neuroticism was associated with a tendency to focus on the negative interpretation of social comparison

  5. Technical Note: Comparison between a direct and the standard, indirect method for dissolved organic nitrogen determination in freshwater environments with high dissolved inorganic nitrogen concentrations

    DEFF Research Database (Denmark)

    Graeber, Daniel; Gelbrecht, Jörg; Kronvang, Brian

    2012-01-01

    Research on dissolved organic nitrogen (DON) in aquatic systems with high dissolved inorganic nitrogen (DIN, the sum of NO3–, NO2– and NH4+) concentrations is often hampered by high uncertainties regarding the determined DON concentration. The reason is that DON is determined indirectly...... accuracy at high DIN : TDN ratios, we investigated the DON measurement accuracy of this standard approach according to the DIN : TDN ratio and compared it to the direct measurement of DON by size-exclusion chromatography (SEC) for freshwater systems. For this, we used standard compounds and natural samples...... separation of DON from DIN. For SEC, DON recovery rates were 91–108% for five pure standard compounds and 89–103% for two standard compounds, enriched with DIN. Moreover, SEC resulted in 93–108% recovery rates for DON concentrations of natural samples at a DIN : TDN ratio of 0.8 and the technique...

  6. Comparison of indirect hemagglutination and 51Chromium release tests for detection of herpes simplex virus types 1 and 2 antibodies in patients with recurrent herpes infections

    International Nuclear Information System (INIS)

    Kesavalu, L.; Seth, P.

    1980-01-01

    Indirect hemagglutination and 51 Cr release tests (IHAT and 51-CRT respectively) were compared in patients with recurrent herpes simplex virus (HSV) infections from whom HSV-1 or HSV-2 was isolated. Both tests were equally sensitive and specific in detecting HSV antibodies. However, IHAT was more specific in detecting homologous HSV antibody response in patients with recurrent HSV-2 infections. Past infections with HSV-1 in the patients with dual infections were detected by determining HSV-type specific antibodies by inhibition of IHAT. Cross absorption studies showed that the antibody reactivity measured by the two tests was qualitatively and quantitatively different. Nevertheless, IHAT has been found to be more appropriate test for seroepidemiologic studies of HSV-2 infections because of its specificity, rapidity and less cost, whereas, 51-CRT appears to measure antibodies against recent and more predominant type of infecting HSV. (Author)

  7. Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays.

    Science.gov (United States)

    Gornowicz-Porowska, Justyna; Seraszek-Jaros, Agnieszka; Bowszyc-Dmochowska, Monika; Kaczmarek, Elżbieta; Pietkiewicz, Paweł; Bartkiewicz, Paweł; Dmochowski, Marian

    2017-02-01

    Pemphigus and bullous pemphigoid (BP) are identified by autoantibodies (abs) against desmoglein 1, 3 (DSG1/3) and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF) using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection) and modified (IgG4 detection) mosaic for indirect immunofluorescence (IIFc - IIF commercial, IIFm - IIF modified) and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP) molecular diagnostics. To compare diagnostic accuracy of commercial (IgG detection) and modified (IgG4 detection) mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP. Sera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher's exact test. There are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1)/desmoglein3 (DSG3)/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc. The IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.

  8. Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays

    Directory of Open Access Journals (Sweden)

    Justyna Gornowicz-Porowska

    2017-02-01

    Full Text Available Introduction : Pemphigus and bullous pemphigoid (BP are identified by autoantibodies (abs against desmoglein 1, 3 (DSG1/3 and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection and modified (IgG4 detection mosaic for indirect immunofluorescence (IIFc – IIF commercial, IIFm – IIF modified and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP molecular diagnostics. Aim : To compare diagnostic accuracy of commercial (IgG detection and modified (IgG4 detection mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP. Material and methods : Sera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher’s exact test. Results: There are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1/desmoglein3 (DSG3/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc. Conclusions : The IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.

  9. Treatment-completion rates with olanzapine long-acting injection versus risperidone long-acting injection in a 12-month, open-label treatment of schizophrenia: indirect, exploratory comparisons

    Directory of Open Access Journals (Sweden)

    Ascher-Svanum H

    2012-05-01

    Full Text Available Haya Ascher-Svanum1, William S Montgomery2, David P McDonnell3, Kristina A Coleman4, Peter D Feldman11Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly Australia Pty Ltd, West Ryde, New South Wales, Australia; 3Eli Lilly and Company, Cork, Ireland; 4OptumInsight, Lilyfield, New South Wales, AustraliaBackground: Little is known about the comparative effectiveness of atypical antipsychotics in long-acting injection formulation. Due to the absence of head-to-head studies comparing olanzapine long-acting injection and risperidone long-acting injection, this study was intended to make exploratory, indirect, cross-study comparisons between the long-acting formulations of these two atypical antipsychotics in their effectiveness in treating patients with schizophrenia.Methods: Indirect, cross-study comparisons between olanzapine long-acting injection and risperidone long-acting injection used 12-month treatment-completion rates, because discontinuation of an antipsychotic for any cause is a recognized proxy measure of the medication's effectiveness in treating schizophrenia. Following a systematic review of the literature, two indirect comparisons were conducted using open-label, single-cohort studies in which subjects were stabilized on an antipsychotic medication before depot initiation. The first analysis compared olanzapine long-acting injection (one study with pooled data from nine identified risperidone long-acting injection studies. The second analysis was a “sensitivity analysis,” using only the most similar studies, one for olanzapine long-acting injection and one for risperidone long-acting injection, which shared near-identical study designs and involved study cohorts with near-identical patient characteristics. Pearson Chi-square tests assessed group differences on treatment-completion rates.Results: Comparison of olanzapine long-acting injection data (931 patients with the pooled data from the nine

  10. Mechanism and comparison of needle-type non-thermal direct and indirect atmospheric pressure plasma jets on the degradation of dyes

    Science.gov (United States)

    Attri, Pankaj; Yusupov, Maksudbek; Park, Ji Hoon; Lingamdinne, Lakshmi Prasanna; Koduru, Janardhan Reddy; Shiratani, Masaharu; Choi, Eun Ha; Bogaerts, Annemie

    2016-10-01

    Purified water supply for human use, agriculture and industry is the major global priority nowadays. The advanced oxidation process based on atmospheric pressure non-thermal plasma (NTP) has been used for purification of wastewater, although the underlying mechanisms of degradation of organic pollutants are still unknown. In this study we employ two needle-type atmospheric pressure non-thermal plasma jets, i.e., indirect (ID-APPJ) and direct (D-APPJ) jets operating at Ar feed gas, for the treatment of methylene blue, methyl orange and congo red dyes, for two different times (i.e., 20 min and 30 min). Specifically, we study the decolorization/degradation of all three dyes using the above mentioned plasma sources, by means of UV-Vis spectroscopy, HPLC and a density meter. We also employ mass spectroscopy to verify whether only decolorization or also degradation takes place after treatment of the dyes by the NTP jets. Additionally, we analyze the interaction of OH radicals with all three dyes using reactive molecular dynamics simulations, based on the density functional-tight binding method. This investigation represents the first report on the degradation of these three different dyes by two types of NTP setups, analyzed by various methods, and based on both experimental and computational studies.

  11. Approximation of Resting Energy Expenditure in Intensive Care Unit Patients Using the SenseWear Bracelet: A Comparison With Indirect Calorimetry.

    Science.gov (United States)

    Sundström, Martin; Mehrabi, Mahboubeh; Tjäder, Inga; Rooyackers, Olav; Hammarqvist, Folke

    2017-08-01

    Indirect calorimetry (IC) is the gold standard for determining energy expenditure in patients requiring mechanical ventilation. Metabolic armbands using data derived from dermal measurements have been proposed as an alternative to IC in healthy subjects, but their utility during critical illness is unclear. The aim of this study was to determine the level of agreement between the SenseWear armband and the Deltatrac Metabolic Monitor in mechanically ventilated intensive care unit (ICU) patients. Adult ICU patients requiring invasive ventilator therapy were eligible for inclusion. Simultaneous measurements were performed with the SenseWear Armband and Deltatrac under stable conditions. Resting energy expenditure (REE) values were registered for both instruments and compared with Bland-Altman plots. Forty-two measurements were performed in 30 patients. The SenseWear Armband measured significantly higher REE values as compared with IC (mean bias, 85 kcal/24 h; P = .027). Less variability was noted between individual SenseWear measurements and REE as predicted by the Harris-Benedict equation (2 SD, ±327 kcal/24 h) than when IC was compared with SenseWear and Harris-Benedict (2 SD, ±473 and ±543 kcal/24 h, respectively). The systematic bias and large variability of the SenseWear armband when compared with gas exchange measurements confer limited benefits over the Harris Benedict equation in determining caloric requirements of ICU patients.

  12. Comparison of Rose Bengal Plate Agglutination, Standard tube agglutination and Indirect ELISA tests for detection of Brucella antibodies in Cows and Buffaloes

    Directory of Open Access Journals (Sweden)

    S. N. Ghodasara

    2010-04-01

    Full Text Available A total of 180 serum samples (107 cows, 73 buffaloes from cases of abortion and various reproductive disorders were collected for detection of Brucella antibody by Rose Bengal Plate Agglutination Test (RBPT, Serum Tube Agglutination Test (STAT and indirect- ELISA (i-ELISA. The overall prevalence of brucellosis by RBPT, STAT and i-ELISA were 11.21%, 16.00% and 24.30% in cows 9.59%, 12.33% and 26.03% in buffaloes respectively. Overall seroprevalence of Brucellosis in cases of abortion, R.O.P. by RBPT, STAT and i-ELISA were 11.32%, 16.04% and 32.08% respectively. When three serological tests were compared, seropositivity was found highest by i-ELISA (25%, followed by STAT (14.45% and RBPT (10.56%. The results shows higher prevalence of brucellosis in cases of abortion and R.O.P., while at lower level from various reproductive disorders as detected serologically indicating endemicity of the infection in villages around Anand city, Gujarat. [Vet. World 2010; 3(2.000: 61-64

  13. Detection of Candida albicans Sap2 in cancer patient serum samples by an indirect competitive enzyme-linked immunosorbent assay for the diagnosis of candidiasis

    OpenAIRE

    Yicun Wang; Xiang Gao; J U Zhi gang; Jingyuan Liu; Shuai Dong; Li Wang

    2013-01-01

    Background: The secreted aspartyl proteinases 2 (Sap2) of Candida albicans (C. albicans) is a potential marker of candididasis. It is a virulence factor associated with adherence and tissue invasion. Aim: In order to detect Sap2 in clinical sera, we developed an indirect competitive enzyme-linked immunosorbent assay (ELISA). Materials and Methods: Polyclonal antibodies were produced for Sap2 by injecting Sap2 into a New Zealand White inbred rabbit. They could be used at a dilution exceeding 1...

  14. The Impact of Adjustment for Socioeconomic Status on Comparisons of Cancer Incidence between Two European Countries

    International Nuclear Information System (INIS)

    Donnelly, D. W.; Gavin, A.; Hegarty, A.

    2013-01-01

    Cancer incidence rates vary considerably between countries and by socioeconomic status (SES). We investigate the impact of SES upon the relative cancer risk in two neighbouring countries. Methods. Data on 229,824 cases for 16 cancers diagnosed in 1995-2007 were extracted from the cancer registries in Northern Ireland (NI) and Republic of Ireland (RoI). Cancers in the two countries were compared using incidence rate ratios (IRRs) adjusted for age and age plus area-based SES. Results. Adjusting for SES in addition to age had a considerable impact on NI/RoI comparisons for cancers strongly related to SES. Before SES adjustment, lung cancer incidence rates were 11% higher for males and 7% higher for females in NI, while after adjustment, the IRR was not statistically significant. Cervical cancer rates were lower in NI than in RoI after adjustment for age (IRR: 0.90 (0.84-0.97)), with this difference increasing after adjustment for SES (IRR: 0.85 (0.79-0.92)). For cancers with a weak or nonexistent relationship to SES, adjustment for SES made little difference to the IRR. Conclusion. Socioeconomic factors explain some international variations but also obscure other crucial differences; thus, adjustment for these factors should not become part of international comparisons.

  15. The Impact of Adjustment for Socioeconomic Status on Comparisons of Cancer Incidence between Two European Countries

    Directory of Open Access Journals (Sweden)

    David W. Donnelly

    2013-01-01

    Full Text Available Background. Cancer incidence rates vary considerably between countries and by socioeconomic status (SES. We investigate the impact of SES upon the relative cancer risk in two neighbouring countries. Methods. Data on 229,824 cases for 16 cancers diagnosed in 1995–2007 were extracted from the cancer registries in Northern Ireland (NI and Republic of Ireland (RoI. Cancers in the two countries were compared using incidence rate ratios (IRRs adjusted for age and age plus area-based SES. Results. Adjusting for SES in addition to age had a considerable impact on NI/RoI comparisons for cancers strongly related to SES. Before SES adjustment, lung cancer incidence rates were 11% higher for males and 7% higher for females in NI, while after adjustment, the IRR was not statistically significant. Cervical cancer rates were lower in NI than in RoI after adjustment for age (IRR: 0.90 (0.84–0.97, with this difference increasing after adjustment for SES (IRR: 0.85 (0.79–0.92. For cancers with a weak or nonexistent relationship to SES, adjustment for SES made little difference to the IRR. Conclusion. Socioeconomic factors explain some international variations but also obscure other crucial differences; thus, adjustment for these factors should not become part of international comparisons.

  16. An indirect comparison and cost per responder analysis of adalimumab, methotrexate and apremilast in the treatment of methotrexate-naïve patients with psoriatic arthritis.

    Science.gov (United States)

    Betts, Keith A; Griffith, Jenny; Friedman, Alan; Zhou, Zheng-Yi; Signorovitch, James E; Ganguli, Arijit

    2016-01-01

    Apremilast was recently approved for the treatment of active psoriatic arthritis (PsA). However, no studies compare apremilast with methotrexate or biologic therapies, so its relative comparative efficacy remains unknown. This study compared the response rates and incremental costs per responder associated with methotrexate, apremilast, and biologics for the treatment of active PsA. A systematic literature review was performed to identify phase 3 randomized controlled clinical trials of approved biologics, methotrexate, and apremilast in the methotrexate-naïve PsA population. Using Bayesian methods, a network meta-analysis was conducted to indirectly compare rates of achieving a ≥20% improvement in American College of Rheumatology component scores (ACR20). The number needed to treat (NNT) and the incremental costs per ACR20 responder (2014 US$) relative to placebo were estimated for each of the therapies. Three trials (MIPA for methotrexate, PALACE-4 for apremilast, and ADEPT for adalimumab) met all inclusion criteria. The NNTs relative to placebo were 2.63 for adalimumab, 6.69 for apremilast, and 8.31 for methotrexate. Among methotrexate-naïve PsA patients, the 16 week incremental costs per ACR20 responder were $3622 for methotrexate, $26,316 for adalimumab, and $45,808 for apremilast. The incremental costs per ACR20 responder were $222,488 for apremilast vs. methotrexate. Among methotrexate-naive PsA patients, adalimumab was found to have the lowest NNT for one additional ACR20 response and methotrexate was found to have the lowest incremental costs per ACR20 responder. There was no statistical evidence of greater efficacy for apremilast vs. methotrexate. A head-to-head trial between apremilast and methotrexate is recommended to confirm this finding.

  17. Social comparisons and quality of life following a prostate cancer diagnosis.

    Science.gov (United States)

    Umstead, Kendall L; Kalia, Sarah S; Madeo, Anne C; Erby, Lori H; Blank, Thomas O; Visvanathan, Kala; Roter, Debra L

    2018-02-09

    The objective was to explore the relationships among cognitive appraisals of prostate cancer (challenge, threat, and harm/loss), social comparisons, and quality of life in men previously diagnosed. Design, Sample, & Methods: Men who had participated in prostate cancer support groups completed a cross-sectional questionnaire (N = 189). Multivariable linear regression was used to evaluate social comparisons as mediators of quality of life while controlling for uncertainty and optimism. Positive and negative social comparisons were parallel mediators of the relationships between challenge or threat appraisals and quality of life, while only negative social comparisons mediated the relationship between harm/loss appraisals and quality of life. These findings demonstrate the importance of social comparisons in accounting for the effect of cognitive appraisals of prostate cancer on quality of life among men in support groups. Implications for Psychosocial Providers: Interventions to improve quality of life could address reduction of maladaptive comparisons, a strategy that could be tailored based on the patient's appraisal of prostate cancer.

  18. Biological characteristics and clinical outcome of triple negative primary breast cancer in older women - comparison with their younger counterparts.

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    Binafsha M Syed

    Full Text Available Triple negative (ER, PgR and HER2 negative breast cancers (TNBCs are often considered as a poor prognostic phenotype. There is dearth of evidence showing the prevalence and biological behaviour of TNBCs in older women. This study aimed to analyse their biological characteristics in comparison with a well characterised younger series from a single centre with long term clinical follow-up. Over 37 years (1973-2010, 1,758 older (≥70 years women with early operable (<5 cm primary breast cancer were managed in a dedicated clinic and have complete clinical information available. Of these 813 patients underwent primary surgery and 575 had good quality tumour samples available for tissue microarray analysis using indirect immunohistochemistry. A total of 127 patients (22.1% had TNBCs and full biological analysis of 15 biomarkers was performed. The results were compared with those of their younger (<70 years counterparts 342 (18.9% from a previously characterised, consecutive series of primary breast cancer treated in the same unit (1986-1998. The 127 older patients with TNBCs showed lower rates of Ki67 and CK 7/8 positivity and high rates of bcl2 and CK18 positivity when compared with their younger counterparts (p<0.05. There was no significant difference in the long term clinical outcome between the two age groups, despite the fact that 47% of the younger patients had adjuvant chemotherapy, while none in the older cohort received such treatment. EGFR, axillary stage and pathological size showed prognostic significance in older women with TNBCs on univariate analysis. Despite not having received adjuvant chemotherapy, the older series had clinical outcome similar to the younger patients almost half of whom had chemotherapy. This appears to be related to other biomarkers (in addition to ER/PgR/HER2 eg Ki67, bcl2 and cytokeratins which have different expression patterns influencing prognosis.

  19. Prognostic value of microscopic peritoneal dissemination: comparison between colon and gastric cancer.

    Science.gov (United States)

    Vogel, P; Rüschoff, J; Kümmel, S; Zirngibl, H; Hofstädter, F; Hohenberger, W; Jauch, K W

    2000-01-01

    We evaluated the incidence and prognostic relevance of microscopic intraperitoneal tumor cell dissemination of colon cancer in comparison with dissemination of gastric cancer as a rational for additive intraperitoneal therapy. Peritoneal washouts of 90 patients with colon and 111 patients with gastric cancer were investigated prospectively. Sixty patients with benign diseases and 8 patients with histologically proven gross visible peritoneal carcinomatosis served as controls. Intraoperatively, 100 ml of warm NaCl 0.9 percent were instilled and 20 ml were reaspirated. In all patients hematoxylin and eosin staining (conventional cytology) was performed. Additionally, in 36 patients with colon cancer and 47 patients with gastric cancer, immunostaining with the HEA-125 antibody (immunocytology) was prepared. The results of cytology were assessed for an association with TNM category and cancer grade, based on all patients, and with patient survival, among the R0 resected patients. In conventional cytology 35.5 percent (32/90) of patients with colon cancer and 42.3 percent (47/111) of patients with gastric cancer had a positive cytology. In immunocytology 47.2 percent (17/36) of patients with colon cancer and 46.8 percent (22/47) of patients with gastric cancer were positive. In colon cancer, positive conventional cytology was associated with pT and M category (P = 0.044 and P = 0.0002), whereas immunocytology was only associated with M category (P = 0.007). No association was found between nodal status and immunocytology in colon cancer and with the grading. There was a statistically significant correlation between pT M category and conventional and immunocytology in gastric cancer (P influences survival time after R0 resections only in patients with gastric but not with colon cancer, our results may provide a basis for a decision on additive, prophylactic (intraperitoneal) therapy in gastric but not colon cancer.

  20. Comparison of lifestyle risk factors by family history for gastric, breast, lung and colorectal cancer.

    Science.gov (United States)

    Huang, Xin-En; Hirose, Kaoru; Wakai, Kenji; Matsuo, Keitaro; Ito, Hidemi; Xiang, Jin; Takezaki, Toshiro; Tajima, Kazuo

    2004-01-01

    To assess the theoretical impact of lifestyle of a cancer family history in first-degree relatives (CFH) and clarify interactions between CFH and lifestyle factors, hospital-based comparison and case-reference studies were conducted in Nagoya, Japan. Totals of 1988 gastric, 2455 breast, 1398 lung and 1352 colorectal cancer patients, as well as 50,706 non-cancer outpatients collected from 1988 to 1998, were checked for lifestyle factors, which included dietary and physical exercise habits, as well as smoking/drinking status. General lifestyle factors with non-cancer outpatients did not differ by the CFH status. Case-reference analyses showed that frequent intake of fruits, raw vegetables, carrots, pumpkin, cabbage and lettuce, as well as frequent physical exercise, were associated with decreased risk for all four sites of cancer, while habitual smoking increasing the risk of gastric, and more particularly, lung cancer. Interestingly, the study revealed the magnitude of odds ratios for the above lifestyle factors obtained from CFH positives to be similar to those from CFH negatives for these four sites of cancer. There were no significant interactions between CFH and any particular lifestyle factor. In conclusion, our results suggest no appreciable influence of CFH on lifestyle related risk factors for gastric, breast, lung, and colorectal cancer. Habitual smoking increased, while frequent physical exercise and raw vegetables intake decreased cancer risk, regardless of the CFH status.

  1. Dying in Palliative Care Units and in Hospital: A Comparison of the Quality of Life of Terminal Cancer Patients.

    Science.gov (United States)

    Viney, Linda L.; And Others

    1994-01-01

    Compared quality of life of terminal cancer patients (n=182) in two palliative care units with that of those in general hospital. Patients in specialized palliative care units were found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less…

  2. Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups.

    Science.gov (United States)

    Cohen, Miri

    2014-02-01

    Previous studies have reported that older cancer patients experience lower psychological distress than younger patients, but most prior studies do not differentiate between age groups within the 'older' category. The aim of this study was to assess the intensity of the symptoms of depression, anxiety, and somatic symptoms among different age groups of older cancer patients. Participants were composed of 321 cancer patients 60 years and older, who were divided into three age groups: 60-69, 70-79, and 80+ years. The participants answered the Brief Symptom Inventory-18, which included subscales for depression, anxiety, and somatic symptoms and the cancer-related problem list, in addition to providing personal and cancer-related details. Depressive, anxiety, and somatic symptoms and cancer-related problems were lowest in the 70-79 years age group and highest in the 80+ years age group. Comparisons between pairs of groups showed significant differences between each of the groups in Brief Symptom Inventory total scores and between the 80+ years age group and the other two groups in regard to depressive symptoms and cancer-related problems. Differences, related to anxiety and somatic symptoms, were significant for the 70-79 year olds, in comparison with the youngest and oldest groups. Intensity of symptoms was explained by older age, higher number of cancer-related problems, female gender, and lower income. Nonlinear relations exist between age and psychological symptoms, which is in line with the postponement of age-related health and functional decline in the modern era. These results suggest that the study of psychological reactions to cancer should examine differences between age groups among older cancer patients. Copyright © 2013 John Wiley & Sons, Ltd.

  3. Cost-Effectiveness Comparison of Breast Cancer Screening and Vascular Event Primary Prevention with Aspirin in Wales

    Science.gov (United States)

    Morgan, Gareth

    2011-01-01

    Aim: For the first time, this article presents a cost-effectiveness comparison of a breast cancer screening programme with a possible health education programme with aspirin for vascular event primary prevention. Background: Breast cancer screening is a well established part of cancer control programmes yet recent evidence on this intervention has…

  4. Model Comparison for Breast Cancer Prognosis Based on Clinical Data.

    Directory of Open Access Journals (Sweden)

    Sabri Boughorbel

    Full Text Available We compared the performance of several prediction techniques for breast cancer prognosis, based on AU-ROC performance (Area Under ROC for different prognosis periods. The analyzed dataset contained 1,981 patients and from an initial 25 variables, the 11 most common clinical predictors were retained. We compared eight models from a wide spectrum of predictive models, namely; Generalized Linear Model (GLM, GLM-Net, Partial Least Square (PLS, Support Vector Machines (SVM, Random Forests (RF, Neural Networks, k-Nearest Neighbors (k-NN and Boosted Trees. In order to compare these models, paired t-test was applied on the model performance differences obtained from data resampling. Random Forests, Boosted Trees, Partial Least Square and GLMNet have superior overall performance, however they are only slightly higher than the other models. The comparative analysis also allowed us to define a relative variable importance as the average of variable importance from the different models. Two sets of variables are identified from this analysis. The first includes number of positive lymph nodes, tumor size, cancer grade and estrogen receptor, all has an important influence on model predictability. The second set incudes variables related to histological parameters and treatment types. The short term vs long term contribution of the clinical variables are also analyzed from the comparative models. From the various cancer treatment plans, the combination of Chemo/Radio therapy leads to the largest impact on cancer prognosis.

  5. Comparison of Different Promoter Methylation Assays in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Karijn P. M. Suijkerbuijk

    2010-01-01

    Full Text Available Background: Promoter hypermethylation has emerged as a promising cancer biomarker. Currently, a large variety of quantitative and non-quantitative techniques is used to measure methylation in clinical specimens. Here we directly compared three commonly used methylation assays and assessed the influence of tissue fixation, target sequence location and the amount of DNA on their performance.

  6. Pedal indirect lymphangiography

    International Nuclear Information System (INIS)

    Lee, Kil Woo; Hong, Myung Sun; Kim, In Jae

    1994-01-01

    Recently, indirect lymphangiography has been developed as a relatively good and noninvasive imaging modality of the lymphatic system at extremities. But the disadvantage of the indirect lymphangiography is a low contrast ratio between the surrounding tissues and the contrast media in lymphatic vessels, because dimeric nonionic contrast media is water soluble and diluted in the proximal leg lymphatic vessels. We could have relatively better image than previously published images for the leg lymphatic system, when we injected contrast media with adequate high pressure in intradermal space of the interdigital areas at the foot dorsum. So, we would like to report the results. We could study all 9 lymphedemas(primary: 6, secondary: 3) from April 1990 to May 1993 on outpatient base. They were diagnosed as lymphedema clinically and radiologically. Ten ml of dimeric nonionic aget, iotrolan(Isovist 300) was injected into intradermal space with five 30-gauge needles. The injection speed was more than 0.2 ml/min. We have done one side pedal lymphangiogram in 30 minutes. The evaluation of the anterior superficial lymphatics was according to the criteria of the Weissleder. The results were as follows: 1. All lymphatic vessels from foot to inguinal area could be visualized. 2. Two or three inferior inguinal lymph nodes could be visualized about 42%. 3. The most common abnormal finding of the lymphedma was the neovascularization of the lymphatics on indirect pedal lymphangiogram. If we use adequate technique relatively high pressure injection, correct intradermal needle insertion, adequate soft tissue exposure technique indirect lymphangiography is considered to be a safe and noninvasive imaging modality for the evaluation of the lymphedema of lower extremity lymphatics including inferior inguinal lymph nodes

  7. Effects of the source of social comparison information on former cancer patients' quality of life

    NARCIS (Netherlands)

    Brakel, T.M.; Dijkstra, A.; Buunk, Abraham (Bram)

    2012-01-01

    Objective. Life, following curative treatment, can be a struggle for former cancer patients. In this phase of their illness, social comparison information may help to improve a patient's quality of life (QOL). The objective of this study was to determine whether the effects of this information

  8. Targeting cancer patients' quality of life through social comparison : A randomised trial

    NARCIS (Netherlands)

    Brakel, Thecla M.; Dijkstra, Arie; Buunk, Abraham P.

    2014-01-01

    Objective: Former cancer patients' quality of life can be improved by offering social comparison information. Whether patients, however, benefit from the information may depend on how negative they perceive their present and their future. Design: We conducted a randomised experimental field study

  9. Indirect two-sided relative ranking: a robust similarity measure for gene expression data

    Directory of Open Access Journals (Sweden)

    Licamele Louis

    2010-03-01

    Full Text Available Abstract Background There is a large amount of gene expression data that exists in the public domain. This data has been generated under a variety of experimental conditions. Unfortunately, these experimental variations have generally prevented researchers from accurately comparing and combining this wealth of data, which still hides many novel insights. Results In this paper we present a new method, which we refer to as indirect two-sided relative ranking, for comparing gene expression profiles that is robust to variations in experimental conditions. This method extends the current best approach, which is based on comparing the correlations of the up and down regulated genes, by introducing a comparison based on the correlations in rankings across the entire database. Because our method is robust to experimental variations, it allows a greater variety of gene expression data to be combined, which, as we show, leads to richer scientific discoveries. Conclusions We demonstrate the benefit of our proposed indirect method on several datasets. We first evaluate the ability of the indirect method to retrieve compounds with similar therapeutic effects across known experimental barriers, namely vehicle and batch effects, on two independent datasets (one private and one public. We show that our indirect method is able to significantly improve upon the previous state-of-the-art method with a substantial improvement in recall at rank 10 of 97.03% and 49.44%, on each dataset, respectively. Next, we demonstrate that our indirect method results in improved accuracy for classification in several additional datasets. These datasets demonstrate the use of our indirect method for classifying cancer subtypes, predicting drug sensitivity/resistance, and classifying (related cell types. Even in the absence of a known (i.e., labeled experimental barrier, the improvement of the indirect method in each of these datasets is statistically significant.

  10. Comparison of submerged and unsubmerged printing of ovarian cancer cells.

    Science.gov (United States)

    Davidoff, Sherry N; Au, David; Smith, Samuel; Brooks, Amanda E; Brooks, Benjamin D

    2015-01-01

    A high-throughput cell based assay would greatly aid in the development and screening of ovarian cancer drug candidates. Previously, a three-dimensional microfluidic printer that is not only capable of controlling the location of cell deposition, but also of maintaining a liquid, nutrient rich environment to preserve cellular phenotype has been developed (Wasatch Microfluidics). In this study, we investigated the impact (i.e., viability, density, and phenotype) of depositing cells on a surface submerged in cell culture media. It was determined that submersion of the microfluidic print head in cell media did not alter the cell density, viability, or phenotype.. This article describes an in depth study detailing the impact of one of the fundamental components of a 3D microfluidic cell printer designed to mimic the in vivo cell environment. Development of such a tool holds promise as a high-throughput drug-screening platform for new cancer therapeutics.

  11. [Comparison of robotic surgery documentary in gynecological cancer].

    Science.gov (United States)

    Vargas-Hernández, Víctor Manuel

    2012-01-01

    Robotic surgery is a surgical technique recently introduced, with major expansion and acceptance among the medical community is currently performed in over 1,000 hospitals around the world and in the management of gynecological cancer are being developed comprehensive programs for implementation. The objectives of this paper are to review the scientific literature on robotic surgery and its application in gynecological cancer to verify its safety, feasibility and efficacy when compared with laparoscopic surgery or surgery classical major surgical complications, infections are more common in traditional radical surgery compared with laparoscopic or robotic surgery and with these new techniques surgical and staying hospital are lesser than the former however, the disadvantages are the limited number of robot systems, their high cost and applies only in specialized centers that have with equipment and skilled surgeons. In conclusion robotic surgery represents a major scientific breakthrough and surgical management of gynecological cancer with better results to other types of conventional surgery and is likely in the coming years is become its worldwide.

  12. Cancer incidence in atomic bomb survivors. Part IV: Comparison of cancer incidence and mortality

    International Nuclear Information System (INIS)

    Ron, E.; Preston, D.L.; Mabuchi, Kiyohiko; Thompson, D.E.; Soda, Midori

    1994-01-01

    This report compares cancer incidence and mortality among atomic bomb survivors in the Radiation Effects Research Foundation Life Span Study (LSS) cohort. Because the incidence data are derived from the Hiroshima and Nagasaki tumor registries, case ascertainment is limited to the time (1958-1987) and geographic restrictions (Hiroshima and Nagasaki) of the registries, whereas mortality data are available from 1950-1987 anywhere in Japan. With these conditions, there were 9,014 first primary incident cancer cases identified among LSS cohort members compared with 7,308 deaths for which cancer was listed as the underlying cause of death on death certificates. When deaths were limited to those occurring between 1958-1987 in Hiroshima or Nagasaki, there were 3,155 more incident cancer cases overall, and 1,262 more cancers of the digestive system. For cancers of the oral cavity and pharynx, skin, breast, female and male genital organs, urinary system and thyroid, the incidence series was at least twice as large as the comparable mortality series. Although the incidence and mortality data are dissimilar in many ways, the overall conclusions regarding which solid cancers provide evidence of a significant dose response generally confirm the mortality findings. When either incidence or mortality data are evaluated, significant excess risks are observed for all solid cancers, stomach, colon, liver (when it is defined as primary liver cancer or liver cancer not otherwise specified on the death certificate), lung, breast, ovary and urinary bladder. No significant radiation effect is seen for cancers of the pharynx, rectum, gallbladder, pancreas, nose, larynx, uterus, prostate or kidney in either series. There is evidence of a significant excess of nonmelanoma skin cancer in the incidence data, but not in the mortality series. 19 refs., 2 figs., 10 tabs

  13. The ability to identify the intraparotid facial nerve for locating parotid gland lesions in comparison to other indirect landmark methods: evaluation by 3.0 T MR imaging with surface coils

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Mana; Fujii, Shinya; Nishihara, Keisuke; Matsusue, Eiji; Kodani, Kazuhiko; Kaminou, Toshio; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori (Japan); Kawamoto, Katsuyuki [Tottori University, Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori (Japan)

    2010-11-15

    It is important to know whether a parotid gland lesion is in the superficial or deep lobe for preoperative planning. We aimed to investigate the ability of 3.0 T magnetic resonance (MR) imaging with surface coils to identify the intraparotid facial nerve and locate parotid gland lesions, in comparison to other indirect landmark methods. We retrospectively evaluated 50 consecutive patients with primary parotid gland lesions. The position of the facial nerve was determined by tracing the nerve in the stylomastoid foramen and then following it on sequential MR sections through the parotid gland. The retromandibular vein and the facial nerve line (FN line) were also identified. For each radiologist and each method, we determined the diagnostic ability for deep lobe lesions and superficial lobe lesions, as well as accuracy. These abilities were compared among the three methods using the Chi-square test with Yates' correction. Mean diagnostic ability for deep lobe lesions, the diagnostic ability for superficial lobe lesions, and accuracy were 92%, 86%, 87%, respectively, for the direct identification method; 67%, 89%, 86%, respectively, for the retromandibular vein method; and 25%, 99%, 90%, respectively, for the FN line method. The direct identification method had significantly higher diagnostic ability for deep lesions than the FN line method (P < 0.01), but significantly lower diagnostic ability for superficial lobe lesions than the FN line method (P < 0.01). Direct identification of the intraparotid facial nerve enables parotid gland lesions to be correctly located, particularly those in the deep lobes. (orig.)

  14. CONTRIBUTION OF INDIRECT TAXES

    Directory of Open Access Journals (Sweden)

    CHIRCULESCU MARIA FELICIA

    2015-08-01

    Full Text Available The work is based on the fact that at any time and in any society, taxation is regarded as undesirable for all taxpayers. The existence and it's manifestation is justified, because the operation of any company involves costs that must be covered by sufficient resources. Since ancient times, each state has adopted its own tax system, more or less perfected, as the state has experienced a greater or lesser economic and military power At the base of this work stays the fact that tax systems are a key factor influencing the overall efficiency of the economy. They determine the size tendency to save, invest and work, influencing the increase in production and employment, which is essential sights integral economic strategy, making tax reform an important component of economic reform. This paper aims to analyze the indirect taxes and their contribution to the public revenues in Romania, the purpose paper contains an analysis based on statistical series as indirect taxation is where tax harmonization was possible. Through analyzes, the paper aims to provide answers to the problem of the contradiction between the growing need for budgetary revenues, which entails a continuous amplification and diversification of taxation, on the one hand, and the need to stimulate economic development, on the other hand. The harmonization of indirect taxation had been achieved since this touches the free movement of goods and the freedom to supply services, not being able to say the same thing about direct taxation, which is why the European Community Treaty does not specify expressly the alignment of direct taxation, considering that direct taxation is a matter of Internal Policies that, for a country free option.

  15. Comparison of different treatments for unresectable esophageal cancer.

    Science.gov (United States)

    Reed, C E

    1995-01-01

    Many patient with esophageal cancer have advanced disease that in not amenable to curative treatment. For these individuals the relief of dysphagia is of utmost importance to the quality of their remaining survival time. This article reviews and compares the methods of palliation with focus on indications and contraindications, advantages as well as disadvantages of each technique, success rates, and complications. Tumor characteristics, the physician's experience, the institution's capabilities, cost, and patient preference will influence choice of palliation. Methods are often complementary rather than competitive.

  16. Comparison of breast cancer mucin (BCM) and CA 15-3 in human breast cancer

    NARCIS (Netherlands)

    Garcia, M.B.; Blankenstein, M.A.; Wall, E. van der; Nortier, J.W.R.; Schornagel, J.H.; Thijssen, J.H.H.

    1990-01-01

    The Breast Cancer Mucin (BCM) enzyme immunoassay utilizes two monoclonal antibodies (Mab), M85/34 and F36/22, for the identification of a mucin-like glycoprotein in serum of breast cancer patients. We have compared BCM with CA 15-3, another member of the human mammary epithelial antigen

  17. Comparison of Pancreas Juice Proteins from Cancer Versus Pancreatitis Using Quantitative Proteomic Analysis

    Science.gov (United States)

    Chen, Ru; Pan, Sheng; Cooke, Kelly; Moyes, Kara White; Bronner, Mary P.; Goodlett, David R.; Aebersold, Ruedi; Brentnall, Teresa A.

    2008-01-01

    Objectives Pancreatitis is an inflammatory condition of the pancreas. However, it often shares many molecular features with pancreatic cancer. Biomarkers present in pancreatic cancer frequently occur in the setting of pancreatitis. The efforts to develop diagnostic biomarkers for pancreatic cancer have thus been complicated by the false-positive involvement of pancreatitis. Methods In an attempt to develop protein biomarkers for pancreatic cancer, we previously use quantitative proteomics to identify and quantify the proteins from pancreatic cancer juice. Pancreatic juice is a rich source of proteins that are shed by the pancreatic ductal cells. In this study, we used a similar approach to identify and quantify proteins from pancreatitis juice. Results In total, 72 proteins were identified and quantified in the comparison of pancreatic juice from pancreatitis patients versus pooled normal control juice. Nineteen of the juice proteins were overexpressed, and 8 were underexpressed in pancreatitis juice by at least 2-fold compared with normal pancreatic juice. Of these 27 differentially expressed proteins in pancreatitis, 9 proteins were also differentially expressed in the pancreatic juice from pancreatic cancer patient. Conclusions Identification of these differentially expressed proteins from pancreatitis juice provides useful information for future study of specific pancreatitis-associated proteins and to eliminate potential false-positive biomarkers for pancreatic cancer. PMID:17198186

  18. Prevalence of bile duct cancer among printing industry workers in comparison with other industries.

    Science.gov (United States)

    Okamoto, Etsuji; Kikuchi, Kiyotaka; Endo, Ginji

    2013-01-01

    The aim of this study was to assess the risk of developing bile duct cancer among workers in the other printing industry in comparison with workers in all industries in general. Prevalence of bile duct cancer was compared between workers in the printing industry and age-standardized controls in all other industries using the claims database of the Japan Health Insurance Association, which insures workers of small-medium sized employers of all industries. Young (aged 30-49) male workers in the printing industry showed an elevated but insignificant standardized prevalence rate ratio (SPRR) for bile duct cancer in comparison with workers in all other industries (SPRR: 1.78; 95%CI: 0.63-5.00). The risk was higher for intrahepatic bile duct cancer but remained insignificant (SPRR: 3.03; 95%CI: 0.52-17.56). The sharply elevated risk of bile duct cancer observed among proof-printing workers of a printing factory in Osaka may not be generalizable to workers in the printing industry nationwide.

  19. Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world

    Science.gov (United States)

    Li, Zhongmin; Yang, Lei; Du, Changzheng; Fang, Xuedong; Wang, Ning; Gu, Jin

    2017-01-01

    Background Population-based epidemiologic studies about colorectal cancer are lacking in China. This study aims to provide a basis for colorectal cancer screening and prevention, through analysis and comparisons the characteristics of the trends in colorectal cancer incidence in Beijing and selected representative regions. RESULTS The annual incidence rate in Beijing region increased significantly, from 9.40/100,000 in 1998 to 18.61/100,000 in 2012. The stratified rate showed that the incidence of distal colon adenocarcinoma increased substantially in men, especially in those aged > 75 years and residing in urban areas. Although the incidence rate in Beijing is still lower than in Shanghai, Jiashan, and Hong Kong in China, it is increasing rapidly. Further, the incidence rate in Beijing is lower than in New York, Oxford and Osaka, but higher than in Mumbai and Kyadondo. The incidence trend in Beijing is increasing especially in older groups, while in other regions such as New York, it is decreasing in these age groups. Materials and Methods Colorectal cancer incidence data were obtained from Beijing Cancer Registry and Cancer Incidence in Five Continents Plus database. All incidence rates were age-standardized according to Segi's world population. Incidence trends were characterized by calculating the annual percent changes using the Joinpoint Regression Program. Conclusions Compared with other regions, Beijing has a medium level of colorectal cancer incidence, however, it is increasing significantly. There are obvious differences in the cancer subsite, sex and age distributions between Beijing and other regions. Prevention and screening of colorectal cancer in Beijing should be strengthened. PMID:28445947

  20. Direct and indirect methods for the quantification of leg volume: Comparison between water displacement volumetry, the disk model method and the frustum sign model method, using the correlation coefficient and the limits of agreement

    NARCIS (Netherlands)

    D.M.K.S. Kaulesar Sukul (D. M K S); P.Th. den Hoed (Pieter); T. Johannes (Tanja); R. van Dolder (R.); E. Benda (Eric)

    1993-01-01

    textabstractVolume changes can be measured either directly by water-displacement volumetry or by various indirect methods in which calculation of the volume is based on circumference measurements. The aim of the present study was to determine the most appropriate indirect method for lower leg volume

  1. Dosimetric comparison of treatment techniques IMRT and VMAT for breast cancer

    International Nuclear Information System (INIS)

    Urbina, G. L.; Garcia, B. G.

    2015-10-01

    In this study the dosimetric distribution was compared in the different treatment techniques such as Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) in female patients with breast cancer with stage II-B and III-A, 6 cases (both calculated on VMAT and IMRT) were studied, comparison parameter that are taken into account are: compliance rate, homogeneity index, monitor units, volume dose 50 Gy (D-50%) and 5 Gy (D-5%) volume dose. Comparisons are made in primary tumor volume to optimize treatment in patients with breast cancer, with IMRT using Step, Shoot and VMAT Monte Carlo algorithm, in addition to the organs at risk; the concern to make this work is due to technological advances in radiotherapy and the application of new treatment techniques, that increase the accuracy allowing treatment dose climbing delivering a higher dose to the patient. (Author)

  2. Esophagographic findings of early esophageal cancer : comparison with pathologic results

    International Nuclear Information System (INIS)

    Chung, Jae Joon; Kim, Choong Bai; Kim, Ho Guen; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik

    1998-01-01

    The purpose of this study is to investigate the esophagographic findings of early esophageal cancer (EEC), and to compare these with the pathologic results, and to thus determine the most useful method of esophagography for detection of EEC. We examined 18 patients (M:F=16:2) with pathologically proven EEC; 17 cases were squamous cell carcinoma and one was adenocarcinoma. Tumor size, shape and location were evaluated by esophagography and the findings were compared with the pathologic results. The tumors were 0.5 - 7 cm in size; all except two were smaller than 4 cm. Twelve were located in the middle esophagus, five cases in the lower esophagus and one case in the upper esophagus; in ten cases, the margin was ill-defined. Esophagography showed that eight cases were of the superficial depressed type, seven were the superficial elevated type, and three were the tumorous type. All 18 cases were detected by double contrast study, but mucosal relief study and barium filling study revealed only ten and eight cases, respectively; for the detection of EEC double contrast study was thus the most useful. EEC was commonly demonstrated in the middle esophagus with an ill-defined margin; it was of the superficial depressed or elevated type. For the detection of EEC, double contrast study was the most useful. (author). 14 refs., 1 tab., 5 figs

  3. Ballistic fractures: indirect fracture to bone.

    Science.gov (United States)

    Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia

    2011-11-01

    Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.

  4. New oral anticoagulants are not superior to warfarin in secondary prevention of stroke or transient ischemic attacks, but lower the risk of intracranial bleeding: insights from a meta-analysis and indirect treatment comparisons.

    Directory of Open Access Journals (Sweden)

    Partha Sardar

    Full Text Available PURPOSE: Patients with Atrial Fibrillation (AF and prior stroke are classified as high risk in all risk stratification schemes. A systematic review and meta-analysis was performed to compare the efficacy and safety of New Oral Anticoagulants (NOACs to warfarin in patients with AF and previous stroke or transient ischemic attack (TIA. METHODS: Three randomized controlled trials (RCTs, including total 14527 patients, comparing NOACs (apixaban, dabigatran and rivaroxaban with warfarin were included in the analysis. Primary efficacy endpoint was ischemic stroke, and primary safety endpoint was intracranial bleeding. Random-effects models were used to pool efficacy and safety data across RCTs. RevMan and Stata software were used for direct and indirect comparisons, respectively. RESULTS: In patients with AF and previous stroke or TIA, effects of NOACs were not statistically different from that of warfarin, in reduction of stroke (Odds Ratio [OR] 0.86, 95% confidence interval [CI] 0.73- 1.01, disabling and fatal stroke (OR 0.85, 95% CI 0.71-1.04, and all-cause mortality (OR 0.90, 95% CI 0.79 -1.02. Randomization to NOACs was associated with a significantly lower risk of intracranial bleeding (OR 0.42, 95% CI 0.25-0.70. There were no major differences in efficacy between apixaban, dabigatran (110 mg BID and 150 mg BID and rivaroxaban. Major bleeding was significantly lower with apixaban and dabigatran (110 mg BID compared with dabigatran (150 mg BID and rivaroxaban. CONCLUSION: NOACs may not be more effective than warfarin in the secondary prevention of ischemic stroke in patients with a prior history of cerebrovascular ischemia, but have a lower risk of intracranial bleeding.

  5. Comparison of elective inguinal node irradiation techniques in anal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  6. Comparison of elective inguinal node irradiation techniques in anal cancer

    International Nuclear Information System (INIS)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub

    2011-01-01

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  7. Comparison of bone mineral density in young patients with breast cancer and healthy women

    Directory of Open Access Journals (Sweden)

    Sousan Kolahi

    2014-05-01

    Full Text Available BACKGROUND: Almost 1 in 8 women will have breast cancer during their lifetime. Several risk factors were identified; however, 70% of females with breast cancer have no risk factors. Many risk factors are associated with sex steroid hormones. Some studies have been focused on identification of the indices of cumulative exposures to estrogen during the patients’ life. One of these indicators is bone mineral density (BMD. Our aim was the comparison of BMD in young patients with and without breast cancer, and finding a relationship between breast cancer and bone density. METHODS: In this case-control study, 120 people were enrolled; 40 patients with breast cancer and 80 normal healthy persons as control group. Measurement of BMD was performed in both groups and compared. RESULTS: Both groups were matched in age, weight, age at menarche, age at first marriage and first pregnancy, number of pregnancies over 32 weeks and lactation period, and taking supplemental calcium and vitamin D. However, there was a significant difference between the two groups in terms of estrogen intake, family history of breast cancer, and history of breast masses (P = 0.03, P = 0.03, P ≤ 0.01, respectively. A significant difference was found between BMD, bone mineral content (BMC, and t-scores of lumbar spine of the two groups; they were higher in the control group (P = 0.08, P ≤ 0.01, P = 0.06, respectively. CONCLUSIONS: This study shows that bone mineral density of young patients with breast cancer is not higher than normal similar age females; thus, BMD is not directly a risk factor for breast cancer.

  8. A social comparison theory analysis of group composition and efficacy of cancer support group programs.

    Science.gov (United States)

    Carmack Taylor, Cindy L; Kulik, James; Badr, Hoda; Smith, Murray; Basen-Engquist, Karen; Penedo, Frank; Gritz, Ellen R

    2007-07-01

    Group-based psychosocial programs provide an effective forum for improving mood and social support for cancer patients. Because some studies show more benefit for patients with initially high psychosocial distress, and little or no benefit for patients with initially low distress, support programs may better address patient needs by only including distressed patients. However, distressed patients may benefit particularly from the presence of nondistressed patients who model effective coping, an idea many researchers and extensions of social comparison theory support. We present a theoretical analysis, based on a social comparison perspective, of how group composition (heterogeneous group of distressed and nondistressed patients versus homogeneous group of distressed patients) may affect the efficacy of cancer support programs. We propose that a heterogeneous group allows distressed patients maximal opportunity for the various social comparison activities they are likely to prefer; a homogeneous group does not. Though the presence of nondistressed patients in a heterogeneous group potentially benefits distressed patients, the benefits for nondistressed patients are unclear. For nondistressed patients, heterogeneous groups may provide limited opportunities for preferred social comparison activity and may create the possibility for no benefit or even negative effects on quality of life. We also discuss ethical issues with enrolling nondistressed patients whose presence may help others, but whose likelihood of personal benefit is questionable.

  9. Outcome of triple negative breast cancer: comparison of sporadic and BRCA1-associated cancers.

    Science.gov (United States)

    Tung, Nadine; Gaughan, Elizabeth; Hacker, Michele R; Lee, Larissa J; Alexander, Brian; Poles, Emily; Schnitt, Stuart J; Garber, Judy E

    2014-07-01

    The majority of breast cancers developing in BRCA1 mutation carriers are triple negative breast cancers (TNBC), an aggressive subtype that accounts for 15-20 % of sporadic breast cancer. We compare the clinical outcome and sites of relapse of TNBC in BRCA1 mutation carriers and non-carriers who received adjuvant chemotherapy. Women with stage I-III TNBC who had BRCA1 testing within 36 months of diagnosis and received adjuvant chemotherapy were identified from clinical databases at two academic institutions. Sites of relapse, freedom from distant metastasis (FFDM), and breast cancer-specific survival (BCSS) were determined. RCA1 carriers (n = 89) were significantly younger at diagnosis (P < 0.0001) than non-carriers (n = 175). FFDM at 5 years was 80.5 % for carriers and 76.9 % for non-carriers; with median follow-up of 55 months, hazard ratio (HR) was 0.90, P = 0.71. Sites of recurrence, including brain, did not differ significantly. BCSS at 5 years was 88.1 % for carriers and 81.4 % for non-carriers; HR 0.60; P = 0.15 at 55 months follow-up. BRCA1 carriers who underwent oophorectomy had a significantly lower rate of death from TNBC, with an adjusted HR of 0.30 (95 % CI 0.10-0.94). Adjusting for age, oophorectomy, and prophylactic mastectomy, BRCA1 mutation status was not an independent predictor of survival (HR 2.1; P = 0.13). BRCA1 mutation carriers with TNBC had similar survival rates and sites of recurrence to non-carriers after treatment with conventional chemotherapy. Carriers who underwent oophorectomy had a significantly lower rate of breast cancer-related death; this finding should be studied further in all women with TNBC.

  10. Prevalence and impact of severe fatigue in adolescent and young adult cancer patients in comparison with population-based controls.

    Science.gov (United States)

    Poort, Hanneke; Kaal, Suzanne E J; Knoop, Hans; Jansen, Rosemarie; Prins, Judith B; Manten-Horst, Eveliene; Servaes, Petra; Husson, Olga; van der Graaf, Winette T A

    2017-09-01

    The current study determined the prevalence of severe fatigue in adolescent and young adult (AYA) cancer patients (aged 18-35 years at diagnosis) consulting a multidisciplinary AYA team in comparison with gender- and age-matched population-based controls. In addition, impact of severe fatigue on quality of life and correlates of fatigue severity were examined. AYAs with cancer (n = 83) completed questionnaires including the Checklist Individual Strength (CIS-fatigue), Quality of Life (QoL)-Cancer Survivor, Hospital Anxiety and Depression Scale (reflecting psychological distress), and the Cancer Worry Scale (reflecting fear of cancer recurrence or progression). The vast majority of participants had been treated with chemotherapy (87%) and had no active treatment at the time of participation (73.5%). Prevalence of severe fatigue (CIS-fatigue score ≥35) in AYAs with cancer (48%, n = 40/83) was significantly higher in comparison with matched population-based controls (20%, n = 49/249; p fatigued AYAs with cancer reported lower QoL compared to non-severely fatigued AYAs with cancer (p fatigue severity (p fatigue based on a validated cut-off score was highly prevalent in this group of AYAs with cancer. QoL is significantly affected by severe fatigue, stressing the importance of detection and management of this symptom in those patients affected by a life-changing diagnosis of cancer in late adolescence or young adulthood.

  11. An international comparison of stakeholder motivation to implement liver cancer control.

    Science.gov (United States)

    Bridges, John F P; Joy, Susan M; Blauvelt, Barri M; Yan, Weili; Marsteller, Jill A

    2015-06-01

    The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources. To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources. Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients. In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P motivation was observed among stakeholders working at the international level relative to the local level (P = 0.017). Motivation was positively associated with a country's relative burden of liver cancer (P = 0.015) and negatively associated with their level of resources (P = 0.018). This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources

  12. Patient-based dosimetric comparison of interstitial and intracavitary brachytherapy in cases of cancer cervix

    International Nuclear Information System (INIS)

    Bansal, Anil K.; Julka, P.K.; Sharma, D.N.; Rustogi, Ashish; Subramani, V.; Prabhakar, R.; Rath, G.K.; Semwal, Manoj K.; Thulkar, S.

    2008-01-01

    Brachytherapy in the form of High Dose Rate (HDR) intracavitary radiotherapy (ICRT) along with external beam radiotherapy(EBRT) is the main treatment in cancer cervix. Of late, some large centres have started practicing template based transperineal interstitial brachytherapy (TIB) for advanced/ bulky cancer cervix. Usually, TIB is given for patients with advanced disease/ distorted anatomy or recurrent disease for better lateral target coverage. CT/MRI/USG based planning has made volumetric dosimetry possible for the target and the organs at risk (OARs). This has resulted in better correlation between dose received and treatment outcome in terms of tumour control and late toxicities as against the point dosimetry system. It has been shown by many studies that ICRU based point dose reporting may not represent the actual doses received by the OARs. Though it is expected that TIB gives better target coverage and OAR sparing in advanced/ bulky cancer cervix cases as compared to ICRT, detailed patient studies on the subject have not been reported. We have carried out dosimetric comparison between ICRT and TIB for cancer cervix patients undergoing treatment at our centre in terms of treated volume and doses to OARs

  13. Effects of the source of social comparison information on former cancer patients' quality of life.

    Science.gov (United States)

    Brakel, Thecla M; Dijkstra, Arie; Buunk, Abraham P

    2012-11-01

    Life, following curative treatment, can be a struggle for former cancer patients. In this phase of their illness, social comparison information may help to improve a patient's quality of life (QOL). The objective of this study was to determine whether the effects of this information depend on the following two variables: (1) the individual's physical health and (2) the individual's sensitivity to social comparison. In the current study, the effects on a patient's QOL were tested that occur when they are listening to a psychological oncological expert talking about cancer patients' experiences. Three different recorded interviews with experts were compared (on negative emotions, effective coping, or both), and individual differences were tested as moderators. In addition, the expert source conditions were compared with a condition in which the source was not an expert but a former patient. In a randomized field experiment, 154 Dutch former cancer patients (M(age) = 55 years; 68% women) were assigned to one of the four conditions (three expert source and one former patient source condition). QOL was assessed after 2 months. The effects of the expert source conditions on QOL depended on the participants' physical health (good vs. poor) and on the participants' sensitivity to social comparison (whether the recipient reacts with contrast or identification), as indicated by significant three-way interactions (p source conditions was at least as effective as the former patient source condition. The results show that desired and undesired effects are found when individual differences relevant to the processing of intervention information are examined. ©2012 The British Psychological Society.

  14. Supersymmetric dark matter: Indirect detection

    International Nuclear Information System (INIS)

    Bergstroem, L.

    2000-01-01

    Dark matter detection experiments are improving to the point where they can detect or restrict the primary particle physics candidates for non baryonic dark matter. The methods for detection are usually categorized as direct, i.e., searching for signals caused by passage of dark matter particles in terrestrial detectors, or indirect. Indirect detection methods include searching for antimatter and gamma rays, in particular gamma ray lines, in cosmic rays and high-energy neutrinos from the centre of the Earth or Sun caused by accretion and annihilation of dark matter particles. A review is given of recent progress in indirect detection, both on the theoretical and experimental side

  15. The Complexity of Indirect Translation

    DEFF Research Database (Denmark)

    Wenjie, L. I.

    2017-01-01

    its complex nature, and thus determined that many facets of ITr remain to be studied. The present article will try to encompass the complexity of ITr by looking into the reasons for translating indirectly, the challenge of finding out mediating texts (MTs), indirectness in both translation...... of which have been translated and interpreted indirectly through major languages like English, will be employed as examples. Hopefully, this study will offer more insights into the nature of translation as a social activity and raise further interests in studying translation as a complex phenomenon....

  16. A simplified indirect bonding technique

    Directory of Open Access Journals (Sweden)

    Radha Katiyar

    2014-01-01

    Full Text Available With the advent of lingual orthodontics, indirect bonding technique has become an integral part of practice. It involves placement of brackets initially on the models and then their transfer to teeth with the help of transfer trays. Problems encountered with current indirect bonding techniques used are (1 the possibility of adhesive flash remaining around the base of the brackets which requires removal (2 longer time required for the adhesive to gain enough bond strength for secure tray removal. The new simplified indirect bonding technique presented here overcomes both these problems.

  17. The logic of indirect speech

    Science.gov (United States)

    Pinker, Steven; Nowak, Martin A.; Lee, James J.

    2008-01-01

    When people speak, they often insinuate their intent indirectly rather than stating it as a bald proposition. Examples include sexual come-ons, veiled threats, polite requests, and concealed bribes. We propose a three-part theory of indirect speech, based on the idea that human communication involves a mixture of cooperation and conflict. First, indirect requests allow for plausible deniability, in which a cooperative listener can accept the request, but an uncooperative one cannot react adversarially to it. This intuition is supported by a game-theoretic model that predicts the costs and benefits to a speaker of direct and indirect requests. Second, language has two functions: to convey information and to negotiate the type of relationship holding between speaker and hearer (in particular, dominance, communality, or reciprocity). The emotional costs of a mismatch in the assumed relationship type can create a need for plausible deniability and, thereby, select for indirectness even when there are no tangible costs. Third, people perceive language as a digital medium, which allows a sentence to generate common knowledge, to propagate a message with high fidelity, and to serve as a reference point in coordination games. This feature makes an indirect request qualitatively different from a direct one even when the speaker and listener can infer each other's intentions with high confidence. PMID:18199841

  18. Male breast cancer: a nation-wide population-based comparison with female breast cancer.

    Science.gov (United States)

    Lautrup, Marianne D; Thorup, Signe S; Jensen, Vibeke; Bokmand, Susanne; Haugaard, Karen; Hoejris, Inger; Jylling, Anne-Marie B; Joernsgaard, Hjoerdis; Lelkaitis, Giedrius; Oldenburg, Mette H; Qvamme, Gro M; Soee, Katrine; Christiansen, Peer

    2018-05-01

    Describe prognostic parameters of Danish male breast cancer patients (MBCP) diagnosed from 1980-2009. Determine all-cause mortality compared to the general male population and analyze survival/mortality compared with Danish female breast cancer patients (FBCP) in the same period. The MBCP cohort was defined from three national registers. Data was extracted from medical journals. Data for FBCP is from the DBCG database. Overall survival (OS) was quantified by Kaplan-Meier estimates. Standardized mortality ratios (SMRs) were calculated based on mortality rate among patients relative to the mortality rate in the general population. The association between SMR and risk factors were analyzed in univariate and multivariable Poisson regression models. Separate models for each gender were used for the analyses. We found a marked difference in OS for the two genders. For the total population of MBCP, 5- and 10-year survivals were 55.1% and 31.7%, respectively. For FBCP, the corresponding figures were 76.8% and 59.3%. Median age at diagnosis for FBCP was 61 years and 70 years for MBCP. By applying SMR, the difference in mortality between genders equalized and showed pronounced age-dependency. For males <40 years, SMR was 9.43 and for females 19.56 compared to SMR for males 80 + years (0.95) and females 80 + years (0.89). During the period 1980-2009, the risk of dying gradually decreased for FBCP (p < .0001). The risk 1980-1984 was 35% higher than 2005-2009 (RR 1.35). Although the risk of dying for MBCP was also lowest in 2005-2009, there was no clear tendency (p = .1439). The risk was highest in 1990-1994 (RR =2.48). We found better OS for FBCP than for MBCP. But SMR showed similar mortality rate for the two genders, except for very young FBCP, who had higher SMR. Furthermore, significantly improved survival over time for FBCP was observed, with no clear tendency for MBCP.

  19. Comparison of tumor biology of two distinct cell sub-populations in lung cancer stem cells.

    Science.gov (United States)

    Wang, Jianyu; Sun, Zhiwei; Liu, Yongli; Kong, Liangsheng; Zhou, Shixia; Tang, Junlin; Xing, Hongmei Rosie

    2017-11-14

    Characterization of the stem-like properties of cancer stem cells (CSCs) remain indirect and qualitative, especially the ability of CSCs to undergo asymmetric cell division for self renewal and differentiation, a unique property of cells of stem origin. It is partly due to the lack of stable cellular models of CSCs. In this study, we developed a new approach for CSC isolation and purification to derive a CSC-enriched cell line (LLC-SE). By conducting five consecutive rounds of single cell cloning using the LLC-SE cell line, we obtained two distinct sub-population of cells within the Lewis lung cancer CSCs that employed largely symmetric division for self-renewal (LLC-SD) or underwent asymmetric division for differentiation (LLC-ASD). LLC-SD and LLC-ASD cell lines could be stably passaged in culture and be distinguished by cell morphology, stem cell marker, spheroid formation and subcutaneous tumor initiation efficiency, as well as orthotopic lung tumor growth, progression and survival. The ability LLC-ASD cells to undergo asymmetric division was visualized and quantified by the asymmetric segregation of labeled BrdU and NUMB to one of the two daughter cells in anaphase cell division. The more stem-like LLC-SD cells exhibited higher capacity for tumorigenesis and progression and shorter survival. As few as 10 LLC-SD could initiate subcutaneous tumor growth when transplanted to the athymic mice. Collectively, these observations suggest that the SD-type of cells appear to be on the top of the hierarchical order of the CSCs. Furthermore, they have lead to generated cellular models of CSC self-renewal for future mechanistic investigations.

  20. Cancer and Social Media: A Comparison of Traffic about Breast Cancer, Prostate Cancer, and Other Reproductive Cancers on Twitter and Instagram.

    Science.gov (United States)

    Vraga, Emily K; Stefanidis, Anthony; Lamprianidis, Georgios; Croitoru, Arie; Crooks, Andrew T; Delamater, Paul L; Pfoser, Dieter; Radzikowski, Jacek R; Jacobsen, Kathryn H

    2018-01-01

    Social media are often heralded as offering cancer campaigns new opportunities to reach the public. However, these campaigns may not be equally successful, depending on the nature of the campaign itself, the type of cancer being addressed, and the social media platform being examined. This study is the first to compare social media activity on Twitter and Instagram across three time periods: #WorldCancerDay in February, the annual month-long campaigns of National Breast Cancer Awareness Month (NBCAM) in October and Movember in November, and during the full year outside of these campaigns. Our results suggest that women's reproductive cancers - especially breast cancer - tend to outperform men's reproductive cancer - especially prostate cancer - across campaigns and social media platforms. Twitter overall generates substantially more activity than Instagram for both cancer campaigns, suggesting Instagram may be an untapped resource. However, the messaging for both campaigns tends to focus on awareness and support rather than on concrete actions and behaviors. We suggest health communication efforts need to focus on effective messaging and building engaged communities for cancer communication across social media platforms.

  1. Outcomes and cost comparisons after introducing a robotics program for endometrial cancer surgery.

    Science.gov (United States)

    Lau, Susie; Vaknin, Zvi; Ramana-Kumar, Agnihotram V; Halliday, Darron; Franco, Eduardo L; Gotlieb, Walter H

    2012-04-01

    To evaluate the effect of introducing a robotic program on cost and patient outcome. This was a prospective evaluation of clinical outcome and cost after introducing a robotics program for the treatment of endometrial cancer and a retrospective comparison to the entire historical cohort. Consecutive patients with endometrial cancer who underwent robotic surgery (n=143) were compared with all consecutive patients who underwent surgery (n=160) before robotics. The rate of minimally invasive surgery increased from 17% performed by laparoscopy to 98% performed by robotics in 2 years. The patient characteristics were comparable in both eras, except for a higher body mass index in the robotics era (median 29.8 compared with 27.6; Probotics had longer operating times (233 compared with 206 minutes), but fewer adverse events (13% compared with 42%; Probotics compared with the historical group (Can$7,644 compared with Can$10,368 [Canadian dollars]; Psurgery, the short-term recurrence rate appeared lower in the robotics group compared with the historic cohort (11 recurrences compared with 19 recurrences; Probotics for endometrial cancer surgery increased the proportion of patients benefitting from minimally invasive surgery, improved short-term outcomes, and resulted in lower hospital costs. II.

  2. On the comprehensibility and perceived privacy protection of indirect questioning techniques.

    Science.gov (United States)

    Hoffmann, Adrian; Waubert de Puiseau, Berenike; Schmidt, Alexander F; Musch, Jochen

    2017-08-01

    On surveys that assess sensitive personal attributes, indirect questioning aims at increasing respondents' willingness to answer truthfully by protecting confidentiality. However, the assumption that subjects understand questioning procedures fully and trust them to protect their privacy is rarely tested. In a scenario-based design, we compared four indirect questioning procedures in terms of their comprehensibility and perceived privacy protection. All indirect questioning techniques were found to be less comprehensible by respondents than a conventional direct question used for comparison. Less-educated respondents experienced more difficulties when confronted with any indirect questioning technique. Regardless of education, the crosswise model was found to be the most comprehensible among the four indirect methods. Indirect questioning in general was perceived to increase privacy protection in comparison to a direct question. Unexpectedly, comprehension and perceived privacy protection did not correlate. We recommend assessing these factors separately in future evaluations of indirect questioning.

  3. International comparison of the factors influencing reimbursement of targeted anti-cancer drugs.

    Science.gov (United States)

    Lim, Carol Sunghye; Lee, Yun-Gyoo; Koh, Youngil; Heo, Dae Seog

    2014-11-29

    Reimbursement policies for anti-cancer drugs vary among countries even though they rely on the same clinical evidence. We compared the pattern of publicly funded drug programs and analyzed major factors influencing the differences. We investigated reimbursement policies for 19 indications with targeted anti-cancer drugs that are used variably across ten countries. The available incremental cost-effectiveness ratio (ICER) data were retrieved for each indication. Based on the comparison between actual reimbursement decisions and the ICERs, we formulated a reimbursement adequacy index (RAI): calculating the proportion of cost-effective decisions, either reimbursement of cost-effective indications or non-reimbursement of cost-ineffective indications, out of the total number of indications for each country. The relationship between RAI and other indices were analyzed, including governmental dependency on health technology assessment, as well as other parameters for health expenditure. All the data used in this study were gathered from sources publicly available online. Japan and France were the most likely to reimburse indications (16/19), whereas Sweden and the United Kingdom were the least likely to reimburse them (5/19 and 6/19, respectively). Indications with high cost-effectiveness values were more likely to be reimbursed (ρ = -0.68, P = 0.001). The three countries with high RAI scores each had a healthcare system that was financed by general taxation. Although reimbursement policies for anti-cancer drugs vary among countries, we found a strong correlation of reimbursements for those indications with lower ICERs. Countries with healthcare systems financed by general taxation demonstrated greater cost-effectiveness as evidenced by reimbursement decisions of anti-cancer drugs.

  4. Indirect Reciprocity; A Field Experiment.

    Science.gov (United States)

    van Apeldoorn, Jacobien; Schram, Arthur

    2016-01-01

    Indirect reciprocity involves cooperative acts towards strangers, either in response to their kindness to third parties (downstream) or after receiving kindness from others oneself (upstream). It is considered to be important for the evolution of cooperative behavior amongst humans. Though it has been widely studied theoretically, the empirical evidence of indirect reciprocity has thus far been limited and based solely on behavior in laboratory experiments. We provide evidence from an online environment where members can repeatedly ask and offer services to each other, free of charge. For the purpose of this study we created several new member profiles, which differ only in terms of their serving history. We then sent out a large number of service requests to different members from all over the world. We observe that a service request is more likely to be rewarded for those with a profile history of offering the service (to third parties) in the past. This provides clear evidence of (downstream) indirect reciprocity. We find no support for upstream indirect reciprocity (in this case, rewarding the service request after having previously received the service from third parties), however. Our evidence of downstream indirect reciprocity cannot be attributed to reputational effects concerning one's trustworthiness as a service user.

  5. Indirect Reciprocity under Incomplete Observation

    Science.gov (United States)

    Nakamura, Mitsuhiro; Masuda, Naoki

    2011-01-01

    Indirect reciprocity, in which individuals help others with a good reputation but not those with a bad reputation, is a mechanism for cooperation in social dilemma situations when individuals do not repeatedly interact with the same partners. In a relatively large society where indirect reciprocity is relevant, individuals may not know each other's reputation even indirectly. Previous studies investigated the situations where individuals playing the game have to determine the action possibly without knowing others' reputations. Nevertheless, the possibility that observers of the game, who generate the reputation of the interacting players, assign reputations without complete information about them has been neglected. Because an individual acts as an interacting player and as an observer on different occasions if indirect reciprocity is endogenously sustained in a society, the incompleteness of information may affect either role. We examine the game of indirect reciprocity when the reputations of players are not necessarily known to observers and to interacting players. We find that the trustful discriminator, which cooperates with good and unknown players and defects against bad players, realizes cooperative societies under seven social norms. Among the seven social norms, three of the four suspicious norms under which cooperation (defection) to unknown players leads to a good (bad) reputation enable cooperation down to a relatively small observation probability. In contrast, the three trustful norms under which both cooperation and defection to unknown players lead to a good reputation are relatively efficient. PMID:21829335

  6. Merging Children's Oncology Group Data with an External Administrative Database Using Indirect Patient Identifiers: A Report from the Children's Oncology Group.

    Directory of Open Access Journals (Sweden)

    Yimei Li

    Full Text Available Clinical trials data from National Cancer Institute (NCI-funded cooperative oncology group trials could be enhanced by merging with external data sources. Merging without direct patient identifiers would provide additional patient privacy protections. We sought to develop and validate a matching algorithm that uses only indirect patient identifiers.We merged the data from two Phase III Children's Oncology Group (COG trials for de novo acute myeloid leukemia (AML with the Pediatric Health Information Systems (PHIS. We developed a stepwise matching algorithm that used indirect identifiers including treatment site, gender, birth year, birth month, enrollment year and enrollment month. Results from the stepwise algorithm were compared against the direct merge method that used date of birth, treatment site, and gender. The indirect merge algorithm was developed on AAML0531 and validated on AAML1031.Of 415 patients enrolled on the AAML0531 trial at PHIS centers, we successfully matched 378 (91.1% patients using the indirect stepwise algorithm. Comparison to the direct merge result suggested that 362 (95.7% matches identified by the indirect merge algorithm were concordant with the direct merge result. When validating the indirect stepwise algorithm using the AAML1031 trial, we successfully matched 157 out of 165 patients (95.2% and 150 (95.5% of the indirectly merged matches were concordant with the directly merged matches.These data demonstrate that patients enrolled on COG clinical trials can be successfully merged with PHIS administrative data using a stepwise algorithm based on indirect patient identifiers. The merged data sets can be used as a platform for comparative effectiveness and cost effectiveness studies.

  7. The need for a rapid and comprehensive adoption of the revised European standard population in cancer incidence comparisons.

    Science.gov (United States)

    Crocetti, Emanuele; Dyba, Tadek; Martos, Carmen; Randi, Giorgia; Rooney, Roisin; Bettio, Manola

    2017-09-01

    As cancer incidence varies according to age, it is important to rule out differences in age structures in any comparison. A common way of adjusting for these differences is using direct age standardization, which applies age-specific weights from a standard population. Eurostat has recently introduced a revised European standard population (RESP). The effect of using the new standard, in comparison with that introduced in 1976 [European standard population (ESP)], is evaluated. Cancer incidence data for prostate and testis cancer for Denmark, Finland, Sweden, Norway, and Iceland from the NORDCAN web site, and for Ireland and Italy-Genoa from Cancer Incidence in five Continents-X, were analyzed. Incidence rates were directly age standardized using ESP and RESP. The RESP conferred greater weight to adults and the elderly than the ESP. For prostate cancer, age-standardized rates computed with RESP are consistently higher by between 50 and 60% than those computed with ESP. However, the use of RESP, instead of ESP, has little impact on the pattern of time trends, the relative ranking of countries, the values of relative risks, or the percentage differences between age-standardized rates. For testis cancer, RESP and ESP provide very similar results because this cancer is more common in young men. Both ESP and RESP are in circulation. It is, therefore, important that European cancer registries reach consensus on a single standard to use to avoid erroneous comparisons of data computed with different standards. Given that Eurostat recently introduced RESP and is using this standard for data collected from the European Union Member States, it would make sense to rally behind RESP.

  8. Indirect techniques in nuclear astrophysics

    International Nuclear Information System (INIS)

    Mukhamedzhanov, A.M.; Tribble, R.E.; Blokhintsev, L.D.; Cherubini, S.; Spitaleri, C.; Kroha, V.; Nunes, F.M.

    2005-01-01

    It is very difficult or often impossible to measure in the lab conditions nuclear cross sections at astrophysically relevant energies. That is why different indirect techniques are used to extract astrophysical information. In this talk different experimental possibilities to get astrophysical information using radioactive and stable beams will be addressed. 1. The asymptotic normalization coefficient (ANC) method. 2. Radiative neutron captures are determined by the spectroscopic factors (SP). A new experimental technique to determine the neutron SPs will be addressed. 3. 'Trojan Horse' is another unique indirect method, which allows one to extract the astrophysical factors for direct and resonant nuclear reactions at astrophysically relevant energies. (author)

  9. A comparison of salvage surgery following CRT and following BRT for advanced hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Kamijo, Tomoyuki; Onitsuka, Tetsuro; Yokota, Tomoya

    2016-01-01

    There are still few comparison reports regarding the safety of salvage surgery for recurrence and persistence following platinum-based chemoradiotherapy (CRT) and cetuximab-based bioradiotherapy (BRT), which are frequently used as non-surgical therapies for advanced head and neck carcinomas. This study compared the safety of salvage surgery following CRT against that following BRT for advanced hypopharyngeal cancer. The study examined 34 cases who underwent salvage surgery following CRT and 7 cases who underwent salvage surgery following BRT from September 2002 to December 2015. The number of cases that were able to undergo salvage surgery was 34 among 67 recurrence and persistence cases following CRT and 7 of 8 cases following BRT. In terms of the surgical procedure, salvage neck dissection was conducted for 22 cases in the CRT group and 5 cases in the BRT group, with no significant differences observed between both including the surgical time and amount of bleeding, and with no major complications in either group. Total hypopharynx or total laryngectomy resection for salvage was conducted for 19 cases in the CRT group and 3 cases in the BRT group, upon which we observed anastomotic leakage in 3 cases in the CRT group and 1 case in the BRT group; however, there was no significant difference in the onset frequency. There was no clear difference regarding safety between salvage surgery following CRT and following BRT for locally advanced hypopharyngeal cancer. However, regarding the adaptation of salvage surgery, the possibility of limitations in the CRT group was suggested in comparison with the BRT group. (author)

  10. Quality of life in Arab Muslim cancer survivors following hematopoietic stem cell transplantation: comparison with matched healthy group.

    Science.gov (United States)

    Alaloul, Fawwaz; Brockopp, Dorothy Y; Andrykowski, Michael A; Hall, Lynne A; Al Nusairat, Taghreed S

    2015-07-01

    The aims of this study were to determine if quality of life (QOL) among Arab Muslim hematopoietic stem cell transplantation (HSCT) survivors differs from that of a healthy matched comparison group and to examine the relationships of demographic and medical variables and perceived social support with post-HSCT QOL. HSCT survivors (n = 63) were recruited from the King Hussein Cancer Center outpatient clinic. A matched (age, gender, education), healthy comparison group (n = 63) was recruited through public advertisements. Participants completed the EORTC-30 QOL scale and the Medical Outcomes Study Social Support Survey. Differences were found between the Arab Muslim HSCT survivor and healthy comparison groups for physical functioning (p Western HSCT survivors in the social and emotional QOL domains. Given growing numbers of Arab and Muslim cancer survivors in the USA and other Western countries, future research is warranted.

  11. Comparison of manual and automatic MR-CT registration for radiotherapy of prostate cancer.

    Science.gov (United States)

    Korsager, Anne Sofie; Carl, Jesper; Riis Østergaard, Lasse

    2016-05-08

    In image-guided radiotherapy (IGRT) of prostate cancer, delineation of the clini-cal target volume (CTV) often relies on magnetic resonance (MR) because of its good soft-tissue visualization. Registration of MR and computed tomography (CT) is required in order to add this accurate delineation to the dose planning CT. An automatic approach for local MR-CT registration of the prostate has previously been developed using a voxel property-based registration as an alternative to a manual landmark-based registration. The aim of this study is to compare the two registration approaches and to investigate the clinical potential for replacing the manual registration with the automatic registration. Registrations and analysis were performed for 30 prostate cancer patients treated with IGRT using a Ni-Ti prostate stent as a fiducial marker. The comparison included computing translational and rotational differences between the approaches, visual inspection, and computing the overlap of the CTV. The computed mean translational difference was 1.65, 1.60, and 1.80mm and the computed mean rotational difference was 1.51°, 3.93°, and 2.09° in the superior/inferior, anterior/posterior, and medial/lateral direction, respectively. The sensitivity of overlap was 87%. The results demonstrate that the automatic registration approach performs registrations comparable to the manual registration.

  12. Comparison of manual and automatic MR‐CT registration for radiotherapy of prostate cancer

    Science.gov (United States)

    Carl, Jesper; Østergaard, Lasse Riis

    2016-01-01

    In image‐guided radiotherapy (IGRT) of prostate cancer, delineation of the clinical target volume (CTV) often relies on magnetic resonance (MR) because of its good soft‐tissue visualization. Registration of MR and computed tomography (CT) is required in order to add this accurate delineation to the dose planning CT. An automatic approach for local MR‐CT registration of the prostate has previously been developed using a voxel property‐based registration as an alternative to a manual landmark‐based registration. The aim of this study is to compare the two registration approaches and to investigate the clinical potential for replacing the manual registration with the automatic registration. Registrations and analysis were performed for 30 prostate cancer patients treated with IGRT using a Ni‐Ti prostate stent as a fiducial marker. The comparison included computing translational and rotational differences between the approaches, visual inspection, and computing the overlap of the CTV. The computed mean translational difference was 1.65, 1.60, and 1.80 mm and the computed mean rotational difference was 1.51°, 3.93°, and 2.09° in the superior/inferior, anterior/posterior, and medial/lateral direction, respectively. The sensitivity of overlap was 87%. The results demonstrate that the automatic registration approach performs registrations comparable to the manual registration. PACS number(s): 87.57.nj, 87.61.‐c, 87.57.Q‐, 87.56.J‐ PMID:27167285

  13. Quantitative comparison of a human cancer cell surface proteome between interphase and mitosis.

    Science.gov (United States)

    Özlü, Nurhan; Qureshi, Mohammad H; Toyoda, Yusuke; Renard, Bernhard Y; Mollaoglu, Gürkan; Özkan, Nazlı E; Bulbul, Selda; Poser, Ina; Timm, Wiebke; Hyman, Anthony A; Mitchison, Timothy J; Steen, Judith A

    2015-01-13

    The cell surface is the cellular compartment responsible for communication with the environment. The interior of mammalian cells undergoes dramatic reorganization when cells enter mitosis. These changes are triggered by activation of the CDK1 kinase and have been studied extensively. In contrast, very little is known of the cell surface changes during cell division. We undertook a quantitative proteomic comparison of cell surface-exposed proteins in human cancer cells that were tightly synchronized in mitosis or interphase. Six hundred and twenty-eight surface and surface-associated proteins in HeLa cells were identified; of these, 27 were significantly enriched at the cell surface in mitosis and 37 in interphase. Using imaging techniques, we confirmed the mitosis-selective cell surface localization of protocadherin PCDH7, a member of a family with anti-adhesive roles in embryos. We show that PCDH7 is required for development of full mitotic rounding pressure at the onset of mitosis. Our analysis provided basic information on how cell cycle progression affects the cell surface. It also provides potential pharmacodynamic biomarkers for anti-mitotic cancer chemotherapy. © 2014 The Authors.

  14. Cancer Survivors' Social Context in the Return to Work Process: Narrative Accounts of Social Support and Social Comparison Information.

    Science.gov (United States)

    Armaou, M; Schumacher, L; Grunfeld, E A

    2017-10-04

    Purpose Returning to work is a process that is intertwined with the social aspects of one's life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients' perceptions of the role of their social context in relation to returning to work following treatment. Methods Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers' support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions Two functions of the social context of returning to work after cancer were apparent in the participants' narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one's readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual's successful return to the workplace.

  15. Environmental effects of indirect subsidies

    International Nuclear Information System (INIS)

    Van Beers, C.P.; De Moor, A.P.G.; Van den Bergh, J.C.J.M.; Oosterhuis, F.H.

    2003-01-01

    The aim of the study on the title subject is to develop a transparent integrated method to determine and analyze the environmental impacts of indirect subsidies, applied in the sectors agriculture, energy, mobility, and tourism. From the results it appears that the hazardous effects of subsidies are big. Examples are milk, the regulating energy levy, and kerosene [nl

  16. Indirect searches for dark matter

    Indian Academy of Sciences (India)

    The current status of indirect searches for dark matter has been reviewed in a schematic way here. The main relevant experimental results of the recent years have been listed and the excitements and disappointments that their phenomenological interpretations in terms of almost-standard annihilating dark matter have ...

  17. Indirect methods in nuclear astrophysics

    International Nuclear Information System (INIS)

    Bertulani, C.A.; Shubhchintak; Mukhamedzhanov, A.; Kadyrov, A. S.; Kruppa, A.; Pang, D. Y.

    2016-01-01

    We discuss recent developments in indirect methods used in nuclear astrophysics to determine the capture cross sections and subsequent rates of various stellar burning processes, when it is difficult to perform the corresponding direct measurements. We discuss in brief, the basic concepts of Asymptotic Normalization Coefficients, the Trojan Horse Method, the Coulomb Dissociation Method, (d,p), and charge-exchange reactions. (paper)

  18. Indirect Reciprocity : A Field Experiment

    NARCIS (Netherlands)

    van Apeldoorn, J.; Schram, A.

    2016-01-01

    Indirect reciprocity involves cooperative acts towards strangers, either in response to their kindness to third parties (downstream) or after receiving kindness from others oneself (upstream). It is considered to be important for the evolution of cooperative behavior amongst humans. Though it has

  19. Indirect reciprocity with optional interactions.

    Science.gov (United States)

    Ghang, Whan; Nowak, Martin A

    2015-01-21

    Indirect reciprocity is a mechanism for the evolution of cooperation that is relevant for prosocial behavior among humans. Indirect reciprocity means that my behavior towards you also depends on what you have done to others. Indirect reciprocity is associated with the evolution of social intelligence and human language. Most approaches to indirect reciprocity assume obligatory interactions, but here we explore optional interactions. In any one round a game between two players is offered. A cooperator accepts a game unless the reputation of the other player indicates a defector. For a game to take place, both players must accept. In a game between a cooperator and a defector, the reputation of the defector is revealed to all players with probability Q. After a sufficiently large number of rounds the identity of all defectors is known and cooperators are no longer exploited. The crucial condition for evolution of cooperation can be written as hQB>1, where h is the average number of rounds per person and B=(b/c)-1 specifies the benefit-to-cost ratio. We analyze both stochastic and deterministic evolutionary game dynamics. We study two extensions that deal with uncertainty: hesitation and malicious gossip. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Associations of child adjustment with parent and family functioning: comparison of families of women with and without breast cancer.

    Science.gov (United States)

    Vannatta, Kathryn; Ramsey, Rachelle R; Noll, Robert B; Gerhardt, Cynthia A

    2010-01-01

    To examine the impact of maternal breast cancer on the emotional and behavioral functioning of school-age children; evaluate whether child adjustment is associated with variations in distress, marital satisfaction, and parenting behavior evidenced by mothers and fathers; and determine whether these associations differ from families that are not contending with cancer. Participants included 40 children (age 8-16 years) of mothers with breast cancer along with their parents as well as 40 families of comparison classmates not affected by parental illness. Questionnaires assessing the domains of interest were administered in families' homes. Mothers with breast cancer and their spouses reported higher levels of distress than comparison parents; child internalizing problems were inversely associated with parental adjustment in both groups. No group differences were found in any indicators of family functioning, including parent-child relationships. Warm and supportive parenting by both mothers and fathers were associated with lower levels of child internalizing behavior, but only in families affected by breast cancer. These results suggest that children of mothers with breast cancer, such as most children, may be at risk for internalizing behavior when parents are distressed. These children may particularly benefit from interactions with mothers and fathers who are warm and supportive, and maintenance of positive parenting may partially account for the apparent resilience of these youth.

  1. Comparison between surgery and radiofrequency ablation for stage I non-small cell lung cancer

    International Nuclear Information System (INIS)

    Kim, So Ri; Han, Hyo Jin; Park, Seoung Ju; Min, Kyung Hoon; Lee, Min Hee; Chung, Chi Ryang; Kim, Min Ho; Jin, Gong Yong; Lee, Yong Chul

    2012-01-01

    Surgical resection remains as the treatment of choice for non-small cell lung cancer (NSCLC) and provides the best opportunity for cure and long-term survival. Minimally invasive percutaneous ablative therapies, such as radiofrequency ablation (RFA) for treating lung cancers, are currently being studied as treatment alternatives. But, to date, there is little information on comparison of therapeutic effects between surgery and RFA in patients with early stage lung malignancy. We aimed to investigate the clinical significance of RFA as an alternative curative modality for the early stage lung cancer through analyzing the long-term mortality of both treatment groups; surgery vs. RFA. Twenty-two patients of stage I NSCLC were included for this comparative analysis. To minimize confounding effects, we conducted a matching process. In which patients of RFA group (n = 8) were matched with patients of surgery group (n = 14) on the following variables; gender, age (±3 years), tumor node metastasis stage, and calendar year of surgery or RFA (±2 years). The mean survival duration of RFA group and surgery group were 33.18 ± 7.90 and 45.49 ± 7.21, respectively (months, p = 0.297). Log-rank analysis showed that there was no significant difference in overall survival (p = 0.054) between two groups. These results have shown that RFA can offer the survival comparable to that by surgery to stage I NSCLC patients, especially to the patients impossible for the surgery. This study provides an evidence for the use of RFA as a treatment alternative with low procedural morbidity for inoperable early-stage NSCLC patients.

  2. Differential expression of carbohydrate antigen 19-9 in human colorectal cancer: A comparison with colon and rectal cancers

    Science.gov (United States)

    ZHANG, SHUAI; CHEN, YIJUN; ZHU, ZHANMENG; DING, YUNLONG; REN, SHUANGYI; ZUO, YUNFEI

    2013-01-01

    Colorectal cancer is one of the leading causes of cancer-related mortality, being the third most commonly diagnosed cancer among men and the second among women. Accumulating evidence regarding carbohydrate antigen (CA) demonstrated that tumor-associated antigens are clinically useful for the diagnosis, staging and monitoring of human gastrointestinal cancers, particularly colorectal cancer. There has been an extensive investigation for sensitive and specific markers of this disease. Currently, the gastrointestinal cancer-associated carbohydrate antigen 19-9 (CA19-9) is the most widely applied tumor marker in cancer diagnosis. Despite a similar etiology and cancer incidence rates, there are anatomical and clinical differences between colon and rectal cancer, as well as differences regarding tumor progression and adjuvant treatments. To investigate whether CA19-9 is differentially expressed between colon and rectal cancer, we conducted a differential analysis of serum CA19-9 levels among 227 cases of colorectal cancer, analyzing gender, age, Dukes’ stage and distant metastasis for human colon and rectal cancer as a single entity, separately and as matched pairs. We demonstrated that the serum CA19-9 levels in colorectal cancer were upregulated in advanced stages with distant metastasis. By contrast, the serum CA19-9 levels in colon cancer displayed a differential and upregulated behavior in advanced stages with distant metastasis. By analyzing as matched pairs, the upregulated serum CA19-9 levels in rectal cancer during the early stages without distant metastasis further supported our hypothesis that the expression of CA19-9 displays a site-specific differential behavior. The integrative analysis suggested a significant difference between human colon and rectal cancer, justifying individualized therapy for these two types of cancer. PMID:24649295

  3. Indirect measurements of X-ray spectra

    International Nuclear Information System (INIS)

    Mainardi, R.T.

    2006-01-01

    To the effects of measuring the spectral distribution of the radiation emitted by the x-ray tubes and electron accelerators, numerous procedures that are grouped in two big categories exist at the present time: direct and indirect methods. The first ones use high resolution detectors that should be positioned, together with the appropriate collimator, in the direction of the x ray beam. The user should be an expert in the use and correction of the obtained data by the different effects that affect the detector operation such as efficiency and resolution in terms of the energy of the detected radiation. The indirect procedures, although its are more simple to use, its also require a considerable space along the beam to position the ionization chamber and the necessary absorbents to construct by this way the denominated attenuation curve. We will analyze the operation principle of the indirect methods and a new proposal in which such important novelties are introduced as the beam dispersion to avoid to measure along the main beam and that of determination of the attenuation curve in simultaneous form. By this way, with a single shot of the tube, the attenuation curve is measured, being necessary at most a shot of additional calibration to know the relative response of the detectors used in the experimental array. The physical processes involved in the obtaining of an attenuation curve are very well well-known and this it finishes it can be theoretically calculated if the analytic form of the spectrum is supposed well-known. Finally, we will see a spectra reconstruction example with the Kramers parametric form and comparisons with numeric simulations carried out with broadly validated programs as well as the possibility of the use of solid state dosemeters in the obtention of the attenuation curve. (Author)

  4. Indirect vs direct bonding of mandibular fixed retainers in orthodontic patients: Comparison of retainer failures and posttreatment stability. A 2-year follow-up of a single-center randomized controlled trial.

    Science.gov (United States)

    Egli, Fabienne; Bovali, Efstathia; Kiliaridis, Stavros; Cornelis, Marie A

    2017-01-01

    The objectives of this 2-arm parallel trial were to compare the numbers of failures of mandibular fixed retainers bonded with indirect and direct methods and to investigate the posttreatment changes 2 years after placement. Sixty-four consecutive patients from the postgraduate orthodontic clinic of the University of Geneva in Switzerland were randomly allocated to either an indirect or a traditional direct bonding procedure of a mandibular fixed retainer at the end of their orthodontic treatment (T0). Eligibility criteria were the presence of the 4 mandibular incisors and the 2 mandibular canines, and no active caries, restorations, fractures, or periodontal disease of these teeth. The patients were randomized in blocks of 4 (using an online randomization service) with allocation concealment secured by contacting the sequence generator for assignment. The patients were recalled 12 months and 24 months (T3) after retainer bonding. The main outcome was any first-time failure of retainers (ie, at least 1 composite pad debonded or fractured); unexpected posttreatment changes of the mandibular incisors and canines were a secondary outcome. Impressions and lateral cephalograms were taken at T0 and T3: changes in mandibular intercanine and interpremolar distances and mandibular incisor inclination were assessed. Blinding was applicable for outcome assessment only. The chi-square test and Cox regression were used to compare the survival rates of the retainers bonded with direct and indirect methods. Paired t tests were used to assess differences in intercanine and interpremolar distances and mandibular incisor inclination at T0 and T3. Significance was set at P direct bonding group (log-rank test, P = 0.64). The hazard ratio was 1.26 (95% confidence interval, 0.56-2.81; P = 0.58). Bond failures occurred mainly during the first year. There were no clinically significant changes in mandibular intercanine distance, interpremolar distance, and incisor inclination

  5. Indirect taxation in the European Union

    OpenAIRE

    Ene, Sebastian; Micuda, Dan

    2007-01-01

    Indirect taxes are levied on the production and consumption of goods and services. They influence the retail price, and hence affect patterns of trade and consumption. Indirect taxes are ultimately paid by the final consumer. Sales and turnover taxes, excise duties and tariffs are the basic indirect taxes. In contrast with direct taxes, indirect taxes are seldom progressive. The principles for the levying of these taxes will be considered before the analysis of indirect taxes.

  6. Dosimetric comparison of 3DCRT versus IMRT in whole breast irradiation of early stage breast cancer

    Directory of Open Access Journals (Sweden)

    Mudasir Ashraf

    2014-08-01

    .......................................................Cite this article as:Ashraf M, Janardhan N, Bhavani P, Shivakumar R, Ibrahim S, Reddy PY, Surrendharen J, Sarangnathan B, Johnson B, Madhuri B, Dar RA. Dosimetric comparison of 3DCRT versus IMRT in whole breast irradiation of early stage breast cancer. Int J Cancer Ther Oncol 2014; 2(3:020318. DOI: 10.14319/ijcto.0203.18

  7. Dosimetric comparison of treatment techniques IMRT and VMAT for breast cancer; Comparacion dosimetrica de las tecnicas de tratamiento IMRT y VMAT para cancer en mama

    Energy Technology Data Exchange (ETDEWEB)

    Urbina, G. L. [Universidad Nacional de Ingenieria, Maestria en Fisica Medica, Av. Tupac Amaru s/n, Rimac, Lima 25 (Peru); Garcia, B. G., E-mail: gerlup@hotmail.com [Red AUNA, Clinica Delgado, Av. Angamos Cdra. 4 esquina Gral. Borgono, Miraflores, Lima (Peru)

    2015-10-15

    In this study the dosimetric distribution was compared in the different treatment techniques such as Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) in female patients with breast cancer with stage II-B and III-A, 6 cases (both calculated on VMAT and IMRT) were studied, comparison parameter that are taken into account are: compliance rate, homogeneity index, monitor units, volume dose 50 Gy (D-50%) and 5 Gy (D-5%) volume dose. Comparisons are made in primary tumor volume to optimize treatment in patients with breast cancer, with IMRT using Step, Shoot and VMAT Monte Carlo algorithm, in addition to the organs at risk; the concern to make this work is due to technological advances in radiotherapy and the application of new treatment techniques, that increase the accuracy allowing treatment dose climbing delivering a higher dose to the patient. (Author)

  8. Electronic Commerce and Indirect Taxation

    OpenAIRE

    Watanabe, Satoshi

    2001-01-01

    This paper considers the reason why indirect tax issues arise in the context of electronic commerce and discusses relevant issues. To do so, the paper presents a simple framework to understand and examine these issues in the international context. It also identifies common and different issues of the VAT system and the RST system. It demonstrates that an emerging solution proposed in the context of the VAT system can be affected with difficult problems that were regarded to be problems of the...

  9. Local experience in cervical cancer imaging: Comparison in tumour assessment between TRUS and MRI.

    Science.gov (United States)

    Ordeanu, Claudia; Pop, Diana Cristina; Badea, Radu; Csutak, Csaba; Todor, Nicolae; Ordeanu, Calin; Kerekes, Reka; Coza, Ovidiu; Nagy, Viorica; Achimas-Cadariu, Patriciu; Irimie, Alexandru

    2015-01-01

    The aim of study was to analyze the accuracy of TRUS (transrectal ultrasound) vs. MRI (magnetic resonance imaging) and clinical gynecological examination estimation in the evaluation of tumor dimensions. The patients inclusion criterion included primarily pathologically squamous cell carcinoma, but excluded were patients who had not undergone BT (brachytherapy) and treated with palliative intent. We offer two types of treatment for locally advanced cervical cancer: (a) radiochemotherapy followed by surgery and (b) exclusive radiochemotherapy. Imaging tests follow the presence of tumor and tumor size (width and thickness). Each examination was performed by a different physician who had no knowledge of the others' findings. All patients underwent MRI prior to EBRT (external beam radiation therapy) while 18 of them also at the time of the first brachytherapy application. For the analysis we used the r-Pearson correlation coefficient. In 2013, 26 patients with cervical cancer were included. A total of 44 gynecological examinations were performed, 44 MRIs and 18 TRUSs. For the comparisons prior to EBRT the correlation coefficient between TRUS vs. MRI was r = 0.79 for AP and r = 0.83 for LL, for GYN vs. MRI was r = 0.6 for AP and r = 0.75 for LL. Prior to BT for GYN vs. MRI, r values were 0.60 and 0.63 for AP and LL, respectively; for GYN vs. TRUS, r values were 0.56 and 0.78 for AP and LL, respectively. A high correlation between the three examinations was obtained. As such, TRUS can be considered a suitable method in the evaluation of tumor dimensions.

  10. SU-E-T-210: Comparison of Proton with Electron Boost in Breast Cancer Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Y; Chang, A [Procure Proton Therapy Center, Oklahoma City, OK (United States); Liu, Y [INTEGRIS Cancer Institute of Oklahoma, Oklahoma City, OK (United States)

    2015-06-15

    Purpose: Electron beams are commonly used for boost radiation following whole breast irradiation (WBI) to improve the in-breast local control. Proton beams have a finite range and a sharper distal dose falloff compared to electron beams, thus potentially sparing more heart and lung in breast treatment. The purpose of the study is to compare protons with electrons for boost breast treatment in terms of target coverage and normal tissue sparing. Methods: Six breast cancer patients were included in this study. All women received WBI to 45–50 Gy, followed by a 10–16.2 Gy boost with standard fractionation. If proton beams were used for the boost treatment, an electron plan was retrospectively generated for comparison using the same CT set and structures, and vice versa if electron beams were used for treatment. Proton plans were generated using the treatment planning system (TPS) with two to three uniform scanning proton beams. Electron plans were generated using the Pinnacle TPS with one single en face beam. Dose-volume histograms (DVH) were calculated and compared between proton and electron boost plans. Results: Proton plans show a similar boost target coverage, similar skin dose, and much better heart and lung sparing. For an example patient, V95% for PTV was 99.98% and skin (5 mm shell) received a max dose close to the prescription dose for both protons and electrons; however, V2 and V5 for the ipsilateral lung and heart were 37.5%, 17.9% and 19.9%, 4.9% respectively for electrons, but were essentially 0 for protons. Conclusions: This dosimetric comparison demonstrates that while both proton therapy and electron therapy provided similar coverage and skin dose, proton therapy could largely reduce the dose to lung and heart, thus leading to potential less side effects.

  11. Detection of sentinel lymph nodes in cervical cancer. A comparison of two protocols

    International Nuclear Information System (INIS)

    Kraft, O.; Sevcik, L.; Klat, J.; Koliba, P.; Curik, R.; Kriozva, H.

    2006-01-01

    The aim of this study was lymphatic mapping to identify SLN in cervical cancer (CaCerv) with radioactive colloids, intraoperative detection with patent blue dye (PBD) and gamma probe (GP) and biopsy and comparison of two protocols. In 54 patients with CaCerv before hysterectomy and lymph nodes dissection (LND) we performed preoperative lymphoscintigraphy utilizing 99m Tc-colloid (Nanocoll, SentiScint or Nanocis), activity 40 MBq, on the operation day (30 women) or the day before operation (24 women). Gynaecologists injected 4 peritumoral injections of colloid into the cervix around the tumour. Scintigraphy followed 25-50 minutes (one-day protocol) or 12-19 hours (two-day protocol) after injection. Gynaecologists also injected 4 peritumoral injections of PBD into the cervix around the tumour. All women underwent SLN biopsy and LND (in average 35 lymph nodes were taken) and hysterectomy. SLNs (active and/or blue lymph nodes) were examined by a pathologist [histopathology and immunohistochemistry (IH) with detection of cytokeratine]. No SLN was examined without IH. The gynaecologists withdrew 123 SLNs (on average 2.27/1 patient) and in total 1898 lymph nodes (on average 35/1 patient). In 1 woman the tumour was inoperable. Two-day protocol, which involved scintigraphy, PBD and GP detected SLNs on both sides (45 SLNs) in 17 women (70.8%), SLNs on the one side (6 SLNs) in 3 patients (12.5%) and no SLNs were found in 4 women (16.7%). One-day protocol detected SLNs on both sides in 23 patients (74.1%) - 63 SLNs, in 7 women on one side (25.9%) - 9 SLNs. Metastases in SLNs (with or without metastases in other LN) were found in 21 patients (38.9%) - in 1 woman of stage FIGO IB1, in 1 woman of stage FIGO IB2, in 1 patient of stage FIGO IIIA and in all 18 patients of stage FIGO IIIB. False negative SLN detection was 0%. In SLN detection in patients with CaCerv, all 3 methods - scintigraphy, PBD and GP - should be used, and the success rate of SLN detection increases, although

  12. a comparative study of direct and indirect solar drying of mango

    African Journals Online (AJOL)

    BARTH EKWUEME

    appropriate to a family scale traditional mango drying. ... before its marketing. Also, direct ..... measured using a digital probe thermohygrometer of ...... Comparison of direct and indirect solar drying kinetics Amelie and Brooks mango varieties.

  13. Comparison of normal tissue pharmacokinetics with 111In/9Y monoclonal antibody m170 for breast and prostate cancer

    International Nuclear Information System (INIS)

    Lehmann, Joerg; DeNardo, Gerald L.; Yuan, Aina; Shen Sui; O'Donnell, Robert T.; Richman, Carol M.; De Nardo, Sally J.

    2006-01-01

    Purpose: Radioactivity deposition in normal tissues limits the dose deliverable by radiopharmaceuticals (RP) in radioimmunotherapy (RIT). This study investigated the absorbed radiation dose in normal tissues for prostate cancer patients in comparison to breast cancer patients for 2 RPs using the monoclonal antibody (MAb) m170. Methods and Materials: 111 In-DOTA-glycylglycylglycyl-L-p-isothiocyanatophenylalanine amide (GGGF)-m170 and 111 In-1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (DOTA) 2-iminothiolane (2IT)-m170, representing the same MAb and chelate with and without a cleavable linkage, were studied in 13 breast cancer and 26 prostate cancer patients. Dosimetry for 9 Y was calculated using 111 In MAb pharmacokinetics from the initial imaging study for each patient, using reference man- and patient-specific masses. Results: The reference man-specific radiation doses (cGy/MBq) were not significantly different for the breast and the prostate cancer patients for both RPs in all but one tissue-RP combination (liver, DOTA-2IT). The patient-specific doses had differences between the groups most of which can be related to weight differences. Conclusions: Similar normal tissue doses were calculated for two groups of patients having different cancers and genders. This similarity combined with continued careful analysis of the imaging data might allow the use of higher starting doses in early phase RIT studies

  14. Long-term survivors of childhood cancer report quality of life and health status in parity with a comparison group

    OpenAIRE

    Sundberg, K. K.; Doukkali, E. B.; Lampic, C.; Eriksson, L. E.; Arvidson, J.; Wettergren, L.

    2010-01-01

    Background: There is a need for more knowledge about how survivors of childhood cancer perceive their lives and what influence current health status has on their quality of life. The purpose was to describe this among a group of long-term survivors and among a comparison group. \\ud \\ud Procedure: Telephone interviews were performed with a cohort of 246 long-term survivors and 296 randomly selected from the general population using the Schedule for the Evaluation of Individual Quality of Life-...

  15. 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.

  16. 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.

  17. Comparison of dental health of patients with head and neck cancer receiving IMRT vs conventional radiation.

    Science.gov (United States)

    Duarte, Victor M; Liu, Yuan F; Rafizadeh, Sassan; Tajima, Tracey; Nabili, Vishad; Wang, Marilene B

    2014-01-01

    To analyze the dental health of patients with head and neck cancer who received comprehensive dental care after intensity-modulated radiation therapy (IMRT) compared with radiation therapy (RT). Historical cohort study. Veteran Affairs (VA) hospital. In total, 158 patients at a single VA hospital who were treated with RT or IMRT between 2003 and 2011 were identified. A complete dental evaluation was performed prior to radiation treatment, including periodontal probing, tooth profile, cavity check, and mobility. The dental treatment plan was formulated to eliminate current and potential dental disease. The rates of dental extractions, infections, caries, mucositis, xerostomia, and osteoradionecrosis (ORN) were analyzed, and a comparison was made between patients treated with IMRT and those treated with RT. Of the 158 patients, 99 were treated with RT and 59 were treated with IMRT. Compared with those treated with IMRT, significantly more patients treated with RT exhibited xerostomia (46.5% vs 16.9%; P radiation treatment (32.2% vs 11.1%; P = .002; OR, 3.8; 95% CI, 1.65-8.73). Patients who were treated with IMRT had fewer instances of dental disease, more salivary flow, and fewer requisite posttreatment extractions compared with those treated with RT. The number of posttreatment extractions has been reduced with the advent of IMRT and more so with a complete dental evaluation prior to treatment.

  18. Laparoscopic intersphincteric resection for low rectal cancer: comparison of stapled and manual coloanal anastomosis.

    Science.gov (United States)

    Cong, J C; Chen, C S; Ma, M X; Xia, Z X; Liu, D S; Zhang, F Y

    2014-05-01

    The study aim was to analyse the safety and feasibility of laparoscopic intersphincteric resection with stapled coloanal anastomosis for low rectal cancer. Between March 2009 and August 2010, 22 patients underwent laparoscopic intersphincteric resection with a stapled coloanal anastomosis without a diverting ileostomy. The results were compared retrospectively with hand-sewn coloanal anastomoses performed between January 2001 and May 2009, which included 55 open and 38 laparoscopic intersphincteric resections. The morbidity comparison only included data relevant to the anastomosis. Function was compared using the Saito function questionnaire and the Wexner score and only involved data relevant to the laparoscopy. The anastomotic complication rates were similar for fistula, bleeding and neorectal mucosal prolapse (P = 0.526, P = 0.653 and P = 0.411, respectively). Anastomotic leakage and stricture formation of the stapled coloanal anastomosis were significantly lower than those of the hand-sewn coloanal anastomosis (P = 0.037 and P = 0.028, respectively). There were no significant differences in the Saito function questionnaire and the Wexner score between the stapled and hand-sewn coloanal anastomotic groups (all P > 0.05). Laparoscopic intersphincteric resection with a stapled coloanal anastomosis is technically feasible and is less likely to result in anastomotic leakage and stricture formation than a hand-sewn anastomosis. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  19. A comprehensive comparison of random forests and support vector machines for microarray-based cancer classification

    Directory of Open Access Journals (Sweden)

    Wang Lily

    2008-07-01

    Full Text Available Abstract Background Cancer diagnosis and clinical outcome prediction are among the most important emerging applications of gene expression microarray technology with several molecular signatures on their way toward clinical deployment. Use of the most accurate classification algorithms available for microarray gene expression data is a critical ingredient in order to develop the best possible molecular signatures for patient care. As suggested by a large body of literature to date, support vector machines can be considered "best of class" algorithms for classification of such data. Recent work, however, suggests that random forest classifiers may outperform support vector machines in this domain. Results In the present paper we identify methodological biases of prior work comparing random forests and support vector machines and conduct a new rigorous evaluation of the two algorithms that corrects these limitations. Our experiments use 22 diagnostic and prognostic datasets and show that support vector machines outperform random forests, often by a large margin. Our data also underlines the importance of sound research design in benchmarking and comparison of bioinformatics algorithms. Conclusion We found that both on average and in the majority of microarray datasets, random forests are outperformed by support vector machines both in the settings when no gene selection is performed and when several popular gene selection methods are used.

  20. Comparison of visual inspection of cervix and pap smear for cervical cancer screening

    International Nuclear Information System (INIS)

    Tayyeb, R.; Khawaja, N.P.; Malik, N.

    2003-01-01

    Objective: To evaluate the performance of visual inspection of cervix (VIA) after application of 3% acetic acid in cervical cancer screening in comparison with PAP smear. Results: Out of 540 subjects, 356 were negative with both screening techniques. One hundred and fifty-six subjects were positive with VIA (28.9%) while PAP smear was positive in seventy-eight subjects (14.4%). The sensitivity of VIA was 93.9% and of PAP smear was 46.9%. Corresponding specificities were 30.4% and 69.5%. There was no significant difference between the positive predictive value (PPV) of both test (p<0.05). The accuracy of VIA was 77.5% compared to 52.8% of PAP smear. The difference was highly significant (p < 0.01). Conclusion: These results indicate that VIA is more sensitive and has a higher accuracy as compared to PAP smear. It could, therefore, be valuable in detection of precancerous lesions of cervix. Low cost, easy applicability and immediate results make VIA a useful screening test in developing countries like Pakistan as compared to PAP smear. (author)

  1. Indirect detection of dark matter

    International Nuclear Information System (INIS)

    Pieri, L.

    2008-01-01

    In the Cold Dark Matter scenario, the Dark Matter particle candidate may be a Weakly Interacting Massive Particle (Wimp). Annihilation of two Wimps in local or cosmological structures would result in the production of a number of standard model particles such as photons, leptons and baryons which could be observed with the presently available or future experiments such as the Pamela or Glast satellites or the Cherenkov Telescopes. In this work we review the status-of-the-art of the theoretical and phenomenological studies about the possibility of indirect detection of signals coming from Wimp annihilation.

  2. Indirect detection of dark matter

    International Nuclear Information System (INIS)

    Carr, J; Lamanna, G; Lavalle, J

    2006-01-01

    This article is an experimental review of the status and prospects of indirect searches for dark matter. Experiments observe secondary particles such as positrons, antiprotons, antideuterons, gamma-rays and neutrinos which could originate from annihilations of dark matter particles in various locations in the galaxy. Data exist from some experiments which have been interpreted as hints of evidence for dark matter. These data and their interpretations are reviewed together with the new experiments which are planned to resolve the puzzles and make new measurements which could give unambiguous results

  3. Indirect Medical Education and Disproportionate Share Adj...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Indirect Medical Education and Disproportionate Share Adjustments to Medicare Inpatient Payment Rates The indirect medical education (IME) and disproportionate share...

  4. Survivors of childhood cancer and comparison peers: the influence of early family factors on distress in emerging adulthood.

    Science.gov (United States)

    Robinson, Kristen E; Gerhardt, Cynthia A; Vannatta, Kathryn; Noll, Robert B

    2009-02-01

    This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. Copyright 2009 APA, all rights reserved.

  5. Indirect costs of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Filip Raciborski

    2015-12-01

    Full Text Available It is estimated that in Poland about 400,000 persons in general suffer from inflammatory joint diseases, including rheumatoid arthritis (RA. Epidemiological surveys documenting the frequency and disturbance of musculoskeletal disorders in the Polish population are few in number. Most of the estimations are based on epidemiological data from other countries (prevalence of 0.5–1%. According to the data of the National Health Fund in Poland 135,000–157,000 persons in total are treated because of rheumatoid arthritis per year [ICD10 (International Statistical Classification of Diseases and Related Health Problems: M05, M06]. In the case of this group of diseases indirect costs significantly outweigh the direct costs. Indirect costs increase together with activity level of the disease. The cost analysis of productivity loss of RA patients indicates that sickness absenteeism and informal care are the most burdensome. At the national level it amounts in total from 1.2 billion to 2.8 billion PLN per year, depending on the method of analysis. These costs could be significantly reduced through early diagnosis and introduction of effective treatment.

  6. Do infants detect indirect reciprocity?

    Science.gov (United States)

    Meristo, Marek; Surian, Luca

    2013-10-01

    In social interactions involving indirect reciprocity, agent A acts prosocially towards B and this prompts C to act prosocially towards A. This happens because A's actions enhanced its reputation in the eyes of third parties. Indirect reciprocity may have been of central importance in the evolution of morality as one of the major mechanisms leading to the selection of helping and fair attitudes. Here we show that 10-month-old infants expect third parties to act positively towards fair donors who have distributed attractive resources equally between two recipients, rather than toward unfair donors who made unequal distributions. Infants' responses were dependent on the reciprocator's perceptual exposure to previous relevant events: they expected the reciprocator to reward the fair donor only when it had seen the distributive actions performed by the donors. We propose that infants were able to generate evaluations of agents that were based on the fairness of their distributive actions and to generate expectations about the social preferences of informed third parties. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Indirect reciprocity with trinary reputations.

    Science.gov (United States)

    Tanabe, Shoma; Suzuki, Hideyuki; Masuda, Naoki

    2013-01-21

    Indirect reciprocity is a reputation-based mechanism for cooperation in social dilemma situations when individuals do not repeatedly meet. The conditions under which cooperation based on indirect reciprocity occurs have been examined in great details. Most previous theoretical analysis assumed for mathematical tractability that an individual possesses a binary reputation value, i.e., good or bad, which depends on their past actions and other factors. However, in real situations, reputations of individuals may be multiple valued. Another puzzling discrepancy between the theory and experiments is the status of the so-called image scoring, in which cooperation and defection are judged to be good and bad, respectively, independent of other factors. Such an assessment rule is found in behavioral experiments, whereas it is known to be unstable in theory. In the present study, we fill both gaps by analyzing a trinary reputation model. By an exhaustive search, we identify all the cooperative and stable equilibria composed of a homogeneous population or a heterogeneous population containing two types of players. Some results derived for the trinary reputation model are direct extensions of those for the binary model. However, we find that the trinary model allows cooperation under image scoring under some mild conditions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Indirect Cost Reimbursement: An Industrial View.

    Science.gov (United States)

    Bolton, Robert

    1987-01-01

    The meaning of indirect costs in an industrial environment is discussed. Other factors considered are corporate policies; nature of work being supported; the uniqueness of the work; who is doing the negotiating for industry; and indirect rates. Suggestions are offered for approaches to indirect cost reimbursement. (Author/MLW)

  9. Language shifts in free indirect discourse

    NARCIS (Netherlands)

    Maier, Emar

    Free indirect discourse is a way of reporting what a protagonist thinks or says that is distinct from both direct and indirect discourse. In particular, while pronouns and tenses are presented from the narrator's perspective, as in indirect discourse, other indexical and expressive elements reflect

  10. Directe en indirecte werknemersparticipatie in Europa

    NARCIS (Netherlands)

    van Houten, Gijs; Akkerman, Agnes; Sluiter, Roderick; Jansen, Giedo; Vermeylen, Greet

    2016-01-01

    This study looks at different forms of direct and indirect employee participation in the EU. The research questions are: (1) which forms of direct and indirect employee participation can we distinguish?; (2) to what extent do forms of direct and indirect employee participation coincide within

  11. Comparison of Serum Selenium Levels in Breast Cancer Patients and Healthy People at a Cancer Institute in 2004

    Directory of Open Access Journals (Sweden)

    M Maleki

    2007-01-01

    Full Text Available Introduction: Breast Cancer is one of the most important fatal cancers in women. The mean age of breast cancer in Iran is 48.8 years which is very lower than other countries. Selenium can play an important role in reduction of cancer in several ways, for example selenium increases immunity response and protects cells from oxidation of free radicals and also decreases carcinogenic metabolites. Breast cancer is one of the most important cancers in our country because its incidence is very high and the mean age of patients is very low. Different studies have shown the benefits of selenium in prevention of cancer and since many years selenium has been used as a dietary supplement in advanced countries. Several studies regarding relationship between selenium levels and breast cancer have been done in different countries. We therefore planned a study to evaluate serum selenium levels in breast cancer patients and compare them with a healthy control group. Methods: We selected 45 patients younger than 48 years old and 33 patients older than 48 years old who had not yet received any therapy (surgery, chemotherapy, etc for their cancer as a case group and 46 healthy people who were matched with the patients as a control group and included 23 persons younger and 23 persons older than 48 years old. From each participant, 5cc blood was derived and in several stages, serum selenium levels were evaluated using atomic absorption technology. Data about type of cancer, stage, grade, IHC and cigarette smoking were also collected. Results: The mean Se level was 161.20 μg/l (SD=46.27 μg/l in the patients and 189.13 μg/l (SD=48.75 μg/l in the control group that was statistically significant (P48 years old was 155.39 μg/l (SD=46.68 μg/l that was lower than the control groups. Difference in serum selenium levels between patients and controls in the older group was significant (P=0.007, but in the younger group, it was not statistically significant (P=0

  12. Cancer in Guam and Hawaii: A comparison of two U.S. Island populations.

    Science.gov (United States)

    Hernandez, Brenda Y; Bordallo, Renata A; Green, Michael D; Haddock, Robert L

    2017-10-01

    Cancer disparities within and across populations provide insight into the influence of lifestyle, environment, and genetic factors on cancer risk. Guam cancer incidence and mortality were compared to that of Hawaii using data from their respective population-based, central cancer registries. In 2009-2013, overall cancer incidence was substantially lower in Guam than in Hawaii for both sexes while overall cancer mortality was higher for Guam males. Cervical cancer incidence and prostate cancer mortality were higher in Guam. Both incidence and mortality were higher among Guam men for cancers of the lung & bronchus, liver & intrahepatic bile duct, and nasopharynx; Chamorro men were disproportionately affected by these cancers. Filipinos and Whites in Guam had lower overall cancer incidence compared to Filipinos and Whites in Hawaii. Although breast cancer incidence was significantly lower in Guam compared to Hawaii, women in Guam presented at younger ages and with rarer disease histologies such as inflammatory carcinoma were more prevalent. Guam patients were also diagnosed at younger ages for cancers of bladder, pancreas, colon & rectum, liver & intrahepatic bile duct, lung & bronchus, stomach, non-Hodgkin lymphoma, and leukemia. Smoking, infectious agents, and betel nut chewing appear to be important contributors to the burden of cancer in Guam. Earlier onset of cancer in Guam suggests earlier age of exposure to key risk factors and/or a more aggressive pathogenesis. Contrasting cancer patterns within Guam and between Guam and Hawaii underscore the potential influence of genes, lifestyle, and environmental factors on cancer development and progression. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Energy Expenditure Evaluation in Humans and Non-Human Primates by SenseWear Armband. Validation of Energy Expenditure Evaluation by SenseWear Armband by Direct Comparison with Indirect Calorimetry

    Science.gov (United States)

    Casiraghi, Francesca; Chavez, Alberto O.; Davalli, Alberto M.; Naegelin, Terry; Comuzzie, Anthony G.; Frost, Patricia; Musi, Nicolas; Folli, Franco

    2013-01-01

    Introduction The purpose of this study was to compare and validate the use of SenseWear Armband (SWA) placed on the arm (SWA ARM) and on the back (SWA BACK) in healthy humans during resting and a cycle-ergometer exercise and to evaluate the SWA to estimate Resting Energy Expenditure (REE) and Total Energy Expenditure (TEE) in healthy baboons. Methods We studied 26 (15F/11M) human subjects wearing SWA in two different anatomical sites (arm and back) during resting and a cycle-ergometer test and directly compared these results with indirect calorimetry evaluation (IC), performed at the same time. We then inserted the SWA in a metabolic jacket for baboons and evaluated the TEE and REE in free living condition for 6 days in 21 (8F/13M) non-human primates. Results In humans we found a good correlation between SWA place on the ARM and on the BACK with IC during the resting experiment (1.1±0.3 SWAs, 1±0.2 IC kcal/min) and a slight underestimation in the SWAs data compared with IC during the cycle-ergometer exercise (5±1.9 SWA ARM, 4.5±1.5 SWA BACK and 5.4±2.1 IC kcal/min). In the non-human primate (baboons) experiment SWA estimated a TEE of 0.54±0.009 kcal/min during free living and a REE of 0.82±0.06 kcal/min. Conclusion SWA, an extremely simple and inexpensive apparatus, provides quite accurate measurements of energy expenditure in humans and in baboons. Energy expenditure data obtained with SWA are highly correlated with the data obtained with “gold standard”, IC, in humans. PMID:24069218

  14. Energy expenditure evaluation in humans and non-human primates by SenseWear Armband. Validation of energy expenditure evaluation by SenseWear Armband by direct comparison with indirect calorimetry.

    Science.gov (United States)

    Casiraghi, Francesca; Lertwattanarak, Raweewan; Luzi, Livio; Chavez, Alberto O; Davalli, Alberto M; Naegelin, Terry; Comuzzie, Anthony G; Frost, Patricia; Musi, Nicolas; Folli, Franco

    2013-01-01

    The purpose of this study was to compare and validate the use of SenseWear Armband (SWA) placed on the arm (SWA ARM) and on the back (SWA BACK) in healthy humans during resting and a cycle-ergometer exercise and to evaluate the SWA to estimate Resting Energy Expenditure (REE) and Total Energy Expenditure (TEE) in healthy baboons. We studied 26 (15F/11M) human subjects wearing SWA in two different anatomical sites (arm and back) during resting and a cycle-ergometer test and directly compared these results with indirect calorimetry evaluation (IC), performed at the same time. We then inserted the SWA in a metabolic jacket for baboons and evaluated the TEE and REE in free living condition for 6 days in 21 (8F/13M) non-human primates. In humans we found a good correlation between SWA place on the ARM and on the BACK with IC during the resting experiment (1.1±0.3 SWAs, 1±0.2 IC kcal/min) and a slight underestimation in the SWAs data compared with IC during the cycle-ergometer exercise (5±1.9 SWA ARM, 4.5±1.5 SWA BACK and 5.4±2.1 IC kcal/min). In the non-human primate (baboons) experiment SWA estimated a TEE of 0.54±0.009 kcal/min during free living and a REE of 0.82±0.06 kcal/min. SWA, an extremely simple and inexpensive apparatus, provides quite accurate measurements of energy expenditure in humans and in baboons. Energy expenditure data obtained with SWA are highly correlated with the data obtained with "gold standard", IC, in humans.

  15. Prevalence of Types of Cancers in the Elderly Covered by Insurance of the Islamic Republic of Iran Broadcasting Company in 2015 - Comparison with Younger Groups.

    Science.gov (United States)

    Roshani, Zahra; Akbari Kamrani, Ahmad Ali; Shati, Mohsen; Sahaf, Robab

    2016-01-01

    Presently, the world population of the elderly is growing. By improving health hygiene and welfare indicators, mortality and birth rates decrease and life expectancy increases, making the present century the century of elderly. Aging is one of the main risk factors for development of cancer, which itself is the second cause of death in old people. This study was conducted to assess the prevalence of cancer in the elderly covered by the Islamic Republic of Iran Broadcasting (IRIB) insurance program and to obtain suitable programs for cancer screening and early detection, increase patient survival, improve elderly care and to reclaim the cost of treatment in comparison to the national and international statistics. This is a cross-sectional study conducted on all elderly patients diagnosed with malignancy based on their pathology reports. In this study, of the total 75,500 patients covered by IRIB insurance, 17.2% belonged to the elderly group, males accounting for 53.3%. The most common cancers in old men were prostatic cancer (61.3%), colon cancer (10.3%) cancer of the hematologic system, bladder cancer (9.6%), lung cancer (9.1%), thyroid cancer (3.9%) and brain tumors (1.3%). In the elderly women, the most common cancers were breast cancer (80.1%), colon cancer (5.1%), thyroid cancers (4.4%), bladder and hematologic system malignancies (3.6), lung cancer (2.9%) and brain tumors (0.7%). In addition, the prevalence of cancer was almost the same as national and international statistics. With the exception of non-melanoma skin cancer no difference was shown in prevalence of cancer between IRIB elderly patients and the other groups of cancer patients in Iran.

  16. Comparison of candidate serologic markers for type I and type II ovarian cancer

    DEFF Research Database (Denmark)

    Lu, Dan; Kuhn, Elisabetta; Bristow, Robert E

    2011-01-01

    To examine the value of individual and combinations of ovarian cancer associated blood biomarkers for the discrimination between plasma of patients with type I or II ovarian cancer and disease-free volunteers....

  17. A Comparison of daily megavoltage CT and ultrasound image guided radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Peng Cheng; Kainz, Kristofer; Lawton, Colleen; Li, X. Allen

    2008-01-01

    In order to quantify the differences between ultrasound-imaging and megavoltage-CT (MVCT) daily prostate localization in prostate-cancer radiotherapy and their dosimetric impacts, daily shifts were analyzed for a total of 140 prostate cancer patients; 106 positioned using ultrasound-based imaging [B-mode Acquisition and Targeting (BAT)], and 34 using the MVCT from a TomoTherapy Hi-Art unit. The shifts indicated by the two systems were compared statistically along the right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions. The systematic and random variations among the daily alignments were calculated. Margins to account for these shifts were estimated. The mean shifts and standard deviations along the R/L, S/I, and A/P directions were -0.11±3.80, 0.67±4.67, and 2.71±6.31 mm for BAT localizations and -0.98±5.13, 0.27±3.35, and 1.00±4.22 mm for MVCT localizations, respectively. The systematic and random variations in daily shifts based on MVCT were generally smaller than those based on BAT, especially along the A/P direction. A t-test showed this difference to be statistically significant. The planning target volume margins in the A/P direction estimated to account for daily variations were 8.81 and 14.66 mm based on MVCT and BAT data, respectively. There was no statistically significant difference in the daily prostate movement pattern between the first few fractions and the remaining fractions. Dosimetric comparison of MVCT and BAT prostate alignments was performed for seven fractions from a patient. The degradation from the plan caused by the MVCT alignment is trivial, while that by BAT is substantial. The MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is more reliable and precise for prostate localization. Ultrasound-based localization may overestimate the daily prostate motion, particularly in the A/P direction, negatively impacting prostate dose coverage and rectal

  18. Radiotherapy of prostate cancer with or without intensity modulated beams: a planning comparison

    International Nuclear Information System (INIS)

    Meerleer, Gert O. de; Vakaet, Luc A.M.L.; Gersem, Werner R.T. de; Wagter, Carlos de; Naeyer, Bart de; Neve, Wilfried de

    2000-01-01

    Purpose: To evaluate whether intensity modulated radiotherapy (IMRT) by static segmented beams allows the dose to the main portion of the prostate target to escalate while keeping the maximal dose at the anterior rectal wall at 72 Gy. The value of such IMRT plans was analyzed by comparison with non-IMRT plans using the same beam incidences. Methods and Materials: We performed a planning study on the CT data of 32 consecutive patients with localized adenocarcinoma of the prostate. Three fields in the transverse plane with gantry angles of 0 deg. , 116 deg. , and 244 deg. were isocentered at the center of gravity of the target volume (prostate and seminal vesicles). The geometry of the beams was determined by beam's eye view autocontouring of the target volume with a margin of 1.5 cm. In study 1, the beam weights were determined by a human planner (3D-man) or by computer optimization using a biological objective function with (3D-optim-lim) or without (3D-optim-unlim) a physical term to limit target dose inhomogeneity. In study 2, the 3 beam incidences mentioned above were used and in-field uniform segments were added to allow IMRT. Plans with (IMRT-lim) or without (IMRT-unlim) constraints on target dose inhomogeneity were compared. In the IMRT-lim plan, target dose inhomogeneity was constrained between 15% and 20%. After optimization, plans in both studies were normalized to a maximal rectal dose of 72 Gy. Biological (tumor control probability [TCP], normal tissue complication probability [NTCP]) and physical indices for tumor control and normal tissue complication probabilities were computed, as well as the probability of the uncomplicated local control (P+). Results: The IMRT-lim plan was superior to all other plans concerning TCP (p =no. 89%). For bladder, maximal bladder dose was significantly higher in the IMRT-unlim plan compared to all other plans (p no. <=no. 0.0001). P+ was significantly higher in both IMRT-plans than in all other plans. The 3D

  19. A Comparison of daily megavoltage CT and ultrasound image guided radiation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Peng Cheng; Kainz, Kristofer; Lawton, Colleen; Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 (United States)

    2008-12-15

    In order to quantify the differences between ultrasound-imaging and megavoltage-CT (MVCT) daily prostate localization in prostate-cancer radiotherapy and their dosimetric impacts, daily shifts were analyzed for a total of 140 prostate cancer patients; 106 positioned using ultrasound-based imaging [B-mode Acquisition and Targeting (BAT)], and 34 using the MVCT from a TomoTherapy Hi-Art unit. The shifts indicated by the two systems were compared statistically along the right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions. The systematic and random variations among the daily alignments were calculated. Margins to account for these shifts were estimated. The mean shifts and standard deviations along the R/L, S/I, and A/P directions were -0.11{+-}3.80, 0.67{+-}4.67, and 2.71{+-}6.31 mm for BAT localizations and -0.98{+-}5.13, 0.27{+-}3.35, and 1.00{+-}4.22 mm for MVCT localizations, respectively. The systematic and random variations in daily shifts based on MVCT were generally smaller than those based on BAT, especially along the A/P direction. A t-test showed this difference to be statistically significant. The planning target volume margins in the A/P direction estimated to account for daily variations were 8.81 and 14.66 mm based on MVCT and BAT data, respectively. There was no statistically significant difference in the daily prostate movement pattern between the first few fractions and the remaining fractions. Dosimetric comparison of MVCT and BAT prostate alignments was performed for seven fractions from a patient. The degradation from the plan caused by the MVCT alignment is trivial, while that by BAT is substantial. The MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is more reliable and precise for prostate localization. Ultrasound-based localization may overestimate the daily prostate motion, particularly in the A/P direction, negatively impacting prostate dose coverage

  20. Evaluation and comparison of textural feature representation for the detection of early stage cancer in endoscopy

    NARCIS (Netherlands)

    Setio, A.A.A.; Sommen, van der F.; Zinger, S.; Schoon, E.J.; With, de P.H.N.

    2013-01-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The novel technology of High Definition (HD) endoscopy enables physicians to find texture patterns related to early cancer. It encourages the development of a Computer-Aided Decision (CAD) system in order to help physicians

  1. Mammographic features and subsequent risk of breast cancer: a comparison of qualitative and quantitative evaluations in the Guernsey prospective studies.

    Science.gov (United States)

    Torres-Mejía, Gabriela; De Stavola, Bianca; Allen, Diane S; Pérez-Gavilán, Juan J; Ferreira, Jorge M; Fentiman, Ian S; Dos Santos Silva, Isabel

    2005-05-01

    Mammographic features are known to be associated with breast cancer but the magnitude of the effect differs markedly from study to study. Methods to assess mammographic features range from subjective qualitative classifications to computer-automated quantitative measures. We used data from the UK Guernsey prospective studies to examine the relative value of these methods in predicting breast cancer risk. In all, 3,211 women ages > or =35 years who had a mammogram taken in 1986 to 1989 were followed-up to the end of October 2003, with 111 developing breast cancer during this period. Mammograms were classified using the subjective qualitative Wolfe classification and several quantitative mammographic features measured using computer-based techniques. Breast cancer risk was positively associated with high-grade Wolfe classification, percent breast density and area of dense tissue, and negatively associated with area of lucent tissue, fractal dimension, and lacunarity. Inclusion of the quantitative measures in the same model identified area of dense tissue and lacunarity as the best predictors of breast cancer, with risk increasing by 59% [95% confidence interval (95% CI), 29-94%] per SD increase in total area of dense tissue but declining by 39% (95% CI, 53-22%) per SD increase in lacunarity, after adjusting for each other and for other confounders. Comparison of models that included both the qualitative Wolfe classification and these two quantitative measures to models that included either the qualitative or the two quantitative variables showed that they all made significant contributions to prediction of breast cancer risk. These findings indicate that breast cancer risk is affected not only by the amount of mammographic density but also by the degree of heterogeneity of the parenchymal pattern and, presumably, by other features captured by the Wolfe classification.

  2. Comparison of the Mismatch Repair System between Primary and Metastatic Colorectal Cancers Using Immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Jiyoon Jung

    2017-03-01

    Full Text Available Background Colorectal cancer (CRC is one of the most common malignancies worldwide. Approximately 10%–15% of the CRC cases have defective DNA mismatch repair (MMR genes. Although the high level of microsatellite instability status is a predictor of favorable outcome in primary CRC, little is known about its frequency and importance in secondary CRC. Immunohistochemical staining (IHC for MMR proteins (e.g., MLH1, MSH2, MSH6, and PMS2 has emerged as a useful technique to complement polymerase chain reaction (PCR analyses. Methods In this study, comparison between the MMR system of primary CRCs and paired liver and lung metastatic lesions was done using IHC and the correlation with clinical outcomes was also examined. Results Based on IHC, 7/61 primary tumors (11.4% showed deficient MMR systems, while 13/61 secondary tumors (21.3% showed deficiencies. In total, 44 cases showed proficient expression in both the primary and metastatic lesions. Three cases showed deficiencies in both the primary and paired metastatic lesions. In 10 cases, proficient expression was found only in the primary lesions, and not in the corresponding metastatic lesions. In four cases, proficient expression was detected in the secondary tumor, but not in the primary tumor. Conclusions Although each IHC result and the likely defective genes were not exactly matched between the primary and the metastatic tumors, identical results for primary and metastatic lesions were obtained in 77% of the cases (47/61. These data are in agreement with the previous microsatellite detection studies that used PCR and IHC.

  3. Comparison of radioimmunotherapy and external beam radiotherapy in colon cancer xenografts

    International Nuclear Information System (INIS)

    Buras, R.R.; Wong, J.F.C.; Kuhn, J.A.; Beatty, B.G.; Williams, L.E.; Beatty, J.D.; Wanek, P.M.

    1993-01-01

    Radioimmunotherapy and external beam radiotherapy were compared in a nude mouse human colon cancer model. Radioimmunotherapy was delivered by intraperitoneal injection of 90 Y-labeled anticarcinoembryonic antigen monoclonal antibody (anti-CEA MAB). Single fraction external beam radiotherapy was delivered using a 60 Co teletherapy unit. Control groups received saline, unlabeled anit-CEA monoclonal antibody and labeled nonspecific monoclonal antibody. Tumor growth suppression was expressed as delay to reach 2g compared to saline controls. Unlabeled anti-CEA monoclonal antibody and labeled nonspecific monoclonal antibody had no effect. External beam radiotherapy of 300, 600, 1000 and 2000 cGy produced growth delays of 3, 12, 17, and 22 days, respectively. Radioimmunotherapy with 120 μCi, 175 μCi, and 225 μCi resulted in growth delays of 20, 34, and 36 days. Estimated absorbed tumor dose was 1750 cGy in the 120 μCi group. Similar comparisons were done with the more radioresistant WiDr human colon carcinoma cell line. External beam radiotherapy doses of 400, 800, 1200, and 1600 cGy resulted in growth delays of 6, 21, 36 and 48 days, respectively. Radioimmunotherapy of 120 μCi and 175 μCi resulted in growth delays of 9 and 19 days, respectively. The 120 μCi dose delivered an estimated absorbed tumor dose of 1080 cGy to WiDr tumors. In summary, for the radiosensitive LS174T line, radioimmunotherapy produced biologic effects that were comparable to a similar dose of single fraction external beam radiotherapy. For the more radioresistant WiDr tumor, radioimmunotherapy produced a biologic effect which was less than a similar dose of single fraction external beam radiotherapy. These studies suggest that a tumor's response to radioimmunotherapy relative to that of external beam radiotherapy is, in part, dependent on tumor radiosensitivity and repair capacity. 23 refs., 5 figs. 4 tabs

  4. Comparison of cancer survival in New Zealand and Australia, 2006-2010.

    Science.gov (United States)

    Aye, Phyu S; Elwood, J Mark; Stevanovic, Vladimir

    2014-12-19

    Previous studies have shown substantially higher mortality rates from cancer in New Zealand compared to Australia, but these studies have not included data on patient survival. This study compares the survival of cancer patients diagnosed in 2006-10 in the whole populations of New Zealand and Australia. Identical period survival methods were used to calculate relative survival ratios for all cancers combined, and for 18 cancers each accounting for more than 50 deaths per year in New Zealand, from 1 to 10 years from diagnosis. Cancer survival was lower in New Zealand, with 5-year relative survival being 4.2% lower in women, and 3.8% lower in men for all cancers combined. Of 18 cancers, 14 showed lower survival in New Zealand; the exceptions, with similar survival in each country, being melanoma, myeloma, mesothelioma, and cervical cancer. For most cancers, the differences in survival were maximum at 1 year after diagnosis, becoming smaller later; however, for breast cancer, the survival difference increased with time after diagnosis. The lower survival in New Zealand, and the higher mortality rates shown earlier, suggest that further improvements in recognition, diagnosis, and treatment of cancer in New Zealand should be possible. As the survival differences are seen soon after diagnosis, issues of early management in primary care and time intervals to diagnosis and treatment may be particularly important.

  5. Comparison of cancer incidence and mortality in three GDP per capita levels in China, 2013.

    Science.gov (United States)

    Yang, Zhixun; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Xia, Changfa; Li, He; Wang, Li; Wang, Yanhong; Chen, Wanqing

    2017-10-01

    In this research, the patterns of cancer incidence and mortality in areas with different gross domestic product per capita (GDPPC) levels in China were explored, using data from population-based cancer registries in 2013, collected by the National Central Cancer Registry (NCCR). Data from 255 cancer registries were qualified and included in this analysis. Based on the GDPPC data of 2014, cities/counties were divided into 3 levels: high-, middle- and low-GDPPC areas, with 40,000 and 80,000 RMB per year as cut points. We calculated cancer incidences and mortalities in these three levels, stratified by gender and age group. The national population of the Fifth Census in 2000 and Segi's population were applied for age-standardized rates. The crude incidence and mortality rates as well as age-standardized incidence rate (ASIR) showed positive associations with GDPPC level. The age-standardized mortality rate (ASMR) nevertheless showed a negative association with GDPPC level. The ASMR in high-, middle- and low-GDPPC areas was 103.12/100,000, 112.49/100,000 and 117.43/100,000, respectively. Lung cancer was by far the most common cancer in all three GDPPC levels. It was also the leading cause of cancer death, regardless of gender and GDPPC level. Negative associations with GDPPC level were found for the ASIRs of lung, stomach, esophageal and liver cancer, whereas colorectal and breast cancer showed positive associations. Except for breast cancer, the ASMRs of the other five cancers were always higher in middle- and low-GDPPC areas than in high-GDPPC areas. The economic development is one of the main factors of the heavy cancer burden on Chinese population. It would be reasonable to implement cancer control strategies referring to the local GDPPC level.

  6. A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding

    Directory of Open Access Journals (Sweden)

    Carter Ashley JR

    2012-07-01

    Full Text Available Abstract Background Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; “Years of Life Lost” (YLL measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Methods Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Results Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers. Conclusions These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden.

  7. Readability Comparison of Pro- and Anti-Cancer Screening Online Messages in Japan

    Science.gov (United States)

    Okuhara, Tsuyoshi; Ishikawa, Hirono; Okada, Masahumi; Kato, Mio; Kiuchi, Takahiro

    2016-01-01

    Background: Cancer screening rates are lower in Japan than those in western countries. Health professionals publish pro-cancer screening messages on the internet to encourage audiences to undergo cancer screening. However, the information provided is often difficult to read for lay persons. Further, anti-cancer screening activists warn against cancer screening with messages on the Internet. We aimed to assess and compare the readability of pro- and anti-cancer screening online messages in Japan using a measure of readability. Methods: We conducted web searches at the beginning of September 2016 using two major Japanese search engines (Google.jp and Yahoo!.jp). The included websites were classified as “anti”, “pro”, or “neutral” depending on the claims, and “health professional” or “non-health professional” depending on the writers. Readability was determined using a validated measure of Japanese readability. Statistical analysis was conducted using two-way ANOVA. Results: In the total 159 websites analyzed, anti-cancer screening online messages were generally easier to read than pro-cancer screening online messages, Messages written by health professionals were more difficult to read than those written by non-health professionals. Claim × writer interaction was not significant. Conclusion: When health professionals prepare pro-cancer screening materials for publication online, we recommend they check for readability using readability assessment tools and improve text for easy comprehension when necessary. PMID:28125867

  8. Breast Cancer Epidemiology in Gulf Cooperation Council Countries: A Regional and International Comparison.

    Science.gov (United States)

    Albeshan, Salman M; Mackey, Martin G; Hossain, Syeda Z; Alfuraih, Abdulrahman A; Brennan, Patrick C

    2017-07-13

    Breast cancer is the most frequently diagnosed noncutaneous malignancy in women living in Gulf Cooperation Council countries. The present report aimed to highlight the similarities and variations in breast cancer incidence, age at diagnosis, clinicopathologic features, molecular characteristics, and lifestyle factors that contribute to an increasing incidence of breast cancer compared with neighboring Arab and westernized countries. The data presented, although having important implications for policy makers, also highlights the need for further research. Such research would ensure that effective prevention and detection strategies are tailored to the specific needs of the Gulf women such that the management of breast cancer is optimized. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Cancer of the ovary, fallopian tube, and peritoneum: a population-based comparison of the prognostic factors and outcomes.

    Science.gov (United States)

    Rottmann, Miriam; Burges, A; Mahner, S; Anthuber, C; Beck, T; Grab, D; Schnelzer, A; Kiechle, M; Mayr, D; Pölcher, M; Schubert-Fritschle, G; Engel, J

    2017-09-01

    The objective was to compare the prognostic factors and outcomes among primary ovarian cancer (OC), fallopian tube cancer (FC), and peritoneal cancer (PC) patients in a population-based setting. We analysed 5399 OC, 327 FC, and 416 PC patients diagnosed between 1998 and 2014 in the catchment area of the Munich Cancer Registry (meanwhile 4.8 million inhabitants). Tumour site differences were examined by comparing prognostic factors, treatments, the time to progression, and survival. The effect of the tumour site was additionally analysed by a Cox regression model. The median age at diagnosis, histology, and FIGO stage significantly differed among the tumour sites (p < 0.001); PC patients were older, more often diagnosed with a serous subtype, and in FIGO stage III or IV. The time to progression and survival significantly differed among the tumour sites. When stratified by FIGO stage, the differences in time to progression disappeared, and the differences in survival considerably weakened. The differences in the multivariate survival analysis showed an almost identical outcome in PC patients (HR 1.07 [0.91-1.25]) and an improved survival of FC patients (HR 0.63 [0.49-0.81]) compared to that of OC patients. The comparison of OC, FC, and PC patients in this large-scale population-based study showed differences in the prognostic factors. These differences primarily account for the inferior outcome of PC patients, and for the improved survival of FC compared to OC patients.

  10. Gene Expression Profiles for Predicting Metastasis in Breast Cancer: A Cross-Study Comparison of Classification Methods

    Directory of Open Access Journals (Sweden)

    Mark Burton

    2012-01-01

    Full Text Available Machine learning has increasingly been used with microarray gene expression data and for the development of classifiers using a variety of methods. However, method comparisons in cross-study datasets are very scarce. This study compares the performance of seven classification methods and the effect of voting for predicting metastasis outcome in breast cancer patients, in three situations: within the same dataset or across datasets on similar or dissimilar microarray platforms. Combining classification results from seven classifiers into one voting decision performed significantly better during internal validation as well as external validation in similar microarray platforms than the underlying classification methods. When validating between different microarray platforms, random forest, another voting-based method, proved to be the best performing method. We conclude that voting based classifiers provided an advantage with respect to classifying metastasis outcome in breast cancer patients.

  11. Direct versus indirect detection of supersymmetric dark matter

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    This document gathers the slides that were presented during the workshop 'direct versus indirect detection of supersymmetric dark matter'(about 30 contributions). This workshop intended to bring together people from the particle theory community, astrophysicists and cosmologists, as well as experimentalists involved in the detection of dark matter. The aim is to generate a discussion about current and future strategies for detection of SUSY dark matter (with focus, but not exclusively, on neutralinos). Complementarities between accelerator, direct and indirect searches as well as a comparison between the uncertainties in direct and indirect searches of dark matter, are supposed to be discussed. Among the issues which will be addressed are: -) the crucial questions related to the structure of galaxies (local dark matter density, clumping, anomalous velocity distributions, etc.) ; -) the possibilities offered by the present and future experimental facilities for direct and indirect (photon, neutrino) searches; -) the potential for the discovery of SUSY at LHC and beyond; and -) the parameterization of the SUSY breaking models beyond the minimal versions.

  12. Direct versus indirect detection of supersymmetric dark matter

    International Nuclear Information System (INIS)

    2003-01-01

    This document gathers the slides that were presented during the workshop 'direct versus indirect detection of supersymmetric dark matter'(about 30 contributions). This workshop intended to bring together people from the particle theory community, astrophysicists and cosmologists, as well as experimentalists involved in the detection of dark matter. The aim is to generate a discussion about current and future strategies for detection of SUSY dark matter (with focus, but not exclusively, on neutralinos). Complementarities between accelerator, direct and indirect searches as well as a comparison between the uncertainties in direct and indirect searches of dark matter, are supposed to be discussed. Among the issues which will be addressed are: -) the crucial questions related to the structure of galaxies (local dark matter density, clumping, anomalous velocity distributions, etc.) ; -) the possibilities offered by the present and future experimental facilities for direct and indirect (photon, neutrino) searches; -) the potential for the discovery of SUSY at LHC and beyond; and -) the parameterization of the SUSY breaking models beyond the minimal versions

  13. Planning comparison between intensity modulated radiation therapy and intensity modulated proton therapy in a case of head and neck cancer

    Science.gov (United States)

    Nguyen, T. T. C.; Nguyen, B. T.; Mai, N. V.

    2018-03-01

    In this work, we made the comparison between IMRT plan and IMPT plan for a head and neck case. We used Prowess Panther to perform IMRT plan and LAP- CERR for IMPT plan. The result showed that IMPT plan had better coverage than IMRT plan. In the IMRT plan, normal structures received higher dose with higher volume. Especially, the maximum dose of spinal cord is 31.5 Gy (RBE) using IMRT technique compared to 13.5 Gy (RBE) using IMPT technique. These results showed that IMPT is beneficial for head and neck cancer compared to IMRT technique.

  14. Contribution of Arab countries to breast cancer research: comparison with non-Arab Middle Eastern countries.

    Science.gov (United States)

    Sweileh, Waleed M; Zyoud, Sa'ed H; Al-Jabi, Samah W; Sawalha, Ansam F

    2015-01-01

    Breast cancer is one of the most common types of cancers affecting women worldwide. The main objective of this study was to assess and compare research activity in breast cancer in Arab countries with non-Arab Middle Eastern countries. Publications about "breast cancer" as a research topic were retrieved using the ISI Web of Science database. Analysis was confined to original research and review articles. Research productivity was assessed by assessing number of publications and time trend of these publications, names of journals, citation analysis, top 10 active institutions as well as country contribution to breast cancer research. The quantity and quality of publications from Arab countries in addition to 3 other Middle East countries (Turkey, Iran and Israel) were assessed and compared using the h-index tool. A total of 1658 original research and review articles about "breast cancer" were published from Arab countries. Annual research productivity from Arab countries in the field of "breast cancer" was negligible but showed a significant increase in the last decade. Retrieved documents had relatively high citation parameters as measured by h-index of 61 and average citations of 17.46 per document. The highest research productivity was from Egypt with a total publication of 582 (35.10%). Cairo University with a total of 149 (8.99%) publications had the highest research productivity among institutions in Arab world. Forty four documents (2.65%) of breast cancer documents were published in Saudi Medical Journal. Arab researchers collaborated mostly with researchers from the United States of America (305; 18.40%) in breast cancer research. Compared with other non-Arab Middle Eastern countries, Arab countries had higher research productivity than some countries and lower than others, particularly Israel. The present data reveals a good contribution of some Arab countries to the field of "breast cancer" research. There is a gap between Arab countries and Israel in

  15. Indirect Self-Destructiveness and Emotional Intelligence.

    Science.gov (United States)

    Tsirigotis, Konstantinos

    2016-06-01

    While emotional intelligence may have a favourable influence on the life and psychological and social functioning of the individual, indirect self-destructiveness exerts a rather negative influence. The aim of this study has been to explore possible relations between indirect self-destructiveness and emotional intelligence. A population of 260 individuals (130 females and 130 males) aged 20-30 (mean age of 24.5) was studied by using the Polish version of the chronic self-destructiveness scale and INTE, i.e., the Polish version of the assessing emotions scale. Indirect self-destructiveness has significant correlations with all variables of INTE (overall score, factor I, factor II), and these correlations are negative. The intensity of indirect self-destructiveness differentiates significantly the height of the emotional intelligence and vice versa: the height of the emotional intelligence differentiates significantly the intensity of indirect self-destructiveness. Indirect self-destructiveness has negative correlations with emotional intelligence as well as its components: the ability to recognize emotions and the ability to utilize emotions. The height of emotional intelligence differentiates the intensity of indirect self-destructiveness, and vice versa: the intensity of indirect self-destructiveness differentiates the height of emotional intelligence. It seems advisable to use emotional intelligence in the prophylactic and therapeutic work with persons with various types of disorders, especially with the syndrome of indirect self-destructiveness.

  16. Postoperative Intensity Modulated Radiation Therapy in High Risk Prostate Cancer: A Dosimetric Comparison

    International Nuclear Information System (INIS)

    Digesu, Cinzia; Cilla, Savino; De Gaetano, Andrea; Massaccesi, Mariangela; Macchia, Gabriella; Ippolito, Edy; Deodato, Francesco; Panunzi, Simona; Iapalucci, Chiara; Mattiucci, Gian Carlo; D'Angelo, Elisa; Padula, Gilbert D.A.; Valentini, Vincenzo; Cellini, Numa

    2011-01-01

    The aim of this study was to compare intensity-modulated radiation therapy (IMRT) with 3D conformal technique (3D-CRT), with respect to target coverage and irradiation of organs at risk for high dose postoperative radiotherapy (PORT) of the prostate fossa. 3D-CRT and IMRT treatment plans were compared with respect to dose to the rectum and bladder. The dosimetric comparison was carried out in 15 patients considering 2 different scenarios: (1) exclusive prostate fossa irradiation, and (2) pelvic node irradiation followed by a boost on the prostate fossa. In scenario (1), a 3D-CRT plan (box technique) and an IMRT plan were calculated and compared for each patient. In scenario (2), 3 treatment plans were calculated and compared for each patient: (a) 3D-CRT box technique for both pelvic (prophylactic nodal irradiation) and prostate fossa irradiation (3D-CRT only); (b) 3D-CRT box technique for pelvic irradiation followed by an IMRT boost to the prostatic fossa (hybrid 3D-CRT and IMRT); and (c) IMRT for both pelvic and prostate fossa irradiation (IMRT only). For exclusive prostate fossa irradiation, IMRT significantly reduced the dose to the rectum (lower Dmean, V50%, V75%, V90%, V100%, EUD, and NTCP) and the bladder (lower Dmean, V50%, V90%, EUD and NTCP). When prophylactic irradiation of the pelvis was also considered, plan C (IMRT only) performed better than plan B (hybrid 3D-CRT and IMRT) as respect to both rectum and bladder irradiation (reduction of Dmean, V50%, V75%, V90%, equivalent uniform dose [EUD], and normal tissue complication probability [NTCP]). Plan (b) (hybrid 3D-CRT and IMRT) performed better than plan (a) (3D-CRT only) with respect to dose to the rectum (lower Dmean, V75%, V90%, V100%, EUD, and NTCP) and the bladder (Dmean, EUD, and NTCP). Postoperative IMRT in prostate cancer significantly reduces rectum and bladder irradiation compared with 3D-CRT.

  17. Propensity Score Matched Comparison of Intensity Modulated Radiation Therapy vs Stereotactic Body Radiation Therapy for Localized Prostate Cancer: A Survival Analysis from the National Cancer Database

    Directory of Open Access Journals (Sweden)

    Anthony Ricco

    2017-08-01

    Full Text Available PurposeNo direct comparisons between extreme hypofractionation and conventional fractionation have been reported in randomized trials for the treatment of localized prostate cancer. The goal of this study is to use a propensity score matched (PSM analysis with the National Cancer Database (NCDB for the comparison of stereotactic body radiation therapy (SBRT and intensity modulated radiation therapy (IMRT for organ confined prostate cancer.MethodsMen with localized prostate cancer treated with radiation dose ≥72 Gy for IMRT and ≥35 Gy for SBRT to the prostate only were abstracted from the NCDB. Men treated with previous surgery, brachytherapy, or proton therapy were excluded. Matching was performed to eliminate confounding variables via PSM. Simple 1–1 nearest neighbor matching resulted in a matched sample of 5,430 (2,715 in each group. Subset analyses of men with prostate-specific antigen (PSA > 10, GS = 7, and GS > 7 yielded matched samples of 1,020, 2,194, and 247, respectively.ResultsNo difference in survival was noted between IMRT and SBRT at 8 years (p = 0.65. Subset analyses of higher risk men with PSA > 10 or GS = 7 histology or GS > 7 histology revealed no difference in survival between IMRT and SBRT (p = 0.58, p = 0.68, and p = 0.62, respectively. Variables significant for survival for the matched group included: age (p < 0.0001, primary payor (p = 0.0001, Charlson/Deyo Score (p = 0.0002, PSA (p = 0.0013, Gleason score (p < 0.0001, and use of hormone therapy (p = 0.02.ConclusionUtilizing the NCDB, there is no difference in survival at 8 years comparing IMRT to SBRT in the treatment of localized prostate cancer. Subset analysis confirmed no difference in survival even for intermediate- and high-risk patients based on Gleason Score and PSA.

  18. Health Locus of Control in Indonesian Women with Breast Cancer: a Comparison with Healthy Women

    NARCIS (Netherlands)

    Iskandarsyah, A.; de Klerk, C.; Suardi, D.R.; Sadarjoen, S.S.; Passchier, J.

    2014-01-01

    The aims of this study were to assess whether Indonesian women with breast cancer havea higher external health locus of control (HLC) than healthy women, and to explore the association between HLC and symptoms of anxiety and depression. In this study, 120 consecutive women with breast cancer were

  19. Comparison of sonographic features in benign prostate hyperplasia and prostate cancer

    International Nuclear Information System (INIS)

    Choi, Won Young; Hong, Hyun Sook; Kang, Eun Young; Seol, Hae Young; Suh, Won Hyuck

    1988-01-01

    Transrectal sonography of prostate was sensitive to textural changes produced by both benign prostate hyperplasia (BPH) and prostate cancers. During recent 4 years, twenty cases of BPH and twenty cases of prostate cancers proven histologically were analyzed in their sonographic features, retrospectively, by using transrectal prostate sonography and suprapubic prostate sonography. The results were as follows: 1. Mean weights of BPH and prostate cancers was 40.4g and 47.6g, respectively. 2. Sonographic features of BPH revealed isoechogenecity in 11 cases, homogeneity in 18 cases, well defined capsular margins in 19 cases, and calcification in 16 cases. 3. Sonographic features of prostate cancers revealed mixed echogenecity in 14 cases, inhomogeneity in 15 cases, poorly defined capsular margin in 14 cases, and calcifications in 13 cases. 4. Authors concluded that prostate sonography were valuable diagnostic modality in the differentiation of BPH and prostate cancers.

  20. Cancer treatment decision-making among young adults with lung and colorectal cancer: a comparison with adults in middle age.

    Science.gov (United States)

    Mack, Jennifer W; Cronin, Angel; Fasciano, Karen; Block, Susan D; Keating, Nancy L

    2016-09-01

    Our aim is to understand experiences with treatment decision-making among young adults with cancer. We studied patients with lung cancer or colorectal cancer in the Cancer Care Outcomes Research and Surveillance Consortium, a prospective cohort study. We identified 148 young adult patients aged 21-40 years who completed baseline interview questions about cancer treatment decision-making; each was propensity score matched to three middle adult patients aged 41-60 years, for a cohort of 592 patients. Patients were asked about decision-making preferences, family involvement in decision-making, and worries about treatment. An ordinal logistic regression model evaluated factors associated with more treatment worries. Young and middle-aged adults reported similar decision-making preferences (p = 0.80) and roles relative to physicians (p = 0.36). Although family involvement was similar in the age groups (p = 0.21), young adults were more likely to have dependent children in the home (60% younger versus 28% middle-aged adults, p Young adults reported more worries about time away from family (p = 0.002), and, in unadjusted analyses, more cancer treatment-related worries (mean number of responses of 'somewhat' or 'very' worried 2.5 for younger versus 2.2 for middle-aged adults, p = 0.02.) However, in adjusted analyses, worries were associated with the presence of dependent children in the home (odds ratio [OR] 1.55, 95% CI = 1.07-2.24, p = 0.02), rather than age. Young adults involve doctors and family members in decisions at rates similar to middle-aged adults but experience more worries about time away from family. Patients with dependent children are especially likely to experience worries. Treatment decision-making strategies should be based on individual preferences and needs rather than age alone. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Comparison of effective atomic numbers of the cancerous and normal kidney tissue

    International Nuclear Information System (INIS)

    Manjunatha, H.C.

    2015-01-01

    The effective atomic number (Z eff ) and electron density (N e ) of normal kidney and cancerous kidney have been computed for total and partial photon interactions by computing the molecular, atomic, and electronic cross section in the wide energy range of 1 keV-100 GeV using WinXCOM. The mean Z eff and N e of normal kidney and cancerous kidney in the various energy ranges and for total and partial photon interactions are tabulated. The variation of effective N e with energy is shown graphically for all photon interactions. In addition to this computer tomography (CT), numbers of normal kidney and cancerous kidney for photon interaction and energy absorption is also computed. The role of Z eff in the dual-energy dividing radiography is also discussed. The values of Z eff and N e for cancerous kidney are higher than normal kidney. This is due to the levels of elements K, Ca, Fe, Ni, and Se are lower and those of the elements Ti, Co, Zn, As, and Cd are higher in the cancer tissue of kidney than those observed in the normal tissue. The soft tissue and cancerous tissue are very similar, but their atomic number differs. The cancerous tissue exhibits a higher Z eff than the normal tissue. This fact helps in the dual-energy dividing radiography which enables to improve the diagnosis of the kidney cancer. Hence, the computed values may be useful in the diagnosis of the kidney cancer. CT numbers for normal kidney are higher than cancerous kidney. (author)

  2. Comparison of serum lipid profiles between normal controls and breast cancer patients

    Directory of Open Access Journals (Sweden)

    Pikul Laisupasin

    2013-01-01

    Full Text Available Background: Researchers have reported association of plasma/serum lipids and lipoproteins with different cancers. Increase levels of circulating lipids and lipoproteins have been associated with breast cancer risk. Aim: The aim of this study is to compare serum lipid profiles: total-cholesterol (T-CHOL, triglyceride (TG, high density lipoprotein-cholesterol (HDL-C, low density lipoprotein-cholesterol (LDL-C and very low density lipoprotein-cholesterol (VLDL-C between breast cancer patients and normal participants. Materials and Methods: A total of 403 women in this study were divided into two groups in the period during May 2006-April 2007. Blood samples were collected from 249 patients with early stage breast cancer and 154 normal controls for serum lipid profiles (T-CHOL, TG, HDL-C, LDL-C and VLDL-C analysis using Hitachi 717 Autoanalyzer (Roche Diagnostic GmbH, Germany. TG, LDL-C and VLDL-C levels in breast cancer group were significantly increased as compared with normal controls group (P < 0.001, whereas HDL-C and T-CHOL levels were not. Results: The results of this study suggest that increased serum lipid profiles may associate with breast cancer risk in Thai women. Further studies to group important factors including, cancer stages, types of cancer, parity, and menopausal status that may affect to lipid profiles in breast cancer patients along with an investigation of new lipid profiles to clarify most lipid factors that may involve in breast cancer development are needed.

  3. Genetic Alterations in Prostate Cancers among African American Men and Comparisons with Cancers from European and Asian Patients

    Science.gov (United States)

    2016-10-01

    ERG (T_E) that creates the fusion of these two genes. Preliminary result analysis suggests that the tumor genome of African American PCa may harbor a...Table 1) that creates the fusion of these two genes, as this fusion is one of the most common somatically acquired changes of genomic structure in...based molecular markers for predication of cancer progression. To evaluate the feasibility of using DNA from FFPE samples, we performed exploratory

  4. Comparison of intraductal spread on dynamic contrast-enhanced MRI with clinicopathologic features in breast cancer

    International Nuclear Information System (INIS)

    Komatsu, Shuhei; Lee, Chol-Joo; Hosokawa, Yohei; Ichikawa, Daisuke; Hamashima, Takashi; Shirono, Koichi; Okabe, Harumi; Kurioka, Hideaki; Oka, Takahiro

    2004-01-01

    Contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a new diagnostic technology in various breast cancer treatments. However, little is known about the correlation between intraductal spread on CE-MRI and clinicopathologic features. This study was designed to evaluate these correlations for the surgical planning of breast cancer. Twenty-six breast cancer lesions (in 26 female patients) treated by breast conserving surgery between March 2001 and March 2003 were evaluated retrospectively. CE-MRI was performed with a 1.5 T unit using a dedicated bilateral breast coil. In detecting intraductal spread of breast cancer, the sensitivity, specificity and accuracy of CE-MRI were 82.4%, 60.0% and 77.3%, respectively. On mammography (MMG), these were 21.1%, 100.0% and 42.3%, respectively. Therefore, CE-MRI has a higher sensitivity and accuracy, although with a lower specificity than MMG. Compared with breast cancer lesions without intraductal spread on CE-MRI, lesions with intraductal spread on CE-MRI were found more frequently in larger-sized tumors (P=0.0088). Preoperative evaluation for intraductal spread by CE-MRI should be more useful than by MMG for breast cancer. When making the surgical decision regarding excision range, particular attention should be paid to this consideration for patients with larger-sized cancer tumors. (author)

  5. MR spectroscopic imaging studies of prostate cancer: comparison of body coil and endorectal coil

    International Nuclear Information System (INIS)

    Li Xinmin; Wang Xiaoying; Guo Xuemei; Wang He; Jiang Xuexiang

    2009-01-01

    Objective: To compare the diagnostic value of MRS acquired by body coil (BODY) and endorectal Coil (ERC) in the detection of prostate cancer. Methods: MRI and 3D MRS were performed in 12 patients with prostate disease, in which 6 of them were proved to have prostate cancer and the other 6 noncancerous disease. Both BODY and ERC MRS were performed in 7 patients, and only BODY MRS was performed in the other 5 patients. All MRS data were quantitatively assessed with a per-sextant method. The metabolic ratio of (Choline + Creatine)/Citrate [(Cho + Crc )/Cit] was measured in each ROI. ROC analysis was carried out to assess and to compare the diagnostic value of BODY and ERC MRS in patients with prostate cancer with Wilcoxon test. Results: (1) The ratios of (Cho + Cre)/Cit in the prostate cancer group (median 1.744, 0.295 to 7.998) was statistically higher than that in the non-prostate cancer group (median 0.412, 0.112 to 2.113)acquired by using BODY MRS(Z=-9.159, P 0.05). (4) ROC analysis for diagnosing prostate cancer showed no significant difference (P=0.851 ) between the areas under the curve of BODY and that of ERC MRS (Az=0.931 and 0.935 respectively). Conclusion: The BODY MRS could provide comparable diagnostic efficacy to ERC MRS in patients with prostate cancer. (authors)

  6. Female breast cancer in Vietnam: a comparison across Asian specific regions.

    Science.gov (United States)

    Trieu, Phuong Dung Yun; Mello-Thoms, Claudia; Brennan, Patrick C

    2015-09-01

    Breast cancer is one of the most commonly diagnosed malignancies and the leading cause of cancer death of women over the world. A large number of females with breast cancer in Vietnam and other Southeast Asian (SEA) countries present at an early age with more aggressive tumors compared with women in Australia. Despite experiencing a low incidence rate, the increasing incidence rate among SEA countries exceeds that of the Westernized world. Changes in reproductive factors, environmental exposures, and lifestyle are the possible causes of this trend. However, limited evidence shows that these factors are associated with breast cancer in the Vietnamese population. Breast cancer incidence rates within Vietnam are not uniform and appear to be dependent on geographic location. Findings from this review have important implications for breast cancer control and treatment in Vietnam. A good understanding of the morphology of the breast and the type and nature of breast cancers presenting in Vietnam is required to facilitate the introduction of an effective national breast screening program.

  7. Female breast cancer in Vietnam:a comparison across Asian speciifc regions

    Institute of Scientific and Technical Information of China (English)

    Phuong Dung Yun Trieu; Claudia Mello-Thoms; Patrick C. Brennan

    2015-01-01

    Breast cancer is one of the most commonly diagnosed malignancies and the leading cause of cancer death of women over the world. A large number of females with breast cancer in Vietnam and other Southeast Asian (SEA) countries present at an early age with more aggressive tumors compared with women in Australia. Despite experiencing a low incidence rate, the increasing incidence rate among SEA countries exceeds that of the Westernized world. Changes in reproductive factors, environmental exposures, and lifestyle are the possible causes of this trend. However, limited evidence shows that these factors are associated with breast cancer in the Vietnamese population. Breast cancer incidence rates within Vietnam are not uniform and appear to be dependent on geographic location. Findings from this review have important implications for breast cancer control and treatment in Vietnam. A good understanding of the morphology of the breast and the type and nature of breast cancers presenting in Vietnam is required to facilitate the introduction of an effective national breast screening program.

  8. Comparison of telomerase activity in prostate cancer, prostatic intraepithelial neoplasia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Soleiman Mahjoub

    2006-11-01

    Full Text Available BACKGROUND: Telomerase is a reverse transcriptase enzyme that synthesizes telomeric DNA on chromosome ends. The enzyme is important for the immortalization of cancer cells because it maintains the telomeres. METHODS: Telomerase activity (TA was measured by fluorescence-based telomeric repeat amplification protocol (FTRAP assay in prostate carcinoma and benign prostatic hyperplasia (BPH. RESULTS: TA was present in 91.4% of 70 prostate cancers, 68.8% of 16 prostatic intraepithelial neoplasia (PIN, 43.3% of 30 BPH*, 21.4% of 14 atrophy and 20% of 15 normal samples adjacent to tumor. There was not any significant correlation between TA, histopathological tumor stage or gleason score. In contrast to high TA in the BPH* tissue from the cancer-bearing gland, only 6.3% of 32 BPH specimens from patients only diagnosed with BPH were telomerase activity-positive. CONCLUSIONS: These results indicate that TA is present in most prostate cancers. The high rate of TA in tissue adjacent to tumor may be attributed either to early molecular alteration of cancer that was histologically unapparent, or to the presence of occult cancer cells. Our findings suggest that the re-expression of telomerase activity could be one step in the transformation of BPH to PIN. KEY WORDS: Telomerase activity, prostate cancer, prostatic intraepithelial neoplasia, benign prostatic hyperplasia.

  9. Factors affecting sexual function: A comparison between women with gynecological or rectal cancer and healthy controls.

    Science.gov (United States)

    Li, Chia-Chun; Rew, Lynn; Chen, Lynn

    2014-11-23

    This study had two purposes: (i) to explore differences in sexual function between women with gynecological or rectal cancer after related pelvic-area treatments and women without cancer; and (ii) to investigate the relationships among body image, anxiety and depression, sexual relationship power, sexual self-schema, and female sexual function. The participants (n = 139) were recruited through Internet cancer support groups and women's health organizations in the USA. Six structured questionnaires were mailed, and the data were analyzed using descriptive and inferential statistics. The results showed that women with gynecological or rectal cancer had significantly worse sexual function than women without cancer. Having gynecological/rectal cancer and a negative sexual self-schema were significantly related to poor sexual function. Furthermore, sexual self-schema moderated the relationship between sexual relationship power and female sexual function. Healthcare providers could give more attention to sexual issues in women who have undergone treatment for gynecological or rectal cancer, especially for those with a negative sexual self-schema and high sexual relationship power, which might improve these women's quality of life. © 2014 Wiley Publishing Asia Pty Ltd.

  10. A mutational comparison of adult and adolescent and young adult (AYA) colon cancer.

    Science.gov (United States)

    Tricoli, James V; Boardman, Lisa A; Patidar, Rajesh; Sindiri, Sivasish; Jang, Jin S; Walsh, William D; McGregor, Paul M; Camalier, Corinne E; Mehaffey, Michele G; Furman, Wayne L; Bahrami, Armita; Williams, P Mickey; Lih, Chih-Jian; Conley, Barbara A; Khan, Javed

    2018-03-01

    It is possible that the relative lack of progress in treatment outcomes among adolescent and young adult (AYA) patients with cancer is caused by a difference in disease biology compared with the corresponding diseases in younger and older individuals. There is evidence that colon cancer is more aggressive and has a poorer prognosis in AYA patients than in older adult patients. To further understand the molecular basis for this difference, whole-exome sequencing was conducted on a cohort of 30 adult, 30 AYA, and 2 pediatric colon cancers. A statistically significant difference in mutational frequency was observed between AYA and adult samples in 43 genes, including ROBO1, MYC binding protein 2 (MYCBP2), breast cancer 2 (early onset) (BRCA2), MAP3K3, MCPH1, RASGRP3, PTCH1, RAD9B, CTNND1, ATM, NF1; KIT, PTEN, and FBXW7. Many of these mutations were nonsynonymous, missense, stop-gain, or frameshift mutations that were damaging. Next, RNA sequencing was performed on a subset of the samples to confirm the mutations identified by exome sequencing. This confirmation study verified the presence of a significantly greater frequency of damaging mutations in AYA compared with adult colon cancers for 5 of the 43 genes (MYCBP2, BRCA2, PHLPP1, TOPORS, and ATR). The current results provide the rationale for a more comprehensive study with a larger sample set and experimental validation of the functional impact of the identified variants along with their contribution to the biologic and clinical characteristics of AYA colon cancer. Cancer 2018;124:1070-82. © 2017 American Cancer Society. © 2017 American Cancer Society.

  11. Synchronization of indirectly coupled Lorenz oscillators

    Indian Academy of Sciences (India)

    Synchronization of indirectly coupled Lorenz oscillators: An experimental study. Amit Sharma Manish Dev Shrimali. Synchronization, Coupled Systems and Networks Volume 77 Issue 5 November 2011 pp 881-889 ... The in-phase and anti-phase synchronization of indirectly coupled chaotic oscillators reported in Phys. Rev ...

  12. Indirect search for dark matter with AMS

    International Nuclear Information System (INIS)

    Goy, Corinne

    2006-01-01

    This document summarises the potential of AMS in the indirect search for Dark Matter. Observations and cosmology indicate that the Universe may include a large amount of Dark Matter of unknown nature. A good candidate is the Ligthest Supersymmetric Particle in R-Parity conserving models. AMS offers a unique opportunity to study Dark Matter indirect signature in three spectra: gamma, antiprotons and positrons

  13. Indirectness in Discourse: Ethnicity as Conversational Style.

    Science.gov (United States)

    Tannen, Deborah

    1981-01-01

    Examines social differences in expectations of indirectness in conversations between married couples, both Greek and Greek-American. Concludes that Greeks are more likely to expect indirectness in the context presented and that Greek-Americans have retained the Greek communicative patterns. (FL)

  14. JUSTIFICATION FOR INDIRECT DISCRIMINATION IN EU

    Directory of Open Access Journals (Sweden)

    Cătălina-Adriana Ivănuş

    2014-11-01

    Full Text Available The right to non-discrimination is very important for a civilized society. EU legislation establishes direct and indirect discrimination, harassment, sexual harassment, instruction to discriminate and any less favourable treatment of a woman related to pregnancy or maternity leave as forms of discrimination. The law and the Court of Justice permit the justification of indirect discrimination.

  15. 77 FR 41899 - Indirect Food Additives: Polymers

    Science.gov (United States)

    2012-07-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 177 [Docket No. FDA-2012-F-0031] Indirect Food Additives: Polymers AGENCY: Food and Drug Administration, HHS. ACTION... CFR part 177 is amended as follows: PART 177--INDIRECT FOOD ADDITIVES: POLYMERS 0 1. The authority...

  16. JUSTIFICATION FOR INDIRECT DISCRIMINATION IN EU

    OpenAIRE

    Cătălina-Adriana Ivănuş

    2014-01-01

    The right to non-discrimination is very important for a civilized society. EU legislation establishes direct and indirect discrimination, harassment, sexual harassment, instruction to discriminate and any less favourable treatment of a woman related to pregnancy or maternity leave as forms of discrimination. The law and the Court of Justice permit the justification of indirect discrimination.

  17. Indirect techniques in nuclear astrophysics: a review.

    Science.gov (United States)

    Tribble, R E; Bertulani, C A; Cognata, M La; Mukhamedzhanov, A M; Spitaleri, C

    2014-10-01

    In this review, we discuss the present status of three indirect techniques that are used to determine reaction rates for stellar burning processes, asymptotic normalization coefficients, the Trojan Horse method and Coulomb dissociation. A comprehensive review of the theory behind each of these techniques is presented. This is followed by an overview of the experiments that have been carried out using these indirect approaches.

  18. Meta-analysis of comparison between brachytherapy and radical prostatectomy for the treatment of localized prostate cancer

    International Nuclear Information System (INIS)

    Fan Xiaodong; Jiang Qing; Yuan Gengbiao; Wang Jiawu

    2012-01-01

    Objective: To compare the therapeutic effect of brachytherapy and radical prostatectomy for localized prostate cancer using a Meta-analysis. Methods: The published data with randomized control trials (RCT) on comparison of brachytherapy and radical prostatectomy for the treatment of localized prostate cancer in PubMed, Wanfang database, Chinese Biomedical Literature Database (CBMdisc), the Excerpta Medica Database (EMBASE), Ovid and Cochrane library were searched and screened. The quality of the studies included was evaluated and the data with 5-year event free survival rate for comparison were extracted. Meta-analysis was performed by RevMan 5.0 (Cochrane reviews software). Results: From six trials, there were 5903 patients that were eligible for the analysis, in which 3323 patients were treated by brachytherapy and other 2580 by radical prostatectomy. The odds ratio of all trials was 1.00 (95% CI: 0.69-1.45, P=0.99) and there was no significant difference of 5-year event free survival rate between two treatment groups. Conclusion: This Meta analysis shows that brachytherapy may have comparable treatment effect than radical prostatectomy. (authors)

  19. Indirect Calorimetry in Mechanically Ventilated Patients

    DEFF Research Database (Denmark)

    Allingstrup, Matilde Jo; Kondrup, Jens; Perner, Anders

    2017-01-01

    Background and Aims: The 2 currently available indirect calorimeters, CCM Express Indirect Calorimeter (MedGraphics, St Paul, MN) and Quark RMR ICU Indirect Calorimeter (COSMED, Rome, Italy), have not been validated against a gold standard in mechanically ventilated patients. Our aim was to do so...... using a gold-standard, modified Tissot bell-spirometer method in mechanically ventilated patients who were hemodynamically, respiratory, and metabolically stable. Methods: We studied 30 patients undergoing general anesthesia and major gynecological surgery. We measured oxygen consumption ((Formula...... of 77 (167) with limits of agreement −249 to 404 kcal/d. Conclusions: The QUARK RMR ICU Indirect Calorimeter compared better with the gold standard for values of (Formula presented.) O2 and REE than did the CCM Express Indirect Calorimeter in mechanically ventilated patients who were circulatory...

  20. Comparison of Dietary Habits and Serum Nitrate Levels in Patients with Esophageal Cancer and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Reza Alipanah_Moghadam

    2017-07-01

    Conclusion: Consumption of fast foods, hot tea and saturated fats may be associated with esophageal cancer. Serum nitrate levels were lower in patients than control group, probably indicating the need for further research in this field.

  1. Mitosis counting in breast cancer : object-level interobserver agreement and comparison to an automatic method

    NARCIS (Netherlands)

    Veta, M.; van Diest, P.J.; Jiwa, M.; Al-Janabi, S.; Pluim, J.P.W.

    2016-01-01

    BACKGROUND: Tumor proliferation speed, most commonly assessed by counting of mitotic figures in histological slide preparations, is an important biomarker for breast cancer. Although mitosis counting is routinely performed by pathologists, it is a tedious and subjective task with poor

  2. Mitosis Counting in Breast Cancer : Object-Level Interobserver Agreement and Comparison to an Automatic Method

    NARCIS (Netherlands)

    Veta, Mitko; van Diest, Paul J; Jiwa, Mehdi; Al-Janabi, Shaimaa; Pluim, JPW

    2016-01-01

    BACKGROUND: Tumor proliferation speed, most commonly assessed by counting of mitotic figures in histological slide preparations, is an important biomarker for breast cancer. Although mitosis counting is routinely performed by pathologists, it is a tedious and subjective task with poor

  3. Comparison of serum from gastric cancer patients and from healthy persons using FTIR spectroscopy

    Science.gov (United States)

    Sheng, Daping; Wu, Yican; Wang, Xin; Huang, Dake; Chen, Xianliang; Liu, Xingcun

    2013-12-01

    Since serum can reflect human beings' physiological and pathological conditions, FTIR spectroscopy was used to compare gastric cancer patients' serum with healthy persons' serum in this study. The H2959/H2931, H1646/H1550, H1314/H1243, H1453/H1400 and H1080/H1550 ratios were calculated, among these ratios, the H2959/H2931 ratio might be a standard for distinguishing gastric cancer patients from healthy persons. Then curve fitting was processed using Gaussian curves in the 1140-1000 cm-1 region, and the result showed that the RNA/DNA ratios of gastric cancer patients' serum were obviously lower than those of healthy persons' serum. The results suggest that FTIR spectroscopy may be a potentially useful tool for diagnosis of gastric cancer.

  4. Alcohol intake and colorectal cancer: a comparison of approaches for including repeated measures of alcohol consumption

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Wu, Kana; Grønbaek, Morten

    2008-01-01

    BACKGROUND: In numerous studies, alcohol intake has been found to be positively associated with colorectal cancer risk. However, the majority of studies included only one exposure measurement, which may bias the results if long-term intake is relevant.METHODS: We compared different approaches...... for including repeated measures of alcohol intake among 47,432 US men enrolled in the Health Professionals Follow-up Study. Questionnaires including questions on alcohol intake had been completed in 1986, 1990, 1994, and 1998. The outcome was incident colorectal cancer during follow-up from 1986 to 2002.RESULTS......: During follow-up, 868 members of the cohort experienced colorectal cancer. Baseline, updated, and cumulative average alcohol intakes were positively associated with colorectal cancer, with only minor differences among the approaches. These results support moderately increased risk for intake >30 g...

  5. Comparison of prognostic models to predict the occurrence of colorectal cancer in asymptomatic individuals

    DEFF Research Database (Denmark)

    Smith, Todd; Muller, David C; Moons, Karel G M

    2018-01-01

    in the European Prospective Investigation into Cancer and Nutrition (EPIC) and the UK Biobank. The performance of the models to predict the occurrence of colorectal cancer within 5 or 10 years after study enrolment was assessed by discrimination (C-statistic) and calibration (plots of observed vs predicted......-based colorectal screening programmes. Future work should both evaluate this potential, through modelling and impact studies, and ascertain if further enhancement in their performance can be obtained....

  6. Consistency and accuracy of diagnostic cancer codes generated by automated registration: comparison with manual registration

    Directory of Open Access Journals (Sweden)

    Codazzi Tiziana

    2006-09-01

    Full Text Available Abstract Background Automated procedures are increasingly used in cancer registration, and it is important that the data produced are systematically checked for consistency and accuracy. We evaluated an automated procedure for cancer registration adopted by the Lombardy Cancer Registry in 1997, comparing automatically-generated diagnostic codes with those produced manually over one year (1997. Methods The automatically generated cancer cases were produced by Open Registry algorithms. For manual registration, trained staff consulted clinical records, pathology reports and death certificates. The social security code, present and checked in both databases in all cases, was used to match the files in the automatic and manual databases. The cancer cases generated by the two methods were compared by manual revision. Results The automated procedure generated 5027 cases: 2959 (59% were accepted automatically and 2068 (41% were flagged for manual checking. Among the cases accepted automatically, discrepancies in data items (surname, first name, sex and date of birth constituted 8.5% of cases, and discrepancies in the first three digits of the ICD-9 code constituted 1.6%. Among flagged cases, cancers of female genital tract, hematopoietic system, metastatic and ill-defined sites, and oropharynx predominated. The usual reasons were use of specific vs. generic codes, presence of multiple primaries, and use of extranodal vs. nodal codes for lymphomas. The percentage of automatically accepted cases ranged from 83% for breast and thyroid cancers to 13% for metastatic and ill-defined cancer sites. Conclusion Since 59% of cases were accepted automatically and contained relatively few, mostly trivial discrepancies, the automatic procedure is efficient for routine case generation effectively cutting the workload required for routine case checking by this amount. Among cases not accepted automatically, discrepancies were mainly due to variations in coding practice.

  7. Comparison of two sus clavicular irradiation techniques in the breast cancer

    International Nuclear Information System (INIS)

    Boukhelif, W.; Henni, M.; Abrous-Anane, S.; Maisonobe, J.A.; Klotz, S.; Leignel, D.; Dessard-Diana, B.; Giraud, P.; Durdux, C.; Housset, M.

    2009-01-01

    Purpose: to compare the irradiation of the sub clavicular area by a non coplanar beam with the irradiation by a classical beam in the breast cancer. Conclusion: In the breast cancer, the non coplanar irradiation of sub clavicular ganglions allows to better protect the lungs comparatively to the classical irradiation and that without modifying the coverage of the sub clavicular target volume. (N.C.)

  8. Quantitative comparison of volumetric modulated arc therapy and intensity modulated radiotherapy plan quality in sino-nasal cancer

    International Nuclear Information System (INIS)

    Sankaralingam, Marimuthu; Glegg, Martin; Smith, Suzanne; James, Allan; Rizwanullah, Mohammed

    2012-01-01

    The aim of this study was to compare various dosimetric parameters of dynamic mlc intensity modulated radiotherapy (IMRT) plans with volumetric modulated arc therapy (VMAT) plans for sino-nasal cancers, which are rare and complex tumors to treat with radiotherapy. IMRT using five fields, coplanar in the sagittal plane and VMAT employing two coplanar arc plans were created for five patients. The plans were assessed by comparing Conformity Index and Sigma Index (dose homogeneity) in the Planning Target Volume (PTV) and through comparison of dose-volume characteristics to the following organs at risk (OARs): Spinal cord, brainstem, eye, ipsilateral and contralateral optic nerve and the volume of brain receiving 10% of the prescribed dose (V 10% ). The total monitor units required to deliver the plan were also compared. Conformity Index was found to be superior in VMAT plans for three patients and in IMRT plans for two patients. Dose homogeneity within the PTV was better with VMAT plans for all five cases. The mean difference in Sigma Index was 0.68%. There was no significant difference in dose between IMRT and VMAT plans for any of the OARs assessed in these patients. The monitor units were significantly reduced in the VMAT plan in comparison to the IMRT plan for four out of five patients, with mean reduction of 66%. It was found in this study that for the treatment of sino-nasal cancer, VMAT produced minimal, and statistically insignificant improvement in dose homogeneity within the PTV when compared with IMRT. VMAT plans were delivered using significantly fewer monitor units. We conclude in this study that VMAT does not offer significant improvement of treatment for sino-nasal cancer over the existing IMRT techniques, but the findings may change with a larger sample of patients in this rare condition. (author)

  9. Dosimetric comparison between helical tomotherapy and volumetric modulated arc-therapy for non-anaplastic thyroid cancer treatment.

    Science.gov (United States)

    Khalifa, Jonathan; Vieillevigne, Laure; Boyrie, Sabrina; Ouali, Monia; Filleron, Thomas; Rives, Michel; Laprie, Anne

    2014-11-26

    To evaluate and compare dosimetric parameters of volumetric modulated arctherapy (VMAT) and helical tomotherapy (HT) for non-anaplastic thyroid cancer adjuvant radiotherapy. Twelve patients with non-anaplastic thyroid cancer at high risk of local relapse received adjuvant external beam radiotherapy with curative intent in our institution, using a two-dose level prescription with a simultaneous integrated boost approach. Each patient was re-planned by the same physicist twice using both VMAT and HT. Several dosimetric quality indexes were used: target coverage index (proportion of the target volume covered by the reference isodose), healthy tissue conformity index (proportion of the reference isodose volume including the target volume), conformation number (combining both previous indexes), Dice Similarity Coefficient (DSC), and homogeneity index ((D2%-D98%)/prescribed dose). Dose-volume histogram statistics were also compared. HT provided statistically better target coverage index and homogeneity index for low risk PTV in comparison with VMAT (respectively 0.99 vs. 0.97 (p=0.008) and 0.22 vs. 0.25 (p=0.016)). However, HT provided poorer results for healthy tissue conformity index, conformation number and DSC with low risk and high risk PTV. As regards organs at risk sparing, by comparison with VMAT, HT statistically decreased the D2% to medullary canal (25.3 Gy vs. 32.6 Gy (p=0.003)). Besides, HT allowed a slight sparing dose for the controlateral parotid (Dmean: 4.3 Gy vs. 6.6 Gy (p=0.032)) and for the controlateral sub-maxillary gland (Dmean: 29.1 Gy vs. 33.1 Gy (p=0.041)). Both VMAT and HT techniques for adjuvant treatment of non-anaplastic thyroid cancer provide globally attractive treatment plans with slight dosimetric differences. However, helical tomotherapy clearly provides a benefit in term of medullary canal sparing.

  10. Comparison of two binuclear vanadium-catecholate complexes: Synthesis, X-ray structure and effects in cancer cells

    Science.gov (United States)

    Chi, Zixiang; Zhu, Linli; Lu, Xiaoming

    2011-08-01

    Two binuclear vanadium-catecholate complexes [Et 3NH] 2[V VO 2(μ-cat)] 2( 1) and [Et 3NH] 2[V VO 2(μ-N-2,3-D)] 2( 2) (cat = catechol, N-2,3-D = naphthalene-2,3-diol) have been synthesized and characterized by X-ray diffraction, IR, UV-vis spectroscopy and cyclic voltammetry (CV). X-ray analysis reveals that the structures of complexes 1 and 2 are both in the anion form of V. Et 3N works as counter-ions and connects the main frame by hydrogen bonding. The electrochemical behavior of the two complexes is studied in comparison to that of the free ligands and the two complexes display different redox potentials. Pharmaceutical screenings of complexes 1 and 2 have been made against two representative cancer cell-lines A-549 (lung cancer) and Bel-7402 (liver cancer) by MTT assay. The inhibition of cell proliferation was determined 72 h after cells were exposed to the tested compounds at a concentration of 5 μg/mL. Complex 1 exhibits well inhibition ratio against both two cell-lines (76.28% and 75.94%), while 2 displays positive and negative effect (65.36% and -68.82%) respectively. In association with X-ray and electrochemistry, a preliminary analysis about the possible inhibitory mechanism is provided.

  11. Comparison of breast cancer detection by diffusion-weighted magnetic resonance imaging and mammography

    International Nuclear Information System (INIS)

    Yoshikawa, Miho I.; Kikuchi, Keiichi; Mochizuki, Teruhito; Ohsumi, Shozo; Sugata, Shigenori; Kataoka, Masaaki; Takashima, Shigemitsu

    2007-01-01

    Breast cancer-detecting ability of diffusion-weighted magnetic resonance imaging (DW-MRI) was investigated by comparing the breast cancer detection rates of DW-MRI and mammography (MMG). The subjects were 48 women who had breast cancer (53 cancer lesions) who underwent DW-MRI before surgery. Altogether, 41 lesions were invasive ductal carcinoma (IDC), 7 were noninvasive ductal carcinoma (NIDC) and 5 were ''others.'' The breast cancer detection rates by MMG and DW-MRI were 84.9% and 94.3% (P -3 , 1.50±0.24 x 10 -3 , 1.12±0.25 x 10 -3 , and 2.01±0.29 x 10 -3 mm 2 /s for IDC, NIDC, others, and normal breast, respectively, showing that the values of IDC and NIDC were significantly different from that of the normal breast (P<0.001 each). A significant difference was also noted between IDC and NIDC (P<0.001). DW-MRI may be useful for detecting breast cancer in a wide age group of women, including young women with dense mammary glands. (author)

  12. A comparison of breast, testicular and prostate cancer in mass print media (1996-2001).

    Science.gov (United States)

    Clarke, Juanne Nancarrow

    2004-08-01

    This paper compares the portrayal of breast, testicular and prostate cancer in mass print English language magazines in the United States and Canada from 1996 to 2001. It is a follow-up of three papers that examined each of these three diseases separately in high circulating magazines up to 1995. It includes both quantitative and qualitative analyses of magazine stories and notes the continuing dominance of a medical perspective regarding disease as well as the association of each type of cancer examined with stereotypically individualized yet feminine and masculine characteristics and pursuits. It notes the conflation of breast cancer, since the discovery of BRCA1 and BRCA2, with the family. To be a 'feminine' woman is to be vulnerable to breast cancer and to be a 'masculine' man is to be vulnerable to testicular cancer when young and prostate cancer when older. The association of disease not just with personhood but also with the specifics of stereotyped masculinity and femininity may construct a more intimate, more personal link between disease and identity. This close attachment of gender and disease may shore up and exacerbate a fear reaction. It may also serve to diminish the awareness of other, more prevalent, causes of death for men and women. The social control consequences of potentially exacerbated disease-specific fear are discussed. Copyright 2003 Elsevier Ltd.

  13. A comparison of robotic arm versus gantry linear accelerator stereotactic body radiation therapy for prostate cancer.

    Science.gov (United States)

    Avkshtol, Vladimir; Dong, Yanqun; Hayes, Shelly B; Hallman, Mark A; Price, Robert A; Sobczak, Mark L; Horwitz, Eric M; Zaorsky, Nicholas G

    2016-01-01

    Prostate cancer is the most prevalent cancer diagnosed in men in the United States besides skin cancer. Stereotactic body radiation therapy (SBRT; 6-15 Gy per fraction, up to 45 minutes per fraction, delivered in five fractions or less, over the course of approximately 2 weeks) is emerging as a popular treatment option for prostate cancer. The American Society for Radiation Oncology now recognizes SBRT for select low- and intermediate-risk prostate cancer patients. SBRT grew from the notion that high doses of radiation typical of brachytherapy could be delivered noninvasively using modern external-beam radiation therapy planning and delivery methods. SBRT is most commonly delivered using either a traditional gantry-mounted linear accelerator or a robotic arm-mounted linear accelerator. In this systematic review article, we compare and contrast the current clinical evidence supporting a gantry vs robotic arm SBRT for prostate cancer. The data for SBRT show encouraging and comparable results in terms of freedom from biochemical failure (>90% for low and intermediate risk at 5-7 years) and acute and late toxicity (6 MV). Finally, SBRT (particularly on a gantry) may also be more cost-effective than conventionally fractionated external-beam radiation therapy. Randomized controlled trials of SBRT using both technologies are underway.

  14. Shear-wave elastographic features of breast cancers: comparison with mechanical elasticity and histopathologic characteristics.

    Science.gov (United States)

    Lee, Su Hyun; Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min; Moon, Hyeong-Gon; Han, Wonshik; Noh, Dong-Young; Lee, Jung Chan; Kim, Hee Chan; Lee, Kyoung-Bun; Park, In-Ae

    2014-03-01

    The objective of this study was to compare the quantitative and qualitative shear-wave elastographic (SWE) features of breast cancers with mechanical elasticity and histopathologic characteristics. This prospective study was conducted with institutional review board approval, and written informed consent was obtained. Shear-wave elastography was performed for 30 invasive breast cancers in 30 women before surgery. The mechanical elasticity of a fresh breast tissue section, correlated with the ultrasound image, was measured using an indentation system. Quantitative (maximum, mean, minimum, and standard deviation of elasticity in kilopascals) and qualitative (color heterogeneity and presence of signal void areas in the mass) SWE features were compared with mechanical elasticity and histopathologic characteristics using the Pearson correlation coefficient and the Wilcoxon signed rank test. Maximum SWE values showed a moderate correlation with maximum mechanical elasticity (r = 0.530, P = 0.003). There were no significant differences between SWE values and mechanical elasticity in histologic grade I or II cancers (P = 0.268). However, SWE values were significantly higher than mechanical elasticity in histologic grade III cancers (P masses were present in 43% of breast cancers (13 of 30) and were correlated with dense collagen depositions (n = 11) or intratumoral necrosis (n = 2). Quantitative and qualitative SWE features reflect both the mechanical elasticity and histopathologic characteristics of breast cancers.

  15. Long-term survivors of childhood cancer report quality of life and health status in parity with a comparison group.

    Science.gov (United States)

    Sundberg, Kay K; Doukkali, Eva; Lampic, Claudia; Eriksson, Lars E; Arvidson, Johan; Wettergren, Lena

    2010-08-01

    There is a need for more knowledge about how survivors of childhood cancer perceive their lives and what influence current health status has on their quality of life. The purpose was to describe this among a group of long-term survivors and among a comparison group. Telephone interviews were performed with a cohort of 246 long-term survivors and 296 randomly selected from the general population using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW). The participants nominated the areas they considered to be most important in life and rated the current status of each area on a seven-point category scale. An overall individual index score was calculated as a measure of quality of life. Self-reported health status was assessed using the Short Form Health Survey (SF-36). Long-term survivors rated their overall quality of life and self-reported health status almost in parity with the comparison group. In both groups, family life, relations to other people, work and career, interests and leisure activities were the areas most frequently reported to influence quality of life. The survivors only differed from the comparison group on one of eight SF-36 scales reflecting problems with daily activities owing to physical health. Health status was not shown to have a major impact on overall quality of life, indicating that health and quality of life should be evaluated distinctively as different constructs. This should be taken in consideration in clinical care of children with childhood cancer and long-term survivors. (c) 2010 Wiley-Liss, Inc.

  16. Comparison of CA15-3 and CEA in breast cancer

    International Nuclear Information System (INIS)

    Rajkovaca, Z.; Mijatovic, J.; Matavulj, A.; Kovacevic, P.; Ponorac, N.

    2002-01-01

    Aim: Tumor markers are potentially powerful means for obtaining information about cancers whilst causing minimal morbidity, inconvenience and cost. CA 15-3 and CEA are considered useful tumor markers in monitoring breast cancer patients. The aim of this study was to evaluate which of these two markers are in better correlate with the disease in patients surgically treated for breast cancer. Material and Methods: We retrospectively reviewed values of CA15-3 and CEA in 342 patients (median age 52.18 years, range 27-78 years) with surgically treated and pathologically proven breast cancer. CA15-3 and CEA was measured by radioimmunoassay. CA15-3 levels above 30 U/ml and CEA levels above 5 ng/ml were considered as positive values. Results: Out of 342 patients, 86 had elevated CA15-3 levels (sensitivity: 25.1%) and 68 of 342 patients had positive CEA levels (sensitivity 19.9%). Two hundred thirty seven (237) of the patients suffering from breast cancer (69.3%) did not have metastatic disease. In this group CA15-3 sensitivity was 94.5%, while CEA sensitivity was 87.3%. One hundred and five (105) patients (30.7%) had metastatic disease. In this group, CA15-3 sensitivity was 69.5% and CEA sensitivity was 36.2% (P < 0.05). With regard to the correlation of the two tumor markers with clinical course patients had significantly higher levels of CA15-3 than of CEA in metastatic breast cancer. Conclusion: This result suggests CA15-3 to be the more sensitive and more specific of the two tumor markers for metastatic breast cancer detection and monitoring

  17. Comparison between Japanese and French interstitial brachytherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Nose, Takayuki; Koizumi, Masahiko; Nishiyama, Kinji; Inoue, Toshihiko

    2001-01-01

    Interstitial brachytherapy is the optimal radiotherapy modality for head and neck cancer because the highest dose conformity can be achieved, and implanted tubes can move synchronously with the tumor movement. Compared with radical surgery, interstitial brachytherapy can achieve equivalent local control with less morbidity and less functional deficit. In Japan, because of technical limitations, interstitial brachytherapy has been confined to treatment of small tongue cancers. To improve our head and neck cancer treatment, technical limitations should be eliminated and a wider indication for interstitial brachytherapy should be achieved. In France, interstitial brachytherapy has been technically more developed and widely indicated than in Japan. We analyzed the differences between Japanese (Osaka) and French (Lyon and Nancy) techniques, to improve our interstitial brachytherapy. Implant devices and techniques: French applicators (Longcip 1) are more flexible and more suitable for loop techniques of the soft palate, the base of the tongue, and the vallecula, than applicators available in Japan. Various implant techniques are established especially for the oropharynx in France. Mandibular protection: Lead blocks used in France can more effectively shield the mandible than our silicone spacers. We showed the dosimetric results in an experimental treatment setting. Dose specification: The five-mm dose specification method used in Japan can work only for easy cases, such as small oral tongue cancers and mouth floor cancers. For complicated implants, such as for the oropharynx, the CTV-based dose specification method used in France is essential for sufficient irradiation. Indications: The indication for head and neck interstitial brachytherapy in Japan is limited mostly to small oral tongue cancers. The indication in France is wider, including the oral cavity, the oropharynx, and postoperative cases. We can refine our head and neck cancer treatment if we combine French

  18. Expression of future prospective in indirect speech

    Directory of Open Access Journals (Sweden)

    Bodnaruk Elena Vladimirovna

    2015-03-01

    Full Text Available The article analyzes the characteristics and use of grammatical semantics and lexical and grammatical means used to create future prospects in double indirect discourse. The material for the study were epic works by contemporary German writers. In the analysis of the empirical material it has been pointed out that indirect discourse has preterial basis and is the kind of most frequent inner speech of characters. The most widely used form with future semantics in preterial indirect speech is conditional I, formally having a conjunctive basis, but is mostly used with the indicative semantics. Competitive to conditional I in indirect speech is preterial indicative. A characteristic feature of the indirect speech is the use of modal verbs, which, thanks to its semantics is usually referred as an action at a later term, creating the prospect of future statements. The most frequent were modal verbs wollen and sollen in the form of the preterite, more rare verbs were m ssen and k nnen. German indirect speech distinguishes the ability to use forms on the basis of conjunctive: preterite and plusquamperfect of conjunctive. Both forms express values similar to those of the indicative. However, conjunctive forms the basis of the data shown in a slightly more pronounced seme of uncertainty that accompanies future uses of these forms in indirect speech. In addition, plusquamperfect conjunctive differs from others by the presence of the seme of completeness.

  19. [Comparison of clinicopathological features and prognosis between left-sided colon cancer and right-sided colon cancer].

    Science.gov (United States)

    Gao, Xianhua; Yu, Guanyu; Liu, Peng; Hao, Liqiang; Liu, Lianjie; Zhang, Wei

    2017-06-25

    To compare the clinicopathological features and prognosis between left-sided colon cancer (LC) and right-sided colon cancer (RC). Clinicopathological and follow-up data of 2 174 colon carcinoma cases undergoing resection at Shanghai Changhai Hospital of The Second Military Medical University from January 2000 to December 2010 were retrospectively analyzed. Patients with transverse colon cancer, overlapping position, unknown location, recurrent cancer, multiple primary cancer, concomitant malignant tumors, preoperative chemotherapy, local resection, incomplete clinical data and missed follow up were excluded. Finally, a total of 1 036 patients, whose primary tumors were radically removed, were enrolled, with 563 patients in LC group (including carcinoma in cecum, ascending colon and hepatic flexure) and 473 in RC group (including carcinoma in splenic flexure, descending colon and sigmoid colon). The clinicopathological features and survival, including median overall survival, 5-year overall survival rate, tumor specific median overall survival, cancer specific 5-year overall survival rate, were compared between LC and RC groups. Tumor specific overall survival was defined as the period between operation date to the date of death caused by cancer progression. Multivariate Cox regression analysis was used to analyze the influencing factors of survival. Propensity score matching was carried out to balance the clinicopathological factors between the two groups with the SAS 9.3, taking the following parameters into consideration (age, gender, gross appearance, tumor diameter, invasion depth, lymph node metastasis, distant metastasis, TNM stages, differentiation, CEA and CA199-9). Patients in RC group and LC group were matched according to the propensity scores and the clinicopathological characteristics and prognosis of two groups were compared again. No significant differences were identified between the two groups in age, distant metastasis and serum CEA level

  20. Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

    Directory of Open Access Journals (Sweden)

    Katz Alan

    2012-11-01

    Full Text Available Abstract Background As the long-term efficacy of stereotactic body radiation therapy (SBRT becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients or SBRT (n = 216 American patients. QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24, and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results The largest differences in QOL occurred in the first 1–6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment

  1. Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer.

    Science.gov (United States)

    Lam, Wendy W T; Au, Angel H Y; Wong, Jennifer H F; Lehmann, Claudia; Koch, Uwe; Fielding, Richard; Mehnert, Anja

    2011-11-01

    The comparison of psychosocial needs across different cultural settings can identify cultural and service impacts on psychosocial outcomes. We compare psychosocial needs in Hong Kong Chinese and German Caucasian women with breast cancer. Completed questionnaires were collected from 348 Chinese and 292 German women with breast cancer for assessing unmet psychosocial needs (Supportive Care Needs Survey Short Form), psychological distress (the Hospital Anxiety and Depression scale), and listed physical and psychological symptoms. Only 11% of the participants reported not needing help for any of the 34 items. More German (14%) than Chinese women (8%) reported no unmet needs (χ(2) = 6.16, P = .013). With both samples combined, the Health System and Information domain unmet needs were the most prevalent, apart from one Psychological need domain item, "Fear about the cancer spreading." Chinese and German samples differed significantly in prevalence and patterns of unmet psychosocial needs. Multivariate adjustment for demographic, clinical, and sample characteristics, psychological distress, and symptoms showed that significantly greater unmet Health system and Information, and Patient care and support domain needs, associated with the presence of symptoms (β = .232, P German group membership, among others. German women reported more anxiety (t = 10.45, P German, but not Chinese women reporting greater anxiety and depression had greater unmet Psychological and Sexuality domain needs (P culture-specific differences in supportive care needs exist. Hong Kong Chinese women prioritize needs for information about their disease and treatment, whereas German Caucasian women prioritize physical and psychological support. Planning for cancer supportive care services or interventions to reduce unmet needs must consider cultural and/or health service contexts.

  2. Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

    International Nuclear Information System (INIS)

    Katz, Alan; Ferrer, Montserrat; Suárez, José Francisco

    2012-01-01

    As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24, and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. The largest differences in QOL occurred in the first 1–6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT

  3. Comparison of survival of patients with metastases from known versus unknown primaries: survival in metastatic cancer

    Directory of Open Access Journals (Sweden)

    Riihimäki Matias

    2013-01-01

    Full Text Available Abstract Background Cancer of unknown primary site (CUP is considered an aggressive metastatic disease but whether the prognosis differs from metastatic cancers of known primary site is not known. Such data may give insight into the biology of CUP and the metastatic process in general. Methods 6,745 cancer patients, with primary metastatic cancer at diagnosis, were identified from the Swedish Cancer Registry, and were compared with 2,881 patients with CUP. Patients were diagnosed and died between 2002 and 2008. The influence of the primary site, known or unknown, on survival in patients with metastases at specific locations was investigated. Hazard ratios (HRs of death were estimated for several sites of metastasis, where patients with known primary sites were compared with CUP patients. Results Overall, patients with metastatic cancers with known primary sites had decreased hazards of death compared to CUP patients (HR = 0.69 [95% CI = 0.66–0.72]. The exceptions were cancer of the pancreas (1.71 [1.54–1.90], liver (1.58 [1.36–1.85], and stomach (1.16 [1.02–1.31]. For individual metastatic sites, patients with liver or bone metastases of known origin had better survival than those with CUP of the liver and bone. Patients with liver metastases of pancreatic origin had an increased risk of death compared with patients with CUP of the liver (1.25 [1.06–1.46]. The median survival time of CUP patients was three months. Conclusions Patients with CUP have poorer survival than patients with known primaries, except those with brain and respiratory system metastases. Of CUP sites, liver metastases had the worst prognosis. Survival in CUP was comparable to that in metastatic lung cancer. The aggressive behavior of CUP may be due to initial immunosuppression and immunoediting which may allow accumulation of mutations. Upon escape from the suppressed state an unstoppable tumor spread ensues. These novel data on the epidemiology of the

  4. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection

    International Nuclear Information System (INIS)

    Pallwein, Leo; Struve, Peter; Aigner, Friedrich; Gradl, Johann; Schurich, Matthias; Frauscher, Ferdinand; Mitterberger, Michael; Horninger, Wolfgang; Bartsch, Georg; Pedross, Florian

    2007-01-01

    A prospective study was performed to determine the value of sonoelastography (SE) targeted biopsy for prostate cancer (PCa) detection. A series of 230 male screening volunteers was examined. Two independent examiners evaluated each subject. One single investigator performed ≤5 SE targeted biopsies into suspicious regions in the peripheral zone only. The stiffness of the lesion was displayed by SE and color-coded from red (soft) to blue (hard). Hard lesions were considered as malignant and targeted by biopsy. Subsequently, another examiner performed ten systematic biopsies. Cancer detection rates of the two techniques were compared. Cancer was detected in 81 of the 230 patients (35%), including 68 (30%) by SE targeted biopsy and in 58 (25%) by systematic biopsy. Cancer was detected by targeted biopsy alone in 23 patients (10%) and by systematic biopsy alone in 13 patients (6%). The detection rate for SE targeted biopsy cores (12.7% or 135 of 1,109 cores) was significantly better than for systematic biopsy cores (5.6% or 130 of 2,300 cores, P < 0.001). SE targeted biopsy in a patient with cancer was 2.9-fold more likely to detect PCa than systematic biopsy. SE targeted biopsy detected more cases of PCa than systematic biopsy, with fewer than half the number of biopsy cores in this prostate-specific antigen screening population. (orig.)

  5. Prognostic analysis and comparison of colon cancer in Han and Hui patients.

    Science.gov (United States)

    Zhang, Mei; Zhao, Qu-Chuan; Liu, Yan-Peng; Yang, Lei; Zhu, Hong-Ming; Chhetri, Jagadish K

    2014-05-07

    To investigate the relevant prognostic factors and their differences between colorectal cancer (CRC) patients of Chinese Han and Hui ethnicities in the Beijing region. A retrospective analysis of 880 patients diagnosed with CRC at Xuanwu Hospital, Capital Medical University between September 2001 and September 2011 was performed. Among the 880 patients, 398 and 482 were Hui and Han, respectively. Characteristics including sex, age, diet, tumor size, primary tumor site, Dukes' stage and degree of differentiation were analyzed for their influence on prognosis. Data on dietary structures were recorded through a questionnaire survey conducted during the patient's first visit, return visit or follow-up checkups. Among patients with colon cancer, the 5-year survival rate for patients of Hui ethnicity was lower than that for Han patients (P = 0.025). Six risk factors (age of onset, dietary structure, tumor size, Dukes' stage, location of cancer and degree of differentiation) in both Han and Hui patients were identified as prognostic factors (P dietary structure was a statistically significant factor, and diet varied significantly between the two ethnic groups. Dietary structure has a significant influence on colon cancer prognosis among Han and Hui patients with colon cancer in Beijing, which may cause a difference in their survival rates.

  6. Comparison of posture and balance in cancer survivors and age-matched controls.

    Science.gov (United States)

    Schmitt, Abigail C; Repka, Chris P; Heise, Gary D; Challis, John H; Smith, Jeremy D

    2017-12-01

    The combination of peripheral neuropathy and other treatment-associated side effects is likely related to an increased incidence of falls in cancer survivors. The purpose of this study was to quantify differences in postural stability between healthy age-matched controls and cancer survivors. Quiet standing under four conditions (eyes open/closed, rigid/compliant surface) was assessed in 34 cancer survivors (2 males, 32 females; age: 54(13) yrs., height: 1.62(0.07) m; mass: 78.5(19.5) kg) and 34 age-matched controls (5 males, 29 females; age: 54(15) yrs.; height: 1.62(0.08) m; mass: 72.8(21.1) kg). Center of pressure data were collected for 30s and the trajectories were analyzed (100Hz). Three-factor (group*surface*vision) mixed model MANOVAs with repeated measures were used to determine the effect of vision and surface on postural steadiness between groups. Cancer survivors exhibited larger mediolateral root-mean square distance and velocity of the center of pressure, as well as increased 95% confidence ellipse area (Ppostural steadiness when compared with age-matched controls. For cancer survivors undergoing rehabilitation focused on existing balance deficits, a small subset of the center of pressure measures presented here can be used to track progress throughout the intervention and potentially mitigate fall risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Comparison of Attitudes Regarding Preimplantation Genetic Diagnosis Among Patients with Hereditary Cancer Syndromes

    Science.gov (United States)

    Rich, Thereasa A.; Liu, Mei; Etzel, Carol J.; Bannon, Sarah A.; Mork, Maureen E.; Ready, Kaylene; Saraiya, Devki S.; Grubbs, Elizabeth G.; Perrier, Nancy D.; Lu, Karen H.; Arun, Banu K.; Woodard, Terri L.; Schover, Leslie R.; Litton, Jennifer K.

    2014-01-01

    Introduction Preimplantation Genetic Diagnosis (PGD) allows couples to avoid having a child with an inherited condition, potentially reducing cancer burden in families with a hereditary cancer predisposition. This study investigated awareness and acceptance of PGD among patients with hereditary cancer syndromes. Methods Questionnaires were mailed to 984 adults with hereditary breast and ovarian cancer, Lynch syndrome, familial adenomatous polyposis, or multiple endocrine neoplasia type 1 or 2. Associations between clinical, demographic, and psychosocial factors and awareness and acceptance of PGD were examined. Results Of 370 respondents (38% return rate), 28% felt their syndrome impacted family planning, 24% were aware of PGD, 72% felt that PGD should be offered, 43% would consider using PGD, and 29% were uncertain. Family experience and syndrome-specific characteristics, such as disease severity, quality of life and availability of medical interventions as well as gender, family planning stage, and religiosity impact perceptions of the acceptability of PGD, though a high level of uncertainty exists. Conclusion Hereditary cancer patients' opinions about the acceptability of PGD are similar to those of genetics and ethical experts. Patients should be told about PGD given that most had not heard of PGD, but feel that PGD should be offered. PMID:24072553

  8. Value of Diffusion Tensor Imaging of Prostate Cancer: Comparison with Systemic Prostate Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seong Kuk; Kim, Dong Won; Ha, Dong Ho; Kwon, Hee Jin; Kang, Myong Jin; Choi, Sun Seob; Nam, Kyung Jin; Kim, Jung Il [Dong-A University, Medical Center, Busan (Korea, Republic of)

    2011-02-15

    This study was performed to evaluate the usefulness of diffusion tensor imaging (DTI) and to correlate systemic twelve biopsy in prostate cancer. Thirty-one patients with suspected prostate cancer underwent MR imaging. DTI was performed prior to a prostate biopsy. We prospectively calculated the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) value in each corresponding biopsy site. Twenty-three of 31 patients had histopathologically proven adenocarcinoma. Among the 276 biopsy cores of 23 patients with prostate cancer, 109 cores showed positive results (39%). The ADC and FA value of positive cores were 1.31 {+-} 0.34x10-3 mm2/s and 0.68 {+-} 0.07, and those of the negative cores were 1.74 {+-} 0.45x10-3 mm2/s and 0.54 {+-} 0.09, respectively. Eight patients without carcinoma showed an ADC value of 1.83 {+-} 0.26x10-3 mm2/s and an FA value of 0.47 {+-} 0.07. The ADC and FA value of positive cores were significantly lower and higher than those of negative cores and cancer-free patients, respectively (p < 0.05). The ADC and FA values using DTI may provide useful diagnostic information in the differentiation of cancerous tissues, although there is overlap in some cases

  9. Comparison of self-reported physical activity in children and adolescents before and during cancer treatment.

    Science.gov (United States)

    Götte, Miriam; Kesting, Sabine; Winter, Corinna; Rosenbaum, Dieter; Boos, Joachim

    2014-06-01

    Physical activities are important for the development of children and increasing evidence suggests beneficial effects of physical activity promotion during cancer treatment as well. The present study aimed at evaluating the current need of exercise interventions in pediatric cancer patients undergoing acute treatment and identifying risk factors for inactivity. Data about self-reported physical activity before and during treatment was collected in a cross-sectional design with the physical activity questionnaire from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in a modified cancer specific version. One hundred thirty pediatric cancer patients with various entities were questioned 3.0 ± 1.6 months since diagnosis. Patients' activity levels before diagnosis mainly matched reference values for healthy children in Germany. Reductions during treatment affected all dimensions of daily physical activities and minutes of exercise per week decreased significantly (P physical activities during treatment were identified for bone tumor patients and in-patient stays. Due to the well known importance of physical activity during childhood and the identified risk of inactivity during cancer treatment, supervised exercise interventions should be implemented into acute treatment phase to enhance activity levels and ensure a continuously support by qualified exercise professionals. © 2013 Wiley Periodicals, Inc.

  10. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Sato, Chiho; Ishigaki, Takeo; Kumada, Hisashi; Miura, Shunichi; Takizawa, Osamu

    2005-01-01

    A relation between apparent diffusion coefficient (ADC) values and tumor cellular density has been reported. The purpose of this study was to measure the ADC values of cervical cancers in the uterus and compare them with those of normal cervical tissues, and to test whether ADC could differentiate between normal and malignant cervical tissues in the uterus. Twelve consecutive female patients with cervical cancer of the uterus and ten female patients with other pelvic abnormalities were included in this study. ADC was measured at 1.5 T with b-factors of 0, 300 and 600 s/mm 2 using single-shot echo-planar diffusion-weighted imaging and a parallel imaging technique. The mean ADC value of cervical cancer lesions was 1.09±0.20 x 10 -3 mm 2 /s, and that of normal cervix tissue was 1.79±0.24 x 10 -3 mm 2 /s (P<0.0001). In nine patients treated by chemotherapy and/or radiation therapy, the mean ADC value of the cervical cancer lesion increased significantly after therapy (P<0.001). The present study showed, with a small number of patients, that ADC measurement has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix. Further study is necessary to determine the accuracy of ADC measurement in monitoring the treatment response. (orig.)

  11. Comparison of qualitative and quantitative approach to prostate MR spectroscopy in peripheral zone cancer detection

    International Nuclear Information System (INIS)

    Klijn, Stijn; De Visschere, Pieter J.; De Meerleer, Gert O.; Villeirs, Geert M.

    2012-01-01

    Objective: To compare the diagnostic performance of a qualitative (pattern recognition) and a quantitative (numerical assessment) approach to magnetic resonance spectroscopy (MRS) in the diagnosis of peripheral zone prostate cancer. Methods: 185 patients (131 with histopathologically proven cancer, 54 normal/benign after at least 12 months follow-up) were prospectively evaluated with qualitative MRS using a 4-point scale between 3/2004 and 1/2008, and retrospectively reassessed using a prototype quantitative postprocessing software in April 2008. Based on pathology and follow-up data, diagnostic performance parameters were calculated. Results: The qualitative and quantitative approaches were concordant in 78.9% (146/185) of cases. The difference between the areas under the ROC curve (0.791 versus 0.772, respectively) was not statistically significant. The sensitivity, specificity and accuracy were 55.7%, 94.4% and 67.0% for the qualitative approach, and 55.0%, 83.3% and 63.2% for the quantitative approach. The sensitivity for high grade tumours (Gleason 4 + 3 or higher) was 85.2% (23/27) for both approaches. All cancers missed on either one approach separately (31/31) and 91% of cancers missed on both approaches together (23/27) were of lower grade (Gleason 3 + 4 or lower). Conclusions: Qualitative and quantitative approaches to MRS yield similar diagnostic results. Discordances in tumour detection only occurred in lower grade cancers.

  12. Comparison of terminally ill cancer- vs. non-cancer patients in specialized palliative home care in Germany - a single service analysis.

    Science.gov (United States)

    Stiel, Stephanie; Heckel, Maria; Seifert, Andreas; Frauendorf, Tobias; Hanke, Roland Martin; Ostgathe, Christoph

    2015-07-25

    Palliative care (PC) is no longer offered with preference to cancer patients (CA), but also to patients with non-malignant, progressive diseases. Taking current death statistics into account, PC in Europe will face a growing number of patients dying from non-cancer diseases (NCA). More insights into specialized palliative home care (SPHC) in NCAs are needed. Retrospective analysis and group comparisons between CAs and NCAs of anonymous data of all patients cared for between December 2009 and June 2012 by one SPHC team in Germany. Patient-, disease- and care-related data are documented in clinical routine by specialized PC physicians and nurses in the Information System Palliative Care 3.0 ® (ISPC®). Overall, 502 patients were cared for by the SPHC team; from 387 patients comprehensive data sets were documented. These 387 data sets (CA: N = 300, 77.5 % and NCA: N = 87, 22.5 %) are used for further analysis here. NCAs were significantly older (81 vs. 73 years; p home care (12 vs. 5 %; p home care (6 vs. 20 %; p homes (50 vs. 20 %; p services seems to takes place late in the disease trajectory, as demonstrated by the lower survival rate for NCAs. Nevertheless, the results show, that NCAs PC needs are as complex and intense as in CAs.

  13. Comparison of Survival Rate in Primary Non-Small-Cell Lung Cancer Among Elderly Patients Treated With Radiofrequency Ablation, Surgery, or Chemotherapy

    International Nuclear Information System (INIS)

    Lee, Heon; Jin, Gong Yong; Han, Young Min; Chung, Gyung Ho; Lee, Yong Chul; Kwon, Keun Sang; Lynch, David

    2012-01-01

    Purpose: We retrospectively compared the survival rate in patients with non-small-cell lung cancer (NSCLC) treated with radiofrequency ablation (RFA), surgery, or chemotherapy according to lung cancer staging. Materials and Methods: From 2000 to 2004, 77 NSCLC patients, all of whom had WHO performance status 0–2 and were >60 years old, were enrolled in a cancer registry and retrospectively evaluated. RFA was performed on patients who had medical contraindications to surgery/unsuitability for surgery, such as advanced lung cancer or refusal of surgery. In the RFA group, 40 patients with inoperable NSCLC underwent RFA under computed tomography (CT) guidance. These included 16 patients with stage I to II cancer and 24 patients with stage III to IV cancer who underwent RFA in an adjuvant setting. In the comparison group (n = 37), 13 patients with stage I to II cancer underwent surgery; 18 patients with stage III to IV cancer underwent chemotherapy; and 6 patients with stage III to IV cancer were not actively treated. The survival curves for RFA, surgery, and chemotherapy in these patients were calculated using Kaplan–Meier method. Results: Median survival times for patients treated with (1) surgery alone and (2) RFA alone for stage I to II lung cancer were 33.8 and 28.2 months, respectively (P = 0.426). Median survival times for patients treated with (1) chemotherapy alone and (2) RFA with chemotherapy for stage III to IV cancer were 29 and 42 months, respectively (P = 0.03). Conclusion: RFA can be used as an alternative treatment to surgery for older NSCLC patients with stage I to II inoperable cancer and can play a role as adjuvant therapy with chemotherapy for patients with stage III to IV lung cancer.

  14. Indirect estimators in US federal programs

    CERN Document Server

    1996-01-01

    In 1991, a subcommittee of the Federal Committee on Statistical Methodology met to document the use of indirect estimators - that is, estimators which use data drawn from a domain or time different from the domain or time for which an estimate is required. This volume comprises the eight reports which describe the use of indirect estimators and they are based on case studies from a variety of federal programs. As a result, many researchers will find this book provides a valuable survey of how indirect estimators are used in practice and which addresses some of the pitfalls of these methods.

  15. Communication challenges experienced by migrants with cancer: A comparison of migrant and English-speaking Australian-born cancer patients.

    Science.gov (United States)

    Hyatt, Amelia; Lipson-Smith, Ruby; Schofield, Penelope; Gough, Karla; Sze, Ming; Aldridge, Lynley; Goldstein, David; Jefford, Michael; Bell, Melanie L; Butow, Phyllis

    2017-10-01

    Understanding the difficulties faced by different migrant groups is vital to address disparities and inform targeted health-care service delivery. Migrant oncology patients experience increased morbidity, mortality and psychological distress, with this tentatively linked to language and communication difficulties. The objective of this exploratory study was to investigate the communication barriers and challenges experienced by Arabic, Greek and Chinese (Mandarin and Cantonese) speaking oncology patients in Australia. This study employed a cross-sectional design using patient-reported outcome survey data from migrant and English-speaking Australian-born patients with cancer. Patients were recruited through oncology clinics and Australian state cancer registries. Data were collected regarding patient clinical and demographic characteristics and health-care and communication experiences. Data from the clinics and registries were combined for analysis. Significant differences were found between migrant groups in demographic characteristics, communication and health-care experiences, and information and care preferences. Chinese patients cited problems with understanding medical information, the Australian health-care system, and communicating with their health-care team. Conversely, Arabic- and Greek-speaking patients reported higher understanding of the health-care system, and less communication difficulties. Our study findings suggest that migrant groups differ from each other in their health communication expectations and requirements. Lower education and health literacy of some groups may play a role in poorer health outcomes. Public health interventions and assistance provided to migrants should be tailored to the specific needs and characteristics of that language or cultural group. Future research directions are discussed. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  16. Comparison of cerebral metabolism of glucose in normal human and cancer patients

    International Nuclear Information System (INIS)

    Si, M.

    2007-01-01

    Full text: Objective: To determine whether the cerebral metabolism in various regions of the normal human brain differs from those of cancer patients in aging by using 18F-FDG PET instrument and SPM software. Materials and Methods We reviewed clinical information of 295 healthy normal samples so called 'normal group' (ranging 21 to 88; mean age+/-SD: 50+/-14) and 290 cancer patients called 'cancer group' (ranging 21 to 85; mean age+/-SD: 54+/-14) who were examined by a whole body GE Discovery LS PET-CT instrument in our center from Aug. 2004 to Dec. 2005.They were selected with: (i) absence of clear focal brain lesions (epilepsy, cerebrovascular diseases etc.); (ii) absence of metabolic diseases, such as hyperthyroidism, hypothyroidism and diabetes; (iii) absence of psychiatric disorders and abuse of drugs and alcohol;( iiii) cancer patients were diagnosed definitely of variable cancers except brain cancer or brain metastasis. Both groups were sub grouped into six with the interval of 10 years old starting from 21, and the gender, educational background and serum glucose are matched. All 12 subgroups were compared to the subgroup of normal 31-40 years old called 'control subgroup' (84 samples; mean age+/-SD: 37.15+/- 2.63). All samples were injected with 18F-FDG (5.55MBq/kg), 45-60 minutes later; their brains were scanned for 10 minutes. Pixel-by-pixel t-statistic analysis was applied to all brain images using the Statistical parametric mapping (SPM2). The hypometabolic areas (p < 0. 01 or p<0.001, uncorrected) were identified in the Stereotaxic coordinate human brain atlas and three dimensional localized by MNI Space utility (MSU) software. Results:1.With increasing of age interval, similar hypometabolic brain areas are detected in both 'normal group' and 'cancer group', they are mainly in the cortical structures such as bilateral prefrontal cortex (BA9), superior temporal gyrus (BA22), parietal cortex (inferior parietal lobule and precuneus(BA40), insula (BA13

  17. Adenopathies in lung cancer: a comparison of pathology, Computed Tomography and endoscopic ultrasound findings

    International Nuclear Information System (INIS)

    Potepan, P.; Meroni, E.; Spinelli, P.

    1999-01-01

    A prospective comparative study with pathology was performed to assess the clinical value of Computed Tomography (CT) and endoscopic ultrasound (EUS) for nodal staging in lung cancer. A total of 329 nodal stations were dissected or sampled and 755 lymph nodes were examined at histology. On a pre-station basis, CT had greater sensitivity (74%) than EUS (56%), but EUS was more specific (83% versus 93%). The accuracy rates of the two techniques were similar. In conclusion, endoscopic ultrasound should be part of a routine preoperative diagnostic approach to non-small-cell lung cancer., because of its high specificity. Results can be improved when EUS and CT are combined., which suggests that these imaging modalities should be used together in selected patients for the noninvasive staging of non-small-cell lung cancer to identify local lymphatic spread [it

  18. Comparison of miRNA and gene expression profiles between metastatic and primary prostate cancer.

    Science.gov (United States)

    Guo, Kaimin; Liang, Zuowen; Li, Fubiao; Wang, Hongliang

    2017-11-01

    The present study aimed to identify the regulatory mechanisms associated with the metastasis of prostate cancer (PC). The microRNA (miRNA/miR) microarray dataset GSE21036 and gene transcript dataset GSE21034 were downloaded from the Gene Expression Omnibus database. Following pre-processing, differentially expressed miRNAs (DEMs) and differentially expressed genes (DEGs) between samples from patients with primary prostate cancer (PPC) and metastatic prostate cancer (MPC) with |log 2 fold change (FC)| >1 and a false discovery rate terms (36 terms), followed by miR-494 (24 terms), miR-30d (18 terms), miR-181a (15 terms), hsa-miR-196a (8 terms), miR-708 (7 terms) and miR-486-5p (2 terms). Therefore, these miRNAs may serve roles in the metastasis of PC cells via downregulation of their corresponding target DEGs.

  19. Quantitative comparison between treatment results for uterine cervix cancer by radiation therapy and surgery

    International Nuclear Information System (INIS)

    Iinuma, Takeshi; Fukuhisa, Kenjiro; Arai, Tatsuo

    1983-01-01

    Treatment results for uterine cervix cancer were evaluated using a new concept named ''Effective Survival Rate''. This rate was calculated by subtracting the weighted sum of incidence rates of various complications from the 5-year survival rate. The numerical values for various complications were assigned as follows: surgical death, 1.0; severe complications, such as fistula ureterovaginalis and ileus, 0.5; mild complications, such as rectum and urinary bladder complications, 0.3 and 0.2. These values were determined with reference to the Karnofsky index of performance status. The effective survival rate was calculated for patients with satage 2 and 3 uterine cervix cancer treated by radiation therapy and surgery, and compared as a function of age between 30 and 70 years. We concluded that the effective survival rate was comparable for radiation therapy and surgery for stage 2 uterine cervix cancer. However, in patients with stage 3, radiation therapy was superior. (author)

  20. A comparison of the results of radiotherapy and surgical treatment of tongue cancer

    International Nuclear Information System (INIS)

    Matsuki, Hirokazu; Ikushima, Hitoshi; Nishitani, Hiromu; Takegawa, Yoshihiro; Kashihara, Kenichi

    2000-01-01

    To investigate the results of tongue cancer treatments retrospectively in order to compare the outcomes of radiotherapy and surgery among patients presenting with early-stage tongue cancer. One-hundred and forty-three patients who underwent radical treatment of tongue cancer between 1976 and 1996 were classified into six treatment groups in order to compare the 5-year survival rate, 5-year local control and lymph node metastasis between the groups. Furthermore, prognostic factors were determined by univariate and multivariate analyses. The 5-year survival rate for the entire subject population was 71%, and that for patients diagnosed as having stage I, II, III and IV tumors was 85%, 80%, 76% and 53%, respectively. The 5-year survival rate of patients who underwent surgical treatment alone for early-stage tongue cancer was higher than that of patients who underwent interstitial radiotherapy alone (100% and 70%, respectively). The 5-year local control rate did not differ significantly between patients who underwent surgical treatment alone for early-stage cancer and those who underwent interstitial radiotherapy alone (87% and 86%, respectively). Furthermore, the survival rate did not differ significantly between patients presenting with cervical lymph node metastasis upon initial examination and those who developed cervical lymph node metastasis later (62% and 69%, respectively). The results of a univariate analysis showed that prognosis was significantly better for women and N0 patients, and the results of a multivariate analysis confirmed that prognosis was significantly better for patients under 60 years of age, women, and N0 patients. The survival rate of patients treated for early-stage tongue cancer was slightly higher for those who underwent surgical treatment alone compared with those who underwent interstitial radiotherapy alone. However, local control was comparable between these two groups of patients. (author)

  1. Clinicopathological analysis of colorectal cancer: a comparison between emergency and elective surgical cases.

    Science.gov (United States)

    Ghazi, Sam; Berg, Elisabeth; Lindblom, Annika; Lindforss, Ulrik

    2013-06-11

    Approximately 15 to 30% of colorectal cancers present as an emergency, most often as obstruction or perforation. Studies report poorer outcome for patients who undergo emergency compared with elective surgery, both for their initial hospital stay and their long-term survival. Advanced tumor pathology and tumors with unfavorable histologic features may provide the basis for the difference in outcome. The aim of this study was to compare the clinical and pathologic profiles of emergency and elective surgical cases for colorectal cancer, and relate these to gender, age group, tumor location, and family history of the disease. The main outcome measure was the difference in morphology between elective and emergency surgical cases. In total, 976 tumors from patients treated surgically for colorectal cancer between 2004 and 2006 in Stockholm County, Sweden (8 hospitals) were analyzed in the study. Seventeen morphological features were examined and compared with type of operation (elective or emergency), gender, age, tumor location, and family history of colorectal cancer by re-evaluating the histopathologic features of the tumors. In a univariate analysis, the following characteristics were found more frequently in emergency compared with elective cases: multiple tumors, higher American Joint Committee on Cancer (AJCC), tumor (T) and node (N) stage, peri-tumor lymphocytic reaction, high number of tumor-infiltrating lymphocytes, signet-ring cell mucinous carcinoma, desmoplastic stromal reaction, vascular and perineural invasion, and infiltrative tumor margin (Pemergency case generally show a more aggressive histopathologic profile and a more advanced stage than do elective cases. Essentially, no difference was seen in location, and therefore it is likely there would be no differences in macro-environment either. Our results could indicate that colorectal cancers needing emergency surgery belong to an inherently specific group with a different etiologic or genetic

  2. A comparison of laparoscopic and open D3 lymphadenectomy for transverse colon cancer.

    Science.gov (United States)

    Kwak, Han Deok; Ju, Jae Kyun; Lee, Soo Young; Kim, Chang Hyun; Kim, Young Jin; Kim, Hyeong Rok

    2017-12-01

    The type of surgery or surgical approach for transverse colon cancer treatment largely depends on the tumor location or surgeon's preference. However, extensive lymphadenectomy appears to improve the long-term outcomes of locally advanced colon cancers. This study was designed to compare the short- and long-term outcomes after surgery via the laparoscopic or open approach with radical D3 lymph node dissection in patients with stage II and III transverse colon cancer. Patients were treated for stage II and III transverse colon cancer between May 2006 and December 2014. This retrospective study evaluated data collected prospectively at a tertiary teaching hospital. Radical D3 lymphadenectomy included the principal middle colic artery nodes. The study included 144 patients among whom 118 (81.9%) underwent laparoscopic surgery. Significantly more patients in the laparoscopic group underwent extended right hemicolectomy compared with the open group (90.7 vs. 65.4%, p = 0.005). The operative time was longer in the laparoscopic group (151.3 vs. 131.2 min, p = 0.021), and the open group had a greater estimated blood loss volume (160.8 vs. 289.3 ml, p = 0.011). Although the groups differed in terms of tumor size (5.8 vs 7.9 cm, p = 0.007), other pathologic outcomes did not differ. The groups did not differ regarding postoperative parameters or disease-free, overall, and cancer-specific survivals. Despite differences in surgical methods and related factors, no long-term differences in outcomes were observed between laparoscopic and open approaches to radical D3 lymphadenectomy in patients with stage II and III transverse colon cancer.

  3. Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging

    OpenAIRE

    Schilling, Kathy; Narayanan, Deepa; Kalinyak, Judith E.; The, Juliette; Velasquez, Maria Victoria; Kahn, Simone; Saady, Matthew; Mahal, Ravinder; Chrystal, Larraine

    2010-01-01

    Purpose The objective of this study was to compare the performance characteristics of 18F-fluorodeoxyglucose (FDG) positron emission mammography (PEM) with breast magnetic resonance imaging (MRI) as a presurgical imaging and planning option for index and ipsilateral lesions in patients with newly diagnosed, biopsy-proven breast cancer. Methods Two hundred and eight women >25 years of age (median age = 59.7 ± 14.1 years) with biopsy-proven primary breast cancer enrolled in this prospective, si...

  4. Integration and comparison of different genomic data for outcome prediction in cancer

    OpenAIRE

    Gomez Rueda, Hugo; Martínez Ledesma, Emmanuel; Martínez Torteya, Antonio; Palacios Corona, Rebeca; Treviño, Victor

    2005-01-01

    Background In cancer, large-scale technologies such as next-generation sequencing and microarrays have produced a wide number of genomic features such as DNA copy number alterations (CNA), mRNA expression (EXPR), microRNA expression (MIRNA), and DNA somatic mutations (MUT), among others. Several analyses of a specific type of these genomic data have generated many prognostic biomarkers in cancer. However, it is uncertain which of these data is more powerful and whether the best data-type is c...

  5. Comparison of ultrasound and computed tomography in staging of bladder cancer

    International Nuclear Information System (INIS)

    Suyama, Bunzo

    1982-01-01

    Preoperative staging of bladder cancer is very important for decision of treating methods and prognostication. The present author used ultrasound via the abdominal wall in the diagnosis of 83 patients with bladder cancer. I estimated the extent of bladder tumor infiltration by ultrasound via the abdominal wall according to Shiraishi's criteria. Ultrasound scans, pelvic angiograms and CT scans were reviewed to determine their accuracy in staging of bladder tumors. Ultrasound scans were excellent in staging of non-infiltrated bladder tumors, while pelvic angiograms and CT scans were excellent in staging of infiltrated bladder tumors. (author)

  6. Impact of the new international association for the study of lung cancer staging system in non-small cell lung cancer: With comparison to the union for international cancer control 6th tumor, node, metastasis edition

    International Nuclear Information System (INIS)

    Lee, Myung Jae; Lee, So Won; Shim, Sung Shine; Ryu, Yon Ju; Kim, Yoo Kyung

    2014-01-01

    To investigate the impact of the proposed International Association for the Study of Lung Cancer (IASLC) tumor, node, metastasis (TNM) system on staging and outcome of non small cell lung cancer (NSCLC). With a total of 501 NSCLC patients with staging according to Union for International Cancer Control (UICC), 6th TNM (TNM-6) were reclassified according to the IASLC proposed TNM staging (TNM-7). The impact of TNM-7 in comparison with TNM-6 was evaluated at three levels: change in substage, staging, and outcome. The outcome measure was to compare the stage-specific overall survival of NSCLC between the two groups of patients. A total of 214 (42.7%) patients had changed TNM staging, and 101 (20.2%) patients had changed stage groupings in TNM-7 compared to TNM-6. Among 100 patients showing changed stage grouping, 72 (14.4%) showed upstage and 29 (5.8%) demonstrated downstage. The TNM-7 system resulted in better separation of survival curves among stage-specific NSCLC than TNM-6 system, especially in separation of stage IIA vs. IIB (p 0.023) and stage IIIB vs. IV (p < 0.001). TNM-7 for lung cancer appears to be superior in defining stage-specific survival groups than TNM-6, especially between stage IIA vs. stage IIB and stage IIIB vs. stage IV.

  7. Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer

    International Nuclear Information System (INIS)

    Takeda, Atsuya; Kunieda, Etsuo; Ohashi, Toshio; Aoki, Yousuke; Koike, Naoyoshi; Takeda, Toshiaki

    2011-01-01

    Purpose: To analyze local control of oligometastatic lung tumors (OLTs) compared with that of primary lung cancer after stereotactic body radiotherapy (SBRT). Materials and methods: Retrospective record review of patients with OLTs who received SBRT with 50 Gy in 5 fractions. Local control rates (LCRs), toxicities, and factors of prognostic significance were assessed. Results: Twenty-one colorectal OLTs, 23 OLTs from other origins, and 188 primary lung cancers were included. Multivariate analysis revealed only tumor origin was prognostically significant (p < 0.05). The 1-year/2-year LCRs in colorectal OLTs and OLTs from other origins were 80%/72% and 94%/94%, respectively. The LCR in colorectal OLTs was significantly worse than that in OLTs from the other origins and primary lung cancers with pathological and clinical diagnosis (p < 0.05, p < 0.0001 and p < 0.005). Among 44 OLT patients, Grades 2 and 3 radiation pneumonitis were identified in 2 and 1 patients, respectively. No other toxicities of more than Grade 3 occurred. Conclusion: SBRT for OLTs is tolerable. The LCR for OLTs from origins other than colorectal cancer is excellent. However, LCR for colorectal OLTs is worse than that from other origins. Therefore dose escalation should be considered to achieve good local control for colorectal OLTs.

  8. Evaluation of bone surrogates for indirect and direct ballistic fractures.

    Science.gov (United States)

    Bir, Cynthia; Andrecovich, Chris; DeMaio, Marlene; Dougherty, Paul J

    2016-04-01

    The mechanism of injury for fractures to long bones has been studied for both direct ballistic loading as well as indirect. However, the majority of these studies have been conducted on both post-mortem human subjects (PMHS) and animal surrogates which have constraints in terms of storage, preparation and testing. The identification of a validated bone surrogate for use in forensic, medical and engineering testing would provide the ability to investigate ballistic loading without these constraints. Two specific bone surrogates, Sawbones and Synbone, were evaluated in comparison to PMHS for both direct and indirect ballistic loading. For the direct loading, the mean velocity to produce fracture was 121 ± 19 m/s for the PMHS, which was statistically different from the Sawbones (140 ± 7 m/s) and Synbone (146 ± 3 m/s). The average distance to fracture in the indirect loading was .70 cm for the PMHS. The Synbone had a statistically similar average distance to fracture (.61 cm, p=0.54) however the Sawbones average distance to fracture was statistically different (.41 cm, pballistic testing was not identified and future work is warranted. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Identification of Methodology of Indirect Assessment of Economy Shadowing

    Directory of Open Access Journals (Sweden)

    Avhustyn Ruslan R.

    2014-03-01

    Full Text Available The article explains the essence of the shadow economy as an objective phenomenon of socio-economic relations and its influence upon national economy security through instruments of pricing, fiscal restrictions, tax control, and banking and insurance regulation. It proves the necessity of use of the indirect method of assessment of the level of economy shadowing along with methods of direct control over the growth of shadowed economic relations, since such an approach would allow rational approach to identification of volumes and level of shadow activity. In the result of the study the article marks out varieties of indirect assessment of economy shadowing (methods of document, accounting and economic analysis, their specific features, advantages and shortcomings and results of practical use. The article reveals approaches and indicators of economic analysis that allow identification of reasons of deviations from the normal economic activity of economic subjects. It provides examples of the indirect method of assessment of the volume of shadowed economy that deal with analysis of demand on money and comparison of rates of the growth of the money supply with the volume of sight drafts with GDP.

  10. Bioelectrochemical Systems for Indirect Biohydrogen Production

    KAUST Repository

    Regan, John M.; Yan, Hengjing

    2014-01-01

    by exoelectrogens at the anode. As an indirect approach to biohydrogen production, these systems are not subject to the hydrogen yield constraints of fermentative processes and have been proven to work with virtually any biodegradable organic substrate

  11. Indirect techniques in nuclear astrophysics: a review

    International Nuclear Information System (INIS)

    Tribble, R E; Mukhamedzhanov, A M; Bertulani, C A; Cognata, M La; Spitaleri, C

    2014-01-01

    In this review, we discuss the present status of three indirect techniques that are used to determine reaction rates for stellar burning processes, asymptotic normalization coefficients, the Trojan Horse method and Coulomb dissociation. A comprehensive review of the theory behind each of these techniques is presented. This is followed by an overview of the experiments that have been carried out using these indirect approaches. (review article)

  12. Comparison of pregabalin versus ketamine in postoperative pain management in breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Essam Mahran

    2015-01-01

    Full Text Available Background: Breast surgery compromises one of the most common cancer surgeries in females and commonly followed by acute postoperative pain. Pregabalin and ketamine have been used in many previous studies and was found to have a good analgesic profile. We assumed that pregabalin and ketamine can be used in control of postoperative pain in female patients undergoing breast cancer surgery. Material and Methods: Ninety female patients scheduled for cancer breast surgery were allocated in three groups (30 patients each, control group (group c received preoperative placebo, pregabalin group (group p received oral 150 mg pregabalin 1 h before surgery, ketamine group (group k received intravenous (IV 0.5 mg/kg ketamine with induction of anesthesia followed by 0.25 mg/kg/h IV throughout the surgery. All patients received general anesthesia and after recovery, the three groups were assessed in the first postoperative 24 h for postoperative visual analog scale (VAS , total 24 h morphine consumption, incidence of postoperative nausea and vomiting (PONV, sedation score >2 and any complications from the drugs used in the study. Results: The use of pregabalin or ketamine was found to reduce total postoperative morphine consumption with P 2. Conclusion: The use of preoperative oral 150 mg pregabalin 1 h before surgery or IV 0.5 mg ketamine with induction of anesthesia can reduce postoperative opioid consumption in breast cancer surgery without change in sedation or PONV and with a good safety profile.

  13. Short- and long-term adaptation to cancer : a comparison of patients with the general population

    NARCIS (Netherlands)

    Schroevers, Maatje Jannetje

    2002-01-01

    Both from a scientific and common sense point of view, there are many ideas about how patients adjust to a life-threatening disease such as cancer. However, the empirical evidence on this topic is still elusive, especially about the consequences that patients may experience in the long term. The

  14. A comparison of morbidity following conformal versus intensity-modulated radiotherapy for urinary bladder cancer.

    Science.gov (United States)

    Søndergaard, Jimmi; Holmberg, Mats; Jakobsen, Annette Ross; Agerbæk, Mads; Muren, Ludvig Paul; Høyer, Morten

    2014-10-01

    In radiotherapy (RT) of urinary bladder cancer, the use of intensity-modulated RT (IMRT) opens for sparing of considerable intestinal volumes. The purpose of the present study was to investigate the acute and late toxicities following either conformal RT (CRT) or IMRT for bladder cancer, and to correlate the toxicities to dose-volume parameters. The study included 116 consecutively treated patients with muscle-invasive bladder cancer who received either CRT (n = 66) or IMRT (n = 50) during 2007-2010. Acute side effects were retrospectively collected whereas late effects were assessed by a cross-sectional evaluation by telephone interview of 44 recurrence-free patients. Acute and late toxicities were scored according to the Common Terminology Criteria for Adverse Event (CTCAE) version 3.0. Acute diarrhoea grade ≥ 2 was more frequent in patients treated by CRT (56%) compared to IMRT (30%) (p = 0.008). Logistic regression analysis showed a correlation between acute diarrhoea and bowel cavity dose-volume parameters in the 10-50 Gy range. Severe late toxicity (grade ≥ 3) was recorded in 10% of the total cohort, with no statistical difference between the IMRT and CRT groups. Patients treated with IMRT for bladder cancer had significantly less acute diarrhoea compared to those treated with CRT, but there was no significant difference in late morbidity between the groups. The risk of acute diarrhoea was related to the volume of bowel irradiated.

  15. Nonionising radiation and risk of human cancer: comparison of ultraviolet and radiofrequency radiation

    International Nuclear Information System (INIS)

    Green, A.

    2003-01-01

    Human exposure to ultraviolet radiation (UVR) comes largely from sunlight, although a small proportion of people receive high dose UVR from artificial sources. The causal link between solar UVR and the keratinocyte cancers, basal cell carcinomas and squamous cell carcinomas of the skin, is well-established based on a large body of observational and experimental evidence. UVR damages molecules such as DNA directly and this is the principal mechanism of carcinogenesis, though other mechanisms such as immunosuppression and interaction with viruses may also be involved. People are also exposed to another form of nonionising radiation, radiofrequency radiation (RFR), through occupation, the community environment from base stations, and through use of cellular telephones and related communications devices. However, unlike UVR, the relationship between RFR and cancer is far from clear. The main tumours that have been investigated to date are brain tumours and leukaemia but assessing the RFR exposure pathway to such cancers poses many methodological challenges for epidemiologists. Refinements to measurement of exposure are the major urgent need, and the lack of evidence regarding carcinogenic effects of RFR in experimental settings complicates the assessment. Further insights into the links between RFR and chronic disease such as cancer are likely in the next few years however when results of several large-scale epidemiological studies now in train around the world become available

  16. Comparison of Plasma Tu-M2-PK and CA19-9 in Pancreatic Cancer

    DEFF Research Database (Denmark)

    Joergensen, Maiken Thyregod; Heegaard, Niels H H; Schaffalitzky de Muckadell, Ove B

    2009-01-01

    because of suspicion of pancreatic cancer. Of these, 51 patients had their conditions diagnosed as PDAC, whereas this diagnosis was ruled out in 52 after 12 months of follow-up. The performance of Tu-M2-PK was compared with that of CA19-9 using cutoff values 15 and 37 U/mL, respectively. RESULTS...

  17. Depressive symptomatology in men receiving androgen deprivation therapy for prostate cancer: a controlled comparison.

    Science.gov (United States)

    Lee, Morgan; Jim, Heather S; Fishman, Mayer; Zachariah, Babu; Heysek, Randy; Biagioli, Matthew; Jacobsen, Paul B

    2015-04-01

    Prostate cancer patients who receive androgen deprivation therapy (ADT) often experience many physical and psychological side effects. ADT may be associated with increased risk for depression, but the relationship between ADT and depression is not fully understood. This study used a longitudinal design to assess depressive symptomatology in patients receiving ADT compared with two groups of matched controls. Participants were men initiating ADT treatment (ADT+ group; n = 61) and their matched controls: prostate cancer patients treated with radical prostatectomy (ADT- group; n = 61), and no-cancer controls (CA- group; n = 61). Depressive symptomatology was assessed using the Center for Epidemiological Studies Depression Scale at ADT initiation and again 6 months later. Differences in depressive symptomatology and rates of clinically significant depressive symptomatology were analyzed between groups at each time point and within groups over time. Between baseline and follow-up, ADT+ participants demonstrated increased depressive symptomatology and increased rates of clinically significant depressive symptomatology (ps depressive symptomatology than both control groups at follow-up (ps depressive symptomatology were higher in the ADT+ group than the ADT- and CA- groups at both time points (baseline: 28%, 5%, 12%; follow-up: 39%, 9%, 11%). Findings support the hypothesis that ADT administration yields increases in depression and suggest that the mechanism behind ADT's association with depression should be explored and that prostate cancer patients treated with ADT should receive particular focus in depression screening and intervention. Copyright © 2014 John Wiley & Sons, Ltd.

  18. Breast cancer screening with digital breast tomosynthesis - 4 year experience and comparison with national data

    Directory of Open Access Journals (Sweden)

    Huay-Ben Pan

    2018-01-01

    Conclusion: There was a 32.2% increase in CDR and a 17.8% decrease in RR when DBT was used as an adjunct to DM, as compared to DM alone. CDRs were approximately twofold better than national average data. DBT was more effective at detecting cancer in ductal carcinoma in situ and stage 1.

  19. Comparison of targeted proteomics approaches for detecting and quantifying proteins derived from human cancer tissues

    Czech Academy of Sciences Publication Activity Database

    Faktor, J.; Suchá, Rita; Páralová, V.; Liu, Y.; Bouchal, P.

    2017-01-01

    Roč. 17, č. 5 (2017), č. článku 1600323. ISSN 1615-9853 R&D Projects: GA MŠk(CZ) LO1609 Institutional support: RVO:67985904 Keywords : cancer * MRM/SRM * SWATH Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Biochemical research methods Impact factor: 4.041, year: 2016

  20. The comparison of thrombocytosis and platelet-lymphocyte ratio as potential prognostic markers in colorectal cancer

    DEFF Research Database (Denmark)

    Baranyai, Zsolt; Krzystanek, Marcin; Josa, Valeria

    2014-01-01

    The aim of the present study was to analyse the preoperative platelet count and the platelet-lymphocyte ratio (PLR) in patients with colorectal cancer (CRC) of different stages and with hepatic metastasis of CRC (mCRC) and to compare these factors as potential prognostic markers. Clinicopathologi...

  1. Comparison of characteristics between frequent participants and non-participants in screening program for stomach cancer.

    Science.gov (United States)

    Fukao, A; Hisamichi, S; Komatsu, S; Shimizu, H; Satoh, H; Nakatsuka, H; Watanabe, T; Fujisaku, S; Ichinowatari, Y; Kuroda, S

    1992-04-01

    To clarify the differences in characteristics between participants and non-participants in the screening program for stomach cancer, life-style and medical histories were compared among 20, 169 subjects who lived in an urban area (Sendai) and a rural area (Wakuya and Tajiri) in Miyagi Prefecture, Japan. All subjects were classified into three groups according to the frequency of participation in the screening program during the last 5 years; i.e., frequent participating group (FPG) for 4 or 5 times, reference group (RG) for 1-3 times and non-participating group (NPG) for 0 times. Subjects in the FPG consumed more milk and green-yellow vegetable whereas those in the NPG consumed less these foods. The age-adjusted proportions of present smokers were higher in the NPG but lower in the FPG significantly. The proportions of subjects who had parental histories of all cancers and stomach cancer and past history of gastro-duodenal ulcer were higher in the FPG and lower in the NPG. To control influences among the variables a stepwise multiple regression analysis was done, and it revealed that smoking and parental history of cancers were strong predictors to explain the frequency of participation.

  2. Apples and pears? A comparison of two sources of national lung cancer audit data in England

    Directory of Open Access Journals (Sweden)

    Aamir Khakwani

    2017-07-01

    Full Text Available In 2014, the method of data collection from NHS trusts in England for the National Lung Cancer Audit (NLCA was changed from a bespoke dataset called LUCADA (Lung Cancer Data. Under the new contract, data are submitted via the Cancer Outcome and Service Dataset (COSD system and linked additional cancer registry datasets. In 2014, trusts were given opportunity to submit LUCADA data as well as registry data. 132 NHS trusts submitted LUCADA data, and all 151 trusts submitted COSD data. This transitional year therefore provided the opportunity to compare both datasets for data completeness and reliability. We linked the two datasets at the patient level to assess the completeness of key patient and treatment variables. We also assessed the interdata agreement of these variables using Cohen's kappa statistic, κ. We identified 26 001 patients in both datasets. Overall, the recording of sex, age, performance status and stage had more than 90% agreement between datasets, but there were more patients with missing performance status in the registry dataset. Although levels of agreement for surgery, chemotherapy and external-beam radiotherapy were high between datasets, the new COSD system identified more instances of active treatment. There seems to be a high agreement of data between the datasets, and the findings suggest that the registry dataset coupled with COSD provides a richer dataset than LUCADA. However, it lagged behind LUCADA in performance status recording, which needs to improve over time.

  3. Depot sterols in comparisons with structural sterols in Cancer pagurus and Eriocheir sinensis

    NARCIS (Netherlands)

    Zandee, D.I.; Kruitwagen, E.C.J.

    The differences in sterol content and sterol composition between the midgut gland and remaining parts (structural lipids) of male and female specimens of Cancer pagurus and Eriocheir sinensis are investigated. There are no differences in sterol content in the structural lipids between male and

  4. A comparison of machine learning techniques for survival prediction in breast cancer.

    Science.gov (United States)

    Vanneschi, Leonardo; Farinaccio, Antonella; Mauri, Giancarlo; Antoniotti, Mauro; Provero, Paolo; Giacobini, Mario

    2011-05-11

    The ability to accurately classify cancer patients into risk classes, i.e. to predict the outcome of the pathology on an individual basis, is a key ingredient in making therapeutic decisions. In recent years gene expression data have been successfully used to complement the clinical and histological criteria traditionally used in such prediction. Many "gene expression signatures" have been developed, i.e. sets of genes whose expression values in a tumor can be used to predict the outcome of the pathology. Here we investigate the use of several machine learning techniques to classify breast cancer patients using one of such signatures, the well established 70-gene signature. We show that Genetic Programming performs significantly better than Support Vector Machines, Multilayered Perceptrons and Random Forests in classifying patients from the NKI breast cancer dataset, and comparably to the scoring-based method originally proposed by the authors of the 70-gene signature. Furthermore, Genetic Programming is able to perform an automatic feature selection. Since the performance of Genetic Programming is likely to be improvable compared to the out-of-the-box approach used here, and given the biological insight potentially provided by the Genetic Programming solutions, we conclude that Genetic Programming methods are worth further investigation as a tool for cancer patient classification based on gene expression data.

  5. A comparison of machine learning techniques for survival prediction in breast cancer

    Directory of Open Access Journals (Sweden)

    Vanneschi Leonardo

    2011-05-01

    Full Text Available Abstract Background The ability to accurately classify cancer patients into risk classes, i.e. to predict the outcome of the pathology on an individual basis, is a key ingredient in making therapeutic decisions. In recent years gene expression data have been successfully used to complement the clinical and histological criteria traditionally used in such prediction. Many "gene expression signatures" have been developed, i.e. sets of genes whose expression values in a tumor can be used to predict the outcome of the pathology. Here we investigate the use of several machine learning techniques to classify breast cancer patients using one of such signatures, the well established 70-gene signature. Results We show that Genetic Programming performs significantly better than Support Vector Machines, Multilayered Perceptrons and Random Forests in classifying patients from the NKI breast cancer dataset, and comparably to the scoring-based method originally proposed by the authors of the 70-gene signature. Furthermore, Genetic Programming is able to perform an automatic feature selection. Conclusions Since the performance of Genetic Programming is likely to be improvable compared to the out-of-the-box approach used here, and given the biological insight potentially provided by the Genetic Programming solutions, we conclude that Genetic Programming methods are worth further investigation as a tool for cancer patient classification based on gene expression data.

  6. Cytogenetic comparisons of synchronous carcinomas and polyps in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Bardi, G; Parada, L A; Bomme, L

    1997-01-01

    Thirty tumorous lesions from seven patients with colorectal cancer were short-term cultured and cytogenetically analysed: 16 non-adenomatous polyps, six adenomas, seven carcinomas, including one in polyp, and one lymph node metastasis. Clonal chromosome aberrations were found in 20 samples in 100...

  7. Comparison of the incidence of oesophageal cancer in two 6-year ...

    African Journals Online (AJOL)

    resulting in 407 000 deaths globally and making it the 8thmost ... most likely cause of cancer-related deaths.[1] Globally ... for 90% of cases in most European and Asian countries. .... in the African population represented here was much greater.

  8. Comparison of proteomic biomarker panels in urine and serum for ovarian cancer diagnosis

    DEFF Research Database (Denmark)

    Petri, Anette Lykke; Simonsen, Anja Hviid; Høgdall, Estrid

    2010-01-01

    The purposes of this study were to confirm previously found candidate epithelial ovarian cancer biomarkers in urine and to compare a paired serum biomarker panel and a urine biomarker panel from the same study cohort with regard to the receiver operating characteristic curve (ROC) area under the ...

  9. Gamma-camera 18F-FDG PET in diagnosis and staging of patients presenting with suspected lung cancer and comparison with dedicated PET

    DEFF Research Database (Denmark)

    Oturai, Peter S; Mortensen, Jann; Enevoldsen, Henriette

    2004-01-01

    It is not clear whether high-quality coincidence gamma-PET (gPET) cameras can provide clinical data comparable with data obtained with dedicated PET (dPET) cameras in the primary diagnostic work-up of patients with suspected lung cancer. This study focuses on 2 main issues: direct comparison...

  10. Lower risk of cancer in patients on metformin in comparison with those on sulfonylurea derivatives: Results from a large population-based follow-up study

    NARCIS (Netherlands)

    R. Ruiter (Rikje); L.E. Visser (Loes); M.P.P. van Herk-Sukel (Myrthe); J.W.W. Coebergh (Jan Willem); H.R. Haak (Harm); P.H. Geelhoed-Duijvestijn; S.M.J.M. Straus (Sabine); R.M.C. Herings (Ron); B.H.Ch. Stricker (Bruno)

    2012-01-01

    textabstractOBJECTIVE - Numerous studies have suggested a decreased risk of cancer in patients with diabetes on metformin. Because different comparison groups were used, the effect magnitude is difficult to estimate. Therefore, the objective of this study was to further analyze whether, and to what

  11. Comparison of Western and Asian Guidelines Concerning the Management of Colon Cancer.

    Science.gov (United States)

    Pellino, Gianluca; Warren, Oliver; Mills, Sarah; Rasheed, Shahnawaz; Tekkis, Paris P; Kontovounisios, Christos

    2018-02-01

    Guidelines are important to standardize treatments and optimize outcomes. Several societies have published authoritative guidelines for patients with colon cancer, and a certain degree of variation can be predicted. This study aims to compare Western and Asian guidelines for the management of colon cancer. A literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies published between 2010 and 2017 by the online resources from the official Web sites of the societies/panels. Sources included guidelines by European Society of Medical Oncology, the Japanese Society for Cancer of the Colon and Rectum, and the National Comprehensive Cancer Network. Only full-text studies and the latest guidelines dealing with colon cancer were included. Studies and guidelines were separately assessed by 2 authors, who independently identified discrepancies and areas for further research. These were discussed and agreed with by all the authors. The recommendations of the guidelines of each society were compared, seeking discrepancies and potential areas for improvement. Endoscopic techniques for the management of early colon cancer are discussed in detail in the Asian guidelines. Asian guidelines advocate extended (D3) lymphadenectomy on a routine basis in T3/T4 and in selected T2 patients, whereas such an approach is still under investigation in Western countries. Only US guidelines describe neoadjuvant chemotherapy and radiotherapy. All the guidelines recommend adjuvant treatment in selected stage II patients, but agreement exists that this is performed without solid evidence, because better outcomes are hypothesized based on studies including stage III or stage II/III patients. The role of cytoreductive surgery with intra-abdominal chemotherapy is dubious, and European guidelines only recommend it in the setting of trials. Asian guidelines endorse an aggressive surgical approach to peritoneal disease. Only US

  12. FDG PET/CT in cancer: comparison of actual use with literature-based recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Henrik; Johansen, Allan; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark); Holdgaard, Paw Christian [Vejle Hospital, Department of Nuclear Medicine, Vejle (Denmark); Madsen, Poul Henning [Vejle Hospital, Department of Medicine, Vejle (Denmark); Knudsen, Lene Meldgaard [Odense University Hospital, Department of Haematological, Odense (Denmark); Gad, Dorte; Gravergaard, Anders Eggert [Odense University Hospital, Department of Plastic Surgery, Odense (Denmark); Rohde, Max; Godballe, Christian [Odense University Hospital, Department of ORL Head and Neck Surgery, Odense (Denmark); Engelmann, Bodil Elisabeth [Naestved Sygehus, Department of Clinical Physiology and Nuclear Medicine, Naestved (Denmark); Bech, Karsten [Aabenraa Sygehus, Organ Centre, Aabenraa (Denmark); Teilmann-Joergensen, Dorte [Aabenraa Sygehus, Department of Gynaecoligcal and Obstetrics, Aabenraa (Denmark); Mogensen, Ole [Odense University Hospital, Department of Gynaecoligcal and Obstetrics, Odense (Denmark); Karstoft, Jens [Odense University Hospital, Department of Radiology, Odense (Denmark); Johansen, Joergen [Odense University Hospital, Department of Oncology, Odense (Denmark); Christensen, Janne Buck [Odense University Hospital, Department of Quality and Research/HTA, Odense (Denmark); Collaboration: on behalf of the PET/CT Task Force of the Region of Southern Denmark

    2016-04-15

    The Region of Southern Denmark (RSD), covering 1.2 of Denmark's 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual use of PET/CT in the RSD with these recommendations. This article summarizes the results. A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012. Rapid Evidence Assessment was applied, using the methodology of systematic reviews with predefined limitations to search PubMed, Embase and the Cochrane Library for articles published in English/Danish/Swedish/Norwegian since 2002. PICO questions were defined, data recorded and quality appraised and rated with regard to strength and evidence level. Consequent recommendations for applications of PET/CT were established. The actual use of PET/CT was compared with these, where grades A and B indicated ''established'' and ''useful'' and grades C and D ''potentially useful'' and ''non-recommendable'' indications, respectively. Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. Evidence-based usefulness was reported in five of six selected cancers; evidence was sparse in the sixth, gynaecological cancers. Actual use of PET/CT agreed well with recommendations. (orig.)

  13. An Indirect Route for Ethanol Production

    Energy Technology Data Exchange (ETDEWEB)

    Eggeman, T.; Verser, D.; Weber, E.

    2005-04-29

    The ZeaChem indirect method is a radically new approach to producing fuel ethanol from renewable resources. Sugar and syngas processing platforms are combined in a novel way that allows all fractions of biomass feedstocks (e.g. carbohydrates, lignins, etc.) to contribute their energy directly into the ethanol product via fermentation and hydrogen based chemical process technologies. The goals of this project were: (1) Collect engineering data necessary for scale-up of the indirect route for ethanol production, and (2) Produce process and economic models to guide the development effort. Both goals were successfully accomplished. The projected economics of the Base Case developed in this work are comparable to today's corn based ethanol technology. Sensitivity analysis shows that significant improvements in economics for the indirect route would result if a biomass feedstock rather that starch hydrolyzate were used as the carbohydrate source. The energy ratio, defined as the ratio of green energy produced divided by the amount of fossil energy consumed, is projected to be 3.11 to 12.32 for the indirect route depending upon the details of implementation. Conventional technology has an energy ratio of 1.34, thus the indirect route will have a significant environmental advantage over today's technology. Energy savings of 7.48 trillion Btu/yr will result when 100 MMgal/yr (neat) of ethanol capacity via the indirect route is placed on-line by the year 2010.

  14. Comparison of 4 established DASH diet indexes: examining associations of index scores and colorectal cancer.

    Science.gov (United States)

    Miller, Paige E; Cross, Amanda J; Subar, Amy F; Krebs-Smith, Susan M; Park, Yikyung; Powell-Wiley, Tiffany; Hollenbeck, Albert; Reedy, Jill

    2013-09-01

    Multiple diet indexes have been developed to capture the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and examine relations with health outcomes but have not been compared within the same study population to our knowledge. We compared 4 established DASH indexes and examined associations with colorectal cancer. Scores were generated from a food-frequency questionnaire in the NIH-AARP Diet and Health Study (n = 491,841). Separate indexes defined by Dixon (7 food groups, saturated fat, and alcohol), Mellen (9 nutrients), Fung (7 food groups and sodium), and Günther (8 food groups) were used. HRs and 95% CIs for colorectal cancer were generated by using Cox proportional hazard models. From 1995 through 2006, 6752 incident colorectal cancer cases were ascertained. In men, higher scores were associated with reduced colorectal cancer incidence by comparing highest to lowest quintiles for all indexes as follows: Dixon (HR: 0.77; 95% CI: 0.69, 0.87), Mellen (HR: 0.78; 95% CI: 0.71, 0.86), Fung (HR: 0.75; 95% CI: 0.68, 0.83), and Günther (HR: 0.81; 95% CI: 0.74, 0.90). Higher scores in women were inversely associated with colorectal cancer incidence by using methods defined by Mellen (HR: 0.79; 95% CI: 0.68, 0.91), Fung (HR: 0.84; 95% CI: 0.73, 0.96), and Günther (HR: 0.84; 95% CI: 0.73.0.97) but not Dixon (HR: 1.01; 95% CI: 0.80, 1.28). The consistency in findings, particularly in men, suggests that all indexes capture an underlying construct inherent in the DASH dietary pattern, although the specific index used can affect results.

  15. Comparison of 4 established DASH diet indexes: examining associations of index scores and colorectal cancer123

    Science.gov (United States)

    Cross, Amanda J; Subar, Amy F; Krebs-Smith, Susan M; Park, Yikyung; Powell-Wiley, Tiffany; Hollenbeck, Albert; Reedy, Jill

    2013-01-01

    Background: Multiple diet indexes have been developed to capture the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and examine relations with health outcomes but have not been compared within the same study population to our knowledge. Objective: We compared 4 established DASH indexes and examined associations with colorectal cancer. Design: Scores were generated from a food-frequency questionnaire in the NIH-AARP Diet and Health Study (n = 491,841). Separate indexes defined by Dixon (7 food groups, saturated fat, and alcohol), Mellen (9 nutrients), Fung (7 food groups and sodium), and Günther (8 food groups) were used. HRs and 95% CIs for colorectal cancer were generated by using Cox proportional hazard models. Results: From 1995 through 2006, 6752 incident colorectal cancer cases were ascertained. In men, higher scores were associated with reduced colorectal cancer incidence by comparing highest to lowest quintiles for all indexes as follows: Dixon (HR: 0.77; 95% CI: 0.69, 0.87), Mellen (HR: 0.78; 95% CI: 0.71, 0.86), Fung (HR: 0.75; 95% CI: 0.68, 0.83), and Günther (HR: 0.81; 95% CI: 0.74, 0.90). Higher scores in women were inversely associated with colorectal cancer incidence by using methods defined by Mellen (HR: 0.79; 95% CI: 0.68, 0.91), Fung (HR: 0.84; 95% CI: 0.73, 0.96), and Günther (HR: 0.84; 95% CI: 0.73.0.97) but not Dixon (HR: 1.01; 95% CI: 0.80, 1.28). Conclusion: The consistency in findings, particularly in men, suggests that all indexes capture an underlying construct inherent in the DASH dietary pattern, although the specific index used can affect results. PMID:23864539

  16. Comparison of patients by family history with gastric and non-gastric cancer.

    Science.gov (United States)

    Zhou, Xue-Fu; He, Yu-Long; Song, Wu; Peng, Jian-Jun; Zhang, Chang-Hua; Li, Wen; Wu, Hui

    2009-06-07

    To compare the gastric cancer (GC) patients by their family history with gastric and non-GC. Positive family histories within second-degree relatives and clinicopathological features were obtained for 256 patients. Of the 256 probands, 112 (76 male, 36 female) were incorporated into familial GC (FGC) group: at least two GC members; 144 (98 male, 46 female) were included in the non-FGC group (relatives only affected with non-GCs). Of 399 tumors in relatives (181 from FGC against 212 from non-FGC), GC was the most frequent, followed by esophageal, hepatocellular, and colorectal cancer. Nasopharyngeal cancer was next to lung cancer but prior to breast and urogenital cancers. Most affected members aggregated within first-degree relatives (FGC: 66 siblings, 48 fathers, 31 mothers, four offspring; non-FGC: 56 fathers, 55 siblings, 43 mothers, and 15 offspring). The ratio of males to females in affected first-degree relatives was usually higher in male probands. Paternal history of GC was a slight risk for GC in males (OR = 1.19, 95% CI: 0.53-2.69), while risk of GC by maternal history of non-GCs was increased in females (OR = 0.46, 95% CI: 0.22-0.97). Diffuse-GC was the major histological type in all subgroups. Difference in tumor sites between the two groups was derived from an excess of upper sites in non-FGC female probands. Distribution of associated non-GCs in a family history of GC may vary with geographic areas. GC may have different genetic and/or environmental etiology in different families, and a certain subtype may be inherited in a female-influenced fashion.

  17. Comparison of three shortened questionnaires for assessment of quality of life in advanced cancer.

    Science.gov (United States)

    Chiu, Leonard; Chiu, Nicholas; Chow, Edward; Cella, David; Beaumont, Jennifer L; Lam, Henry; Popovic, Marko; Bedard, Gillian; Poon, Michael; Wong, Erin; Zeng, Liang; Bottomley, Andrew

    2014-08-01

    Quality of life (QoL) assessment questionnaires can be burdensome to advanced cancer patients, thus necessitating the need for shorter assessment instruments than traditionally available. We compare three shortened QoL questionnaires in regards to their characteristics, validity, and reliability. A literature search was conducted to identify studies that employed or discussed three abridged QoL questionnaires: the European Organization for Research and Treatment of Cancer Quality of Life Core 15-Palliative Care (EORTC QLQ-C15-PAL), the Functional Assessment of Cancer Therapy-General-7 (FACT-G7), and the Functional Assessment of Chronic Illness Therapy-Palliative Care-14 (FACIT-PAL-14). Articles that discussed questionnaire length, intended use, scoring procedure, and validation were included. The 7-item FACT-G7 is the shortest instrument, whereas the EORTC QLQ-C15-PAL and the FACIT-PAL-14 contain 14 and 15 items, respectively. All three questionnaires have similar recall period, item organization, and subscale components. Designed as core questionnaires, all three maintain content and concurrent validity of their unabridged original questionnaires. Both the EORTC QLQ-C15-PAL and the FACT-G7 demonstrate good internal consistency and reliability, with Cronbach's α ≥0.7 deemed acceptable. The developmental study for the FACIT-PAL-14 was published in 2013 and subsequent validation studies are not yet available. The EORTC QLQ-C15-PAL and the FACT-G7 were found to be reliable and appropriate for assessing health-related QoL issues-the former for palliative cancer patients and the latter for advanced cancer patients receiving chemotherapy. Conceptually, the FACIT-PAL-14 holds promise to cover social and emotional support issues that are not completely addressed by the other two questionnaires; however, further validation is needed.

  18. Cross-cultural comparison of breast cancer patients' Quality of Life in the Netherlands and Japan.

    Science.gov (United States)

    Fischer, M J; Inoue, K; Matsuda, A; Kroep, J R; Nagai, S; Tozuka, K; Momiyama, M; Weijl, N I; Langemeijer-Bosman, D; Ramai, S R S; Nortier, J W R; Putter, H; Yamaoka, K; Kubota, K; Kobayashi, K; Kaptein, A A

    2017-11-01

    Cultural differences are hypothesized to influence patients' Quality of Life (QoL) reports. However, there is a lack of empirical cross-cultural studies comparing QoL of patients with cancer. This study aims to compare QoL of women with breast cancer in the Netherlands and Japan, and to investigate the association of QoL with sociodemographic, clinical, and psychological variables (illness perceptions). Dutch (n = 116) and Japanese (n = 148) women with early breast cancer undergoing chemotherapy completed the EORTC QLQ-C30 and Brief Illness Perception Questionnaire immediately before their second cycle of chemotherapy. Dutch women reported poorer Physical, Role, Emotional, and Cognitive functioning than Japanese women. Additionally, illness perceptions were significantly different in Japan and the Netherlands, but these did not vary across treatment type. In Japan, QoL of women receiving AC-chemotherapy was better than that of women receiving FEC-chemotherapy, whereas in the Netherlands, QoL did not vary as a function of chemotherapy. Illness perceptions about symptom severity, adverse consequences, and emotional representations were negatively related to most domains of patients' QoL in both countries. Adding illness perceptions as covariates to the ANOVA analyses rendered the effects of country and treatment type on QoL non-significant. Comparing Dutch and Japanese women with early breast cancer revealed important differences in treatment modalities and illness perceptions which both appear to influence QoL. Perceptions about cancer have been found to vary across cultures, and our study suggests that these perceptions should be considered when performing cross-cultural studies focusing on patient-reported outcomes.

  19. Comparison of tomosynthesis plus digital mammography and digital mammography alone for breast cancer screening.

    Science.gov (United States)

    Haas, Brian M; Kalra, Vivek; Geisel, Jaime; Raghu, Madhavi; Durand, Melissa; Philpotts, Liane E

    2013-12-01

    To compare screening recall rates and cancer detection rates of tomosynthesis plus conventional digital mammography to those of conventional digital mammography alone. All patients presenting for screening mammography between October 1, 2011, and September 30, 2012, at four clinical sites were reviewed in this HIPAA-compliant retrospective study, for which the institutional review board granted approval and waived the requirement for informed consent. Patients at sites with digital tomosynthesis were offered screening with digital mammography plus tomosynthesis. Patients at sites without tomosynthesis underwent conventional digital mammography. Recall rates were calculated and stratified according to breast density and patient age. Cancer detection rates were calculated and stratified according to the presence of a risk factor for breast cancer. The Fisher exact test was used to compare the two groups. Multivariate logistic regression was used to assess the effect of screening method, breast density, patient age, and cancer risk on the odds of recall from screening. A total of 13 158 patients presented for screening mammography; 6100 received tomosynthesis. The overall recall rate was 8.4% for patients in the tomosynthesis group and 12.0% for those in the conventional mammography group (P tomosynthesis reduced recall rates for all breast density and patient age groups, with significant differences (P tomosynthesis versus 5.2 per 1000 in patients receiving conventional mammography alone (P = .70). Patients undergoing tomosynthesis plus digital mammography had significantly lower screening recall rates. The greatest reductions were for those younger than 50 years and those with dense breasts. A nonsignificant 9.5% increase in cancer detection was observed in the tomosynthesis group. © RSNA, 2013.

  20. Comparison of virtual cystoscopy and ultrasonography for bladder cancer detection: A meta-analysis

    International Nuclear Information System (INIS)

    Qu Xinhua; Huang Xiaolu; Wu Lianming; Huang Gang; Ping Xiong; Yan Weili

    2011-01-01

    Background and purpose: Bladder cancer is the most commonly diagnosed malignancy in patients presenting with haematuria. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the detection validity (sensitivity and specificity) of virtual cystoscopy (VC) and ultrasonography (US). Methods: We searched MEDLINE, EMBASE, PubMed and the Cochrane Library for studies evaluating diagnosis validity of VC and US between January 1966 and December 2009. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. Results: A total of 26 studies that included 3084 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for bladder cancer detection using CT virtual cystoscopy (CTVC), MR virtual cystoscopy (MRVC) and US was 0.939 (95% CI, 0.919-0.956), 0.908 (95% CI, 0.827-0.959) and 0.779 (95% CI, 0.744-0.812), respectively. The pooled specificity for bladder cancer detection using CTVC, MRVC and US was 0.981 (95% CI, 0.973-0.988), 0.948 (95% CI, 0.884-0.983) and 0.962 (95% CI, 0.953-0.969), respectively. The pooled diagnostic odd ratio (DOR) estimate for CTVC (604.22) were significantly higher than for MRVC (144.35, P < 0.001) and US (72.472, P < 0.001). Conclusion: Our results showed that both CTVC and MRVC are better imaging methods for diagnosing bladder cancer than US. CTVC has higher diagnostic value (sensitivity, specificity and DOR) for the detection of bladder cancer than either MRCT or US.

  1. Comparison of Genetic Variants in Cancer-Related Genes between Chinese Hui and Han Populations.

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    Chaoyong Tian

    Full Text Available The Chinese Hui population, as the second largest minority ethnic group in China, may have a different genetic background from Han people because of its unique demographic history. In this study, we aimed to identify genetic differences between Han and Hui Chinese from the Ningxia region of China by comparing eighteen single nucleotide polymorphisms in cancer-related genes.DNA samples were collected from 99 Hui and 145 Han people from the Ningxia Hui Autonomous Region in China, and SNPs were detected using an improved multiplex ligase detection reaction method. Genotyping data from six 1000 Genomes Project population samples (99 Utah residents with northern and western European ancestry (CEU, 107 Toscani in Italy (TSI, 108 Yoruba in Ibadan (YRI, 61 of African ancestry in the southwestern US (ASW, 103 Han Chinese in Beijing (CHB, and 104 Japanese in Tokyo (JPT were also included in this study. Differences in the distribution of alleles among the populations were assessed using χ2 tests, and FST was used to measure the degree of population differentiation.We found that the genetic diversity of many SNPs in cancer-related genes in the Hui Chinese in Ningxia was different from that in the Han Chinese in Ningxia. For example, the allele frequencies of four SNPs (rs13361707, rs2274223, rs465498, and rs753955 showed different genetic distributions (p0.000 between the Hui and Han populations.These results suggest that some SNPs associated with cancer-related genes vary among different Chinese ethnic groups. We suggest that population differences should be carefully considered in evaluating cancer risk and prognosis as well as the efficacy of cancer therapy.

  2. Comparison of virtual cystoscopy and ultrasonography for bladder cancer detection: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Qu Xinhua; Huang Xiaolu [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127 (China); Department of Ultrasonic, Ninth People' s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011 (China); Wu Lianming [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127 (China); Huang Gang [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127 (China); Ping Xiong, E-mail: pxiong6@126.com [Department of Ultrasonic, Ninth People' s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011 (China); Yan Weili, E-mail: wl_yan67@126.com [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127 (China)

    2011-11-15

    Background and purpose: Bladder cancer is the most commonly diagnosed malignancy in patients presenting with haematuria. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the detection validity (sensitivity and specificity) of virtual cystoscopy (VC) and ultrasonography (US). Methods: We searched MEDLINE, EMBASE, PubMed and the Cochrane Library for studies evaluating diagnosis validity of VC and US between January 1966 and December 2009. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. Results: A total of 26 studies that included 3084 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for bladder cancer detection using CT virtual cystoscopy (CTVC), MR virtual cystoscopy (MRVC) and US was 0.939 (95% CI, 0.919-0.956), 0.908 (95% CI, 0.827-0.959) and 0.779 (95% CI, 0.744-0.812), respectively. The pooled specificity for bladder cancer detection using CTVC, MRVC and US was 0.981 (95% CI, 0.973-0.988), 0.948 (95% CI, 0.884-0.983) and 0.962 (95% CI, 0.953-0.969), respectively. The pooled diagnostic odd ratio (DOR) estimate for CTVC (604.22) were significantly higher than for MRVC (144.35, P < 0.001) and US (72.472, P < 0.001). Conclusion: Our results showed that both CTVC and MRVC are better imaging methods for diagnosing bladder cancer than US. CTVC has higher diagnostic value (sensitivity, specificity and DOR) for the detection of bladder cancer than either MRCT or US.

  3. Assessment of cabozantinib treatment on QT interval in a phase 3 study in medullary thyroid cancer: evaluation of indirect QT effects mediated through treatment-induced changes in serum electrolytes.

    Science.gov (United States)

    Miles, Dale R; Lacy, Steven A; Wada, David R; Milwee, Steve; Yaron, Yifah; Nguyen, Linh T

    2017-08-01

    This study evaluated factors impacting QTc interval in a phase 3 trial of cabozantinib in progressive, metastatic, medullary thyroid cancer (MTC). Electrocardiogram (12-lead ECG) measurements were obtained at screening, and at pre-dose, and 2, 4, and 6 h post-dose on Days 1 and 29 in a phase 3 study in patients with MTC treated with cabozantinib (140 mg/day). Central tendency analyses were conducted on baseline-corrected QTc values. Linear and nonlinear mixed-effects models were used to evaluate potential factors affecting the QTc interval, including serum electrolytes, patient demographics, and cabozantinib concentration. Central tendency analysis showed that oral cabozantinib (140 mg/day) produced a 10-15 ms increase in delta-delta Fridericia corrected QT (∆∆QTcF) and delta-delta study-specific corrected QT (∆∆QTcS) on Day 29, but not on Day 1. Further analysis showed that QTcS provided a slightly more accurate QT correction than QTcF. Mixed-effects models evaluating serum electrolytes, age, sex, and cabozantinib concentration showed that decreased serum calcium and potassium could explain the majority of cabozantinib treatment-associated QTcS prolongation observed in this study. Cabozantinib treatment prolongs the ∆∆QTcF interval by 10-15 ms. There was the absence of a strong relationship between cabozantinib concentration and QTcS prolongation. Cabozantinib treatment effects on serum calcium and potassium best explain the QTcS prolongation observed in this study.

  4. Evaluation of head and neck cancer with 18F-FDG PET: a comparison with conventional methods

    International Nuclear Information System (INIS)

    Kresnik, E.; Mikosch, P.; Gallowitsch, H.J.; Heinisch, M.; Unterweger, O.; Kumnig, G.; Gomez, I.; Lind, P.; Kogler, D.; Wieser, S.; Gruenbacher, G.; Raunik, W.

    2001-01-01

    The aim of this study was to evaluate the usefulness of 18 F-FDG PET in the diagnosis and staging of primary and recurrent malignant head and neck tumours in comparison with conventional imaging methods [including ultrasonography, radiography, computed tomography (CT) and magnetic resonance imaging (MRI)], physical examination, panendoscopy and biopsies in clinical routine. A total of 54 patients (13 female, 41 male, age 61.3±12 years) were investigated retrospectively. Three groups were formed. In group I, 18 F-FDG PET was performed in 15 patients to detect unknown primary cancers. In group II, 24 studies were obtained for preoperative staging of proven head and neck cancer. In group III, 18 F-FDG PET was used in 15 patients to monitor tumour recurrence after radiotherapy and/or chemotherapy. In all patients, imaging was obtained at 70 min after the intravenous administration of 180 MBq 18 F-FDG. In 11 of the 15 patients in group I, the primary cancer could be found with 18 F-FDG, yielding a detection rate of 73.3%. In 4 of the 15 patients, CT findings were also suggestive of the primary cancer but were nonetheless equivocal. In these patients, 18 F-FDG showed increased 18 F-FDG uptake by the primary tumour, which was confirmed by histology. One patient had recurrence of breast carcinoma that could not be detected with 18 F-FDG PET, but was detected by CT. In three cases, the primary cancer could not be found with any imaging method. Among the 24 patients in group II investigated for staging purposes, 18 F-FDG PET detected a total of 13 local and three distant lymph node metastases, whereas the conventional imaging methods detected only nine local and one distant lymph node metastases. The results of 18 F-FDG PET led to an upstaging in 5/24 (20.8%) patients. The conventional imaging methods were false positive in 5/24 (20.8%). There was one false positive result using 18 F-FDG PET. Among the 15 patients of group III with suspected recurrence after radiotherapy

  5. Determination of Aldehyde Dehydrogenase (ALDH Isozymes in Human Cancer Samples - Comparison of Kinetic and Immunochemical Assays

    Directory of Open Access Journals (Sweden)

    Dorota Borecka

    2002-12-01

    Full Text Available A fluorimetric assay of aldehyde dehydrogenase isozymes, based on naphthaldehyde oxidation, is compared with Western Blotting analysis on several clinical samples obtained from surgery. The comparison reveals qualitatively good correlation of ALDH1A1 isozyme detection with two methods and somewhat worse on ALDH3A1 assay.

  6. Comparison of Quality of Life and Nutritional Status in Gastric Cancer Patients Undergoing Gastrectomies.

    Science.gov (United States)

    Lim, Hee-Sook; Cho, Gyu-Seok; Park, Yoon-Hyung; Kim, Soon-Kyung

    2015-07-01

    The aim of this study was to compare the quality of life (QoL) depending on the postoperative survival period or nutritional status in gastric cancer patients. Surviving gastric cancer patients (n = 222) after the gastrectomy were included in the study at Soonchunhyang University Bucheon Hospital from April 2010 to August 2012. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and a gastric cancer-specific module, the EORTC QLQ-STO22, were used to assess the QoL. The postoperative survival period of the patients fell into two groups; the less-than-1-year group or the more-than-1-year group, and the nutritional status of the patients fell into three groups by a score of patient generated-subjective global assessment (SGA)-A, B, and C. As a result, the rate of malnutrition was 34.5% in the less-than-1-year group and 19.8% in the more-than-1-year group, respectively. Score for the fatigue (p = 0.006), loss of appetite (p = 0.002), reflux (p = 0.027) and body image (p = 0.004) in which the QoL was significantly lower in the less-than-1-year group than in the more-than-1-year group. The score of QoL according to the nutritional status of all subjects, overall health status (p = 0.043), physical functioning (p = 0.016), fatigue (p = 0.006), pain (p = 0.028), loss of appetite (p = 0.017), reflux (p = 0.003), eating restriction (p = 0.002), anxiety (p = 0.010), and body image (p = 0.001) was significantly lower in the SGA-C group than in other SGA groups. These results suggest that the nutritional status of the gastrectomy patients with stomach cancer may impact on their QoL. It is necessary to to develop nutritional intervention to improve QoL in gastric cancer patients with postoperative malnutrition.

  7. Comparison of two interventional therapies followed by radical hysterectomy for women with cervical cancer

    International Nuclear Information System (INIS)

    Yu Lei; Xiang Xianhong; Guo Wenbo; Huang Yonghui; Zhuang Wenquan; Tan Guosheng; Yang Jianyong

    2010-01-01

    Objective: To evaluate the curative effects of uterine artery chemoembolization (UACE) and internal iliac arterial infusion chemotherapy (IAIC) followed by radical hysterectomy for the treatment of cervical cancer and to determine the prognostic factors affecting survival. Methods: Eighty-one patients with cervical cancer treated between June 1997 and November 2007 were retrospectively analyzed. Patients were divided into two groups: the UACE group (n=41) and the IAIC group (n=40). The UACE group was treated by bilateral uterine artery chemoembolization. The IAIC group was treated by bilateral internal iliac arterial infusion chemotherapy. All patients were treated by carboplatin-based combination chemotherapy and underwent radical hysterectomy 2 weeks after 1-3 times of UACE or IAIC, Radiotherapy was performed on 24 requisite patients with high risk of pathological factors after radical surgery. Results: The clinical response rate of the UACE group was 73.2%, significantly higher than that in the IAIC group (40.0%, P=0.003). The effective rate for clinical stage IB cervical cancer in the UACE group was 86.7%, significantly higher than 28.6% in the IAIC group (P=0.002). However for FIGO stage II cervical cancer, the effective rates between the two groups had no significant difference (P=0.202). Postoperative pathologic examinations showed the pathological complete response rate and the negative percentages of pelvic lymph node metastasis in the UACE group were slightly higher than those in the IAIC group (14.6% and 87.8% vs. 5.0% and 80.0%, P=0.264 and P=0.313). The recurrent rate in the UACE group was lower than that in the IAIC group (9.8% vs. 22.5%, P=0.118). The negative percentage of lymphovascular space invasion in the UACE group was slightly lower than that in the IAIC group (90.2% vs. 100.0%, P=0.072). The 5-year overall survival rates in the UACE group and the IAIC group were 94% and 83%, respectively (P=0.429). Univariate an multivariate analysis showed

  8. The COLOFOL trial: study design and comparison of the study population with the source cancer population

    Directory of Open Access Journals (Sweden)

    Hansdotter Andersson P

    2016-01-01

    Full Text Available Pernilla Hansdotter Andersson,1 Peer Wille-Jørgensen,2 Erzsébet Horváth-Puhó,3 Sune Høirup Petersen,2 Anna Martling,4 Henrik Toft Sørensen,3 Ingvar Syk1 On behalf of the COLOFOL Study Group 1Department of Surgery, Skåne University Hospital, Malmö, Sweden; 2Abdominal Disease Center K, Bispebjerg University Hospital, Copenhagen, Denmark; 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden Introduction: The COLOFOL trial, a prospective randomized multicenter trial comparing two follow-up regimes after curative surgical treatment for colorectal cancer, focuses on detection of asymptomatic recurrences. This paper aims to describe the design and recruitment procedure in the COLOFOL trial, comparing demographic characteristics between randomized patients and eligible patients not included in the study. Materials and methods: COLOFOL was designed as a pragmatic trial with wide inclusion criteria and few exclusion criteria, in order to obtain a sample reflecting the general patient population. To be eligible, patients had to be 75 years or younger and curatively resected for stage II or III colorectal cancer. Exclusion criteria were hereditary colorectal cancer, no signed consent, other malignancy, and life expectancy less than 2 years due to concomitant disease. In four of the 24 participating centers, we scrutinized hospital inpatient data to identify all colorectal cancer patients who underwent surgery, in order to ascertain all eligible patients who were not included in the study and to compare them with enrolled patients. Results: Of a total of 4,445 eligible patients, 2,509 patients were randomized (56.4% inclusion rate. A total of 1,221 eligible patients were identified in the scrutinized hospitals, of which 684 (56% were randomized. No difference in age or sex distribution was observed between randomized and nonrandomized

  9. Sick leave for follow-up control in thyroid cancer patients: comparison between stimulation with Thyrogen and thyroid hormone withdrawal.

    Science.gov (United States)

    Borget, I; Corone, C; Nocaudie, M; Allyn, M; Iacobelli, S; Schlumberger, M; De Pouvourville, G

    2007-05-01

    The clinical benefits of recombinant human thyroid-stimulating hormone (rhTSH; Thyrogen) are well established as an alternative stimulation procedure to thyroid hormone withdrawal in the diagnostic follow-up of thyroid cancer patients. By avoiding periods of hypothyroidism, patients do not suffer from a decreased quality of life and keep their ability to work. This study compared the frequency, the duration and the cost of sick leave for follow-up control between rhTSH and withdrawal. The study population consisted of patients with thyroid carcinoma first treated by thyroidectomy and radioiodine ablation. Patients were recruited at their control visit between October 2004 and May 2006 in three hospitals, both prospectively and retrospectively. Collection data consisted of patient information, job characteristics and duration of sick leave during the month before and the month after control. The valuation of sick leave used the friction cost method. Among the 306 patients included, 292 (95%) completed the entire questionnaire. The mean age was 46.7 years. Among the 194 active patients, patients treated with rhTSH, when compared with patients treated by withdrawal, were less likely to require sick leave (11 vs 33%; P=0.001). The mean duration of sick leave was shorter (3.1 vs 11.2 days; P=0.002) and indirect costs due to absenteeism accounted for 454 Euro +/- 1673 vs 1537 Euro +/- 2899 for withdrawal stimulation. For active patients, rhTSH treatment reduced the length and the cost of sick leave by 8.1 days and 1083 Euro per control respectively, when compared with withdrawal treatment.

  10. Comparison of three radiotherapy modalities on biochemical control and overall survival for the treatment of prostate cancer: A systematic review

    International Nuclear Information System (INIS)

    Pieters, Bradley R.; Back, Djuna Z. de; Koning, Caro C.E.; Zwinderman, Aeilko H.

    2009-01-01

    Background and Purpose: For the radiation treatment of prostate cancer high dose should be delivered for optimal biochemical control. Treatment can be given by dose-escalated external beam radiotherapy (EBRT) or external beam radiotherapy combined with a radioactive seed implantation (EBSeeds) or high-dose rate (HDR) brachytherapy (EBTI). Differences in outcome between the modalities were assessed by a systematic review. Materials and methods: A systematic search was performed resulting in 40 articles to be used. Data were extracted on biochemical control and overall survival at 3, 5, and 8 years and other time points mentioned in the articles. Also known prognostic parameters were noted. Comparison of the modalities was done by a Weibull survival analysis and estimation of Hazard Ratio's (HR) was done with 95% confidence intervals (95% CIs). Results: The HR for biochemical recurrence was 1.40 (95% CI 1.31-1.51) for EBRT relative to EBTI, and was 1.37 (95% CI 1.26-1.49) for EBSeeds relative to EBTI. The HR for overall survival was 1.50 (95% CI 1.29-1.73) for EBRT relative to EBTI, and was 2.33 (95% CI 2.04-2.66) for EBSeeds relative to EBTI. Conclusion: The combination of external beam radiotherapy and HDR brachytherapy results in a superior biochemical control and overall survival found in a systematic review on radiotherapy for prostate cancer.

  11. Pencil beam scanning proton therapy vs rotational arc radiation therapy: A treatment planning comparison for postoperative oropharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Apinorasethkul, Ontida, E-mail: Ontida.a@gmail.com; Kirk, Maura; Teo, Kevin; Swisher-McClure, Samuel; Lukens, John N.; Lin, Alexander

    2017-04-01

    Patients diagnosed with head and neck cancer are traditionally treated with photon radiotherapy. Proton therapy is currently being used clinically and may potentially reduce treatment-related toxicities by minimizing the dose to normal organs in the treatment of postoperative oropharyngeal cancer. The finite range of protons has the potential to significantly reduce normal tissue toxicity compared to photon radiotherapy. Seven patients were planned with both proton and photon modalities. The planning goal for both modalities was achieving the prescribed dose to 95% of the planning target volume (PTV). Dose-volume histograms were compared in which all cases met the target coverage goals. Mean doses were significantly lower in the proton plans for the oral cavity (1771 cGy photon vs 293 cGy proton, p < 0.001), contralateral parotid (1796 cGy photon vs 1358 proton, p < 0.001), and the contralateral submandibular gland (3608 cGy photon vs 3251 cGy proton, p = 0.03). Average total integral dose was 9.1% lower in proton plans. The significant dosimetric sparing seen with proton therapy may lead to reduced side effects such as pain, weight loss, taste changes, and dry mouth. Prospective comparisons of protons vs photons for disease control, toxicity, and patient-reported outcomes are therefore warranted and currently being pursued.

  12. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer.

    Science.gov (United States)

    Roganovic, Dragana; Djilas, Dragana; Vujnovic, Sasa; Pavic, Dag; Stojanov, Dragan

    2015-11-16

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p tomosynthesis and breast MRI was not significant (p=0.20).

  13. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Dragana Roganovic

    2015-11-01

    Full Text Available Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI, digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p < 0.001, while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20. 

  14. Detection of tumor markers in prostate cancer and comparison of sensitivity between real time and nested PCR.

    Science.gov (United States)

    Matsuoka, Takayuki; Shigemura, Katsumi; Yamamichi, Fukashi; Fujisawa, Masato; Kawabata, Masato; Shirakawa, Toshiro

    2012-06-27

    The objective of this study is to investigate and compare the sensitivity in conventional PCR, quantitative real time PCR, nested PCR and western blots for detection of prostate cancer tumor markers using prostate cancer (PCa) cells. We performed conventional PCR, quantitative real time PCR, nested PCR, and western blots using 5 kinds of PCa cells. Prostate specific antigen (PSA), prostate specific membrane antigen (PSMA), and androgen receptor (AR) were compared for their detection sensitivity by real time PCR and nested PCR. In real time PCR, there was a significant correlation between cell number and the RNA concentration obtained (R(2)=0.9944) for PSA, PSMA, and AR. We found it possible to detect these markers from a single LNCaP cell in both real time and nested PCR. By comparison, nested PCR reached a linear curve in fewer PCR cycles than real time PCR, suggesting that nested PCR may offer PCR results more quickly than real time PCR. In conclusion, nested PCR may offer tumor maker detection in PCa cells more quickly (with fewer PCR cycles) with the same high sensitivity as real time PCR. Further study is necessary to establish and evaluate the best tool for PCa tumor marker detection.

  15. Three-dimensional trabecular bone architecture of the lumbar spine in bone metastasis from prostate cancer: comparison with degenerative sclerosis

    International Nuclear Information System (INIS)

    Tamada, Tsutomu; Sone, Teruki; Imai, Shigeki; Kajihara, Yasumasa; Fukunaga, Masao; Jo, Yoshimasa

    2005-01-01

    Prostate cancer frequently metastasizes to bone, inducing osteosclerotic lesions. The objective of this study was to clarify the three-dimensional (3D) trabecular bone microstructure in bone metastasis from prostate cancer by comparison with normal and degenerative sclerotic bone lesions, using microcomputed tomography (micro-CT). A total of 32 cancellous bone samples were excised from the lumbar spine of six autopsy patients: 15 metastatic samples (one patient), eight degenerative sclerotic samples (four patients) and the rest from normal sites (three patients). The samples were serially scanned cross-sectionally by micro-CT with a pixel size of 23.20 μm, slice thickness of 18.56 μm, and image matrix of 512 x 512. Each image data set consisted of 250 consecutive slices. The volumes of interest (96 x 96 x 120 voxels) were defined in the original image sets and 3D indices of the trabecular microstructure were determined. The trabecular thickness (Tb.Th) in degenerative sclerotic lesions was significantly higher than that in normal sites, whereas no significant difference was observed in trabecular number (Tb.N). By contrast, in metastatic lesions, the Tb.N was significantly higher with increased bone volume fraction (BV/TV) than in normal sites, and no significant difference was found in Tb.Th. The characteristics of the trabecular surface in the metastatic samples showed concave structural elements with an increase in BV/TV, indicating osteolysis of the trabecular bone. In 3D reconstructed images, increased trabecular bone with an irregular surface was observed in samples from metastatic sites, which were uniformly sclerotic on soft X-ray radiographs. These results support, through 3D morphological features, the strong bone resorption effect in bone metastasis from prostate cancer. (orig.)

  16. Comparison of cancer-associated genetic abnormalities in columnar-lined esophagus tissues with and without goblet cells.

    Science.gov (United States)

    Bandla, Santhoshi; Peters, Jeffrey H; Ruff, David; Chen, Shiaw-Min; Li, Chieh-Yuan; Song, Kunchang; Thoms, Kimberly; Litle, Virginia R; Watson, Thomas; Chapurin, Nikita; Lada, Michal; Pennathur, Arjun; Luketich, James D; Peterson, Derick; Dulak, Austin; Lin, Lin; Bass, Adam; Beer, David G; Godfrey, Tony E; Zhou, Zhongren

    2014-07-01

    To determine and compare the frequency of cancer-associated genetic abnormalities in esophageal metaplasia biopsies with and without goblet cells. Barrett's esophagus is associated with increased risk of esophageal adenocarcinoma (EAC), but the appropriate histologic definition of Barrett's esophagus is debated. Intestinal metaplasia (IM) is defined by the presence of goblet cells whereas nongoblet cell metaplasia (NGM) lacks goblet cells. Both have been implicated in EAC risk but this is controversial. Although IM is known to harbor genetic changes associated with EAC, little is known about NGM. We hypothesized that if NGM and IM infer similar EAC risk, then they would harbor similar genetic aberrations in genes associated with EAC. Ninety frozen NGM, IM, and normal tissues from 45 subjects were studied. DNA copy number abnormalities were identified using microarrays and fluorescence in situ hybridization. Targeted sequencing of all exons from 20 EAC-associated genes was performed on metaplasia biopsies using Ion AmpliSeq DNA sequencing. Frequent copy number abnormalities targeting cancer-associated genes were found in IM whereas no such changes were observed in NGM. In 1 subject, fluorescence in situ hybridization confirmed loss of CDKN2A and amplification of chromosome 8 in IM but not in a nearby NGM biopsy. Targeted sequencing revealed 11 nonsynonymous mutations in 16 IM samples and 2 mutations in 19 NGM samples. This study reports the largest and most comprehensive comparison of DNA aberrations in IM and NGM genomes. Our results show that IM has a much higher frequency of cancer-associated mutations than NGM.

  17. Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy (SBRT)

    Science.gov (United States)

    Puri, Varun; Crabtree, Traves D.; Bell, Jennifer M.; Broderick, Stephen R; Morgensztern, Daniel; Colditz, Graham A.; Kreisel, Daniel; Krupnick, A. Sasha; Patterson, G. Alexander; Meyers, Bryan F.; Patel, Aalok; Robinson, Clifford G.

    2015-01-01

    Introduction The relative roles of surgery and stereotactic body radiation therapy in stage I non-small cell lung cancer (NSCLC) are evolving particularly for marginally operable patients. Since there is limited prospective comparative data for these treatment modalities, we evaluated their relative use and outcomes at the population level using a national database. Methods Patient variables and treatment-related outcomes were abstracted for patients with clinical stage I NSCLC from the National Cancer Database. Patients receiving surgery were compared to those undergoing SBRT in exploratory unmatched and subsequent propensity matched analyses. Results Between 1998 and 2010, 117618 patients underwent surgery or SBRT for clinical stage I NSCLC. Of these, 111731 (95%) received surgery while 5887 (5%) underwent SBRT. Patients in the surgery group were younger, more likely to be males, and had higher Charlson comorbidity scores. SBRT patients were more likely to have T1 (vs.T2) tumors and receive treatment at academic centers. Thirty-day surgical mortality was 2596/109485 (2.4%). Median overall survival favored the surgery group in both unmatched (68.4 months vs. 33.3 months, p<.001) and matched analysis based on patient characteristics (62.3 months vs. 33.1months, p<.001). Disease specific survival was unavailable from the dataset. Conclusion In a propensity matched comparison, patients selected for surgery have improved survival compared with SBRT. In the absence of information on cause of death and with limited variables to characterize comorbidity, it is not possible to assess the relative contribution of patient selection or better cancer control towards the improved survival. Rigorous prospective studies are needed to optimize patient selection for SBRT in the high-risk surgical population. PMID:26334753

  18. Depressive symptoms and positive affect in Chinese and United States breast cancer survivors: a cross-cultural comparison.

    Science.gov (United States)

    Milbury, Kathrin; Kavanagh, April; Meng, Zhiqiang; Chen, Zhen; Chandwani, Kavita D; Garcia, Kay; Perkins, George H; McQuade, Jennifer; Raghuram, Nelamangala V; Nagarathna, Raghuram; Liao, Zhongxing; Nagendra, Hongasandra Ramarao; Chen, Jiayi; Guo, Xiaoma; Liu, Luming; Arun, Banu; Cohen, Lorenzo

    2017-07-01

    Research in the area of cultural response pattern on questionnaires in the oncological setting and direct cross-cultural comparisons are lacking. This study examined response pattern in the reporting of depressive symptoms in Chinese and US women with breast cancer. We hypothesized that Chinese women are less likely to endorse positive affect items compared to their US counterparts. Additionally, we explored cultural differences in the association between positive affect and QOL. Secondary analyses of baseline assessments of two mind-body intervention studies for women with breast cancer undergoing radiotherapy in the USA (N = 62) and China (N = 97) are presented. All participants completed measures of depressive symptoms (CES-D) and cancer-specific QOL (FACT-B). We examined cultural differences on positive and negative affect items on the CES-D. Controlling for demographic factors, ANCOVA revealed a significant cultural difference in positive (F = 7.99, p = 0.005) but not negative affect (p = 0.82) with Chinese women reporting lower positive affect compared to US women (Chinese = 6.97 vs. US = 8.31). There was also a significant cultural difference (F = 3.94, p = 0.03) in the association between positive affect and QOL so that lower positive affect was more strongly associated with worse emotional well-being in Chinese (beta = 0.57, p different cultures to ascertain effective delivery of clinical services to those in need.

  19. Comparisons of Prostate Cancer Inhibitors Abiraterone and TOK-001 Binding with CYP17A1 through Molecular Dynamics.

    Science.gov (United States)

    Xiao, Fei; Yang, Maohua; Xu, Youjun; Vongsangnak, Wanwipa

    2015-01-01

    Cytochrome P450 17A1 (CYP17A1) is associated in the steroid hormone biosynthesis in human. As cell proliferation of prostate cancer in response to androgen steroid, an inhibition of CYP17A1 becomes an alternative approach to inhibit biosynthesis of androgen and support treatment of prostate cancer. However, biology-driven inhibitor development of prostate cancer is poorly elucidated. The aims of this study are to address structural differences at atomic-level between CYP17A1 and inhibitors i.e., abiraterone and TOK-001, and further investigate the effect of point mutation of CYP17A1 on the active site stability and the local interactions that are hydrophobic interaction and hydrogen bonding throughout molecular dynamics (MD) simulation. After performing multiple comparisons among four different complexes across CYP17A1 and inhibitors, interestingly TOK-001 oriented toward the active pocket and formed larger volume with I-helix of CYP17A1 than abiraterone, whereas abiraterone showed tighter binding and more active site stability. Considering on the effect of hydrophobic interaction and hydrogen bonding between abiraterone and CYP17A1, the key residues of Phe114, Ile371, Val482, and Asn202 were identified. This contributes into tight binding interactions; however abiraterone is effectively weakened along with the global conformation mobility increased in A105L mutation. Surprisingly, overall conformation of the CYP17A1 remained stable when bound to TOK-001. This basic knowledge can guide future experiments on design of efficient inhibitors for CYP17A1, which provides theoretical basis of androgen-dependent disease therapy.

  20. A prospective randomized comparison of curved array and radial echoendoscopy in patients with esophageal cancer

    DEFF Research Database (Denmark)

    Siemsen, Mette; Svendsen, Lars Bo; Knigge, Ulrich

    2003-01-01

    BACKGROUND: Both curved array and radial scanning echoendoscopy are used for locoregional staging of cancer arising in the esophagus or cardia. The accuracy of TNM staging of these malignancies by curved array and radial EUS was compared in a prospective, randomized study. METHODS: Patients...... with cancer of the esophagus or cardia were examined by both curved array and radial echoendoscopy in randomized order by the same endosonographer in an unblinded fashion. The staging results and the examination time for the two echoendoscopies were compared and statistically analyzed, and finally compared......, respectively, 15 and 12 minutes (pcancer of the esophagus or cardia. The choice of echoendoscope for TNM staging in patients with these malignancies is, therefore, a question...

  1. Comparison of MRI of liver cancer (preoperative and resected liver specimen) and pathological feature

    International Nuclear Information System (INIS)

    Tanaka, Toshihiko

    1990-01-01

    Twenty-one nodules of hepatocellular carcinoma (HCC) and eighteen nodules of liver metastasis, which were confirmed pathologically, were investigated by MRI before operation and MRI of resected liver specimen. Pre-operative MRI pointed out all HCCs and seventeen metastases. STIR method was most useful for detection of HCCs. T2WI and STIR method were most useful for detection of liver metastases. Pre-operative MRI also revealed 93% of capsule formation, 29% of septal formation, 75% of fatty metamorphosis of HCC and 75% of necrosis of liver metastasis, and post-operative MRI of resected specimens revealed 100% of capsule formation, 71% of septal formation, 75% of fatty metamorphosis of HCC and 88% of necrosis of liver metastasis. T1WI showed a high intensity halo surrounding metastasis. This characteristic peripheral halo was seen in 22% of metastases. These findings corresponded to pathological feature of liver cancer. MRI was thought to be useful diagnostic modality of liver cancer. (author)

  2. Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy.

    Science.gov (United States)

    Planas, J; Celma, A; Placer, J; Maldonado, X; Trilla, E; Salvador, C; Lorente, D; Regis, L; Cuadras, M; Carles, J; Morote, J

    2016-11-01

    To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively. 120 patients with localized prostate cancer were enrolled. Ninety two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion. Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p<0.0001 and 55.1 vs. 36.5 g, p<0.0001; respectively). No differences regarding serum hormonal levels were found at baseline. Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8,54 vs. 4,76 U/l, FSH 22,96 vs. 8,18 U/l, p<0,0001) while T and free testosterone levels were significantly lower (T 360,3 vs. 414,83ng/dl, p 0,039; free testosterone 5,94 vs. 7,5pg/ml, p 0,018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21,01 vs. 8,51 U/l, p<0,001) while T levels remained significantly lower (339,89 vs. 402,39ng/dl, p 0,03). Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Comparison of gamma radiation - induced effects in two human prostate cancer cells

    International Nuclear Information System (INIS)

    Vucic, V.; Adzic, M.; Ruzdijic, S.; Radojcic, M.B. . E-mail address of corresponding author: vesnav@vin.bg.ac.yu; Vucic, V.)

    2005-01-01

    In this study, the effects of gamma radiation on two hormone refractory human prostate cancer cell lines, DU 145 and PC-3, were followed. It was shown that gamma radiation induced significant inhibition of cell proliferation and viability in dose dependent manner. Antiproliferative effects of radiation were similar in both cell lines, and more pronounced than cytotoxic effects. In addition to that, PC-3 cell line was more resistant to radiation -induced cytotoxicity. (author)

  4. Comparison of Oncologic Short Term Results of Laparoscopic Versus Open Surgery of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Solati

    2015-06-01

    Full Text Available Background Today, with improvements in laparoscopy technique, surgery of rectal cancer is performed by laparoscopy. Objectives This study was performed to evaluate oncologic results of open versus laparoscopic surgery of rectal cancer in terms of resection margins, removal of lymph nodes and recurrence rate. Patients and Methods This descriptive-analytic study was performed on 88 patients with middle and lower rectal cancer in the two equivalent groups of laparoscopic and open surgery in Mashhad Ghaem and Omid hospitals during 2011 - 2013. Information including age, sex, number of removed and involved lymph nodes, proximal, distal, and radial margins, tumor stage and location, recurrence and disease-free survival collected in the questionnaire and analyzed using descriptive statistics and frequency distribution tables and t-test. Results Both groups of open and laparoscopic surgery had similar characteristics of age, sex, recurrence and disease-free survival, tumor margins and one-year mortality. The number of removed and involved lymph nodes was higher in the laparoscopic group (5.16 vs. 3.55, respectively, with P < 0.050, and 1.74 vs. 0.59 with P = 0.023, but the ratio of involved lymph nodes to the total number of removed lymph nodes was not different between the two groups (LNR (P = 0.071. Tumor stage was higher in the laparoscopic group and most were in stages II and III (P < 0.001. Conclusions Laparoscopic surgery is an effective technique for safe margin and removing lymph nodes in rectal cancer.

  5. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities

    International Nuclear Information System (INIS)

    Alonso Iracheta, L.; Casa de Julian, M. A. de la; Samper Ots, P.; Penas Cabrera, M. D. de las; Jimenez Gonzalez, J. M.

    2013-01-01

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  6. A comparison between Lynch syndrome and sporadic colorectal cancer survivors' satisfaction with their healthcare providers.

    Science.gov (United States)

    Burton-Chase, Allison M; Parker, Wendy M; Polivka, Katrina M; Gritz, Ellen R; Amos, Christopher I; Lu, Karen H; Lynch, Patrick M; Rodriguez-Bigas, Miguel A; Nancy You, Y; Peterson, Susan K

    2017-03-01

    This study evaluated provider satisfaction in a sample of colorectal cancer (CRC) survivors with and without Lynch syndrome (LS). Participants were case-case-matched CRC survivors with (n = 75) or without (n = 75) LS (mean age of 55; range: 27-93). Participants completed a mailed questionnaire assessing demographics, clinical characteristics, healthcare utilization, psychosocial variables, and provider satisfaction. LS CRC survivors reported lower provider satisfaction scores on three subscales of the Primary Care Assessment Survey: communication (78.14 vs. 83.96; P < 0.05), interpersonal treatment (78.58 vs. 85.30; P < 0.05), and knowledge of the patient (60.34 vs. 69.86; P < 0.01). Among LS CRC survivors, predictors for mean communication and trust subscale scores were location of treatment and socioeconomic status. Higher mean depression scores also were associated with trust, while social support predicted higher satisfaction with communication. Sporadic CRC survivor satisfaction is driven largely by age (communication, interpersonal treatment) and patient anxiety (communication), while seeing a provider more often was associated with increased satisfaction with knowledge of the patient. LS CRC survivors reported lower levels of provider satisfaction than sporadic CRC survivors. LS survivors who received care at The University of Texas MD Anderson Cancer Center, a comprehensive cancer center (CCC), reported higher satisfaction than those receiving care at other institutions. Depressive symptoms and socioeconomic status may impact provider satisfaction ratings. Exploration of other potential predictors of provider satisfaction should be examined in this population. Additionally, further research is needed to examine the potential impact of provider satisfaction on adherence to medical recommendations in LS CRC survivors, particularly those being treated outside of CCCs. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  7. Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery.

    Science.gov (United States)

    Edwards, Janet P; Kelly, Elizabeth J; Lin, Yongtao; Lenders, Taryn; Ghali, William A; Graham, Andrew J

    2012-06-01

    Randomized controlled trials (RCTs) are thought to provide the most accurate estimation of "true" treatment effect. The relative quality of effect estimates derived from nonrandomized studies (nRCTs) remains unclear, particularly in surgery, where the obstacles to performing high-quality RCTs are compounded. We performed a meta-analysis of effect estimates of RCTs comparing surgical procedures for breast cancer relative to those of corresponding nRCTs. English-language RCTs of breast cancer treatment in human patients published from 2003 to 2008 were identified in MEDLINE, EMBASE and Cochrane databases. We identified nRCTs using the National Library of Medicine's "related articles" function and reference lists. Two reviewers conducted all steps of study selection. We included studies comparing 2 surgical arms for the treatment of breast cancer. Information on treatment efficacy estimates, expressed as relative risk (RR) for outcomes of interest in both the RCTs and nRCTs was extracted. We identified 12 RCTs representing 10 topic/outcome combinations with comparable nRCTs. On visual inspection, 4 of 10 outcomes showed substantial differences in summary RR. The pooled RR estimates for RCTs versus nRCTs differed more than 2-fold in 2 of 10 outcomes and failed to demonstrate consistency of statistical differences in 3 of 10 cases. A statistically significant difference, as assessed by the z score, was not detected for any of the outcomes. Randomized controlled trials comparing surgical procedures for breast cancer may demonstrate clinically relevant differences in effect estimates in 20%-40% of cases relative to those generated by nRCTs, depending on which metric is used.

  8. The Comparison Between the Complications after Two Surgical Techniques of Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Mohamad Taghi Rajabi Mashhadi

    2014-08-01

    Full Text Available Introduction: Esophageal cancer is a common gastro intestinal malignancy. One of the most common techniques of surgery in esophageal cancer is transhiatal esophagectomy with esophagogastric anastomosis in the neck. This technique is accompanied by complications like chronic gastero-esophegeal reflux and late stenosis. This study was designed to compare the risk of complications after two surgical techniques for esophageal cancer: esophagogastric anastomosis with partial fundoplication and esophagogastric anastomosis without it. Materials and Methods: In this retrospective cohort study, 100 patients with distal two thirds of esophageal cancer who underwent transhiatal esophagectomy in Ghaem and Omid hospitals Mashhad University of Medical Sciences from 2005 to 2010 were included. Esophagogastric anastomosis to the posterior gastric wall was performed with a partial gastric fundoplication in the first group but simple routine anastomosis was done to the posterior gastric wall in the second group. Results: In a retrospective cohort study 100 patients entered the study with 59 male & 41 female and with a mean age 54.6±6.4 years. Squamous cell carcinoma was observed in 77% of the patients and adenocarcinoma was reported in 23% of them. Seventy-two percent of tumours were located in distal third and 28% were in middle third of esophagus. Esophagogastric anastomotic leakage was observed in 3 cases of fundoplication group and 7 cases of simple anastomosis technique (P=0.182 so there was no significant difference between the two groups. Benign anastomosis stricture was reported in one of the patients who underwent esophagogastric anastomosis with fundoplication, but it was observed in 8 cases with simple anastomosis technique (P=0.03 so there was a significant difference between the two groups. Conclusion: Esophagogastric anastomosis with partial fundal fundoplication is a safe technique with low incidence of anatomic leakage and late stenosis.

  9. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  10. Using nuclear medicine technique in thyroid cancer diagnosis with comparison to ultrasound

    International Nuclear Information System (INIS)

    Chau, T.G.

    2007-01-01

    Full text: We used the following tests- thyroid uptake with I-131, Thyroid imaging with I-131 and Thyroid ultrasound and lymph node metastasis ultrasound. The results are as follows: 1.Thyroid uptake with I-131: This test was for the evaluation of normal thyroid tissue and function of thyroid cancer: The mean of uptake were: 12,7% at 2h and 28,53 % at 24 h after addition I-131. There was no relation to I-131 uptake with tumor size. (2) Thyroid imaging with I131: Diagnosis sensitivity was 98,1%. The cold nodules on scintigram were 92,5%. The warm nodules were 16,8%. And there were no hot nodules. (3) Thyroid ultrasound and lymph node metastasis ultrasound. Diagnosis sensitivity was 98,3%. Diagnosis sensitivity of lymph node metastasis is 94,1%, accuracy 96,6%. Nuclear medicine technique contributed very much to the diagnosis of thyroid cancer and other cancer diseases. We are using SPECT and other nuclear medicine technique in oncology diagnosis and follow-up therapy. (author)

  11. Comparison between mammography and ultrasonography for palpable breast mass: focusing fibroadenoma and breast cancer

    International Nuclear Information System (INIS)

    Kim, Do Kyun; Koh, Mi Kyung; Choi, Chul Soon; Chung, Soo Young; Yi, Jeong Geun; Yoon, Dae Young; Kim, Ho Chul; Bae, Sang Hoon

    1997-01-01

    The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retros-pectively analysed. In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant(p=3D0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively;the difference was not statistically signigicant(p-0.55). Overall, the diagnostic accuracy of mammography and ultrasonog-raphy was 63% and 82%, respectively, and this difference was statistically significant(p=3D0.0164). The total diagnostic accuracy of both studies was 90%, and this was signigicantly different(p=3D0.044) from that of ultrasonography(82%). In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.=20

  12. Comparison of extended hemicolectomy versus transverse colectomy in patients with cancer of the transverse colon.

    Science.gov (United States)

    van Rongen, I; Damhuis, R A M; van der Hoeven, J A B; Plaisier, P W

    2013-01-01

    Cancer of the transverse colon is rare and postoperative mortality tends to be high. Standard surgical treatment involves either extended hemicolectomy or transverse colectomy, depending on the location of the tumour. The aim of the present study was to compare postoperative mortality and five-year survival between these types of surgery. For this observational study, data on patients with a tumour of the transverse colon, treated by open resection in the Dordrecht Hospital from 1989 through 2003, were derived from the database of the regional cancer registry. Information on type of resection, tumour stage, complications, postoperative mortality (30-day) and survival was abstracted from the medical files. Patients with multi-organ surgery, (sub)total colectomy or stage IV disease were excluded from the analysis, leaving a total series of 103 patients. Transverse colectomy comprised one third of operations, predominantly involving partial resections. Postoperative mortality was 6% (2/34) after transverse colectomy and 7% (5/69) after extended hemicolectomy. Five-year survival was slightly higher for the hemicolectomy group (61% versus 50%), but this difference did not reach statistical significance (p = 0.34). Our results confirm the high postoperative risk after surgery for cancer of the transverse colon and show that this risk does not depend on the type of surgery. Considering the satisfactory results after partial transverse colectomy, segmental resections may be considered as an option for the treatment of localised tumours of the transverse colon.

  13. Comparison between mammography and ultrasonography for palpable breast mass: focusing fibroadenoma and breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Do Kyun; Koh, Mi Kyung; Choi, Chul Soon; Chung, Soo Young; Yi, Jeong Geun; Yoon, Dae Young; Kim, Ho Chul; Bae, Sang Hoon [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retros-pectively analysed. In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant(p=3D0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively;the difference was not statistically signigicant(p-0.55). Overall, the diagnostic accuracy of mammography and ultrasonog-raphy was 63% and 82%, respectively, and this difference was statistically significant(p=3D0.0164). The total diagnostic accuracy of both studies was 90%, and this was signigicantly different(p=3D0.044) from that of ultrasonography(82%). In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.=20.

  14. Comparison between serum levels of carcinoembryonic antigen, sialic acid and phosphohexose isomerase in lung cancer

    International Nuclear Information System (INIS)

    Patel, P.S.; Raval, G.N.; Rawal, R.M.; Balar, D.B.; Patel, G.H.; Shah, P.M.; Patel, D.D.

    1995-01-01

    The identification and application of quantifiable tumor markers as adjuncts to clinical care is a story of both success and failure. The present study compared serum levels of carcinoembryogenic antigen (CEA) with total sialic acid/total protein (TSA/TP) ration and phosphohexose isomerase (PHI) in 192 untreated lung cancer patients as well as 80 age and sex matched controls (44 non-smokers). CEA values were significantly raised (p < 0.001) in smokers as compared to the non-smokers; whereas, TSA/TP and PHI values were comparable between the groups of the groups of the controls. All the bio-markers were significantly elevated (p < 0.00.1) in untreated lung cancer patients as compared to the controls. Receiver operating characteristic curve analysis revealed higher sensitivities of TSA/TP and PHI as compared to CEA at different specificity levels between 60% and 95%. Mean values of CEA, TSA/TP and PHI were higher in non-responders compared to the responders. The results indicate that TSA/TP and PHI are superior tumor markers than CEA for lung cancer patients. (author)

  15. Comparison of post contrast CT urography phases in bladder cancer detection

    Energy Technology Data Exchange (ETDEWEB)

    Helenius, Malin; Dahlman, Par; Lonnemark, Maria; Magnusson, Anders [Uppsala University Hospital, Department of Surgical Sciences, Section of Radiology, Uppsala (Sweden); Brekkan, Einar [Uppsala University Hospital, Department of Surgical Sciences, Section of Urology, Uppsala (Sweden); Wernroth, Lisa [Uppsala University Hospital, Uppsala Clinical Research Center, Uppsala (Sweden)

    2016-02-15

    The aim of this study was to investigate which post-contrast phase(s) in a four-phase CT urography protocol is (are) most suitable for bladder cancer detection. The medical records of 106 patients with visible haematuria who underwent a CT urography examination, including unenhanced, enhancement-triggered corticomedullary (CMP), nephrographic (NP) and excretory (EP) phases, were reviewed. The post-contrast phases (n = 318 different phases) were randomized into an evaluation order and blindly reviewed by two uroradiologists. Twenty-one patients were diagnosed with bladder cancer. Sensitivity for bladder cancer detection was 0.95 in CMP, 0.83 in NP and 0.81 in EP. Negative predictive value (NPV) was 0.99 in CMP, 0.96 in NP and 0.95 in EP. The sensitivity was higher in CMP than in both NP (p-value 0.016) and EP (p-value 0.0003). NPV was higher in CMP than in NP (p-value 0.024) and EP (p-value 0.002). In the CT urography protocol with enhancement-triggered scan, sensitivity and NPV were highest in the corticomedullary phase, and this phase should be used for bladder assessment. (orig.)

  16. Comparison of post contrast CT urography phases in bladder cancer detection

    International Nuclear Information System (INIS)

    Helenius, Malin; Dahlman, Par; Lonnemark, Maria; Magnusson, Anders; Brekkan, Einar; Wernroth, Lisa

    2016-01-01

    The aim of this study was to investigate which post-contrast phase(s) in a four-phase CT urography protocol is (are) most suitable for bladder cancer detection. The medical records of 106 patients with visible haematuria who underwent a CT urography examination, including unenhanced, enhancement-triggered corticomedullary (CMP), nephrographic (NP) and excretory (EP) phases, were reviewed. The post-contrast phases (n = 318 different phases) were randomized into an evaluation order and blindly reviewed by two uroradiologists. Twenty-one patients were diagnosed with bladder cancer. Sensitivity for bladder cancer detection was 0.95 in CMP, 0.83 in NP and 0.81 in EP. Negative predictive value (NPV) was 0.99 in CMP, 0.96 in NP and 0.95 in EP. The sensitivity was higher in CMP than in both NP (p-value 0.016) and EP (p-value 0.0003). NPV was higher in CMP than in NP (p-value 0.024) and EP (p-value 0.002). In the CT urography protocol with enhancement-triggered scan, sensitivity and NPV were highest in the corticomedullary phase, and this phase should be used for bladder assessment. (orig.)

  17. Comparison of 2D and 3D brachytherpay planning for cervical cancer

    International Nuclear Information System (INIS)

    Kim, Jung Hoom

    2017-01-01

    To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to 2 cm3 of bladder to less than 7.5 Gy, and 2cm"3 of rectum to less than 5Gy. In one patient of 10 patients, D2cm3 of rectal dose was over 5Gy and 6 patients at D2cm"3 of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition

  18. A comparison of moving beam methods for the treatment of the breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chu, S S; Lee, D H; Park, C Y; Choi, B S [Yonsei University College of Medicine, Seoul (Korea, Republic of); Nam, J W [National Institute of Health, Seoul (Korea, Republic of)

    1973-12-15

    The method of tangential rotation therapy for non-operated breast cancer has been developed in Yonsei Cancer Center. This method is in principle to avoid the disorder of the lung field by radiotherapy as well as possible and to make an adequate radiation dosage according to each treated region, including breast, axilla, supra or infraclavicullar fossa, and sternum. We have various irradiation methods conducted today, but this continuous and repeated tangential rotation therapy is extraordinary superior to a traditional fixed tangential therapy. The advantages of this method are summarized as follows: 1) Simultaneous treatment with different dose is possible to the breast and the thorax including the sternum. 2) The radiation effect on the intrathoracic organs including lung and heart is almost absent. 3) It is easy to simultaneous irradiation in the large treated region. 4) The dose distribution of various types is possible by changed a rotation angle and an eccentric angle in accordance with irradiated region. 5) The irradiated fields are not overlapped and not so complicated as a fixed polytagential therapy. Therefor the continuous and repeated tangential rotation therapy is an adequate method for the non-operated breast cancer and may be sure of helping for radiation therapy.

  19. Cost comparison of curative therapies for localized prostate cancer in Japan. A single-institution experience

    International Nuclear Information System (INIS)

    Satoh, Takefumi; Ishiyama, Hiromichi; Matsumoto, Kazumasa

    2009-01-01

    In addition to open surgery, curative therapies for prostate cancer now include endoscopic surgery and radiation therapies. Because of the expansion and subdivision of treatment methods for prostate cancer, the medical fee point schedule in Japan was revised in fiscal year 2006. We examined changes in medical income and expenditure after this revision of the medical fee system. We studied income and expenditure, after institution of the new medical fee schedule, for the five types of therapies for prostate cancer performed at our hospital: two surgical therapies (radical retropubic prostatectomy and laparoscopic prostatectomy) and three radiation therapies (three-dimensional conformal radiation therapy, 192 Ir high-dose-rate brachytherapy, and 125 I low-dose-rate brachytherapy). Low-dose-rate brachytherapy was found to be associated with a profit of 199 yen per patient. Laparoscopic prostatectomy, a highly advanced medical treatment that the fee revision changed from a partially insured to an insured procedure, yielded a profit of 75672 yen per patient. However, high-dose-rate brachytherapy was associated with a loss of 654016 yen per patient. Given the loss in hospital income per patient undergoing high-dose-rate brachytherapy, the medical fee point system for this procedure should be reassessed. (author)

  20. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  1. Comparison of 2D and 3D brachytherpay planning for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoom [Dept. of Radiation Oncology, KonYang University Hospital, Daejeon (Korea, Republic of)

    2017-06-15

    To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to 2 cm3 of bladder to less than 7.5 Gy, and 2cm{sup 3} of rectum to less than 5Gy. In one patient of 10 patients, D2cm3 of rectal dose was over 5Gy and 6 patients at D2cm{sup 3} of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.

  2. Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue: A Meta-analysis.

    Science.gov (United States)

    Mustian, Karen M; Alfano, Catherine M; Heckler, Charles; Kleckner, Amber S; Kleckner, Ian R; Leach, Corinne R; Mohr, David; Palesh, Oxana G; Peppone, Luke J; Piper, Barbara F; Scarpato, John; Smith, Tenbroeck; Sprod, Lisa K; Miller, Suzanne M

    2017-07-01

    Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy. To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF-exercise, psychological, combined exercise and psychological, and pharmaceutical-and to identify independent variables associated with treatment effectiveness. PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Library were searched from the inception of each database to May 31, 2016. Randomized clinical trials in adults with cancer were selected. Inclusion criteria consisted of CRF severity as an outcome and testing of exercise, psychological, exercise plus psychological, or pharmaceutical interventions. Studies were independently reviewed by 12 raters in 3 groups using a systematic and blinded process for reconciling disagreement. Effect sizes (Cohen d) were calculated and inversely weighted by SE. Severity of CRF was the primary outcome. Study quality was assessed using a modified 12-item version of the Physiotherapy Evidence-Based Database scale (range, 0-12, with 12 indicating best quality). From 17 033 references, 113 unique studies articles (11 525 unique participants; 78% female; mean age, 54 [range, 35-72] years) published from January 1, 1999, through May 31, 2016, had sufficient data. Studies were of good quality (mean Physiotherapy Evidence-Based Database scale score, 8.2; range, 5-12) with no evidence of publication bias. Exercise (WES, 0.30; 95% CI, 0.25-0.36; P psychological (WES, 0.27; 95% CI, 0.21-0.33; P psychological interventions (WES, 0.26; 95% CI, 0.13-0.38; P psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures (WES range, -0.91 to 0.99). Results suggest that the effectiveness of behavioral interventions, specifically exercise and psychological interventions, is not attributable to

  3. Analysis of indirect taxation in Ukraine

    Directory of Open Access Journals (Sweden)

    Khodyakova Olga V.

    2014-01-01

    Full Text Available The goal of the article is analysis of the structure and dynamics of indirect taxes for the previous five years and also the influence of indirect taxation upon formation of income of the State Budget of Ukraine. The article analyses the modern state of indirect taxation in Ukraine. Specific weight of the value added tax, excise tax and customs duty are considered in the structure of tax receipts of the consolidated budget of Ukraine as indirect taxes. The article shows that receipts of the State Budget of Ukraine are mostly provided by indirect taxes. The Ukrainian taxation system is mostly a factor of reduction of the level of economic growth and investment activity in the country and the existing system of administering is not completely capable of excluding the possibility of tax evasion. The prospect of further studies in this direction is improvement of organisation of tax control in Ukraine and differentiation of the value added tax rates depending on the level of consumption of goods and level of income of consumers.

  4. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients.

    Science.gov (United States)

    Ryu, Seung Wan; Kim, In Ho

    2010-07-14

    To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients. From October 2005 to July 2006, we studied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gastric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student's t test and one-way analysis of variance. Spearman's rank correlation coefficients were calculated to evaluate the association between the scores and variables. The prevalence of malnutrition at admission was 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI assessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were significantly reduced, but the total lymphocyte count, albumin, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnourished by SGA and NRS-2002 had returned to their preoperative status, although their BW, BMI, and anthropometric measurements still indicated a malnourished status. A combination of objective and subjective assessments is needed for the early detection of the nutritional status in case of gastric cancer

  5. A comparison of tumor motion characteristics between early stage and locally advanced stage lung cancers

    International Nuclear Information System (INIS)

    Yu, Z. Henry; Lin, Steven H.; Balter, Peter; Zhang Lifei; Dong Lei

    2012-01-01

    Purpose: With the increasing use of conformal radiation therapy methods for non-small cell lung cancer (NSCLC), it is necessary to accurately determine respiratory-induced tumor motion. The purpose of this study is to analyze and compare the motion characteristics of early and locally advanced stage NSCLC tumors in a large population and correlate tumor motion with position, volume, and diaphragm motion. Methods and materials: A total of 191 (94 early stage, 97 locally advanced) non-small cell lung tumors were analyzed for this study. Each patient received a four-dimensional CT scan prior to receiving radiation treatment. A soft-tissue-based rigid registration algorithm was used to track the tumor motion. Tumor volumes were determined based on the gross tumor volume delineated by physicians in the end of expiration phase. Tumor motion characteristics were correlated with their standardized tumor locations, lobe location, and clinical staging. Diaphragm motion was calculated by subtracting the diaphragm location between the expiration and the inspiration phases. Results: Median, max, and 95th percentile of tumor motion for early stage tumors were 5.9 mm, 31.0 mm, and 20.0 mm, which were 1.2 mm, 12 mm, and 7 mm more than those in locally advanced NSCLC, respectively. The range of motion at 95th percentile is more than 50% larger in early stage lung cancer group than in the locally advanced lung cancer group. Early stage tumors in the lower lobe showed the largest motion with a median motion of 9.2 mm, while upper/mid-lobe tumors exhibited a median motion of 3.3 mm. Tumor volumes were not correlated with motion. Conclusion: The range of tumor motion differs depending on tumor location and staging of NSCLC. Early stage tumors are more mobile than locally advanced stage NSCLC. These factors should be considered for general motion management strategies when 4D simulation is not performed on individual basis.

  6. A Comprehensive Comparison of IMRT and VMAT Plan Quality for Prostate Cancer Treatment

    International Nuclear Information System (INIS)

    Quan, Enzhuo M.; Li Xiaoqiang; Li Yupeng; Wang Xiaochun; Kudchadker, Rajat J.; Johnson, Jennifer L.; Kuban, Deborah A.; Lee, Andrew K.; Zhang Xiaodong

    2012-01-01

    Purpose: We performed a comprehensive comparative study of the plan quality between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for the treatment of prostate cancer. Methods and Materials: Eleven patients with prostate cancer treated at our institution were randomly selected for this study. For each patient, a VMAT plan and a series of IMRT plans using an increasing number of beams (8, 12, 16, 20, and 24 beams) were examined. All plans were generated using our in-house–developed automatic inverse planning (AIP) algorithm. An existing eight-beam clinical IMRT plan, which was used to treat the patient, was used as the reference plan. For each patient, all AIP-generated plans were optimized to achieve the same level of planning target volume (PTV) coverage as the reference plan. Plan quality was evaluated by measuring mean dose to and dose–volume statistics of the organs at risk, especially the rectum, from each type of plan. Results: For the same PTV coverage, the AIP-generated VMAT plans had significantly better plan quality in terms of rectum sparing than the eight-beam clinical and AIP-generated IMRT plans (p < 0.0001). However, the differences between the IMRT and VMAT plans in all the dosimetric indices decreased as the number of beams used in IMRT increased. IMRT plan quality was similar or superior to that of VMAT when the number of beams in IMRT was increased to a certain number, which ranged from 12 to 24 for the set of patients studied. The superior VMAT plan quality resulted in approximately 30% more monitor units than the eight-beam IMRT plans, but the delivery time was still less than 3 min. Conclusions: Considering the superior plan quality as well as the delivery efficiency of VMAT compared with that of IMRT, VMAT may be the preferred modality for treating prostate cancer.

  7. Comparison on Efficacy of S-1 Respectively Combined with Oxaliplatin and Docetaxel for Advanced Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Junna Zhi

    2014-03-01

    Full Text Available Objective: To compare the short-term efficacy and safety of S-1 respectively combined with oxaliplatin (OXA and docetaxel (TXT in treatment of advanced gastric cancer. Method: Forty-three patients with advanced gastric cancer were randomly divided into OXA group (n = 26 and TXT group (n = 17. Drug usage was as follows: oral administration of 40 mg/m2 S-1 during days 1 - 14, twice a day; intravenous injection of 130 mg/m2 OXA on day 1; intravenous injection of 60 mg/m2 TXT on day 1; 3 weeks as one cycle. The efficacy, adverse reactions and quality of life were evaluated 2 cycles after treatment. Results: Adverse reactions could be evaluated in all cases, and efficacy be evaluated in 42 cases. The response rates (RR were 57.7% and 31.3% respectively in OXA and TXT groups, without statistical significance (P = 0.096. The incidence of total leukopenia (100.0%, stomatitis (35.3% and constipation (76.5% was obviously higher in TXT group than in OXA group (50.0%, 3.8%, 38.4%, with statistical significance (P = 0.019, 0.006, 0.015, while that of neurotoxicity lower than in OXA group (53.8% vs. 17.6%, with statistical significance (P = 0.018. Conclusion: For advanced gastric cancer, S-1 combined with OXA is similar to efficacy of combined with TXT, but with less adverse reactions.

  8. Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer.

    Science.gov (United States)

    Omidvari, Shapour; Hamedi, Sayed Hasan; Mohammadianpanah, Mohammad; Razzaghi, Samira; Mosalaei, Ahmad; Ahmadloo, Niloofar; Ansari, Mansour; Pourahmad, Saeideh

    2013-09-01

    This study aimed to investigate local control and survival rates following abdominoperineal resection (APR) compared with low anterior resection (LAR) in lower and middle rectal cancer. In this retrospective study, 153 patients with newly histologically proven rectal adenocarcinoma located at low and middle third that were treated between 2004 and 2010 at a tertiary hospital. The tumors were pathologically staged according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging system. Surgery was applied for 138 (90%) of the patients, of which 96 (70%) underwent LAR and 42 were (30%) treated with APR. Total mesorectal excision was performed for all patients. In addition, 125 patients (82%) received concurrent (neoadjuvant, adjuvant or palliative) pelvic chemoradiation, and 134 patients (88%) received neoadjuvant, adjuvant or concurrent chemotherapy. Patients' follow-up ranged from 4 to 156 (median 37) months. Of 153 patients, 89 were men and 64 were women with a median age of 57 years. One patient (0.7%) was stage 0, 15 (9.8%) stage I, 63 (41.2%) stage II, 51 (33.3%) stage III and 23 (15%) stage IV. There was a significant difference between LAR and APR in terms of tumor distance from anal verge, disease stage and combined modality therapy used. However, there was no significant difference regarding 5-year local control, disease free and overall survival rates between LAR and APR. LAR can provide comparable local control, disease free and overall survival rates compared with APR in eligible patients with lower and middle rectal cancer. Copyright © 2013. Production and hosting by Elsevier B.V.

  9. Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer

    International Nuclear Information System (INIS)

    Omidvari, Sh.; Ahmadloo, N.; Ansari, M.; Hamedi, S.H.; Razzaghi, S.; Mohammadianpanah, M.; Mosalaei, A.; Pourahmad, S.

    2013-01-01

    Introduction: This study aimed to investigate local control and survival rates following abdominoperineal resection (APR) compared with low anterior resection (LAR) in lower and middle rectal cancer. Methods: In this retrospective study, 153 patients with newly histologically proven rectal adenocarcinoma located at low and middle third that were treated between 2004 and 2010 at a tertiary hospital. The tumors were pathologically staged according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging system. Surgery was applied for 138 (90%) of the patients, of which 96 (70%) underwent LAR and 42 were (30%) treated with APR. Total meso rectal excision was performed for all patients. In addition, 125 patients (82%) received concurrent (neoadjuvant, adjuvant or palliative) pelvic chemo radiation, and 134 patients (88%) received neoadjuvant, adjuvant or concurrent chemotherapy. Patients follow-up ranged from 4 to 156 (median 37) months. Results: Of 153 patients, 89 were men and 64 were women with a median age of 57 years. One patient (o.7%) was stage 0, 15 (9.8%) stage I, 63 (41.2%) stage II, 51 (33.3%) stage III and 23 (15%) stage IV. There was a significant difference between LAR and APR in terms of tumor distance from anal verge, disease stage and combined modality therapy used. However, there was no significant difference regarding 5-year local control, disease free and overall survival rates between LAR and APR. Conclusion: LAR can provide comparable local control, disease free and overall survival rates compared with APR in eligible patients with lower and middle rectal cancer

  10. Anastomotic leakage after low anterior resection for rectal cancer: comparison of stapled versus compression anastomosis.

    Science.gov (United States)

    Dauser, Bernhard; Braunschmid, Tamara; Ghaffari, Shahbaz; Riss, Stefan; Stift, Anton; Herbst, Friedrich

    2013-10-01

    Surgical technique and perioperative management in rectal cancer surgery have been substantially improved and standardized during the last decades. However, anastomotic leakage following low anterior resection still is a significant problem. Based on animal experimental data of improved healing of compression anastomosis, we hypothesized that a compression anastomotic device might improve healing rates of the highest-risk anastomoses. All low anterior resections for rectal cancer performed or directly supervised by the senior author between January 2004 and June 2012 were analyzed. Only patients with a stapled or compression anastomosis located within 6 cm from the anal verge were included. Until December 2008, circular staplers were employed, while since January 2009, a novel compression anastomotic device was used for rectal reconstruction exclusively. Out of 197 patients operated for rectal cancer, a total of 96 (34 females, 35.4 %) fulfilled inclusion criteria. Fifty-eight (60.4 %) were reconstructed with circular staplers and 38 (39.6 %) using a compression anastomotic device. Significantly, more laparoscopic procedures were recorded in the compression anastomosis group, but distribution of gender, age, body mass index, American Society of Anaesthesiologists score, rate of preoperative radiotherapy, tumor staging, or stoma diversion rate were similar. Anastomotic leakage was observed in seven cases (7/58, 12.1 %) in the stapled and twice (2/38, 5.3 %) in the compression anastomosis group (p = 0.26). In this series, rectal reconstruction following low anterior resection using a novel compression anastomotic device was safe and (at least) equally effective compared to traditional circular staplers concerning leak rate.

  11. Preoperative chemoradiation for locally advanced rectal cancer: comparison of three radiation dose and fractionation schedules

    International Nuclear Information System (INIS)

    Park, Shin Hyung; Kim, Jae Chul

    2016-01-01

    The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45–50 Gy in 25–28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer

  12. Comparison of the prognostic values of preoperative inflammation-based parameters in patients with breast cancer.

    Directory of Open Access Journals (Sweden)

    Hideya Takeuchi

    Full Text Available Peripheral blood-derived inflammation-based markers, including C-reactive protein (CRP, neutrophil-to-lymphocyte ratio (NLR, lymphocyte-to-monocyte ratio (LMR, and platelet-to-lymphocyte ratio (PLR are indicators of prognosis in various malignant tumors. The present study aimed to identify the inflammation-based parameters that are most suitable for predicting outcomes in patients with breast cancer. Two hundred ninety-six patients who underwent surgery for localized breast cancer were reviewed retrospectively. The association between clinicopathological factors and inflammation-based parameters were investigated. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic indicators associated with disease-free survival (DFS. The NLR level correlated significantly with tumor size (P<0.05. The PLR level correlated with the expression of estrogen receptor and lymph node involvement (P<0.05. Univariate analysis revealed that lower CRP and PLR values as well as tumor size, lymph node involvement, and nuclear grade were significantly associated with superior DFS (CRP: P<0.01; PLR, tumor size, lymph node involvement, and nuclear grade: P<0.05. On multivariate analysis, CRP (hazard ratio [HR]: 2.85, 95% confidence interval [CI]: 1.03-7.88, P<0.05, PLR (HR: 2.61, 95% CI: 1.07-6.36, P<0.05 and nuclear grade (HR: 3.066, 95% CI: 1.26-7.49, P<0.05 were significant prognostic indicators of DFS in patients with breast cancer. Neither LMR nor NLR significantly predicted DFS. Both preoperative CRP and PLR values were independently associated with poor prognosis in patients with breast carcinoma; these were superior to other inflammation-based scores in terms of prognostic ability.

  13. Preoperative chemoradiation for locally advanced rectal cancer: comparison of three radiation dose and fractionation schedules

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul [Dept. of Radiation Oncology, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45–50 Gy in 25–28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer.

  14. Usefulness of preoperative chest multidetector CT for evaluation of breast cancer: comparison with breast MRI

    International Nuclear Information System (INIS)

    Chang, Yun Woo; Kim, Dong Hun; Lee, Min Hyuk

    2005-01-01

    To evaluate the efficacy of chest multidetector-row helical computed tomography (MDCT) in detecting breast cancer in preoperative metastasis work-ups and to assess the accuracy of MDCT compared with magnetic resonance imaging (MRI). MDCT were performed on 69 consecutive patients with 94 lesions of histologically proven breast cancer. Retrospectively, two radiologists performed a blind review of the MDCT images for margin, shape, mass enhancement pattern and the enhancing distribution of non-mass lesions with consensus. CT attenuation values were measured in the average HU on pre-enhancing and enhanced CT in gland, fat, muscle, and in masses with the largest region of interest (ROI). MDCT finding were analyzed and compared with breast MRI. Of the 91 breast lesions detected on MDCT, 64 were mass lesions and 24 were non-mass lesions on enhancement, 86 lesions were malignant and 5 were benign. Three pathologically proven malignant masses were not detected on MDCT. Positive predictive value, false positive rate and false negative rate were 94.5%, 5.3%, 3.2% respectively. The highly predictive features for malignancy were a spiculated or irregular margin, an irregular of round shape, and a heterogeneously or rim enhanced mass. Another highly predictive feature for malignancy was linear or segmentally distributed enhancing non-mass lesions. The CT values of masses in pre-enhanced scans were 38.6 ± 7.9 HU; these values increased to 110.9 ± 26.6 HU after contrast injection (90 sec). The attenuation values from enhancing CT of malignant lesions were significantly higher than those of non-enhancing lesions. The depiction of enhancing masses on MDCT compared with MR imaging were 88.6%. The extension of malignancy were equally well correlated MDCT with MR imaging. The diagnostic value of chest MDCT for preoperative staging is comparable with MR imaging for the detection and extension of lesions. Therefore, chest MDCT of breast cancer can add to the information obtained from

  15. Detection of bone metastasis of prostate cancer. Comparison of whole-body MRI and bone scintigraphy

    International Nuclear Information System (INIS)

    Ketelsen, D.; Roethke, M.; Aschoff, P.; Lichy, M.P.; Claussen, C.D.; Schlemmer, H.P.; Merseburger, A.S.; Reimold, M.

    2008-01-01

    Purpose: prostate cancer continues to be the third leading cancer-related mortality of western men. Early diagnosis of bone metastasis is important for the therapy regime and for assessing the prognosis. The standard method is bone scintigraphy. Whole-body MRI proved to be more sensitive for early detection of skeletal metastasis. However, studies of homogenous tumor entities are not available. The aim of the study was to compare bone scintigraphy and whole-body MRI regarding the detection of bone metastasis of prostate cancer. Materials and methods: 14 patients with histologically confirmed prostate cancer and a bone scintigraphy as well as whole-body MRI within one month were included. The mean age was 68 years. Scintigraphy was performed using the planar whole-body technique (ventral and dorsal projections). Suspect areas were enlarged. Whole-body MRI was conducted using native T1w and STIR sequences in the coronary plane of the whole body, sagittal imaging of spine and breath-hold STIR and T1w-Flash-2D sequences of ribs and chest. Bone scintigraphy and whole-body MRI were evaluated retrospectively by experienced radiologists in a consensus reading on a lesion-based level. Results: whole-body MRI detected significantly more bone metastasis (p = 0.024). 96.4% of the demonstrated skeletal metastases in bone scintigraphy were founded in whole-body MRI while only 58.6% of the depicted metastases in MRI were able to be located in scintigraphy. There was no significant difference regarding bone metastasis greater than one centimeter (p = 0.082) in contrast to metastasis less than one centimeter (p = 0.035). Small osteoblastic metastases showed a considerably higher contrast in T1w sequences than in STIR imaging. Further advantages of whole-body MRI were additional information about extra-osseous tumor infiltration and their complications, for example stenosis of spinal canal or vertebral body fractures, found in 42.9% of patients. (orig.)

  16. A review of Indirect Matrix Converter Topologies

    Directory of Open Access Journals (Sweden)

    Salem Rahmani

    2015-08-01

    Full Text Available Abstract—Matrix Converter (MC is a modern direct AC/AC electrical power converter without dc-link capacitor. MC is operated in four quadrant, assuring a control of the output voltage, amplitude and frequency. The matrix converter has recently attracted significant attention among researchers and it has become increasing attractive for applications of wind energy conversion, military power supplies, induction motor drives, etc. Recently, different MC topologies have been proposed and developed which have their own advantages and disadvantages. Matrix converter can be classified as direct and indirect structures. The direct one has been elaborated in previous work. In this paper the indirect MCs are reviewed. Different characteristics of the indirect MC topologies are mentioned to show the strengths and weaknesses of such converter topologies.

  17. Indirect taxes on food in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Denize Mirian da Silva

    2013-12-01

    Full Text Available The objective of this paper is to estimate the indirect tax burden on food for ten income classes, based on income and household total expenditure in southern Brazil. Thus it can be seen as indirect taxes on foods affect the monetary income and consumption pattern of households. To reach the objectives proposed, will be used the Pintos-Payeras (2008 model. The database iscomposed by microdata from the Household Budgeting Survey (POF 2008-2009 and the tax regulations of the country and the southern states of Brazil. The results show that indirect taxes on food in Southern Brazil is regressive when based on income and expenditure of household , ie , the poorest people pay proportionately more taxes and have their consumption pattern highest taxed ICMS (Brazilian value added tax is the tax that contributes most to the regressivity.

  18. Indirect Comorbidity in Childhood and Adolescence

    Directory of Open Access Journals (Sweden)

    William eCopeland

    2013-11-01

    Full Text Available Objective: Comorbidity between psychiatric disorders is common, but pairwise associations between two disorders may be explained by the presence of other diagnoses that are associated with both disorders or indirect comorbidity. Method: Comorbidities of common childhood psychiatric disorders were tested in three community samples of children ages 6 to 17 (8931 observations of 2965 subjects. Psychiatric disorder status in all three samples was assessed with the Child and Adolescent Psychiatric Assessment. Indirect comorbidity was defined as A-B associations that decreased from significance to nonsignificance after adjusting for other disorders. Results: All tested childhood psychiatric disorders were positively associated in bivariate analyses. After adjusting for comorbidities, many ssociations involving a behavioral disorder and an emotional disorder were attenuated suggesting indirect comorbidity. Generalized anxiety and depressive disorders displayed a very high level of overlap (adjusted OR=37.9. All analyses were rerun with depressive disorders grouped with generalized anxiety disorder in a single distress disorders category. In these revised models, all associations between and emotional disorder and a behavior disorder met our criteria for indirect comorbidity except for the association of oppositional defiant disorder with distress disorders (OR=11.3. Follow-up analyses suggested that the indirect associations were primarily accounted for by oppositional defiant disorder and the distress disorder category. There was little evidence of either sex differences or differences by developmental period Conclusions: After accounting for the overlap between depressive disorders with generalized anxiety disorder, direct comorbidity between emotional and behavioral disorders was uncommon. When there was evidence of indirect comorbidity, ODD and distress disorders were the key intermediary diagnoses accounting for the apparent associations.

  19. Indirect effects in dual radiation action

    International Nuclear Information System (INIS)

    Zaider, M.; Rossi, H.H.

    1988-01-01

    The basic aim in this paper is to establish the link between indirect effects of radiation action and the spatial distribution of radicals at the time of energy deposition as well as throughout subsequent diffusion and interaction. The fact that radicals diffuse for a finite distance before damaging a biomolecule has dramatic effects on their subsequent probability to result in lesions. Thus at very low DMSO concentrations, where p = 0.5, one expects - all other things being equal - some 75% of the lesions to result from indirect or semidirect lesions. The number calculated here is lower (15%), a direct result of the fact that such lesions involve proximity functions modulated by diffusion. At higher DMSO concentrations this percentage becomes progressively smaller, as expected. It appears thus that for low-LET radiation, the relative amount of indirect damage in single tracks (also termed intratrack or single events) action is very small. By contrast, intertrack (or two-event) contributions will have the ratio between direct and (indirect + semidirect) contributions given by p 2 /(1-p 2 ). The reason for this is that sublesions from different tracks are uniformly distributed throughout the cell nucleus; their probability of interaction should not depend on any previous diffusional processes. For the example given above (p = 0.5) they do expect 65% of intertrack (two-hit) lesions to have resulted from indirect or semidirect mechanisms. This contrast between the almost exclusively direct character of intratrack lesions and the dominant role of indirect action in intertrack lesions produced by low-LET radiation is an important conclusion of this study

  20. Large planning target volume in whole abdomen radiation therapy in ovarian cancers - a comparison between volumetric arc and fixed beam based intensity modulation in ovarian cancers: a comparison between volumetric arc and fixed beam based intensity modulation

    International Nuclear Information System (INIS)

    Krishnan, Jayapalan; Rao, Suresh; Hedge, Sanath; Shambhavi

    2013-01-01

    Aim of this study is to assess dosimetric characteristics of multiple iso-centre volumetric-modulated arc therapy for the treatment of a large PTV in whole abdomen and ovarian cancers and in comparison with IMRT. Two patients with Epithelial Ovarian Cancer (EOC) underwent CT-simulation in supine position with vacuum cushion and acquired CT-image with 3 mm slice thickness. IMRT and VMAT plans were generated with multiple isocenter using Eclipse Planning System (V10.0.39) for (6 MV photon) Varian UNIQUE Performance Linac equipped with a Millennium-120 MLC and optimised with Progressive Resolution optimizer (PRO3) for prescription 36 Gy to the whole abdomen (PTV W AR) and 45 Gy with daily fraction of 1.8 Gy to the pelvis and pelvic nodes (PTV P elvis) with Simultaneous Integrated Boost and calculated with AAA algorithm in 2.5 mm grid resolution. Mean, V 95% , V 90% , V 107% and uniformity number (Uniformity was defined as US-95%=D5%-D95%/D mean ) was calculated for Planning Target Volumes (PTVs). Organs at Risk (OAR's) were analysed statistically in terms of dose and volume. MU and delivery time were compared. Pre-treatment quality assurance was scored with Gamma Agreement Index (GAl) with 3% and 3 mm thresholds with EPID as well as corresponding Dynalog files were generated and analysed. Feasibility and deliverability of VMAT plans showed to be a solution for the treatment planning and delivery for a large PTV volume (PTV-WAR) treatments, surrounded by critical structures such as liver, spinal canal, and kidneys, offering good dosimetric features with significant logistic improvements compared to IMRT. VMAT combines the advantages of faster delivery and lower number of monitor units (MU). It would help to reduce potential risk of secondary malignancy. VMAT(RapidArc) showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT

  1. Relative risks of radiation-associated cancer: comparison of second cancer in therapeutically irradiated populations with the Japanese atomic bomb survivors

    International Nuclear Information System (INIS)

    Little, M.P.; Muirhead, C.R.; Haylock, R.G.E.; Thomas, J.M.

    1999-01-01

    In this paper the radiation-associated relative risks of second primary cancer incidence in groups treated for first primary cancer by radiotherapy are compared with radiation-associated relative risk estimates in the Japanese atomic bomb survivor cancer incidence data. For four cancer sites, namely lung cancer, bone cancer, ovarian cancer and leukaemia, the relative risks in the comparable (age at exposure, time since exposure, sex matched) subsets of the Japanese data are significantly greater than those in the majority of second cancer studies. Even when the differences between the relative risks in the Japanese atomic bomb survivors and the medical series do not approach conventional levels of statistical significance, relative risks tend to be higher in the Japanese data than in the second cancer studies. At least for leukaemia, the discrepancy between the Japanese and second cancer risks can be largely explained by cell- sterilisation effects. There are few indications of modification of radiation-associated second cancer relative risk among those treated with adjuvant chemotherapy, nor are there strong indications of modification of radiation- associated relative risk by heritable genetic factors. If anything, there is evidence that second cancer relative excess risks are lower among those patients with cancer-prone disorders than among non-susceptible patients. However, the higher underlying cancer risk in some of these medically exposed populations should also be considered, in particular for those with cancer-prone conditions, so that the absolute excess risk is sometimes higher than in the Japanese data. (orig.)

  2. Global indirect aerosol effects: a review

    Directory of Open Access Journals (Sweden)

    U. Lohmann

    2005-01-01

    Full Text Available Aerosols affect the climate system by changing cloud characteristics in many ways. They act as cloud condensation and ice nuclei, they may inhibit freezing and they could have an influence on the hydrological cycle. While the cloud albedo enhancement (Twomey effect of warm clouds received most attention so far and traditionally is the only indirect aerosol forcing considered in transient climate simulations, here we discuss the multitude of effects. Different approaches how the climatic implications of these aerosol effects can be estimated globally as well as improvements that are needed in global climate models in order to better represent indirect aerosol effects are discussed in this paper.

  3. Biomass Indirect Liquefaction Strategy Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-07-01

    This report is based on the proceedings of the U.S. Department of Energy Bioenergy Technologies Office Biomass Indirect Liquefaction Strategy Workshop. The workshop, held March 20–21, 2014, in Golden, Colorado, discussed and detailed the research and development needs for biomass indirect liquefaction. Discussions focused on pathways that convert biomass-based syngas (or any carbon monoxide, hydrogen gaseous stream) to liquid intermediates (alcohols or acids) and further synthesize those intermediates to liquid hydrocarbons that are compatible as either a refinery feed or neat fuel.

  4. The power of indirect social ties

    OpenAIRE

    Zuo, Xiang; Blackburn, Jeremy; Kourtellis, Nicolas; Skvoretz, John; Iamnitchi, Adriana

    2014-01-01

    While direct social ties have been intensely studied in the context of computer-mediated social networks, indirect ties (e.g., friends of friends) have seen little attention. Yet in real life, we often rely on friends of our friends for recommendations (of good doctors, good schools, or good babysitters), for introduction to a new job opportunity, and for many other occasional needs. In this work we attempt to 1) quantify the strength of indirect social ties, 2) validate it, and 3) empiricall...

  5. Indirect methods for wake potential integration

    International Nuclear Information System (INIS)

    Zagorodnov, I.

    2006-05-01

    The development of the modern accelerator and free-electron laser projects requires to consider wake fields of very short bunches in arbitrary three dimensional structures. To obtain the wake numerically by direct integration is difficult, since it takes a long time for the scattered fields to catch up to the bunch. On the other hand no general algorithm for indirect wake field integration is available in the literature so far. In this paper we review the know indirect methods to compute wake potentials in rotationally symmetric and cavity-like three dimensional structures. For arbitrary three dimensional geometries we introduce several new techniques and test them numerically. (Orig.)

  6. Small cell lung cancer: CT evaluation and comparison with nonhodgkin's lymphoma

    International Nuclear Information System (INIS)

    Whang, Sun Hee; Lee, Kyung Soo; Lee, Byoung Ho

    1991-01-01

    We analyzed plain radiographic and computed tomographic (CT) features of 26 biopsy proven small cell lung cancer (SCLC). Eleven cases of non Hodgkin's lymphoma involving the thorax were also reviewed and compared with the small cell lung cancer for differential diagnostic clues. Centrally manifesting lymphadenopathy was the main findings of SCLC in both plain radiographs and CT. The most frequently involved lymph nodes were subcarinal, right lower paratracheal, left lower paratracheal, and right tracheobronchial node. The most difficult site to identify the lymphadenopathy with simple radiograph was subcarinal, paraesophageal, pulmonary ligamental, anterior mediastinal (group 6), and left upper paratracheal nodes CT scan revealed lymphadenopathy clearly in all of these Groups. Right lower paratracheal and subcarinal nodes were involved frequently in both SCLC's and lymphomas. Bilateral tracheobronchial and bilateral intrapulmonary nodes were involved more frequently in SCLC's while anterior mediastinal, upper paratracheal, and aorticopulmonary (AP) window nodes were involved predominantly in lymphomas. Cystic low attenuation, presumed necrosis lymphadenopathy, was noted in two cases of lymphomas but not found in SCLC's at all. In conclusion, the CT could detect involved lymphadenopathy in SCLC more accurately than plain radiograph and the sites of involved lymphadenopathy may give a differential diagnostic clue between SCLC and lymphoma

  7. Adaptive plan selection vs. re-optimisation in radiotherapy for bladder cancer: A dose accumulation comparison

    International Nuclear Information System (INIS)

    Vestergaard, Anne; Muren, Ludvig Paul; Søndergaard, Jimmi; Elstrøm, Ulrik Vindelev; Høyer, Morten; Petersen, Jørgen B.

    2013-01-01

    Purpose: Patients with urinary bladder cancer are obvious candidates for adaptive radiotherapy (ART) due to large inter-fractional variation in bladder volumes. In this study we have compared the normal tissue sparing potential of two ART strategies: daily plan selection (PlanSelect) and daily plan re-optimisation (ReOpt). Materials and methods: Seven patients with bladder cancer were included in the study. For the PlanSelect strategy, a patient-specific library of three plans was generated, and the most suitable plan based on the pre-treatment cone beam CT (CBCT) was selected. For the daily ReOpt strategy, plans were re-optimised based on the CBCT from each daily fraction. Bladder contours were propagated to the CBCT scan using deformable image registration (DIR). Accumulated dose distributions for the ART strategies as well as the non-adaptive RT were calculated. Results: A considerable sparing of normal tissue was achieved with both ART approaches, with ReOpt being the superior technique. Compared to non-adaptive RT, the volume receiving more than 57 Gy (corresponding to 95% of the prescribed dose) was reduced to 66% (range 48–100%) for PlanSelect and to 41% (range 33–50%) for ReOpt. Conclusion: This study demonstrated a considerable normal tissue sparing potential of ART for bladder irradiation, with clearly superior results by daily adaptive re-optimisation

  8. Comparison between computed tomography with oral oil-based contrast and laparotomy for gastric cancer staging

    International Nuclear Information System (INIS)

    Marco, S. F.; Garcia-Vila, J. H.; Cervera, J.; Gomez, R.; Piqueras, R. M.; Perona, I.; Escrig, J.; Salvador, J. L.

    2000-01-01

    To compare the utility of conventional computed tomography (CT) with oral oil-based contrast with that of laparotomy in the preoperative staging of gastric cancer. We prospectively studied 41 patients diagnosed as having gastric adenocarcinoma according to the results of endoscopy and biopsy. Applying the TNM classification for gastric cancer staging, we compared the findings in CT associated with oral oil-based contrast and intraoperative staging with definitive postoperative pathological staging. Definitive pathological studies demonstrated that there were 7 stage T1-T2 lesions, 26 stage T3 and 8 stage T4. The assessment of lymph node involvement showed that 10 patients presented stage N0 and 31 stage N1-N3. Ten patients had metastases. The diagnostic reliability for tumor staging according to CT was 56% versus 80% for laparotomy. In the determination of nodal involvement CT had a diagnostic yield of 71% versus 6% for laparotomy. Metastatic disease was correctly diagnosed by CT in 83% of cases versus 88% by laparotomy. There were no statistically significant differences between CT with oral oil-based contrast and laparotomy for the staging of nodal involvement and metastases. However, the CT diagnosis was significantly more reliable than laparotomy for the determination of tumor infiltration. (Author) 21 refs

  9. Comparison of quality of life of Turkish cancer patients and their family caregivers.

    Science.gov (United States)

    Yesilbalkan, Oznur Usta; Ozkutuk, Nilay; Ardahan, Melek

    2010-01-01

    The purpose of this study was to compare the quality of life (QoL) of cancer patients and their family caregivers and determine associations. A total of 93 paired patients and caregivers from an outpatient chemotherapy unit of the oncology units were recruited at a large university hospital in İzmir, all completing the Quality of Life Scale (QoLS). The mean age of patients was 45.2 years, and of their family caregivers was 40.5. The results indicated that the patients perceived a poorer quality of life than their family caregivers. There was a middle and positive correlation between the social participation and work performance dimensions of patients' QoL and social participation and work performance dimension of family caregivers' QoL (r =0.273, p 0.05). Caregivers' employment status was found to have an affect on their quality of life (p ommunication skills, financial planning and distress management skills and be given spiritual support to decrease effects of cancer on their quality of life.

  10. Comparison between hemosiderin and Technetium-99 in sentinel lymph node biopsy in human breast cancer

    International Nuclear Information System (INIS)

    Vasques, Paulo Henrique Diogenes; Aquino, Ranniere Gurgel Furtado de; Pinheiro, Luiz Gonzaga Porto; Torres, Roberto Vitor Almeida; Bezerra, Jose Lucas Martins; Brasileiro, Luis Porto

    2015-01-01

    Purpose: To assess the safety and potential equivalence of the use of hemosiderin compared to the Technetium-99 in sentinel lymph node biopsy in human breast cancer. Methods: Non-random sample of 14 volunteer women diagnosed with breast cancer with primary tumors (T1/T2) and clinically tumor-free axilla were submitted to the identification of sentinel lymph node using hemosiderin obtained from autologous blood injected in the periareolar region 24h before surgery on an outpatient basis. Patients received preoperative subareolar intradermal injection of Technetium-99 in the immediate preoperative period. Patients were submitted to sentinel lymph node biopsy, with incision in the axillary fold guided by Gamma-Probe, dissection by planes until the identification of the point of maximum uptake of Technetium-99, identifying the marked nodes and their colors. All surgical specimens were sent for pathological and immunohistochemical study. Results: The results showed no evidence of side effects and/or allergic and non-allergic reactions in patients submitted to SLNB with hemosiderin. The SLN identification rate per patient was 100%. SLNB identification rate per patient with hemosiderin was the same as that of Technetium, with a concordance rate of 100% between the methods. Conclusion: Hemosiderin is a safe dye that is equivalent to Technetium in breast sentinel lymph node biopsy. (author)

  11. Preliminary Comparison of Oral and Intestinal Human Microbiota in Patients with Colorectal Cancer: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Edda Russo

    2018-01-01

    Full Text Available In this study Next-Generation Sequencing (NGS was used to analyze and compare human microbiota from three different compartments, i.e., saliva, feces, and cancer tissue (CT, of a selected cohort of 10 Italian patients with colorectal cancer (CRC vs. 10 healthy controls (saliva and feces. Furthermore, the Fusobacterium nucleatum abundance in the same body site was investigated through real-time quantitative polymerase chain reaction (qPCR to assess the association with CRC. Differences in bacterial composition, F. nucleatum abundance in healthy controls vs. CRC patients, and the association of F. nucleatum with clinical parameters were observed. Taxonomic analysis based on 16S rRNA gene, revealed the presence of three main bacterial phyla, which includes about 80% of reads: Firmicutes (39.18%, Bacteroidetes (30.36%, and Proteobacteria (10.65%. The results highlighted the presence of different bacterial compositions; in particular, the fecal samples of CRC patients seemed to be enriched with Bacteroidetes, whereas in the fecal samples of healthy controls Firmicutes were one of the major phyla detected though these differences were not statistically significant. The CT samples showed the highest alpha diversity values. These results emphasize a different taxonomic composition of feces from CRC compared to healthy controls. Despite the low number of samples included in the study, these results suggest the importance of microbiota in the CRC progression and could pave the way to the development of therapeutic interventions and novel microbial-related diagnostic tools in CRC patients.

  12. Comparison of the internalization of targeted dendrimers and dendrimer-entrapped gold nanoparticles into cancer cells.

    Science.gov (United States)

    Shi, Xiangyang; Wang, Su He; Lee, Inhan; Shen, Mingwu; Baker, James R

    2009-11-01

    Dendrimer-based nanotechnology significantly advances the area of targeted cancer imaging and therapy. Herein, we compared the difference of surface acetylated fluorescein isocyanate (FI) and folic acid (FA) modified generation 5 (G5) poly(amidoamine) dendrimers (G5.NHAc-FI-FA), and dendrimer-entrapped gold nanoparticles with similar modifications ([(Au(0))(51.2)-G5.NHAc-FI-FA]) in terms of their specific internalization to FA receptor (FAR)-overexpressing cancer cells. Confocal microscopic studies show that both G5.NHAc-FI-FA and [(Au(0))(51.2-)G5.NHAc-FI-FA] exhibit similar internalization kinetics regardless of the existence of Au nanoparticles (NPs). Molecular dynamics simulation of the two different nanostructures reveals that the surface area and the FA moiety distribution from the center of the geometry are slightly different. This slight difference may not be recognized by the FARs on the cell membrane, consequently leading to similar internalization kinetics. This study underlines the fact that metal or inorganic NPs entrapped within dendrimers interact with cells in a similar way to that of dendrimers lacking host NPs. 2009 Wiley Periodicals, Inc.

  13. Comparison of Four PD-L1 Immunohistochemical Assays in Lung Cancer.

    Science.gov (United States)

    Hendry, Shona; Byrne, David J; Wright, Gavin M; Young, Richard J; Sturrock, Sue; Cooper, Wendy A; Fox, Stephen B

    2018-03-01

    Four different programmed death ligand 1 immunohistochemical assays are approved or in development as companion or complementary diagnostics to different immunotherapeutic agents in lung carcinoma. We sought to determine whether these assays are technically equivalent and whether one antibody can be used on an alternate staining platform. Serial sections of tissue microarrays constructed from 368 cases of resected lung cancer were stained for 22C3 and 28-8 on the Dako Link 48 platform (Dako, Carpinteria, Ca) and for SP142 and SP263 on the Ventana Benchmark Ultra platform (Ventana Medical Systems, Tucson, AZ) strictly as per product insert. A protocol was developed to use the 22C3 antibody on the Ventana Benchmark Ultra platform. Differences in mean tumor cell and immune cell staining were observed between the four assays (p Link 48 platform and the alternate Ventana Benchmark Ultra platform (ICC = 0.921, κ = 0.897). Concordance between the four programmed death ligand 1 immunohistochemical assays when performed and scored as intended show that apart from 28-8 and 22C3, they cannot be used interchangeably in clinical practice. A protocol was successfully developed to use 22C3 on an alternate platform, which may help to overcome some barriers to implementation. Copyright © 2017 International Association for the Study of Lung Cancer. All rights reserved.

  14. Comparison of orofacial pain of patients with different stages of precancer and oral cancer.

    Science.gov (United States)

    Yang, Yanjie; Zhang, Peipei; Li, Wenlu

    2017-03-16

    Orofacial pain impairs a patient's speech, swallowing, eating and interpersonal relations. Thirty-seven patients with a premalignant oral lesion, 124 patients with oral squamous cell carcinoma (OSSC), and 21 patients with a recurrence of OSSC were evaluated for their orofacial pain. The University of California San Francisco Oral Cancer Pain Questionnaire was administered to these patients at their initial visit, before they were prescribed analgesics for pain and before any treatment. Significant differences with respect to orofacial pain between the groups could be evaluatedwere observed. Patients with recurrence had the highest facial pain and patients with precancer had the lowest. Patients with OSSC and recurrence of OSSC reported significant levels of orofacial pain and functional restriction because of pain. Moreover, patients with recurrence of OSSC experienced significantly higher function-related pain, rather than pain qualities. These findings suggest that an important predictor for recurrence of OSSC may be the onset of orofacial pain that is exacerbated during function. The present study examined orofacial pain depending on the disease severity of precancer and oral cancer patients. Earlier recognition of symptoms of OSSC may improve early detection of its recurrence.

  15. Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status.

    Science.gov (United States)

    Reese, J B; Finan, P H; Haythornthwaite, J A; Kadan, M; Regan, K R; Herman, J M; Efron, J; Diaz, L A; Azad, N S

    2014-02-01

    Research examining effects of ostomy use on sexual outcomes is limited. Patients with colorectal cancer were compared on sexual outcomes and body image based on ostomy status (never, past, and current ostomy). Differences in depression were also examined. Patients were prospectively recruited during clinic visits and by tumor registry mailings. Patients with colorectal cancer (N = 141; 18 past ostomy; 25 current ostomy; and 98 no ostomy history) completed surveys assessing sexual outcomes (medical impact on sexual function, Female Sexual Function Index, International Index of Erectile Function), body image distress (Body Image Scale), and depressive symptoms (Center for Epidemiologic Studies Depression Scale-Short Form). Clinical information was obtained through patient validated self-report measures and medical records. Most participants reported sexual function in the dysfunctional range using established cut-off scores. In analyses adjusting for demographic and medical covariates and depression, significant group differences were found for ostomy status on impact on sexual function (p ostomy groups reported worse impact on sexual function than those who never had an ostomy (p ostomy group reported worse body image distress than those who never had an ostomy (p ostomies as part of their treatment. Clinical information and support should be offered.

  16. Comparison between hemosiderin and Technetium-99 in sentinel lymph node biopsy in human breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vasques, Paulo Henrique Diogenes; Aquino, Ranniere Gurgel Furtado de; Pinheiro, Luiz Gonzaga Porto, E-mail: luizgporto@uol.com.br [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Departamento de Cirurgia; Alves, Mayara Maia [Rede Nordeste de Biotecnologia (RENORBIO/UFC), Fortaleza, CE (Brazil); Torres, Roberto Vitor Almeida; Bezerra, Jose Lucas Martins [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Faculdade de Medicina; Brasileiro, Luis Porto [Faculdades INTA, Sobral, CE (Brazil). Faculdade de Medicina

    2015-11-15

    Purpose: To assess the safety and potential equivalence of the use of hemosiderin compared to the Technetium-99 in sentinel lymph node biopsy in human breast cancer. Methods: Non-random sample of 14 volunteer women diagnosed with breast cancer with primary tumors (T1/T2) and clinically tumor-free axilla were submitted to the identification of sentinel lymph node using hemosiderin obtained from autologous blood injected in the periareolar region 24h before surgery on an outpatient basis. Patients received preoperative subareolar intradermal injection of Technetium-99 in the immediate preoperative period. Patients were submitted to sentinel lymph node biopsy, with incision in the axillary fold guided by Gamma-Probe, dissection by planes until the identification of the point of maximum uptake of Technetium-99, identifying the marked nodes and their colors. All surgical specimens were sent for pathological and immunohistochemical study. Results: The results showed no evidence of side effects and/or allergic and non-allergic reactions in patients submitted to SLNB with hemosiderin. The SLN identification rate per patient was 100%. SLNB identification rate per patient with hemosiderin was the same as that of Technetium, with a concordance rate of 100% between the methods. Conclusion: Hemosiderin is a safe dye that is equivalent to Technetium in breast sentinel lymph node biopsy. (author)

  17. Comparison of VMAT and IMRT strategies for cervical cancer patients using automated planning.

    Science.gov (United States)

    Sharfo, Abdul Wahab M; Voet, Peter W J; Breedveld, Sebastiaan; Mens, Jan Willem M; Hoogeman, Mischa S; Heijmen, Ben J M

    2015-03-01

    In a published study on cervical cancer, 5-beam IMRT was inferior to single arc VMAT. Here we compare 9, 12, and 20 beam IMRT with single and dual arc VMAT. For each of 10 patients, automated plan generation with the in-house Erasmus-iCycle optimizer was used to assist an expert planner in generating the five plans with the clinical TPS. For each patient, all plans were clinically acceptable with a high and similar PTV coverage. OAR sparing increased when going from 9 to 12 to 20 IMRT beams, and from single to dual arc VMAT. For all patients, 12 and 20 beam IMRT were superior to single and dual arc VMAT, with substantial variations in gain among the study patients. As expected, delivery of VMAT plans was significantly faster than delivery of IMRT plans. Often reported increased plan quality for VMAT compared to IMRT has not been observed for cervical cancer. Twenty and 12 beam IMRT plans had a higher quality than single and dual arc VMAT. For individual patients, the optimal delivery technique depends on a complex trade-off between plan quality and treatment time that may change with introduction of faster delivery systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Comparison of VMAT and IMRT strategies for cervical cancer patients using automated planning

    International Nuclear Information System (INIS)

    Sharfo, Abdul Wahab M.; Voet, Peter W.J.; Breedveld, Sebastiaan; Mens, Jan Willem M.; Hoogeman, Mischa S.; Heijmen, Ben J.M.

    2015-01-01

    Background and purpose: In a published study on cervical cancer, 5-beam IMRT was inferior to single arc VMAT. Here we compare 9, 12, and 20 beam IMRT with single and dual arc VMAT. Material and methods: For each of 10 patients, automated plan generation with the in-house Erasmus-iCycle optimizer was used to assist an expert planner in generating the five plans with the clinical TPS. Results: For each patient, all plans were clinically acceptable with a high and similar PTV coverage. OAR sparing increased when going from 9 to 12 to 20 IMRT beams, and from single to dual arc VMAT. For all patients, 12 and 20 beam IMRT were superior to single and dual arc VMAT, with substantial variations in gain among the study patients. As expected, delivery of VMAT plans was significantly faster than delivery of IMRT plans. Conclusions: Often reported increased plan quality for VMAT compared to IMRT has not been observed for cervical cancer. Twenty and 12 beam IMRT plans had a higher quality than single and dual arc VMAT. For individual patients, the optimal delivery technique depends on a complex trade-off between plan quality and treatment time that may change with introduction of faster delivery systems

  19. National Comparison of Hospital Performances in Lung Cancer Surgery: The Role Of Casemix Adjustment.

    Science.gov (United States)

    Beck, Naomi; Hoeijmakers, Fieke; van der Willik, Esmee M; Heineman, David J; Braun, Jerry; Tollenaar, Rob A E M; Schreurs, Wilhelmina H; Wouters, Michel W J M

    2018-04-03

    When comparing hospitals on outcome indicators, proper adjustment for casemix (a combination of patient- and disease characteristics) is indispensable. This study examines the need for casemix adjustment in evaluating hospital outcomes for Non-Small Cell Lung Cancer (NSCLC) surgery. Data from the Dutch Lung Cancer Audit for Surgery was used to validate factors associated with postoperative 30-day mortality and complicated course with multivariable logistic regression models. Between-hospital variation in casemix was studied by calculating medians and interquartile ranges for separate factors on hospital level and the 'expected' outcomes per hospital as a composite measure. 8040 patients, distributed over 51 Dutch hospitals were included for analysis. Mean observed postoperative mortality and complicated course were 2.2% and 13.6% respectively. Age, ASA-classification, ECOG performance score, lung function, extent of resection, tumor stage and postoperative histopathology were individual significant predictors for both outcomes of postoperative mortality and complicated course. A considerable variation of these casemix factors between hospital-populations was observed, with the expected mortality and complicated course per hospital ranging from 1.4 to 3.2% and 11.5 to 17.1%. The between-hospital variation in casemix of patients undergoing surgery for NSCLC emphasizes the importance of proper adjustment when comparing hospitals on outcome indicators. Copyright © 2018. Published by Elsevier Inc.

  20. Laparoscopy vs robotics in surgical management of endometrial cancer: comparison of intraoperative and postoperative complications.

    Science.gov (United States)

    Seror, Julien; Bats, Anne-Sophie; Huchon, Cyrille; Bensaïd, Chérazade; Douay-Hauser, Nathalie; Lécuru, Fabrice

    2014-01-01

    To compare the rates of intraoperative and postoperative complications of robotic surgery and laparoscopy in the surgical treatment of endometrial cancer. Unicentric retrospective study (Canadian Task Force classification II-2). Tertiary teaching hospital. The study was performed from January 2002 to December 2011 and included patients with endometrial cancer who underwent laparoscopic or robotically assisted laparoscopic surgical treatment. Data collected included preoperative data, tumor characteristics, intraoperative data (route of surgery, surgical procedures, and complications), and postoperative data (early and late complications according to the Clavien-Dindo classification, and length of hospital stay). Morbidity was compared between the 2 groups. The study included 146 patients, of whom 106 underwent laparoscopy and 40 underwent robotically assisted surgery. The 2 groups were comparable in terms of demographic and preoperative data. Intraoperative complications occurred in 9.4% of patients who underwent laparoscopy and in none who underwent robotically assisted surgery (p = .06). There was no difference between the 2 groups in terms of postoperative events. Robotically assisted surgery is not associated with a significant difference in intraoperative and postoperative complications, even when there were no intraoperative complications of robotically assisted surgery. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  1. Circulating tumor cell detection: A direct comparison between negative and unbiased enrichment in lung cancer.

    Science.gov (United States)

    Xu, Yan; Liu, Biao; Ding, Fengan; Zhou, Xiaodie; Tu, Pin; Yu, Bo; He, Yan; Huang, Peilin

    2017-06-01

    Circulating tumor cells (CTCs), isolated as a 'liquid biopsy', may provide important diagnostic and prognostic information. Therefore, rapid, reliable and unbiased detection of CTCs are required for routine clinical analyses. It was demonstrated that negative enrichment, an epithelial marker-independent technique for isolating CTCs, exhibits a better efficiency in the detection of CTCs compared with positive enrichment techniques that only use specific anti-epithelial cell adhesion molecules. However, negative enrichment techniques incur significant cell loss during the isolation procedure, and as it is a method that uses only one type of antibody, it is inherently biased. The detection procedure and identification of cell types also relies on skilled and experienced technicians. In the present study, the detection sensitivity of using negative enrichment and a previously described unbiased detection method was compared. The results revealed that unbiased detection methods may efficiently detect >90% of cancer cells in blood samples containing CTCs. By contrast, only 40-60% of CTCs were detected by negative enrichment. Additionally, CTCs were identified in >65% of patients with stage I/II lung cancer. This simple yet efficient approach may achieve a high level of sensitivity. It demonstrates a potential for the large-scale clinical implementation of CTC-based diagnostic and prognostic strategies.

  2. COMPARISON OF HYPOFRACTIONATED RADIATION THERAPY VERSUS CONVENTIONAL RADIATION THERAPY IN POST MASTECTOMY BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Abhilash

    2016-03-01

    Full Text Available INTRODUCTION Breast cancer is the most common cancer in women worldwide and a leading cause of cancer death in females and accounts for 1.8 million new cases and approximately 0.5 million deaths annually. Patients who present with locally advanced breast cancer (LABC require multidisciplinary team approach that incorporates diagnostic imaging, surgery, chemotherapy and histopathological assessment, including molecular-based studies, radiation, and, if indicated, biologic and hormonal therapies. Hypofractionated radiation therapy following mastectomy has been used in many institutions for several decades and have demonstrated equivalent local control, cosmetic and normal tissues between 50 Gy in 25 fractions and various hypofractionated radiotherapy prescriptions employing 13-16 fractions. Evidence suggests that hypofractionated radiotherapy may also be safe and effective for regional nodal disease. AIMS AND OBJECTIVES To compare the local control and side effects of hypofractionated radiation therapy with conventional radiation therapy in post mastectomy carcinoma breast with stage II and III and to compare the tolerability and compliance of both schedules. MATERIALS AND METHODS The study was conducted on 60 histopathologically proven patients of carcinoma of breast, treated surgically with modified radical mastectomy. Group I patients were given external radiation to chest flap and drainage areas, a dose of 39 Gy/13 fractions/3.1 weeks, a daily dose 3 Gy for 13 fractions in 4 days a week schedule and Group II patients were given external radiation to chest flap and drainage areas, a dose of 50 Gy/25 fractions/5 weeks, to receive a daily dose 2 Gy for 25 fractions in a 5 days a week schedule. RESULTS The median age at presentation in Group I and II was 48 and 50 years respectively. Locoregional control after completion of radiotherapy in Group I vs. Group II was 26/30 (86.7% vs. 27/30 (90% respectively. Acute reactions and their grades in Group

  3. Indirect Taxes and Public Debt in the 'World of Islam' before 1800

    NARCIS (Netherlands)

    Fritschy, W.; S. Cavaciocchi,

    2008-01-01

    Indirect taxes and public debt in the ‘world of Islam’ before 1800. A comparison of Western and Islamic public finance. Wantje Fritschy – Vrije Universiteit Amsterdam – June 2007 The ‘world of islam’ and ‘the West’ before 1800 seem to have displayed different ‘fiscal values’: not only was it

  4. Comparison of imaging diagnosis of pyogenic abscess and inflammatory cancer in the breast: focused on MRI

    International Nuclear Information System (INIS)

    Ko, Mi Gyoung; Chung, Soo Young; Yang, Ik; Park, Jong Ho; Lee, Kyung Won; Lee, Yul; Chung, Bong Wha; Kim, Jong Hyun

    1999-01-01

    To compare the radiologic findings of pyogenic abscess(PA) and inflammatory cancer(IC) of the breast, as seen on mammograms, US, and MR images and to evaluate the usefulness of the differential diagnostic findings of MRI for differentiation of PA and IC of the breast. We retrospectively analyzed the mammographic, US and MR findings of nine histopathologically proven cases of PA and four cases of IC of the breast . Parenchymal density, mass density, skin thickening and calcification were evaluated by mammography, and the extent of lesion and its morphologic characteristics and changes of dermal lymphatics by US and MRI. The latter was also used to analyse signal intensity and enhancement pattern. Mammographic findings for both lesions were non-specific. US showed that the pyogenic abscess was a hypoechoic and anechoic complex lesion with posterior acoustic enhancement, while inflammatory cancer was a speculated lesion with a heterogeneous hypoechoic echotexture. On 3D-GRE dynamic enhanced MRI, PA was shown in six cases(66.7 %) to be a lesion with superficial periareolar involvement, in contrast to the deep parenchymal spread seen in all cases of IC. A central non-enhanced portion with an irregular thick peripheral enhanced rim was seen in eight cases of PA(88.9 %), and in all cases of IC an inhomogeneously enhanced spiculated lesion in parenchyma and a diffusely enhanced dermal and subcutaneous layer was apparent. An MRI time-intensity curve showed that the enhancement pattern was slow in five cases of PA(55.6 %) and irregular in four(44.4 %), while for IC it was rapid in three cases(33.3 %) and irregular in one(11.1 %). As compared with mammography and US, 3D-GRE dynamic MRI was a useful method for the differential diagnosis of PA and IC of the breast. The characteristic MR findings of PA were a central non-enhanced portion with an irregularly thick peripheral enhanced rim, located mainly in the superficial periareloar area and spreading into the parenchymal layer

  5. Comparison of imaging diagnosis of pyogenic abscess and inflammatory cancer in the breast: focused on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Mi Gyoung; Chung, Soo Young; Yang, Ik; Park, Jong Ho; Lee, Kyung Won; Lee, Yul; Chung, Bong Wha; Kim, Jong Hyun [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To compare the radiologic findings of pyogenic abscess(PA) and inflammatory cancer(IC) of the breast, as seen on mammograms, US, and MR images and to evaluate the usefulness of the differential diagnostic findings of MRI for differentiation of PA and IC of the breast. We retrospectively analyzed the mammographic, US and MR findings of nine histopathologically proven cases of PA and four cases of IC of the breast . Parenchymal density, mass density, skin thickening and calcification were evaluated by mammography, and the extent of lesion and its morphologic characteristics and changes of dermal lymphatics by US and MRI. The latter was also used to analyse signal intensity and enhancement pattern. Mammographic findings for both lesions were non-specific. US showed that the pyogenic abscess was a hypoechoic and anechoic complex lesion with posterior acoustic enhancement, while inflammatory cancer was a speculated lesion with a heterogeneous hypoechoic echotexture. On 3D-GRE dynamic enhanced MRI, PA was shown in six cases(66.7 %) to be a lesion with superficial periareolar involvement, in contrast to the deep parenchymal spread seen in all cases of IC. A central non-enhanced portion with an irregular thick peripheral enhanced rim was seen in eight cases of PA(88.9 %), and in all cases of IC an inhomogeneously enhanced spiculated lesion in parenchyma and a diffusely enhanced dermal and subcutaneous layer was apparent. An MRI time-intensity curve showed that the enhancement pattern was slow in five cases of PA(55.6 %) and irregular in four(44.4 %), while for IC it was rapid in three cases(33.3 %) and irregular in one(11.1 %). As compared with mammography and US, 3D-GRE dynamic MRI was a useful method for the differential diagnosis of PA and IC of the breast. The characteristic MR findings of PA were a central non-enhanced portion with an irregularly thick peripheral enhanced rim, located mainly in the superficial periareloar area and spreading into the parenchymal layer

  6. Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging.

    Science.gov (United States)

    Schilling, Kathy; Narayanan, Deepa; Kalinyak, Judith E; The, Juliette; Velasquez, Maria Victoria; Kahn, Simone; Saady, Matthew; Mahal, Ravinder; Chrystal, Larraine

    2011-01-01

    The objective of this study was to compare the performance characteristics of (18)F-fluorodeoxyglucose (FDG) positron emission mammography (PEM) with breast magnetic resonance imaging (MRI) as a presurgical imaging and planning option for index and ipsilateral lesions in patients with newly diagnosed, biopsy-proven breast cancer. Two hundred and eight women >25 years of age (median age = 59.7 ± 14.1 years) with biopsy-proven primary breast cancer enrolled in this prospective, single-site study. MRI, PEM, and whole-body positron emission tomography (WBPET) were conducted on each patient within 7 business days. PEM and WBPET images were acquired on the same day after intravenous administration of 370 MBq of FDG (median = 432.9 MBq). PEM and MRI images were blindly evaluated, compared with final surgical histopathology, and the sensitivity determined. Substudy analysis compared the sensitivity of PEM versus MRI in patients with different menopausal status, breast density, and use of hormone replacement therapy (HRT) as well as determination of performance characteristics for additional ipsilateral lesion detection. Two hundred and eight patients enrolled in the study of which 87% (182/208) were analyzable. Of these analyzable patients, 26.4% (48/182), 7.1% (13/182), and 64.2% (120/182) were pre-, peri-, and postmenopausal, respectively, and 48.4% (88/182) had extremely or heterogeneously dense breast tissue, while 33.5% (61/182) had a history of HRT use. Ninety-two percent (167/182) underwent core biopsy for index lesion diagnosis. Invasive cancer was found in 77.5% (141/182), while ductal carcinoma in situ (DCIS) and/or Paget's disease were found in 22.5% (41/182) of patients. Both PEM and MRI had index lesion depiction sensitivity of 92.8% and both were significantly better than WBPET (67.9%, p performance characteristics are not affected by patient menopausal/hormonal status or breast density.

  7. MR diffusion weighted imaging of gastric cancer: b-value determination and comparison with routine sequences

    International Nuclear Information System (INIS)

    Zhao Xiaopeng; Tang Lei; Sun Yingshi; Li Jie; Cao Kun

    2007-01-01

    Objective: To choose the optimal b-values for the DWI of gastric cancer (GC), and investigate the value of DWI in the diagnosis of GCs. Methods: MRI examinations (T 1 WI, T 2 WI, and DWI) were performed on 31 patients with gastric cancer. Three diffusion-weighted sequences were designed with different b values, including 300 s/mm 2 (low), 600 s/mm 2 (intermediate), and 1000 s/mm 2 (high). Free water grade was used to evaluate the suppression of content in gastric lumen. Background contrast grade was used to evaluate the discriminating ability of different sequences between GC and nearby tissues. The ADCs of GCs, nearby gastric wall region, and free water in gastric lumen were measured. SNR Ca , CNR Ca-GW and SIR CaGW of high b-value DWI and routine MRI sequences were evaluated and compared. Results: The signal intensity of free water in gastric lumen decreased as b-value increased, and the SIR were 8.11± 0.77 (b=300 s/mm 2 ), 2.70±0.35 (b=600 s/mm 2 ), and 1.13±0.22 (b=1000 s/mm 2 ) (F55.368, P 2 =16.692, P 2 =9.923, P -3 mm 2 /s, (1.43±0.41) x 10 -3 mm 2 /s, and (1.18±0.25) x 10 -3 mm 2 /s; (F=12.066, P 1 WI (CNR: 12.46 vs. 2.35, Z=-3.746, P 2 WI (CNR: 12.46 vs. 3.92, Z=-3.518, P 2 ) is reasonable for DWI of GCs, which can reflect diffusion condition of water molecules more accurately, suppress signal of content in gastric lumen, and possess higher contrast. DWI can be a supplementary method of routine MRI examination for better demonstration of gastric cancers. (authors)

  8. COMPARISON OF CONVENTIONAL RADIATIOTHERAPY AND ACCELERATED HYPERFRACTIONATED RADIATIOTHERAPY IN CHEMORADIATION TREATMENT FOR SMALL CELL LUNG CANCER

    Directory of Open Access Journals (Sweden)

    I. A. Gulidov

    2013-01-01

    Full Text Available The 5-year treatment outcomes of 69 patients with stage IIA–IIIA locally advanced small cell lung cancer have been presented. Accelerated hyperfractionated radiotherapy was administered in the uneven daily dose fractionation (single dose of 1 + 1,5 Gy with a 5–6hour interval to a total dose of 60–70 Gy depending on the health status and lung function. The complete response was achieved in 13 (42 % patients, the median survival was 28 months and the 5-year survival rate was 26,2 %. Grade III lung and pericardium toxicities (according to RTOG toxicity scale were observed in 3,2 % and 6,5 % of patients, respectively. No grade III–IV radiation-induced blood and esophageal damages were found.

  9. Dose comparison using deformed image registration method on breast cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Won; Kim, Jung Hoon [Dept. of Radiation Oncology, KonYang University Hospital, Daejeon (Korea, Republic of); Won, Young Jin [Dept. of Radiation Oncology, InJe University Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2017-03-15

    The purpose of this study is to reconstruct the treatment plan by applying CBCT and DIR to dose changes according to the change of the patient's motion and breast shape in the large breast cancer patients and to compare the doses using TWF, FIF and IMRT. CT and CBCT were performed with MIM6 to create DIRCT and each treatment plan was made. The patient underwent computed tomography simulation in both prone and supine position. The homogeneity index (HI), conformity index (CI), coverage index (CVI) to the left breast as planning target volume (PTV) were determined and the doses to the lung, heart, and right breast as organ at risk (OAR) were compared by using dose-volume histogram and the unique property of each organ. The value of HI of the PTV breast increased in all treatment planning methods using DIRCT, and CVI and CI were decreased in the treatment planning methods using DIRCT.

  10. Serum tumor marker CYFRA 21-1 in the diagnostics of squamous cell lung cancer - comparison with CEA

    International Nuclear Information System (INIS)

    Berzinec, P.; Letkovicova, M.; Arpasova, M.; Zuffova, H.

    1996-01-01

    The aim of the study was to test the diagnostic value tumor marker CYFRA 21-1 for squamous cell lung cancer (SQCLC) in comparison with carcinoembryonic antigen (CEA). Ninety-one patients were induced in this study: 56 with SQCLC - Group I, 25 with other types of lung cancer - Group II, 10 with benign respiratory tract diseases - Group III. Median CYFRA 21-1 serum concentration (ng/ml) was: in Group I: 4.52 (0.94 - >16), in Group II: 3.58 (1.72 - >16), in Group III: 2.05 (0.99 - 3.41). Median CEA serum concentration (ng/ml) was: in Group I: 4.49 (076- >20), in Group II: 3.32 (1.17 - >20), in Group III: 3.09 (1.84 - 6.37). There was a highly significant difference between the levels of CYFRA 21-1 in group I and Group III (p < 0.001), but there was no statistically significant difference between the levels of CEA in Group I and III. Sensitivity of CYFRA 21-1 by the cut-off 3.33 ng/ml in the diagnostics of SQCLC was 0.68, specificity 0.090, positive predictive value 0.91, negative predictive value 0.65. Sensitivity of CEA by cut-off 4.61 ng/ml was 0.5 by the same specificity 0.90. CYFRA 21-1 has high sensitivity, specificity and positive predictive value in the diagnostics of SQCLC. Sensitivity of CYFRA 21-1 is significantly higher than sensitivity of CEA in this settings. (author)

  11. Randomized comparison of surgical stress and the nutritional status between laparoscopy-assisted and open distal gastrectomy for gastric cancer.

    Science.gov (United States)

    Aoyama, Toru; Yoshikawa, Takaki; Hayashi, Tsutomu; Hasegawa, Shinichi; Tsuchida, Kazuhito; Yamada, Takanobu; Cho, Haruhiko; Ogata, Takashi; Fujikawa, Hirohito; Yukawa, Norio; Oshima, Takashi; Rino, Yasushi; Masuda, Munetaka

    2014-06-01

    Laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy (ODG). This study was performed as an exploratory analysis of a phase III trial comparing LADG and ODG for stage I gastric cancer during the period between May and December of 2011. All patients received the same perioperative care via fast-track surgery. The level of surgical stress was evaluated based on the white blood cell count and the interleukin-6 (IL-6) level. The nutritional status was measured according to the total body weight, amount of lean body mass, lymphocyte count, and prealbumin level. Twenty-six patients were randomized to receive ODG (13 patients) or LADG (13 patients). The baseline characteristics and surgical outcomes were similar between the two groups. The median IL-6 level increased from 0.8 to 36.3 pg/dl in the ODG group and from 1.5 to 53.3 pg/dl in the LADG group. The median amount of lean body mass decreased from 48.3 to 46.8 kg in the ODG group and from 46.6 to 46.0 kg in the LADG group. There are no significant differences between two groups. The level of surgical stress and the nutritional status were found to be similar between the ODG and LADG groups in a randomized comparison using the same perioperative care of fast-track surgery.

  12. Electroglottographic Comparison of Voice Outcomes in Patients With Advanced Laryngopharyngeal Cancer Treated by Chemoradiotherapy or Total Laryngectomy

    International Nuclear Information System (INIS)

    Kazi, Rehan; Venkitaraman, Ramachandran; Johnson, Catherine; Prasad, Vyas; Clarke, Peter; Rhys-Evans, Peter; Nutting, Christopher M.; Harrington, Kevin J.

    2008-01-01

    Purpose: To conduct prospective electroglottographic analyses of voice outcomes after radical chemoradiotherapy for locally advanced laryngopharyngeal cancers and to compare them with patients who have undergone total laryngectomy (TL). Patients and Methods: Twenty-one patients (19 male, 2 female, median age [range] 65 [50-85] years) with Stage III/IV laryngopharyngeal cancer received induction chemotherapy followed by radical chemoradiotherapy. Electroglottography, using the sustained vowel /i/ and connected speech, was performed before treatment and 1, 6, and 12 months after treatment. In addition, single voice recordings were taken from 21 patients (16 male, 5 female, aged 65 [50-84] years) who had undergone TL and surgical voice restoration and from 21 normal controls (18 male, 3 female, aged 65 [33-80] years). Results: Before treatment the vocal measures for the chemoradiotherapy patients were significantly different from normal controls in jitter (p = 0.02), maximum phonation time (MPT) (p = 0.001), and words per minute (WPM) (p = 0.01). At 12 months after treatment MPT and WPM had normalized, but jitter and normalized noise energy were significantly worse than in normal controls. Comparison of voice outcomes at 12 months for chemoradiotherapy patients revealed superiority over the TL group in all parameters except MPT (18.2 s vs. 10.4 s, p = 0.06). Analysis of the recovery of voice up to 12 months after treatment revealed progressive improvement in most electroglottographic measures. Conclusions: This prospective study demonstrates significantly better outcome for patients treated with chemoradiotherapy as compared with TL. Progressive normalization of many voice parameters occurs over the 12 months following chemoradiotherapy

  13. Comparison of nutritional status assessment parameters in predicting length of hospital stay in cancer patients.

    Science.gov (United States)

    Mendes, J; Alves, P; Amaral, T F

    2014-06-01

    Undernutrition has been associated with an increased length of hospital stay which may reflect the patient prognosis. The aim of this study was to quantify and compare the association between nutritional status and handgrip strength at hospital admission with time to discharge in cancer patients. An observational prospective study was conducted in an oncology center. Patient-Generated Subjective Global Assessment, Nutritional Risk Screening 2002 and handgrip strength were conducted in a probabilistic sample of 130 cancer patients. The association between baseline nutritional status, handgrip strength and time to discharge was evaluated using survival analysis with discharge alive as the outcome. Nutritional risk ranged from 42.3 to 53.1% depending on the tool used. According to Patient-Generated Subjective Global Assessment severe undernutrition was present in 22.3% of the sample. The association between baseline data and time to discharge was stronger in patients with low handgrip strength (adjusted hazard ratio, low handgrip strength: 0.33; 95% confidence interval: 0.19-0.55), compared to undernourished patients evaluated by the other tools; Patient-Generated Subjective Global Assessment: (adjusted hazard ratio, severe undernutrition: 0.45; 95% confidence interval: 0.27-0.75) and Nutritional Risk Screening 2002: (adjusted hazard ratio, with nutritional risk: 0.55; 95% confidence interval: 0.37-0.80). An approximate 3-fold decrease in probability of discharge alive was observed in patients with low handgrip strength. Decreasing handgrip strength tertiles allowed to discriminate between patients who will have longer hospital stay, as well as undernutrition and nutritional risk assessed by Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. Comparison of 5-fluorouracil/leucovorin and capecitabine in preoperative chemoradiotherapy for locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Kim, Dae Yong; Jung, Kyung Hae; Kim, Tae Hyun; Kim, Duck-Woo; Chang, Hee Jin; Jeong, Jun Yong; Kim, Young Hoon; Son, Seok-Hyun; Yun, Tak; Hong, Chang Won; Sohn, Dae Kyung; Lim, Seok-Byung; Choi, Hyo Seong; Jeong, Seung-Yong; Park, Jae-Gahb

    2007-01-01

    Purpose: To describe our experience with a bolus injection of 5-fluorouracil and leucovorin (FL) vs. capecitabine in terms of radiologic and pathologic findings in preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer. Methods: The study enrolled 278 patients scheduled for preoperative CRT using two protocols with different chemotherapeutic regimens. Pelvic radiotherapy (50.4 Gy) was delivered concurrently with FL (n = 145) or capecitabine (n = 133). Surgery was performed 6 weeks after CRT completion. Tumor responses to CRT were measured using both radiologic and pathologic examination. Magnetic resonance volumetry was performed at the initial workup and just before surgery after completion of preoperative CRT. Post-CRT pathology tests were used to determine tumor stage and regression. Results: Radiologic examination showed that tumor volume decreased by 68.2% ± 20.5% in the FL group and 68.3% ± 22.3% in the capecitabine group (p = 0.970). Postoperative pathologic T stage determination showed that downstaging occurred in 44.3% of FL and 49.9% of capecitabine patients (p = 0.571). The tumor regression grades after CRT were Grade 1 (minimal response) in 22.6% and 21.0%, Grade 2 (moderate response) in 53.2% and 50.0%, Grade 3 (near-complete response) in 12.9% and 12.9%, and Grade 4 (complete response) in 11.3% and 16.1% of the FL and capecitabine groups, respectively (p = 0.758). Conclusion: In the present study, the radiologic and pathologic findings did not reveal significant differences in short-term tumor responses between preoperative FL and capecitabine CRT for locally advanced rectal cancer. Long-term results and a prospective randomized trial are needed

  15. Comparison of setup deviations for two thermoplastic immobilization masks in glottis cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jae Hong [Dept. of Biomedical Engineering, College of Medicine, The Catholic University, Seoul (Korea, Republic of)

    2017-03-15

    The purpose of this study was compare to the patient setup deviation of two different type thermoplastic immobilization masks for glottis cancer in the intensity-modulated radiation therapy (IMRT). A total of 16 glottis cancer cases were divided into two groups based on applied mask type: standard or alternative group. The mean error (M), three-dimensional setup displacement error (3D-error), systematic error (Σ), random error (σ) were calculated for each group, and also analyzed setup margin (mm). The 3D-errors were 5.2 ± 1.3 mm and 5.9 ± 0.7 mm for the standard and alternative groups, respectively; the alternative group was 13.6% higher than the standard group. The systematic errors in the roll angle and the x, y, z directions were 0.8°, 1.7 mm, 1.0 mm, and 1.5 mm in the alternative group and 0.8°, 1.1 mm, 1.8 mm, and 2.0 mm in the alternative group. The random errors in the x, y, z directions were 10.9%, 1.7%, and 23.1% lower in the alternative group than in the standard group. However, absolute rotational angle (i.e., roll) in the alternative group was 12.4% higher than in the standard group. For calculated setup margin, the alternative group in x direction was 31.8% lower than in standard group. In contrast, the y and z direction were 52.6% and 21.6% higher than in the standard group. Although using a modified thermoplastic immobilization mask could be affect patient setup deviation in terms of numerical results, various point of view for an immobilization masks has need to research in terms of clinic issue.

  16. A dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Reid F.; Zhai, Huifang; Both, Stefan; Metz, James M.; Plastaras, John P.; Ben-Josef, Edgar, E-mail: Edgar.Ben-Josef@uphs.upenn.edu [University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Mayekar, Sonal U. [Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States); Apisarnthanarax, Smith [University of Washington, Seattle, Washington 98109 (United States)

    2014-08-15

    Purpose: Uncontrolled local growth is the cause of death in ∼30% of patients with unresectable pancreatic cancers. The addition of standard-dose radiotherapy to gemcitabine has been shown to confer a modest survival benefit in this population. Radiation dose escalation with three-dimensional planning is not feasible, but high-dose intensity-modulated radiation therapy (IMRT) has been shown to improve local control. Still, dose-escalation remains limited by gastrointestinal toxicity. In this study, the authors investigate the potential use of double scattering (DS) and pencil beam scanning (PBS) proton therapy in limiting dose to critical organs at risk. Methods: The authors compared DS, PBS, and IMRT plans in 13 patients with unresectable cancer of the pancreatic head, paying particular attention to duodenum, small intestine, stomach, liver, kidney, and cord constraints in addition to target volume coverage. All plans were calculated to 5500 cGy in 25 fractions with equivalent constraints and normalized to prescription dose. All statistics were by two-tailed paired t-test. Results: Both DS and PBS decreased stomach, duodenum, and small bowel dose in low-dose regions compared to IMRT (p < 0.01). However, protons yielded increased doses in the mid to high dose regions (e.g., 23.6–53.8 and 34.9–52.4 Gy for duodenum using DS and PBS, respectively; p < 0.05). Protons also increased generalized equivalent uniform dose to duodenum and stomach, however these differences were small (<5% and 10%, respectively; p < 0.01). Doses to other organs-at-risk were within institutional constraints and placed no obvious limitations on treatment planning. Conclusions: Proton therapy does not appear to reduce OAR volumes receiving high dose. Protons are able to reduce the treated volume receiving low-intermediate doses, however the clinical significance of this remains to be determined in future investigations.

  17. POPULATION BASED COLORECTAL CANCER SCREENING: COMPARISON OF TWO FAECAL OCCULT BLOOD TESTS

    Directory of Open Access Journals (Sweden)

    Miren Begoña eZubero

    2014-01-01

    Full Text Available Background: The aim of screening for colorectal cancer is to improve prognosis by the detection of cancer at its early stages. In order to inform the decision on the specific test to be used in the population-based programme in the Basque Autonomous Region (Spain, we compared two immunochemical faecal occult blood quantitative tests (I-FOBT. Methods: Residents of selected study areas, aged 50-69 years, were invited to participate in the screening. Two tests based on latex agglutination (OC-Sensor and FOB Gold were randomly assigned to different study areas. A colonoscopy was offered to patients with a positive test result. The cut-off point used to classify a result as positive, according to manufacturer’s recommendations, was 100 ng/ml for both tests. Results: The invited population included 37,999 individuals. Participation rates were 61.8% (n=11,162 for OC-Sensor and 59.1% (n=11,786 for FOB Gold, (p=0.008. Positive rate for OC-Sensor was 6.6% (n=737 and 8.5% (n=1,002 for FOB Gold, (pConclusions: OC-Sensor test appears to be superior for I-FOBT based CRC screening, given its acceptance, ease of use, associated small number of errors and its screening accuracy. FOB-Gold on the other hand, has higher rate of positive values, with more colonoscopies performed, it shows higher detection incidence rates, but involves more false positives.

  18. Colorectal cancer staging: comparison of whole-body PET/CT and PET/MR.

    Science.gov (United States)

    Catalano, Onofrio A; Coutinho, Artur M; Sahani, Dushyant V; Vangel, Mark G; Gee, Michael S; Hahn, Peter F; Witzel, Thomas; Soricelli, Andrea; Salvatore, Marco; Catana, Ciprian; Mahmood, Umar; Rosen, Bruce R; Gervais, Debra

    2017-04-01

    Correct staging is imperative for colorectal cancer (CRC) since it influences both prognosis and management. Several imaging methods are used for this purpose, with variable performance. Positron emission tomography-magnetic resonance (PET/MR) is an innovative imaging technique recently employed for clinical application. The present study was undertaken to compare the staging accuracy of whole-body positron emission tomography-computed tomography (PET/CT) with whole-body PET/MR in patients with both newly diagnosed and treated colorectal cancer. Twenty-six patients, who underwent same day whole-body (WB) PET/CT and WB-PET/MR, were evaluated. PET/CT and PET/MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Correct staging was compared between methods using McNemar's Chi square test. The two methods were in agreement and correct for 18/26 (69%) patients, and in agreement and incorrect for one patient (3.8%). PET/MR and PET/CT stages for the remaining 7/26 patients (27%) were discordant, with PET/MR staging being correct in all seven cases. PET/MR significantly outperformed PET/CT overall for accurate staging (P = 0.02). PET/MR outperformed PET/CT in CRC staging. PET/MR might allow accurate local and distant staging of CRC patients during both at the time of diagnosis and during follow-up.

  19. Comparison of long-term follow up of laparoscopic versus open colectomy for transverse colon cancer.

    Science.gov (United States)

    Agarwal, Samir; Gincherman, Mikhail; Birnbaum, Elisa; Fleshman, James W; Mutch, Matthew

    2015-07-01

    Clinical Outcomes of Surgical Therapy (COST) was a landmark study demonstrating that laparoscopic-assisted colectomy had oncologic outcomes similar to those of open colectomy for colon cancer, but transverse colon cancers (TCCs) were excluded from that study. Oncologic results of a laparoscopic resection for TCC are unknown. This single-institution retrospective 3:1 case-matched review examined patients treated for TCC from January 1, 1996, to April 15, 2009. Laparoscopic colectomy (LC) and open colectomy (OC; extended right, extended left, and total abdominal) cases completed for Stage I to III adenocarcinoma of the transverse colon (hepatic flexure, transverse colon, and splenic flexure) were analyzed. Patients were matched for age, tumor location, and stage. Primary endpoints were overall survival and disease-free survival. Secondary endpoints were length of stay and pathologic parameters. One hundred and twenty-three OC cases were matched with 41 LC cases. There were four conversions (9.7%) in the LC group. Length of stay was reduced by 28% in the LC group (P = 0.02). Complication rate and severity were similar between the two groups (29% vs 24%; P = 0.68). Lymph node harvest was higher in the LC group than in the OC group (23.3 vs 18.6; P = 0.03). All pathologic margins were clear, and no local recurrence was found in either group. Five-year overall survival (61% vs 59%; P = 0.39) and disease-free survival (88% vs 82%; P = 0.23) were similar in the two groups. Short-term recovery was faster and lymph node harvest was improved in the LC group. Thus, laparoscopic management of TCC is a safe and feasible procedure.

  20. Dosimetric Comparison of Three Dimensional Conformal Radiation Radiotherapy and Helical Tomotherapy Partial Breast Cancer

    International Nuclear Information System (INIS)

    Kim, Dae Woong; Kim, Jong Won; Choi, Yun Kyeong; Kim, Jung Soo; Hwang, Jae Woong; Jeong, Kyeong Sik; Choi, Gye Suk

    2008-01-01

    The goal of radiation treatment is to deliver a prescribed radiation dose to the target volume accurately while minimizing dose to normal tissues. In this paper, we comparing the dose distribution between three dimensional conformal radiation radiotherapy (3D-CRT) and helical tomotherapy (TOMO) plan for partial breast cancer. Twenty patients were included in the study, and plans for two techniques were developed for each patient (left breast:10 patients, right breast:10 patients). For each patient 3D-CRT planning was using pinnacle planning system, inverse plan was made using Tomotherapy Hi-Art system and using the same targets and optimization goals. We comparing the Homogeneity index (HI), Conformity index (CI) and sparing of the organs at risk for dose-volume histogram. Whereas the HI, CI of TOMO was significantly better than the other, 3D-CRT was observed to have significantly poorer HI, CI. The percentage ipsilateral non-PTV breast volume that was delivered 50% of the prescribed dose was 3D-CRT (mean: 40.4%), TOMO (mean: 18.3%). The average ipsilateral lung volume percentage receiving 20% of the PD was 3D-CRT (mean: 4.8%), TOMO (mean: 14.2), concerning the average heart volume receiving 20% and 10% of the PD during treatment of left breast cancer 3D-CRT (mean: 1.6%, 3.0%), TOMO (mean: 9.7%, 26.3%) In summary, 3D-CRT and TOMO techniques were found to have acceptable PTV coverage in our study. However, in TOMO, high conformity to the PTV and effective breast tissue sparing was achieved at the expense of considerable dose exposure to the lung and heart.

  1. Comparison of monoclonal antibodies and tritiated ligands for estrogen receptor assays in 241 breast cancer cytosols

    International Nuclear Information System (INIS)

    Goussard, J.; Lechevrel, C.; Martin, P.M.; Roussel, G.

    1986-01-01

    Estrogen receptor determinations have been performed on 241 cytosols from 160 breast cancer tumors using both radioactive ligands ([ 3 H]-estradiol, [3H]R2858) and monoclonal antibodies (Abbott ER-EIA Kit) to compare the two methods and to evaluate the clinical usefulness of the new immunological, simplified assay. Intra- and interassay reproducibility of the enzyme immunoassay (EIA) method was studied during a 6-month period on 35 standard curves with 4 different batches of monoclonal antibodies. Intraassay coefficients of variation studied on duplicates were smaller than 5% in most cases and reproducibility of the curves showed coefficients of variation lower than 10% except for standard 0 and 5 fmol/ml. Pooled cytosols used as control for the dextran coated charcoal method had interassay variation coefficients between 3.8 and 11.4%. Reproducibility has been studied on clinical specimens assayed twice at two different periods with either EIA or dextran coated charcoal methods. Slopes obtained were 1.05 and 0.96, respectively. A good stability of EIA results was obtained with protein concentrations in the range 4-0.15 mg/ml cytosol. No significant effects of dithiothreitol or monothioglycerol (1 mM) on EIA and dextran coated charcoal assay were observed. Eighty breast cancer cytosols were assayed with both EIA and Scatchard analysis. The slope of the regression curve obtained was 1.04 (r = 0.963). Cytosols were assayed by EIA and by a saturating concentration of tritiated ligand (5 nM). With 153 cytosols the EIA/5 nM slope was 1.34 (r = 0.978). This slope can be compared with the slope Scatchard/5 nM obtained with 90 cytosols: 1.29 (r = 0.985). Absence of cross-reactivity of monoclonal ER antibodies with progesterone receptor was observed

  2. Diffusion weighted imaging in patients with rectal cancer: Comparison between Gaussian and non-Gaussian models.

    Directory of Open Access Journals (Sweden)

    Georgios C Manikis

    Full Text Available The purpose of this study was to compare the performance of four diffusion models, including mono and bi-exponential both Gaussian and non-Gaussian models, in diffusion weighted imaging of rectal cancer.Nineteen patients with rectal adenocarcinoma underwent MRI examination of the rectum before chemoradiation therapy in