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Sample records for carcinoma institutional experience

  1. Translocation Renal Cell Carcinomas in Adults: A Single Institution Experience

    OpenAIRE

    Zhong, Minghao; De Angelo, Patricia; Osborne, Lisa; Mondolfi, Paniz; Geller, Matthew; Yang, Youfeng; Linehan, W. Marston; Merino, Maria J.; Cordon-Cardo, Carlos; Cai, Dongming

    2012-01-01

    Translocation renal cell carcinoma is a newly recognized subtype of renal cell carcinoma (RCC) with chromosomal translocations involving TFE3 (Xp11.2) or, less frequently, TFEB (6p21). Xp11 translocation RCC was originally described as a pediatric neoplasm representing 20–40% of pediatric RCCs with a much lower frequency in the adult population. TFEB translocation RCC is very rare, with approximately 10 cases reported in the literature. Here, we describe the clinicopathological features of ad...

  2. Epidemiology and management of breast carcinoma in Egyptian males: Experience of a single Cancer Institute

    International Nuclear Information System (INIS)

    To assess the epidemiological and clinico-pathological features, surgical and reconstructive techniques, adjuvant treatments and clinical outcome of breast carcinoma in males (BCM) at the Egyptian National Cancer Institute (NCI). Patients and methods: Thirty-two males with breast carcinoma presented to NCI between January 2000 and December 2002. They were evaluated by complete history, physical examination, laboratory and radiological investigations. Results: Median age was 59 years. Left sided and retroareolar breast lumps were the commonest presentations. Grade 11 tumors positive for hormone receptors were very common. Stage I, II, 111 and IV disease were encountered in 6.2%, 34.4%, 34.4% and 25.0% of patients, respectively. Curative surgery was done in 22 patients; they received adjuvant hormonal therapy, chemotherapy and radiotherapy in 22,16 and 10 patients, respectively. Eight metastatic patients were treated with palliative measures. Surgery was done in 25 patients; the most common procedure was modified radical mastectomy (40.6%). Primary closure was feasible in 17 patients (68%), local flaps were needed in 4 cases (16%), while myocutaneous flap was done in 3 cases (12%). The commonest complication was development of seroma (9 cases). The overall survival (OS) at 5 years was 65.4%. The disease free survival (DPS) at 5 years was 53.9%. Stage and curative surgery significantly affected OS, while type of surgery was the only variable significantly affecting DPS. Conclusion: Male breast carcinoma occurs at older ages than females, usually in advanced stage. This necessitates directing attention of males and awareness on the prevalence and risk factors for this disease.needed in 4 cases (16%), while myocutaneous flap was done in 3 cases (12%). The commonest complication was development of seroma (9 cases). The overall survival (OS) at 5 years was 65.4%. The disease free survival (DPS) at 5 years was 53.9%. Stage and curative surgery significantly affected OS

  3. Nasopharyngeal carcinoma in children and adolescents - a single institution experience of 158 patients

    International Nuclear Information System (INIS)

    To evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents. Between January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient’s clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed. There were 9 (5.7%) patients in stage II, 60 (38.0%) in stage III and 89 (56.3%) in stage IV according to the UICC2002 staging system. Neck mass (32.3%), headache (21.5%) and nasal obstruction (15.2%) were the most common chief complaints. With a median follow-up time of 62.5 months (range 2.0-225.0 months), the 5-year overall survival (OS) rate, local-regional control (LRC) rate and distant metastasis-free survival (DMFS) rate were 82.6%, 94.9% and 76.4%, respectively. There were 43 (27.2%) patients failed during the follow up, with seven local-regional recurrences and 38 distant metastases. In univariate analysis, the 5-year OS of T4 and T1-3 were 75% and 87.9%, p = 0.01, stage IV and stage II-III were 77.1% and 90%, p = 0.04, respectively. In multivariate analysis, T4 (p = 0.02) and stage IV (p = 0.04) were the independent adverse prognostic factors for OS. Significant reduction in trismus (27.3% v 3.6%, p = 0.03) and G2 xerostomia (37.9% v 10.3%, p = 0.02) was observed in patients treated by IMRT. Most childhood and adolescence nasopharyngeal carcinoma patients were locally advanced diseases at first diagnosed. The treatment results of radiotherapy, with or without chemotherapy, are excellent in our institution. Reducing distant metastasis with new strategies and late toxicities with intensity-modulated radiotherapy are the future directions for the treatment of adolescent nasopharyngeal carcinoma

  4. Actual Incidence and Clinical Behaviour of Follicular Thyroid Carcinoma: An Institutional Experience

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    Carmela De Crea

    2014-01-01

    Full Text Available Follicular thyroid carcinoma classically accounts for 10–32% of thyroid malignancies. We determined the incidence and the behaviour of follicular thyroid carcinoma in an endemic goitre area. A comparative analysis between minimally invasive and widely invasive follicular thyroid carcinoma was performed. The medical records of all patients who underwent thyroidectomy from October 1998 to April 2012 for thyroid malignancies were reviewed. Those who had a histological diagnosis of follicular carcinoma were included. Among 5203 patients, 130 (2.5% were included. Distant metastases at presentation were observed in four patients. Sixty-six patients had a minimally invasive follicular carcinoma and 64 a widely invasive follicular carcinoma. In 63 patients an oxyphilic variant was registered. Minimally/widely invasive ratio was 41/26 for usual follicular carcinoma and 25/38 for oxyphilic variant (P<0.05. Patients with widely invasive tumors had larger tumors (P<0.001 and more frequently oxyphilic variant (P<0.05 than those with minimally invasive tumours. No significant difference was found between widely invasive and minimally invasive tumors and between usual follicular carcinoma and oxyphilic variant regarding the recurrence rate (P=NS. The incidence of follicular thyroid carcinoma is much lower than classically retained. Aggressive treatment, including total thyroidectomy and radioiodine ablation, should be proposed to all patients.

  5. Difference between papillar y and follicular thyroid carcinoma outcomes:an experience from Egyptian institution

    Institute of Scientific and Technical Information of China (English)

    Engy M Aboelnaga; Rehab Allah Ahmed

    2015-01-01

    Objective:Differentiated thyroid carcinomas (DTCs) are classiifed into papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). DTCs are analyzed as a single group in clinical studies that investigated the prognostic factors and prognosis of these malignancies. However, the biological behaviors of these carcinomas signiifcantly differ. In the present study, we aimed to detect differences in the outcomes between PTC and FTC in Mansoura University Hospital in Egypt. Methods:A total of 558 patients with histologically proven thyroid carcinomas from January 2003 to December 2012 were retrospectively enrolled. hTe clinical and pathological data of patients were reviewed. Results:Large primary tumor size, lymph node involvement, extrathyroid extension, and distant metastasis were signiifcant poor prognostic factors for overall survival (OS) in old PTC patients. Cox hazard analysis showed that the patient’s age, extra thyroid extension, and distant metastasis were the only independent prognostic factors. In FTC patients, only the distant metastasis and degree of tumor invasion were signiifcant poor prognostic factors in OS univariate analysis. However, these factors were nonsignificant in multivariate analysis. The 10-year OS rates were 97%and 89%for PTC and FTC, respectively (P=0.003). hTe 10-year disease-free survival (DFS) rates were 77.2%in PTC vs. 65%in FTC (P=0.179). Conclusion:hTe signiifcant prognostic factors vary between the two types of DTCs. hTerefore, PTC and FTC patients need to be analyzed and reported independently. PTC survival is widely and signiifcantly affected by age, extrathyroid extension, and distant metastasis. By contrast, these factors were nonsigniifcant in FTC, which showed poorer survival than PTC.

  6. Difference between papillary and follicular thyroid carcinoma outcomes: an experience from Egyptian institution

    International Nuclear Information System (INIS)

    Differentiated thyroid carcinomas (DTCs) are classified into papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). DTCs are analyzed as a single group in clinical studies that investigated the prognostic factors and prognosis of these malignancies. However, the biological behaviors of these carcinomas significantly differ. In the present study, we aimed to detect differences in the outcomes between PTC and FTC in Mansoura University Hospital in Egypt. A total of 558 patients with histologically proven thyroid carcinomas from January 2003 to December 2012 were retrospectively enrolled. The clinical and pathological data of patients were reviewed. Large primary tumor size, lymph node involvement, extrathyroid extension, and distant metastasis were significant poor prognostic factors for overall survival (OS) in old PTC patients. Cox hazard analysis showed that the patient’s age, extra thyroid extension, and distant metastasis were the only independent prognostic factors. In FTC patients, only the distant metastasis and degree of tumor invasion were significant poor prognostic factors in OS univariate analysis. However, these factors were nonsignificant in multivariate analysis. The 10-year OS rates were 97% and 89% for PTC and FTC, respectively (P=0.003). The 10-year disease-free survival (DFS) rates were 77.2% in PTC vs. 65% in FTC (P=0.179). The significant prognostic factors vary between the two types of DTCs. Therefore, PTC and FTC patients need to be analyzed and reported independently. PTC survival is widely and significantly affected by age, extrathyroid extension, and distant metastasis. By contrast, these factors were nonsignificant in FTC, which showed poorer survival than PTC

  7. Initial institutional experience of uncooled single-antenna microwave ablation for large hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Aim: To evaluate the safety, efficacy, and feasibility of a novel microwave generator, designed to deliver automatically adjusted energy by tissue permittivity feedback control into the tumour via an uncooled antenna, in patients with larger hepatocellular carcinoma (HCC). Materials and methods: Fourteen patients with HCC >5 cm in diameter received surgical or percutaneous microwave ablation with more than 12 months of follow-up. Microwave ablation was performed using a 902–928 MHz generator at 28 W; a single 14 G antenna without water-cooled system was used. The patients were followed up with contrast-enhanced CT and serum alpha-foetoprotein to monitor for tumour recurrence at 1 month and then every 3 months after tumour ablation. Results: The follow-up duration for the 11 male and three female patients (mean tumour size 5.77 cm, range 5–7 cm; mean age 63.8 years) was 15.8 months. The mean ablation time was 2025 s (range 900–3600 s), and the mean ablation session was 2.5 (range 1–4). The complete ablation rate was 85% (17 of 20). Local recurrence rate was 5.8% (1 of 17). All patients survived and the morbidity and mortality rate was 21.4% and 0%, respectively. Conclusions: Microwave tissue ablation using this novel system with tissue permittivity feedback control and a single uncooled antenna has a high complete ablation rate and lower morbidity. It proved to be a fast, easy, and effective option for ablation of large (>5 cm) tumours. - Highlights: • We used a microwave system with tissue permittivity feedback control firstly in Asia. • It can deliver automatic-adjusted energy into tumors quickly via an uncooled antenna. • Tumor ablation using this system has a high complete ablation rate and safety. • It was proved to be a fast and effective option for large (>5 cm) tumor ablation

  8. Neoadjuvant chemotherapy in 13 patients with locally advanced poorly differentiated thyroid carcinoma based on Turin proposal - a single institution experience

    International Nuclear Information System (INIS)

    There is a paradigm that chemotherapy is ineffective in thyroid carcinoma. The aim of our study was to find out whether neoadjuvant chemotherapy before thyroid surgery had an effect on the size of primary tumour in patients with poorly differentiated thyroid carcinoma (PDTC) based on Turin proposal. Altogether, 13 patients (8 women, 5 men; median age 61 years) with PDTC based on Turin proposal were treated with neoadjuvant chemotherapy between 1986 and 2005. Tumour diameter was from 4.5 to 18 cm (median 9 cm). Regional and distant metastases were detected in 6 and 9 patients, respectively. Eight patients had pT4 tumour. Altogether, 29 (range 1–5) cycles of chemotherapy were given. Tumour diameter decreased in all the patients and by more than 30% in 5 patients (= 38%). Two of these five patients had also preoperative external beam irradiation (EBRT). Total thyroidectomy, lobectomy and neck dissection were performed in 10, 3 and 5 cases, respectively. R0 and R1 resection was done in 5 and 8 cases, respectively. Eight patients had postoperative EBRT of the neck and upper mediastinum. The 5-year and 10-year cause-specific survival rates of patients were 66% and 20%, respectively. After neoadjuvant chemotherapy a partial tumour regression was observed in 38% of patients with PDTC based on Turin proposal

  9. Chemo-radiation with or without mandatory split in anal carcinoma: experiences of two institutions and review of the literature

    International Nuclear Information System (INIS)

    The split-course schedule of chemo-radiation for anal cancer is controversial. Eighty-four patients with invasive anal cancer treated with definitive external beam radiotherapy (RT) with a mandatory split of 12 days (52 patients, Montreal, Canada) or without an intended split (32 patients, Zurich, Switzerland) were reviewed. Total RT doses were 52 Gy (Montreal) or 59.4 Gy (Zurich) given concurrently with 5-FU/MMC. After a mean follow-up of 40 ± 27 months, overall survival and local tumor control at 5 years were 57% and 78% (Zurich) compared to 67% and 82% (Montreal), respectively. Split duration of patients with or without local relapse was 15 ± 7 d vs. 14 ± 7 d (Montreal, NS) and 11 ± 11 d vs. 5 ± 7 d (Zurich; P < 0.001). Patients from Zurich with prolonged treatment interruption (≥ 7 d) had impaired cancer-specific survival compared with patients with only minor interruption (<7 d) (P = 0.06). Bowel toxicity was associated with prolonged RT (P = 0.03) duration as well as increased relapse probability (P = 0.05). Skin toxicity correlated with institution and was found in 79% (Montreal) and 28% (Zurich) (P < 0.0001). The study design did not allow demonstrating a clear difference in efficacy between the treatment regimens with or without short mandatory split. Cause-specific outcome appears to be impaired by unplanned prolonged interruption

  10. Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Carl [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Bai, Harrison [Yale University School of Medicine, New Haven, Connecticut (United States); Neboori, Hanmanth [Drexel Medical College, Philadelphia, Pennsylvania (United States); Takita, Cristiane [University of Miami, Miami, Florida (United States); Motwani, Sabin [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Wright, Jean L.; Hobeika, Georges [University of Miami, Miami, Florida (United States); Haffty, Bruce G. [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Jones, Tiffanie [Yale University School of Medicine, New Haven, Connecticut (United States); Goyal, Sharad [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Moran, Meena S., E-mail: meena.moran@yale.edu [Yale University School of Medicine, New Haven, Connecticut (United States)

    2012-11-01

    Purpose: Given the paucity of data on racial disparities in ductal carcinoma in situ (DCIS), the data from a multi-institutional cohort of DCIS patients treated with breast-conserving surgery and whole breast radiation therapy (RT) were analyzed to determine whether racial disparities or differences exist. Methods and Materials: A total of 533 white and 76 black DCIS patients from 3 university-based cancer centers were uniformly treated with breast-conserving surgery and RT. All patient data were collected and analyzed as a function of race. Results: The median follow-up was 5.2 years. No significant racial differences were seen in tumor size, age at diagnosis, estrogen receptor status, necrosis, or grade (all P>.05). Of the treatment parameters, the RT dose delivered, boost, positive margin rates, frequency of hormone receptor status assessment, and receipt of hormonal therapy for the 2 cohorts did not significantly differ (all P>.05). The local relapse-free survival was similar at 5 years (96.1% and 98.1%, P=.399) and 10 years (92.8% vs 95.8%, P=.360), with no significant overall survival difference at 10 years (94.0% vs 88.9%, P=.290) between the white and black patients, respectively. On multivariate analysis, race was not an independent predictor of local relapse-free survival or overall survival when accounting for age, grade, and margin status. Conclusion: In our large cohort of DCIS patients uniformly treated at 3 institutions with breast conservation without any apparent differences in treatment delivery parameters, we demonstrated that the clinical and pathologic features and local survival outcomes did not differ as a function of race. Our results suggest that when black patients with DCIS are appropriately selected for breast conservation and receive adjuvant RT without racial disparities in the treatment parameters, differences in the outcomes as a function of race do not exist.

  11. Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: Given the paucity of data on racial disparities in ductal carcinoma in situ (DCIS), the data from a multi-institutional cohort of DCIS patients treated with breast-conserving surgery and whole breast radiation therapy (RT) were analyzed to determine whether racial disparities or differences exist. Methods and Materials: A total of 533 white and 76 black DCIS patients from 3 university-based cancer centers were uniformly treated with breast-conserving surgery and RT. All patient data were collected and analyzed as a function of race. Results: The median follow-up was 5.2 years. No significant racial differences were seen in tumor size, age at diagnosis, estrogen receptor status, necrosis, or grade (all P>.05). Of the treatment parameters, the RT dose delivered, boost, positive margin rates, frequency of hormone receptor status assessment, and receipt of hormonal therapy for the 2 cohorts did not significantly differ (all P>.05). The local relapse-free survival was similar at 5 years (96.1% and 98.1%, P=.399) and 10 years (92.8% vs 95.8%, P=.360), with no significant overall survival difference at 10 years (94.0% vs 88.9%, P=.290) between the white and black patients, respectively. On multivariate analysis, race was not an independent predictor of local relapse-free survival or overall survival when accounting for age, grade, and margin status. Conclusion: In our large cohort of DCIS patients uniformly treated at 3 institutions with breast conservation without any apparent differences in treatment delivery parameters, we demonstrated that the clinical and pathologic features and local survival outcomes did not differ as a function of race. Our results suggest that when black patients with DCIS are appropriately selected for breast conservation and receive adjuvant RT without racial disparities in the treatment parameters, differences in the outcomes as a function of race do not exist.

  12. Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience

    OpenAIRE

    Besic, Nikola; Schwarzbartl-Pevec, Andreja; Vidergar-Kralj, Barbara; Crnic, Tea; Gazic, Barbara; Marolt Music, Maja

    2016-01-01

    Background It is generally believed that patients with Hürthle cell thyroid carcinoma (HCTC) have a poor prognosis. Furthermore, distant metastases represent the most frequent cause of thyroid cancer-related death of patients with HCTC. The aim of this study was to report the treatment and outcomes of patients with distant metastases. Methods Altogether 108 patients were treated for HCTC from 1972 to 2011 in our tertiary center and 32 patients (19 females, 13 males; median age 64.5 years) had...

  13. The Effect of the Surgical Margins on the Outcome of Patients with Head and Neck Squamous Cell Carcinoma: Single Institution Experience

    International Nuclear Information System (INIS)

    To assess the impact of close or positive surgical margins on the outcome, and to determine whether margin status influence the recurrence rate and the overall survival for patients with head and neck cancers. Records from 1996 to 2001 of 413 patients with primary head and neck squamous cell carcinoma (SCC) treated with surgery as the first line treatment were analysed. Of these patients, 82 were eligible for the study. Patients were followed up for 5 years. Patients with margins between 5-10 mm had 50% recurrence rate (RR), those with surgical margins between 1-5 mm had RR of 59% and those with positive surgical margins had RR of 90% (P=0.004). The 5-year survival rates were 54%, 39% and 10%, respectively (P=0.002). Unsatisfactory surgical margin is an independent risk factor for recurrence free survival as well as overall survival regardless of the other tumor and patient characteristics

  14. Can neck irradiation be an alternative to neck dissection in early stage carcinoma oral tongue operated for primary alone? Experience from a single institute

    Directory of Open Access Journals (Sweden)

    Sushmita Ghoshal

    2016-07-01

    Full Text Available Purpose: To study pattern of failure, locoregional control rates (LCR and disease free survival (DFS in post-operative patients of carcinoma oral tongue, and to study the impact of nodal dissection on DFS in stage I and II patients.Methods: 102 patients of carcinoma oral tongue treated between January 2009 and December 2013 were analyzed. All patients were operated for primary disease, but neck dissection was done in 78 (76.5% patients only. However, radiation to primary site along with neck region was received by all patients. Pattern of failure, LCR and DFS were estimated.Results: At median follow up of 12 months, 10.8% patients failed locally, 10.8% in nodal region, 2.9% both at local and nodal site, and 5.9% patients failed distally. 2 year LCR and DFS was 71.2%, 90.9%, 79.5%, 0% and 55.2%, 64.4%, 57.8%, 0% in stage I, II, III, IV respectively. 2 year DFS in stage I patients, who underwent nodal dissection and post-operative radiation (14 patients was 64.3% and in whom only neck irradiation was done (15 patients, it was 45.8%, however difference was not significant (p = 0.5. But in stage II patients, 33 patients who underwent nodal dissection and post-operative radiation, 2 year DFS was 85.4% and it was 21.4% in 7 patients who underwent neck radiation only, and difference showed trend towards significance (p = 0.05. 2 or more positive lymph nodes post dissection was the only poor prognostic factor that correlated with DFS (p = 0.02Conclusion: While in stage I, neck irradiation alone can be a possible alternative to neck dissection and post-operative radiation; for stage II, neck dissection is mandatory.

  15. Combined magnetic resonance imaging and spectroscopy in the assessment of high grade prostate carcinoma in patients with elevated PSA: A single-institution experience of 356 patients

    International Nuclear Information System (INIS)

    Purpose: To assess the ability of combined whole-prostate magnetic resonance imaging and magnetic resonance spectroscopy imaging (MRI + MRSI) to predict the presence or absence of high grade (Gleason 4 + 3 or higher) prostate carcinoma in men with elevated PSA. Materials and methods: Between March 2002 and September 2007, 356 subjects (mean serum PSA 11.5 ng/ml, range 0.4-133.0 ng/ml) were examined with fast-T2-weighted magnetic resonance imaging (MRI) and 3D-magnetic resonance spectroscopy imaging (MRSI) on a 1.5 T scanner. Prostate cancer was histopathologically proven in 220 patients (41 with high grade and 179 with lower grade cancer) and non-evidence of cancer was determined after at least 12 months (mean 21 months) clinical follow-up in 136 subjects. The sensitivity, false positive rate, and negative predictive value of MRI + MRSI were calculated using histopathology and follow-up results as reference standard. Results: MRI + MRSI had a significantly higher sensitivity for high grade tumors (92.7%) than for lower grade tumors (67.6%), and was false positive in only 7.4% of patients with non-evidence of prostate cancer. For exclusion of a high grade tumor, MRI + MRSI had a negative predictive value of 98.4%. Conclusions: MRI + MRSI holds great potential for predicting presence or absence of high grade tumors in men with elevated PSA. This can be important in the selection of patients for active surveillance, or in the decision to rebiopsy patients with prior negative biopsies.

  16. Oral squamous cell carcinoma in patients with and without predisposing habits in glossal and extra-glossal site: An institutional experience in South India

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    K Ranganathan

    2015-01-01

    Full Text Available INTRODUCTION: We report our cohort of oral squamous cell carcinoma (OSCC patients with or without predisposing habits in glossal and extraglossal sites. MATERIALS AND METHODS: A retrospective analysis of OSCC cases over a period of 13.75 years from the archives of Ragas Dental College and Hospital, Chennai, India. Demographic details, site, details of habits, and grade of OSCC were retrieved. Social Package for Social Service version 17.0 was used to analyze the data. Descriptive statistics, Chi-square test, and comparison of mean were employed appropriately. RESULTS: There were 151 OSCC cases, of which 60.9% (92/151 were males, 21.2% (32/151 were aged ≤40 years and 27.82% (42/151 occurred in the tongue. The glossal to extraglossal site ratio was 1:2.6. Predisposing habits were present in 52.4% of glossal OSCC and 82.6% with extra-glossal sites (P = 0.000. Besides tobacco, exclusive areca nut chewing was observed in 15.23% (23/151 patients. Thirty-nine (25.8% belonged to non-tobacco, non-areca nut, non-alcohol (NTND group with male to female ratio was1:3. DISCUSSION: In our cohort, 112 of 151 OSCC (74.8% had at least one predisposing habit. Chewing of areca nut alone was a predisposing habit by itself. In addition, there was a small, subset of cases that were not associated with history of any habits. This study brings to focus the subsets of OSCC predisposed by areca nut and NTND, that needs to be studied further.

  17. Thyroid carcinoma - experience at Jinnah postgraduate medical centre Karachi

    International Nuclear Information System (INIS)

    Objective: To evaluate the frequency and types of thyroid carcinoma with respect to age and sex groups. Methods: This was a retrospective study conducted at the Department of Pathology, Basic Medical Sciences Institute, Jinnah postgraduate medical centre Karachi. A total of 998 thyroid lesions over a period of 05 years, from July 2000 to June 2005 were reviewed. H and E slides were studied to determine the types and frequencies of malignant lesions of thyroid. Special stains were performed whenever required. Results: A total of 998 thyroid lesions were reviewed, of which 153 were found to be malignant. Papillary carcinoma was the commonest malignant lesion with a frequency of 90.2% followed by 4.5% medullary carcinoma, 2% follicular carcinoma, 2% undifferentiated carcinoma and 0.7% each of mixed medullary and papillary carcinoma and poorly differentiated carcinoma. Females were predominant 82.4% as compared to males 17.6% with female to male ratio 4.7:1. Maximum number of the patients were seen in fourth decade of life followed by third and second decades. Conclusion: The commonest malignant thyroid lesion was papillary carcinoma. Thyroid cancer was more common in females. Patients of papillary, medullary and follicular carcinomas were found in third and fourth decades of life while poorly and undifferentiated carcinomas were diagnosed from fifth to seventh decades of life. (author)

  18. One Institution's Experience With Pancreas Transplantation

    OpenAIRE

    Sutherland, David E. R.; Kendall, David M.; Najarian, John S.; Goetz, Frederick C.

    1985-01-01

    The University of Minnesota has the largest experience with pancreas transplantation of any institution, with 130 cases since 1966, including 116 in 98 patients between July 1978 and June 1985. Currently, 30 patients are insulin-independent, 19 for greater than one year, the longest for seven years. One-year patient and graft survival rates overall are 87% and 30%, respectively. Of 98 recipients, 49 had had previous kidney transplants, while 49 had not, and currently most of the pancreas reci...

  19. Institutional Repositories: The Experience of Master's and Baccalaureate Institutions

    Science.gov (United States)

    Markey, Karen; St. Jean, Beth; Soo, Young Rieh; Yakel, Elizabeth; Kim, Jihyun

    2008-01-01

    In 2006, MIRACLE Project investigators censused library directors at all U.S. academic institutions about their activities planning, pilot testing, and implementing the institutional repositories on their campuses. Out of 446 respondents, 289 (64.8 percent) were from master's and baccalaureate institutions (M&BIs) where few operational…

  20. Radon gas, bronchogenic carcinoma - Ontario experience

    International Nuclear Information System (INIS)

    A review of the procedures followed by the Ontario Worker's Compensation Board in paying insurance benefits to injured workers is presented. Topics include initial methods of handling lung cancer claims, the first guidelines for adjudication of lung cancer, the present guidelines, and a perspective on occupational lung cancers. The Ontario Board has accepted the cause-effect relationship between radon gas decay products and the development of certain bronchogenic carcinomas in those persons so exposed

  1. Long-term outcomes of trimodality treatment for squamous cell carcinoma of the esophagus with cisplatin and/or 5-FU. More than 20 years' experience at a single institution

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    Fakhrian, Khashayar [Ruhr-Universitaet Bochum, Department of Radiation Oncology, Marien Hospital Herne and Sankt Josef Hospital Bochum, Bochum (Germany); Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Universitaetsklinikum der Ruhr-Universitaet Bochum, Klinik fuer Strahlentherapie und Radio-Onkologie, Marienhospital Herne, Herne (Germany); Ordu, Arif Deniz; Molls, Michael [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Lordick, Florian [University Clinic Leipzig, University Cancer Center Leipzig (UCCL), Leipzig (Germany); Technische Universitaet Muenchen, Department of Internal Medicine III (Hematology/Oncology), Munich (Germany); Theisen, Joerg [Technische Universitaet Muenchen, Department of Surgery, Klinikum rechts der Isar, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany); Omrcen, Tomislav [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); University Hospital Split, Center of Oncology and Radiotherapy, Split (Croatia); Nieder, Carsten [Department of Oncology and Palliative Medicine, Nordland Hospital Trust, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Geinitz, Hans [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Krankenhaus der Barmherzigen Schwestern Linz, Department of Radiation Oncology, Linz (Austria)

    2014-12-15

    The purpose of this article is to report the outcome of neoadjuvant radiochemotherapy (N-RCT) + surgery in patients with squamous cell carcinoma of the esophagus at a single institution. We retrospectively reviewed data from patients who were referred to our department for N-RCT. From 1988-2011, 103 patients were treated with N-RCT with cisplatin and/or 5-fluorouracil (5-FU). Group 1: (n = 55) from 1988-2006 with 39.6-40 Gy and 5-FU with (n = 17) or without cisplatin (n = 38). Group 2: from 2003-2010 with 44-45 Gy and 5-FU with (n = 40) or without cisplatin (n = 8). All patients underwent radical resection with reconstruction according to tumor location and 2-field lymph node dissection. The degree of histomorphologic regression was defined as grade 1a (pCR, 0 % residual tumor), grade 1b (pSTR, < 10 % residual tumor), grade 2 (10-50 % residual tumor), and grade 3 (> 50 % residual tumor). Median follow-up time from the start of N-RCT was 100 months (range 2-213 months). The median overall survival (OS) for the whole cohort was 42 months and the 5-year OS was 45 ± 5 %. In the multivariate analysis, worse ECOG performance status (p < 0.001), weight loss > 10 % before the start of the N-RCT (p = 0.025), higher pT category (p = 0.001), and grade 2/3 pathologic remission (p < 0.001) were significantly associated with a poor OS. PCR and pSTR rates for group 1 were 36 % and 18 % compared to 53 % and 22 % for group 2 (p = 0.011). There was a tendency for a better outcome in group 2 patients without statistical significance. The 5-year OS, disease-free survival and recurrent-free survival were 36 ± 7 %, 35 ± 6, and 36 ± 7 % for group 1 and 55 ± 7, 49 ± 7, and 53 ± 7 in group 2 (p = 0.117, p = 0.124, and p = 0.087). There was no significant difference between the two groups considering the postoperative morbidity and mortality. Higher radiation doses and more use of simultaneous cisplatin lead to higher pathologic response rates to N-RCT and may be associated with

  2. Bone scans in nasopharyngeal carcinoma: local experience

    International Nuclear Information System (INIS)

    Introduction: Nasopharyngeal carcinoma (NPC) tops the list of malignancy in Malaysia and ranks first in male malignancy in the state of Sarawak. The majority of the NPC patients presented in the advanced stages and often with distal metastasis usually to the bones. In our local hospital is the new practice of bone scan using Tc99 started last year. Over a period of 9 months from July 2003 to March 2004, 41 NPC patients had the bone scans and our experience in these are reviewed and presented. Method: The NPC patients are selected consecutively including both new and treated patients. The scanner used is Siemen E.cam plus and Technecium (Tc99) the radio-active isotope used. The scan images are read and reported by qualified and trained Radiologists. The bone scans are requested from the ENT Specialist of the ENT department of the Hospital. The bone scan reports are checked by the ENT Specialists and the decisions made as to clinical correlation and further definitive imaging studies. Results: 41 NPC patients were included in the studies, 29 newly diagnosed and bone-canned before treatment started and 12 treated of which 3 being diagnosed having recurrent NPC. Of the 29 newly diagnosed patients, one was found true positive bone scan having increased radio-tracer uptake and confirmed Xray imagings. 3 of the treated patients had true positive bone scan with increased radio-tracer uptake and confirmed Xray imagings. Hence a total of 4 out of the 41 patients (9.8%) had bone metastasis on positive bone scans. Of the 29 newly diagnosed patients, 14 were found false positive bone scan having increased radio-tracer uptake but no confirmed X ray imagings. 4 of the treated patients had false positive bone scan with increased radio-tracer uptake but no confirmed X ray imagings. Hence a total of 18 out of the 41 patients (44%) had no bone metastasis on positive bone scans. There were 6 patients with symptoms referable to the bones' distal to the head and 2 had true positive bone

  3. Carcinoma of the hand: a 20-year experience

    International Nuclear Information System (INIS)

    We reviewed our 20-year experience with cutaneous carcinoma of the hand and identified 70 cases (basal cell 23%, squamous cell 77%). The documented risk factors included solar radiation, trauma, and irradiation. Lesions were treated surgically with amputation, excision, skin graft, or flap closure, and nonsurgically with cryosurgery, curettage, 5-fluorouracil, or irradiation. The recurrence was lower with surgical treatment (3%) than with nonsurgical (33%). Regional lymphadenectomy was required in four patients for metastatic squamous cell carcinoma. Recurrence was greater (9%) and metastasis more common (38%) in patients with Marjolin's type of secondary squamous cell carcinoma than with solar-induced lesions. Cause is an important factor in outcome and should be considered in initial treatment and long-term management

  4. Academic Deficiency: Student Experiences of Institutional Labeling

    Science.gov (United States)

    Barouch-Gilbert, Abraham

    2015-01-01

    Limited existing research examines how undergraduate students in the United States experience the process of being identified as deficient due to their academic performance. The purpose of this phenomenological study was to explore the lived experiences of college students on academic probation who were labeled academically deficient. Students…

  5. Clinicopathological study of male breast carcinoma: 24 years of experience

    International Nuclear Information System (INIS)

    Because breast cancer in men is rare, few patients are available for prospective studies. To learn more about its epidemiology, risk factors, clinical features, genetics and pathology in our country, we conducted a retrospective study of all cases seen in recent decades at our institution. We identified each case of male breast cancer in the database at the Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India, between the years 1983 to 2007. We identified only 32 cases of male breast cancer over the 24-year period. Male breast cancer accounted for 32 (2.8%) of 1141 resected breast specimens, which included all breast lesions and 32 (4.1%) of 780 breast cancer cases. Of the 32 cases, 20 (62.5%) had various associated risk factors. Invasive ductal carcinoma was seen in 30 cases (93.7%). Of 20 cases that underwent molecular studies, 16 (80%) patients had estrogen receptor positivity whereas 14 (70%) had progesterone receptor positivity. Six cases (30%) overexpressed HER2 and p53. The BRCA2 mutation was observed in 4 cases (40%) while no patient presented with the BRCA1 mutation. An incidence of 4.1% for male breast cancer indicates that this disease is not as uncommon as presumed in this part of the world. Breast cancer in men seems more frequently to be hormone receptor positive and the BRCA2 mutation confers a significant risk to men. (author)

  6. Squamous cell carcinoma of the maxillary sinus: A Tata Memorial Hospital experience

    Directory of Open Access Journals (Sweden)

    Qureshi Sajid

    2006-01-01

    Full Text Available Background: The optimal treatment of maxillary sinus carcinoma remains to be defined and there is a paucity of Indian studies on the subject. Aims: To present experience of management of squamous cell carcinoma of the maxillary sinus treated with curative intent at a single institution. Settings and Design:Retrospective study of patients with squamous cell carcinoma of the maxillary sinus who presented between 1994 to 1999. materials and Methods:The records of 73 patients with squamous cell carcinoma of the maxillary sinus were analyzed. Sixty-two patients were evaluable. Forty patients (65% were treated with surgery followed by postoperative radiotherapy, five patients (8% were treated with radiotherapy alone, five patients (8% were treated with surgery alone; 12 patients (19% received chemotherapy. Statistical analysis used: Statistical analysis was done using Kaplan-Meier method. Results: The majority of patients presented with locally advanced disease (52, 84%; nodal involvement was observed in five patients (8%. The most common site of recurrence was at the primary site, which was observed in 28 patients (45% and regional failures occurred in 10 (16%. The 3 and 5-year overall survival was 38% and 35% and the disease free survival was 29% and 26% respectively. The 5-year overall survival after surgery and postoperative radiotherapy was 42%. Conclusions:The majority of patients present with advanced disease resulting in poor outcomes to conventional treatment modalities. Locoregional tumor progression remains a significant pattern of failure. New approaches such as neoadjuvant or concomitant chemoradiotherapy with aggressive surgery need to be considered and evaluated in prospective studies.

  7. Pancreas transplantation: a single-institution experience in Japan

    OpenAIRE

    Okabe, Yasuhiro; Kitada, Hidehisa; Miura, Yoshifumi; Nishiki, Takehiro; Kurihara, Kei; Kawanami, Sayako; Terasaka, Soshi; Kaku, Keizo; Noguchi, Hiroshi; Sugitani, Atsushi; Tanaka, Masao

    2013-01-01

    Purpose We herein report our experience with pancreas transplantation in 26 patients at a single institution in Japan between August 2001 and December 2011. Methods We reviewed the medical records of 26 pancreas transplantations performed in our institute. Results The early complications (within 2 weeks) included one graft venous thrombosis, one arterial thrombosis, and two reoperations for bleeding. Of the 26 pancreas transplant recipients, five lost pancreas graft function. Of 24 simultaneo...

  8. Professional Selection of Entrants to Higher Educational Institutions: International Experience

    OpenAIRE

    Zhanar Y. Sarsekeyeva; Janat A. Karmanova; Rauana B. Mazhenova; Adilzada M. Sharzadin

    2013-01-01

    The article deals with the global experience of the professional selection of entrants to higher educational institutions, which is aimed at the provision of qualified contingent of future specialists. This paper attaches great attention to studying the experience of such countries as England, USA, Spain, Switzerland, Finland, Latvia, Estonia. The increase of the percentage of school-leavers, intentionally focused on selection of professional activity gives confidence that the problem of the ...

  9. Locally advanced hypopharyngeal squamous cell carcinoma: single-institution outcomes in a cohort of patients curatively treated either with or without larynx preservation

    Directory of Open Access Journals (Sweden)

    Isabel Reis

    2016-02-01

    Full Text Available Abstract Objective: The present study was aimed at describing a single-institution experience in the curative treatment of patients diagnosed with locally advanced hypopharyngeal squamous cell carcinoma. Materials and Methods: Data concerning all patients treated for locally advanced hypopharyngeal squamous cell carcinoma between January 2006 and June 2012 were reviewed. Results: A total of 144 patients were included in the present study. The median follow-up period was 36.6 months. Median survival was 26 months, and 2-year and 5-year overall survival rates were, 51% and 30.5%, respectively. Median recurrence-free survival was 18 months and 2-year and 5-year recurrence-free survival rates were 42.8% and 28.5%, respectively. Conclusion: The outcomes in the present series are in line with the literature.

  10. INSTITUTIONAL TRANSFORMATION IN COUNTRIES OF CEE: EXPERIENCE FOR UKRAINE

    Directory of Open Access Journals (Sweden)

    Galyna\tPOCHENCHUK

    2015-12-01

    Full Text Available In the article the experience of post-socialist countries of Central and Eastern Europe on the transformational changes that have been implemented in the political, socio-economic and ideological spheres is considered. The unprecedentness is determined by the scope and timing of reform. The author reviews the main conceptual models of realization of market transformations. The features of centrally-planned or command economy and main stages of market reforms with regard to processes that took place in the reformed countries are characterized. It is determined that the first phase concerned the dismantling of the previous social system and its institutions, so that it was not only started the formation of market structures and the introduction of democratic principles, but also significant negative trends in the economy and social sphere. The second stage of reforms in CEE related to the acquisition of the membership in Member States and relevant preparatory and adaptational measures. Critical importance of institutional reforms to establish an effective functioning of democratic market economy is explained. Based on the analysis of institutional transformations that took place in the reform process in Central and Eastern Europe the main institutional changes in various fields are summarized. With the experience of CEE countries the narrow places of transformation processes in Ukraine are identified and necessary directions for further transformation are reasonably grounded.

  11. Langerhan′s cell histiocytosis: A single institutional experience

    OpenAIRE

    Singh Tejinder; Satheesh C; Appaji L; Aruna Kumari B; Mamatha H; Giri G; Rao Clementina

    2010-01-01

    Background: Langerhans cell histiocytosis (LCH) is a disease that primarily affects bone but can be associated with a clinical spectrum that ranges from a solitary bone lesion with a favorable natural history to a multisystem, life-threatening disease process. Aim: We analyzed our single institutional experience of managing children with LCH. Settings and Design: A total of 40 children of LCH, managed in tertiary cancer center in South India in the period from 2001 to 2005, were evaluated ret...

  12. Langerhan’s cell histiocytosis: A single institutional experience

    OpenAIRE

    Singh, Tejinder; C T Satheesh; Appaji, L.; B S Aruna Kumari; Mamatha, H. S.; G V Giri; Rama Rao, Clementina

    2010-01-01

    Background: Langerhans cell histiocytosis (LCH) is a disease that primarily affects bone but can be associated with a clinical spectrum that ranges from a solitary bone lesion with a favorable natural history to a multisystem, life-threatening disease process. Aim: We analyzed our single institutional experience of managing children with LCH. Settings and Design: A total of 40 children of LCH, managed in tertiary cancer center in South India in the period from 2001 to 2005, were evaluated ret...

  13. Minority Students' Transition Experiences at a Predominantly White Institution

    OpenAIRE

    LaBoone, Kimberly Lavette

    2006-01-01

    The process of transition to college is complex and has received attention from many scholars (e. g. Baker & Siryk, 1999; Beal & Noel, 1980; Choy, Horn, Nunez, & Chen, 2000; Gaither, 1999; Paul & Brier, 2001; Tinto, 1993). Transition impacts persistence in college, hence retention rates (Tinto, 1993). As a result, postsecondary institutions have developed models of transition. In one such model, first year students experience transition in four domains; academic, social, personal-emotional, a...

  14. THE INTERACTION OF GYMNASIUMS WITH SOCIAL INSTITUTIONS IN THE PROCESS OF FORMING SCHOOLCHILDREN'S SOCIAL EXPERIENCE

    OpenAIRE

    Mikhailenko, V.

    2007-01-01

    The article reveals the experience of Novokuznetsk educational institution "Gymnasium № 48" of forming schoolchildren's social experience by means of ecological education and by using the possibilities of interaction between an educational institution and different social institutions of the town.

  15. Professional Selection of Entrants to Higher Educational Institutions: International Experience

    Directory of Open Access Journals (Sweden)

    Zhanar Y. Sarsekeyeva

    2013-01-01

    Full Text Available The article deals with the global experience of the professional selection of entrants to higher educational institutions, which is aimed at the provision of qualified contingent of future specialists. This paper attaches great attention to studying the experience of such countries as England, USA, Spain, Switzerland, Finland, Latvia, Estonia. The increase of the percentage of school-leavers, intentionally focused on selection of professional activity gives confidence that the problem of the professional selection of entrants to higher educational institutions will become more important for the future development of the whole educational system. Personal formation of school-leavers as the potential of the nation and the country as a whole will become the thorniest question for the whole society. Professional selection of applicants is based on such principles as democracy, humanity, scientific validity, professional orientation, availability, phasing, massive involvement. The analysis of foreign experience of professional selection of entrants to higher educational institutions showed that the main objective of professional selection is to identify applicant's professional orientation as a leading personality attribute, features of incentive system, abilities, potential for further self-fulfillment in the chosen profession.

  16. Evolving treatment plan quality criteria from institution-specific experience

    International Nuclear Information System (INIS)

    Purpose: The dosimetric aspects of radiation therapy treatment plan quality are usually evaluated and reported with dose volume histogram (DVH) endpoints. For clinical practicality, a small number of representative quantities derived from the DVH are often used as dose endpoints to summarize the plan quality. National guidelines on reference values for such quantities for some standard treatment approaches are often used as acceptance criteria to trigger treatment plan review. On the other hand, treatment prescription and planning approaches specific to each institution warrants the need to report plan quality in terms of practice consistency and with respect to institution-specific experience. The purpose of this study is to investigate and develop a systematic approach to record and characterize the institution-specific plan experience and use such information to guide the design of plan quality criteria. In the clinical setting, this approach will assist in (1) improving overall plan quality and consistency and (2) detecting abnormal plan behavior for retrospective analysis. Methods: The authors propose a self-evolving methodology and have developed an in-house prototype software suite that (1) extracts the dose endpoints from a treatment plan and evaluates them against both national standard and institution-specific criteria and (2) evolves the statistics for the dose endpoints and updates institution-specific criteria. Results: The validity of the proposed methodology was demonstrated with a database of prostate stereotactic body radiotherapy cases. As more data sets are accumulated, the evolving institution-specific criteria can serve as a reliable and stable consistency measure for plan quality and reveals the potential use of the ''tighter'' criteria than national standards or projected criteria, leading to practice that may push to shrink the gap between plans deemed acceptable and the underlying unknown optimality. Conclusions: The authors have developed

  17. Genitourinary small-cell carcinoma: 11-year treatment experience

    Directory of Open Access Journals (Sweden)

    Kun Chang

    2014-10-01

    Full Text Available The predictive factors of prognosis and treatment strategies for small-cell carcinoma (SCC of the urinary tract are controversial. This study was aimed to investigate the clinical experience and management of patients with SCC of the urinary tract. We collected data of patients who were diagnosed with genitourinary SCC (GSCC between 2002 and 2013 and were treated in the Fudan University Shanghai Cancer Center. A total of 18 patients were diagnosed with GSCC of which 10 originated from the prostate, seven from the bladder and one from the adrenal gland. The mean follow-up time was 15.5 months and progression-free survival (PFS was 9.3 months. Primary tumor resection was attempted in 13 of 18 patients (72.2% in whom radical surgery was performed in six of 14 (42.9% limited disease patients. Most of the patients (13, 72.2% received cisplatin-based chemotherapy. Patients who had normal lactic dehydrogenase (LDH levels showed a significantly higher median PFS and overall survival (OS compared with patients with high LDH levels (P = 0.030, P= 0.010. Patients with limited disease treated with a radical operation experienced a non-significant (P = 0.211 longer PFS compared with patients who were not treated, but this reached statistical significance after analyzing OS (P = 0.211, P= 0.039. Our patients showed a poor prognosis as reported previously. Serum LDH levels beyond the normal range indicate a poor prognosis. For GSCC patients who are diagnosed with limited disease, radical surgery is strongly recommended along with cisplatin-based chemotherapy.

  18. RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab

    Directory of Open Access Journals (Sweden)

    Weichert Wilko

    2010-11-01

    Full Text Available Abstract Background Local control in adjuvant/definitive RT of adenoid cystic carcinoma (ACC is largely dose-dependent. However, some clinical situations do not allow application of tumouricidal doses (i.e. re-irradiation hence radiation sensitization by exploitation of high endothelial growth factor receptor (EGFR-expression in ACC seems beneficial. This is a single-institution experience of combined radioimmunotherapy (RIT with the EGFR-inhibitor cetuximab. Methods Between 2006 and 2010, 9 pts received RIT for advanced/recurrent ACC, 5/9 pts as re-irradiation. Baseline characteristics as well as treatment parameters were retrieved to evaluate efficacy and toxicity of the combination regimen were evaluated. Control rates (local/distant and overall survival were calculated using Kaplan-Meier estimation. Results Median dose was 65 Gy, pts received a median of 6 cycles cetuximab. RIT was tolerated well with only one °III mucositis/dysphagia. Overall response/remission rates were high (77,8%; 2-year estimate of local control was 80% hence reaching local control levels comparable to high-dose RT. Progression-free survival (PFS at 2 years and median overall survival were only 62,5% and 22,2 mo respectively. Conclusion While local control and treatment response in RIT seems promising, PFS and overall survival are still hampered by distant failure. The potential benefit of RIT with cetuximab warrants exploration in a prospective controlled clinical trial.

  19. An experience in World Nuclear University-Summer Institute 2012

    International Nuclear Information System (INIS)

    Full-text: World Nuclear University-Summer Institute (WNU-SI) has been held annually since 2005 in Cristchurh College, Oxford, London. This six weeks course is attended by 80-90 young professionals, or fellow from 20-25 countries across the world. The WNU-SI is designed not only to discuss the full spectrum of issues surrounding nuclear energy, but also emphasis on team building, cultural awareness and the development of leadership potential in multinational environment. Interestingly, the mentors play their role base on their experience in leading the nuclear industry throughout the globe. At the end of the course, the participant could understand the most important issues address in the industry with global perspective, experience and learn from practical teamwork internationally. Finally, this course is believed to be a step in developing a worldwide network among the fellows to support each other in their careers. This paper will discuss the experience gained in WNU-SI 2012. (author)

  20. Cricotracheal resection for laryngeal invasion by thyroid carcinoma: our experience.

    Science.gov (United States)

    Morisod, Benoît; Monnier, Philippe; Simon, Christian; Sandu, Kishore

    2014-08-01

    Invasion of the laryngeal framework by thyroid carcinoma requires specific surgical techniques and carries a higher rate of complications that deserve to be highlighted. We reviewed our data from 1995 to 2012 and found six patients with laryngotracheal invasion by thyroid carcinoma. All underwent total thyroidectomy and single-stage cricotracheal resection, plus anterolateral neck dissection. Three had airway obstruction that necessitated prior endoscopic debulking. None of the patients needed a tracheotomy. There were four cases of papillary carcinoma, and two cases of undifferentiated carcinoma. One patient died of complications of the procedure (anastomotic dehiscence and tracheo-innominate artery fistula). Another died 2 months after the procedure from local recurrence and aspiration pneumonia. One case presented recurrence at 15 months, which was managed by re-excision and adjuvant radiotherapy; after 26 months of follow-up, he has no evidence of locoregional recurrence. The three other patients are alive without evidence of disease at 6, 18 and 41 months, respectively. Cricotracheal resection for subglottic invasion by thyroid carcinoma is an effective procedure, but carries significant risks of complications. This could be attributed to the devascularisation of the tracheal wall due to the simultaneous neck dissection, sacrifice of the strap muscles or of a patch of oesophageal muscle layer. We advocate a sternocleidomastoid flap to cover the anastomosis. Cricotracheal resection for subglottic invasion can be curative with good functional outcomes, even for the advanced stages of thyroid cancer. Endoscopic debulking of the airway prior to the procedure avoids tracheotomy. PMID:24129693

  1. Gastrointestinal stromal tumors: Thirty years experience of an Institution

    OpenAIRE

    Simone Arolfo, Paolo Mello Teggia, Mario Nano

    2011-01-01

    AIM: To report our experience of gastrointestinal stromal tumors (GISTs) during the last 29 years.METHODS: Thirty two cases of GIST referred to our Institution from the 1st January 1981 to the 10th June 2010 were reviewed. Metastases, recurrence and survival data were collected in relation to age, history, clinical presentation, location, size, resection margins and cellular features.RESULTS: Mean age was 63.7 years (range, 40-90) and incidence was slightly higher in males (56%). R0 resection...

  2. Central airways stenoses management--a single institution experience.

    Science.gov (United States)

    Pereszlenyi, A; Majer, I; Janik, M; Demian, J; Igaz, M; Knappkova, S; Eftimova, P; Benej, R; Harustiak, S

    2004-01-01

    Tracheal stenosis is a serious, life-threatening disease with an increasing tendency. The number of complicated tracheal lesions, where resection and anastomosis can not be performed, still increases and the situation requires solution by endoprosthesis. Consequent the management of such complicated obstructive tracheal lesions is individual and time-consuming. The main objective of this study is to review the single institution experience with central airways stenosis treatment and to define the role of endotracheal stenting in tracheal reconstruction surgery. This study presents the retrospective analysis of tracheal stenosis reconstruction by means of our own modification of Montgomery T-tube. (Tab. 3, Fig. 3, Ref. 12.) PMID:15543848

  3. Robotic hepatectomy: initial experience of a single institution in Singapore

    Science.gov (United States)

    Kam, Juinn Huar; Goh, Brian KP; Chan, Chung-Yip; Wong, Jen-San; Lee, Ser-Yee; Cheow, Peng-Chung; Chung, Alexander YF; Ooi, London LPJ

    2016-01-01

    INTRODUCTION In this study, we report our initial experience with robotic hepatectomy. METHODS Consecutive patients who underwent robotic hepatectomy at Singapore General Hospital, Singapore, from February 2013 to February 2015 were enrolled in this study. The difficulty level of operations was graded using a novel scoring system for laparoscopic hepatectomies. RESULTS During the two-year period, five consecutive robotic hepatectomies were performed (one left lateral sectionectomy, one non-anatomical segment II/III resection, one anatomical segment V resection with cholecystectomy, one extended right posterior sectionectomy and one non-anatomical segment V/VI resection). Two hepatectomies were performed for suspected hepatocellular carcinoma, two for solitary liver metastases and one for a large symptomatic haemangioma. The median age of the patients was 53 (range 38–66) years and the median tumour size was 2.5 (range 2.1–7.3) cm. The median total operation time was 340 (range 155–825) minutes and the median volume of blood loss was 300 (range 50–1,200) mL. There were no open conversions and no mortalities or major morbidities (> Clavien-Dindo Grade II). The difficulty level of the operations was graded as low in one case (Score 2), intermediate in three cases (Score 5, 6 and 6) and high in one case (Score 10). There was one minor morbidity, where the patient experienced Grade A bile leakage, which resolved spontaneously. The median length of postoperative hospital stay was 5 (range 4–7) days. CONCLUSION Our initial experience confirmed the feasibility and safety of robotic hepatectomy. PMID:26843059

  4. Liver transplantation for patients with hepatocellular carcinoma at the Liver Cancer Institute of Fudan University, China

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian; HE Yi-feng; YANG Guo-huan; SONG Kang; YUAN Zhou; WANG Yu-qi; TANG Zhao-you; FAN Jia; WU Zhi-quan; QIU Shuang-jian; HUANG Xiao-wu; YU Yao; WANG Zheng; SUN Jian; XIAO Yong-sheng

    2005-01-01

    Background Selection of patients with hepatocellular carcinoma (HCC) for orthotopic liver transplantation (OLT) remains controversial. Since there is a trend to expand the transplant criteria for HCC patients, we reviewed the data of patients with HCC who had received OLT at our institute to determine their survival and prognostic factors.Methods A total of 67 patients with HCC who had undergone OLT from April 2001 through December 2003 were reviewed retrospectively. Selection OLT candidates with HCC was dependent on the anatomical characteristics and/or the severity of underlying liver cirrhosis. The 67 patients were followed up for more than 6 months after transplantation. Their survival rate was calculated by the Kaplan-Meier method. Univariate and multivariate analyses using the Cox proportional hazards regression model were performed to reveal the factors affecting the survival rate.Results No perioperative death occurred in this series. The 1- and 2-year cumulative survival rates were 90.0% and 65.6%, and the disease-free survival (DFS) rates were 77.5% and 62.5% respectively. Univariate analysis revealed the tumor size, portal vein tumor thrombus (PVTT), serum alpha-fetoprotein level, bilobular distribution of tumors, pTNM stage and histological differentiation were statistically significant factors affecting the DFS (P<0.05). Multivariate analysis showed tumor size and PVTT were independent and statistically significant factors affecting the DFS (P=0.005 and 0.010, respectively). In this series, all but 2 received systemic chemotherapy, among them 13 had tumor recurrence within 8 months after OLT.Conclusions OLT is indicated for patients with HCC, even for some patients with end-stage liver disease who may survive longer without tumor recurrence. Adjuvant chemotherapy may decrease the recurrence of HCC after OLT.

  5. Renal cell carcinoma in dialysis patients. A single center experience

    International Nuclear Information System (INIS)

    Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis. In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation. RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5±11.1 years. Dialysis duration before RCC diagnosis was 11.2±7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9±1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5 (11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P=0.01) and smaller tumors (P=0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer. Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients. (author)

  6. Getting nuclear technology transferred beyond the institutes - the Australian experience

    International Nuclear Information System (INIS)

    Australia has had more than 20 years of experience in the RCA Programme with the support of technology transfer projects designed to provide the Member States with further knowledge and skills in the applications of nuclear techniques to their sustainable development. Up to 1997, more than A$3 million has been provided in direct extra budgetary support to a wide ranging programme, backed with a further significant amount of in kind support. The design of these projects has been focused on taking the technologies to the appropriate end users and the results have shown that there has been substantial success in attracting desired participation from senior people outside of the National Nuclear Research Institutes (NNRIs). They now form a group of ambassadors in the wider community, able to assist in the promotion and the introduction of these technologies to particular sectors. This outside group also assists in the development of back stopping capabilities in the NNRIs. (author)

  7. The nEDM experiment at the Paul Scherrer Institute

    CERN Document Server

    Kermaidic, Yoann

    2015-01-01

    The quest for a non-zero electric dipole moment (EDM) of simple systems such as the electron, the neutron or atoms / molecules is a pow- erful way to search for physics beyond the standard model (SM) in par- ticular for new sources of CP violation, complementary to LHC exper- iments. So far, no EDM signal was observed and the upper limit on the neutron EDM, established by the RAL/Sussex/ILL collaboration, is jdnj < 3 x 10e-26 e cm(90% C.L.). This limits was set with an apparatus using ultra cold neutrons stored in a vessel at room temperature. The nEDM collaboration at the Paul Scherrer Institute in Switzerland aims at reaching a sensitivity in the 10e-27 e cm range soon. I will present the current status of the experiment and discuss the prospects for the future.

  8. Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma – benchmark for a prospective multi-institutional study

    International Nuclear Information System (INIS)

    Several single institution phase I and phase II trials of stereotactic ablative body radiotherapy (SABR) for liver tumors have reported promising results and high local control rates of over 90%. However, there are wide variations in dose and fractionation due to different prescription policies and treatment methods across SABR series that have been published to date. This study aims to assess and minimize inter-institutional variations in treatment planning using SABR for hepatocellular carcinoma (HCC) in preparation for a prospective multi-institutional study. Four institutions (A-D) participated in this study. Each institution was provided with data from four cases, including planning and diagnostic CT images and clinical information, and asked to implement three plans (a practice plan and protocol plans 1 and 2). Practice plans were established based on the current treatment protocols at each institution. In protocol plan 1, each institution was instructed to prescribe 40 Gy in five fractions within 95% of the planning target volume (PTV). After protocol plan 1 was evaluated, we made protocol plan 2, The additional regulation to protocol plan 1 was that 40 Gy in five fractions was prescribed to a 70% isodose line of the global maximum dose within the PTV. Planning methods and dose volume histograms (DVHs) including the median PTV D50 (Dm50) and the median normal liver volume that received 20 Gy or higher (Vm20) were compared. In the practice plan, Dm50 was 48.4 Gy (range, 43.6-51.2 Gy). Vm20 was 15.9% (range, 12.2-18.9%). In protocol plan 1, the Dm50 at institution A was higher (51.2 Gy) than the other institutions (42.0-42.2 Gy) due to differences in dose specifications. In protocol plan 2, variations in DVHs were reduced. The Dm50 was 51.9 Gy (range, 51.0-53.1 Gy), and the Vm20 was 12.3% (range, 10.4-13.2%). The homogeneity index was nearly equivalent at all institutions. There were notable inter-institutional differences in practice planning using SABR to

  9. Gastrointestinal Tumor Board: An Evolving Experience in Tehran Cancer Institute

    Directory of Open Access Journals (Sweden)

    Peiman Haddad

    2013-04-01

    Full Text Available Gastrointestinal (GI cancers are a significant source of morbidity and mortality in Iran, with stomach adenocarcinoma as the most common cancer in men and the second common cancer in women. Also, some parts of Northern Iran have one of the highest incidences of esophageal cancer in the world. Multi-disciplinary organ-based joint clinics and tumor boards are a well-recognized necessity for modern treatment of cancer and are routinely utilized in developed countries, especially in major academic centres. But this concept is relatively new in developing countries, where cancer treatment centres are burdened by huge loads of patients and have to cope with a suboptimum availability of resources and facilities. Cancer Institute of Tehran University of Medical Sciences is the oldest and the only comprehensive cancer treatment centre in Iran, with a long tradition of a general tumor board for all cancers. But with the requirements of modern oncology, there has been a very welcome attention to sub-specialized organ-based tumor boards and joint clinics here in the past few years. Considering this, we started a multi-disciplinary tumor board for GI cancers in our institute in early 2010 as the first such endeavor here. We hereby review this 2-year evolving experience. The process of establishment of a GI tumor board, participations from different oncology disciplines and related specialties, the cancers presented and discussed in the 2 years of this tumor board, the general intents of treatment for the decisions made and the development of interest in this tumor board among the Tehran oncology community will be reviewed. The GI tumor board of Tehran Cancer Institute started its work in January 2010, with routine weekly sessions. A core group of 2 physicians from each surgical, radiation and medical oncology departments plus one gastroenterologist, GI pathologist and radiologist was formed, but participation from all interested physicians was encouraged. An

  10. Adjuvant therapy for ampullary carcinomas: The Mayo Clinic experience

    International Nuclear Information System (INIS)

    Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed

  11. Clinicopathological study of male breast carcinoma: 24 years of experience

    OpenAIRE

    Shah, Parveen; Robbani, Irfan; Shah, Omar

    2009-01-01

    BACKGROUND AND OBJECTIVES: Because breast cancer in men is rare, few patients are available for prospective studies. To learn more about its epidemiology, risk factors, clinical features, genetics and pathology in our country, we conducted a retrospective study of all cases seen in recent decades at our institution. PATIENTS AND METHODS: We identified each case of male breast cancer in the database at the Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India, between the year...

  12. Treatment results of pediatric nasopharyngeal carcinoma, NCI, Cairo University experience

    International Nuclear Information System (INIS)

    Investigate treatment outcome, prognostic factors and survival among selected group of Egyptian pediatric nasopharyngeal carcinoma patients. Patients and methods Thirty patients treated from non-metastatic nasopharyngeal carcinoma between 1997 and 2012 were retrospectively evaluated including: TNM staging, chemo-radiotherapy regimens. Survival analysis was done using Kaplan–Meier survival curves. Results Twenty-three males and 7 females (M:F 3.2:1) with median age of 14 years; 84% with stages III/IV. Neck node enlargement was reported in 90% (27/30). Induction chemotherapy followed by radiotherapy was implemented in 80% of patients. Mucositis (87%) was the commonest treatment related toxicity. Nineteen patients (63%) were in CR with a median FU of 69 months (range 24–160). Eleven patients had treatment local and distant failures (2 local, 7 distant and 2 local/distant) at a median FU of 24 and 34 months respectively. 5-year overall and event-free survival rates were 77% and 63% respectively. Prolonged OAP of RT ⩾ 50 days, Hb<11 g% and T4 stage affected EFS and OAS on UVA; while on MVA; prolonged OAP of RT ⩾ 50 days (ρ = 0.002) and T4 stage (ρ = 0.004) affected EFS and only Hb < 11 g% (ρ = 0.019) affected OAS. Late toxicity was reported in 70% of irradiated patients. Conclusion Radio-chemotherapy management for pediatric NPC resulted in comparable treatment outcomes with tolerable late effects. Response adapted radio-chemotherapy regimens in addition to the potential use of IMRT should be recommended to decrease treatment related side effects. Prolonged OAP of RT ⩾ 50 days and low Hb level were encountered as adverse prognostic factors; findings that need further investigation.

  13. Gastrointestinal stromal tumors: Thirty years experience of an Institution

    Institute of Scientific and Technical Information of China (English)

    Simone Arolfo; Paolo Mello Teggia; Mario Nano

    2011-01-01

    AIM: To report our experience of gastrointestinal stromal tumors (GISTs) during the last 29 years.METHODS: Thirty two cases of GIST referred to our Institution from the 1st January 1981 to the 10th June 2010 were reviewed.Metastases, recurrence and survival data were collected in relation to age, history, clinical presentation, location, size, resection margins and cellular features.RESULTS: Mean age was 63.7 years (range, 40-90) and incidence was slightly higher in males (56%).R0 resection was performed in 90.7% of cases, R1 in 6.2% (2 cases) and R2 in 3.1% (one case).Using Fletcher's classification 8/32 (25%) had high risk, 9/32 (28%) intermediate and 15/32 (47%) low risk tumors.Follow-up varied from 1 mo to 29 years, with a median of 8 years; overall survival was 75% (24/32), disease-free survival was 72% and tumor-related mortality was 9.3%.Three patients with high risk GIST were treated with imatinib mesylate: one developed a recurrence after 36 mo, and 2 are free from disease at 41 mo.CONCLUSION: Surgical treatment remains the gold standard therapy for resectable GISTs.Pathological and biological features of the neoplasm represent the most important factors predicting the prognosis.

  14. Langerhan′s cell histiocytosis: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Singh Tejinder

    2010-01-01

    Full Text Available Background: Langerhans cell histiocytosis (LCH is a disease that primarily affects bone but can be associated with a clinical spectrum that ranges from a solitary bone lesion with a favorable natural history to a multisystem, life-threatening disease process. Aim: We analyzed our single institutional experience of managing children with LCH. Settings and Design: A total of 40 children of LCH, managed in tertiary cancer center in South India in the period from 2001 to 2005, were evaluated retrospectively. Materials and Methods: Clinicopathological features, laboratory findings, treatment modalities and long-term outcome were analyzed. Results: Children were aged between 2 months and 12 years, with a mean of 3 years. Majority of the children were below 5 years of age. Group B constituted a bulk of children. Disseminated cases were less (five patients. Liver function dysfunction was seen in four (10% children. Pulmonary interstitial infiltrates were seen in two (5% cases. Diabetes insipidus manifested in three patients. There was one death. Conclusion: A better understanding of the etiology and pathogenesis of LCH will result in more directed and efficacious treatment regimens.

  15. [Training as an institutional function: institutional transformation experience by the Paraná Sanitary Company].

    Science.gov (United States)

    Hübert, I H

    1982-01-01

    The experience of the Companhia de Saneamento do Paraná (SANEPAR) in recent years show that it is possible for a public service enterprise to operate on the entrepreneurial lines of a private business. For it to do this, it must start out with an awareness of entrepreneurial values and by creating an atmosphere that is congenial at the same time to the service mentality, motivation, the realization of individual potential, and efficiency. When the entrepreneurial values to be espoused have been defined and translated into concrete and measurable targets, incentives must be provided. In consequence of measures of this kind, SANEPAR has undergone a distinct institutional transformation whose concrete results are visible and measureable. A central feature of this transformation has been the broad participation and consequent involvement of the employees in the fate of the organization. Because of this involvement and the importance given to human resources, it became necessary to formulate and carry out an extensive personnel development program, in which training has come to the forefront as a means for stimulating and accelerating the realization of human potential. The measures taken have proved highly valid and have indelibly stamped the organization with the values and mentality of service. The assimilation of entrepreneurial values and the motivation and training of the employees has brought about real conditions for the growth and development of the entire organization. PMID:7140617

  16. Radiotherapy for Epidermoid Carcinoma of the Anus: Thirty Years' Experience

    International Nuclear Information System (INIS)

    Purpose: To evaluate the factors associated with disease control and morbidity after radiotherapy for anal carcinoma. Methods and Materials: Between 1975 and 2005, 194 patients with localized epidermoid anal carcinoma underwent radiotherapy. Treatment evolved from radiotherapy with or without surgery, to preoperative chemoradiotherapy, to definitive chemoradiotherapy (CRT). The radiotherapy techniques also evolved. Results: With a median follow-up of 61 months, 57 patients had persistence or recurrence, 9 of whom were successfully salvaged, resulting in 146 (75%) ultimately free of disease (UNED). Univariate analysis for UNED survival showed a strong association with the T and N stage (5-year UNED rate, 88.5% ± 3.4% for those with Stage T1-T2N0; 70.1% ± 4.2% for Stage T3N0; and 52.7% ± 6.6% for Stage III; p > .001) and mobility on palpation (5-year UNED rate, 89.2% ± 4.6% for those with mobile tumors vs. 59.3% ± 6.1% for those with tethered/fixed tumor; p > .001). No association was found with gender, age, preoperative vs. definitive CRT, or human immunodeficiency virus status. The 20 human immunodeficiency virus+ patients all received CRT. The radiotherapy factors associated with Grade 3 or greater late morbidity included anorectal morbidity with tumor dose (29% with a dose ≥55 Gy vs. 9% otherwise), small bowel injury with technique (9% with anteroposterior-posteroanterior supine vs. 0.7% with multiple fields prone), and bone injury with femoral head dose (9% with a dose of ≥44 Gy vs. 0.7% otherwise). Of the 194 patients, 56 had 68 additional malignancies, mainly either antedating the anal cancer or outside the radiation fields. Conclusion: Our results have confirmed that CRT is an effective approach. Patients with human immunodeficiency virus can be treated with CRT. Tumor mobility significantly predicts the outcome; the implications for management are discussed. We also discuss the treatment planning implications of the late morbidity findings. The

  17. New Faculty Experience in Times of Institutional Change

    Science.gov (United States)

    Yeo, Michelle; Bennett, Deb; McNichol, Jane Stoneman; Merkley, Cari

    2015-01-01

    Many post-secondary institutions in Canada over the past decade have made the transition from college to university status. The researchers on this team were hired in the midst of such a transition at one western Canadian institution. As new faculty we were navigating the normal tides of adjusting to a new faculty position, but our induction…

  18. Treatment of hepatocellular carcinoma: A single-center experience

    International Nuclear Information System (INIS)

    Purpose. The comparative efficacy of transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) was investigated. Methods. Two hundred and sixty consecutive patients were retrospectively analyzed: 156 had received between one and six chemoembolization sessions at 3-month intervals, 33 had had PEI, and the remaining 71 patients refused any treatment. The follow-up ranged from 3 to 36 months. Survival rates were statistically analyzed by life-table analysis. Results. Patients' survival was affected by the number of nodules and by the Child's and Okuda's classes; no relationship was found between survival rates and the histologic grade or vascular supply of the tumor. In the case of a single lesion of Okuda's class I, TACE was more effective than PEI. In multifocal HCC, TACE was better than no treatment in Okuda's class I and Child's class A. Conclusion. We suggest TACE as the treatment of choice in Child A or Okuda I patients with multifocal HCCs; it seems of little help in Child B-C or Okuda II-III patients

  19. Ruptured hepatocellular carcinoma following chemoembolization:a western experience

    Institute of Scientific and Technical Information of China (English)

    Narendra Battula; Parthi Srinivasan; Mansoor Madanur; Srinivas Prabhu Chava; Oliver Priest; Mohamed Rela; Nigel Heaton

    2007-01-01

    BACKGROUND:Transcatheter arterial chemoembolization (TACE) is a recommended ifrst line therapy for unresectable hepatocellular carcinoma (HCC). Serious complications such as neutropenic sepsis and hepatic decompensation are well known, but rupture of HCC following TACE is a rare and potentially fatal complication. The aim of this study was to identify the incidence of ruptured HCC following TACE and the associated risk factors. METHODS:A retrospective analysis was performed using our liver database with key words "chemoembolization","ruptured HCC" covering the patients who received chemoembolization from January 1995 to December 2005. There were no exclusions. RESULTS:A total of 294 patients received chemoemboliza-tion in 530 sessions during the 10-year period. Of these, 2 ruptured following treatment (incidence 0.68%). The mean age was 65 years and the interval between the treatment and rupture was 2 and 24 days. The common factors were male sex, large tumor size (range 11-13 cm), and exophytic tumor growth. One patient died 2 days after rupture with hepatic decompensation while the second is alive after a 6-month follow up without tumor recurrence. CONCLUSIONS:Ruptured HCC following TACE is a rare but serious complication. Large tumor size, male sex, and exophytic growth of tumor may be predisposing factors for rupture.

  20. Evaluation acting: the experience of a public research institute

    International Nuclear Information System (INIS)

    Innovation and knowledge management are central questions of the modern world economy where the incorporation of new knowledge is determining for competition. In this context, there is a movement of pression under public research institutions for a more dynamic participation on the local innovation system. The institutions of C and T should prepare to help the companies to insert in the context of open economies and also to compete in the global market. The modernity requires flexibility and organizational changes in the research institutions. Redefinitions of their practices in relation to other aspects such as: financing sources; partnership with other organizations; definition and planning of the objectives; evaluation, diffusion and valorization of the results and the establishing of a measuring system and performance indicators. Aiming at having an effective institutional insertion on the national and regional systems of innovation, the Nuclear Technology Development Center - CDTN reformulated its strategical planning, incorporating the view of the researchers of the Center and external experts. As part of the evaluation process, CDTN organizes an annual seminar for evaluating its projects, focused on presenting the results and also on the analysis of the performance indicators. The result of this pairs review are widely informed to the Institution and is an important tool for the critical analysis of the institutional performance and for corrections to be made by the high direction. This paper presents the methodology for evaluating the results, as well as the difficulties and improvements incorporated to the process, which has been applied for three years. (author)

  1. Medullary carcinoma of the thyroid: Claudius-Regaud center's experience

    International Nuclear Information System (INIS)

    From June 1971 to September 1989, 38 patients had been treated for medullary carcinoma of the thyroid (MCT). Four patients were excluded from the study, because they were rapidly lost of follow up. We have distinguished three groups: i) group 1 (infra-clinic tumor diagnosed at the time of family investigation): four cases treated by radical thyroidectomy and bilateral cervical evidement; ii) group 2 (bulky cervical tumor with metastatic spread): three patients treated with a palliative intent; iii) group 3 (bulky cervical tumor with metastatic spread): 27 patients treated by thyroidectomy (with cervical lymph mode dissection in 23 cases) and post-operative radiotherapy for 20 patients who had histopathologic invading nodes or a large extracapsular spreading. All patients from the group 1 are alive free of recurrence and the median follow up time is 35 months. In group 2: two patients died from the disease three and 10 months after initial therapy and one patient is alive with disease after 72 months of follow up. In group 3: median follow up time is 79 months. Ten patients (37%) had a local and locoregional failure (isolated nodal recurrence: three patients local and/or nodal relapse with metastatic failure: seven patients). For teen per cent of the irradiated patients relapsed in the target volume. Nine patients (33%) had a metastatic relapse without evidence of cervical recurrence. Median period of metastatic recurrence is 47 months. Specific survival and disease free survival of 65 and 45% at 5 years, 54 and 26% at 10 years respectively. From nine prognosis parameters considered, the post-therapy increasing of tumor markers (thyrocalcitonin and/or CE/A) had significant influence on disease free survival (P<0.02). Histological nodal status had no significant influence on actuarial metastatic rate, but 93% of metastatic patients were N+, and 65% of patients with N+ became M+. This study confirms that metastatic dissemination in patients with nodal invading is a

  2. Clinicopathologic analysis of pituitary adenoma: a single institute experience.

    Science.gov (United States)

    Cho, Hwa Jin; Kim, Hanna; Kwak, Yoon Jin; Seo, Jeong Wook; Paek, Sun Ha; Sohn, Chul-Ho; Yun, Jung Min; Kim, Da Seu Ran; Kang, Peter; Park, Peom; Park, Sung-Hye

    2014-03-01

    Pituitary adenoma (PA) is a common benign neuroendocrine tumor; however, the incidence and proportion of hormone-producing PAs in Korean patients remain unknown. Authors analyzed 506 surgically resected and pathologically proven pituitary lesions of the Seoul National University Hospital from 2006 to 2011. The lesions were categorized as: PAs (n = 422, 83.4%), Rathke's cleft cysts (RCCs) (n = 54, 10.6%), inflammatory lesions (n = 8, 1.6%), meningiomas (n = 4), craniopharyngiomas (n = 4), granular cell tumors (n = 1), metastatic renal cell carcinomas (n = 2), germinomas (n = 1), ependymomas (n = 1), and unsatisfactory specimens (n = 9, 1.8%). PAs were slightly more prevalent in women (M: F = 1:1.17) with a mean age of 48.8 yr (9-80 yr). Immunohistochemical analysis revealed that prolactin-producing PAs (16.6%) and growth hormone-producing adenomas (9.2%) were the most common functional PAs. Plurihormonal PAs and nonfunctioning (null cell) adenomas were found in 14.9% and 42.4% of patients with PAs, respectively. The recurrence rate of PAs was 11.1%, but nearly 0% for the remaining benign lesions such as RCCs. 25.4% of patients with PAs were treated by gamma-knife after surgery due to residual tumors or regrowth of residual tumor. In conclusion, the pituitary lesions and the proportions of hormone-producing PAs in Korean patients are similar to those of previous reports except nonfunctioning (null cell) PAs, which are unusually frequent. PMID:24616591

  3. Summer Institute in Engineering and Computer Applications: Learning Through Experience

    Science.gov (United States)

    Langdon, Joan S.

    1995-01-01

    The document describing the Summer Institute project is made up of the following information: Administrative procedures; Seminars/Special Courses/Tours/College fair; Facilities/ Transportation; Staff and Administration; Collaboration; Participant/Project monitoring and evaluation; Fiscal and developmental activities; Job readiness/Job internship development and placement; and Student Follow-up/Tracking. Appendices include presentations, self-evaluations; abstracts and papers developed by the students during their participation in the program.

  4. Stakeholder Involvement. The Institute of Radioprotection and Nuclear Safety Experience

    International Nuclear Information System (INIS)

    Cooperation between experts and people affected by radiation in any radiological accident situation, and more generally public trust in the institutions responsible for evaluation and management of radiological risks, is a key factor for developing efficient radiation protection policies and operations. However, cooperation and trust cannot simply be ordered, and where it has been damaged, or when it is lacking, its rebuilding or enhancement requires the support of a carefully planned process over a number of years. Since 2006, in agreement with the French government ministers overseeing IRSN's development, the institute has embarked on a policy of 'opening to society', aimed at 'bringing together the experts and the stakeholders'. Taking advantage of the modernisation of the national organization for nuclear safety and radiation protection - which has led to a multifaceted system in which the stakeholders are present, particularly in the 'local information committees' (CLI) set up at each nuclear site - IRSN has launched a strategy and an operational implementation programme which basically consists in 'investing in people'. This means people from within the institute itself, to bring about required culture changes, and also people outside the institute, through education, cooperation with CLI and stakeholder associations, and people in research bodies, to move towards more 'society oriented' R and D programmes, for example in order to reduce existing uncertainties in the field of low dose risks. This presentation thus illustrates the path initiated by IRSN, which has already brought about practical results, but which needs to be pursued over a long period in order to build a lasting capital of trust within society. (author)

  5. Marketing Library and Information Services: Comparing Experiences at Large Institutions.

    Science.gov (United States)

    Noel, Robert; Waugh, Timothy

    This paper explores some of the similarities and differences between publicizing information services within the academic and corporate environments, comparing the marketing experiences of Abbot Laboratories (Illinois) and Indiana University. It shows some innovative online marketing tools, including an animated gif model of a large, integrated…

  6. Left main bronchus resection and reconstruction. A single institution experience

    Directory of Open Access Journals (Sweden)

    Ragusa Mark

    2012-04-01

    Full Text Available Abstract Background Left main bronchus resection and reconstruction (LMBRR is a complex surgical procedure indicated for management of inflammatory, benign and low grade malignant lesions. Its application provides maximal parenchymal sparing. Methods Out of 98 bronchoplastic procedures performed at the Authors' Institution in the 1995-2011 period, 4 were LMBRR. Indications were bronchial carcinoid in 2 cases, inflammatory pseudotumor in 1 case, TBC stricture in 1 case. All patients underwent preoperatively a rigid bronchoscopy to restore the airway lumen patency. At surgery a negative resection margin was confirmed by frozen section in the neoplastic patients. In all patients an end-to-end bronchial anastomosis was constructed according to Grillo. Results There were neither mortality nor major complications. Airway lumen was optimal in 3 patients, good in 1. Conclusion LMBRR is a valuable option for the thoracic surgeon. It maximizes the parenchyma-sparing philosophy, broadening the spectrum of potential candidates for cure. It remains a technically demanding procedure, to be carried out by an experienced surgical team. Correct surgical planning affords excellent results, both in the short and long term.

  7. Living in institutional care: residents' experiences and coping strategies.

    Science.gov (United States)

    Timonen, Virpi; O'Dwyer, Ciara

    2009-01-01

    Insights into daily living in residential care settings are rare. This article draws on a qualitative dataset (semi-structured interviews and recordings of residents' council meetings) that gives a glimpse of the experiences and coping strategies of (older) people living in residential care. The data highlight the range of unmet needs of the residents, similar to the categories of physiological, safety, love, esteem, and self-actualization needs in Maslow's hierarchy of needs theory. Our analysis indicates that "higher" and "lower" needs are closely intertwined and mutually reinforcing and should therefore be accorded equal emphasis by professionals (including social workers) employed within residential care settings. PMID:19860294

  8. Multi-Institutional Experience with FOLFIRINOX in Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Parvin F Peddi

    2012-09-01

    Full Text Available Context Combination chemotherapy with FOLFIRINOX (oxaliplatin, irinotecan, fluorouracil, and leucovorin was shown to beeffective in a large phase III trial. Objective The purpose of this study was to examine the tolerance and effectiveness ofFOLFIRINOX as practiced outside of the confines of a clinical trial and to document any dose modifications used by practicing oncologists. Methods Data on patients with all stages of pancreatic adenocarcinoma treated with FOLFIRINOX at three institutions was analyzed for efficacy, tolerance, and use of any dose modifications. Results Total of 61 patients was included in this review. Median age was 58 years (range: 37 to 72 years, 33 were male (54.1% and majority had ECOG performance of 0 or 1 (86.9%, 53 patients. Thirty-eight (62.3% had metastatic disease, while 23 (37.7% were treated for locally advanced or borderline resectable disease. Patients were treated with a median number of four cycles of FOLFIRINOX, with dose modifications in 58.3% (176/302 of all cycles. Ten patients had stable disease (16.4%, four had a partial response (6.6% while eight had progressive disease (13.1% on best imaging following therapy. Median progression-free survival and overall survival were 7.5 months and 13.5 months, respectively. The most common grade 3-4 adverse event was neutropenia at 19.7% (12 cases, with 4.9% (3 cases rate of febrile neutropenia. Twenty-one patients (34.4% were hospitalized as a result of therapy but there were no therapy-related deaths. Twentythree (37.7% had therapy eventually discontinued as a result of adverse events. Conclusion Despite substantial rates of adverse events and use of dose modifications, FOLFIRINOX was found to be clinically effective in both metastatic and non-metastatic patients. Regimen toxicity did not detract from overall response and survival.

  9. Experiences with carotid endarterectomy at Sree Chitra Tirunal Institute

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    Unnikrishnan Madathipat

    2008-01-01

    Full Text Available Background: Atherosclerotic carotid artery disease poses a grave threat to cerebral circulation, leading to a stroke with its devastating sequelae, if left untreated. Carotid endarterectomy has a proven track record with compelling evidence in stroke prevention. Objectives: aTo confirm that carotid endarterectomy (CEA is safe and effective in preventing stroke at both short and long term. b to demonstrate long term patency of internal carotid artery when arteriotomy repair is performed using autologous saphenous vein patch. Materials and Methods: During ten years, from September 1997 to February 2008, thirty nine patients who underwent consecutive carotid endarterectomy at our institute, form the basis of this report. Their age ranged from thirty to seventy eight years, with a mean age of 56. There were four women in this cohort. Thirty seven patients were symptomatic with> 70% stenosis and two were asymptomatic with> 80% stenosis, incidentally detected. Imaging included Duplex scan and MRA for carotid territory and brain, and non-invasive cardiac assessment. Co-morbidities included smoking, hypertension, diabetes, and coronary artery disease. Carotid Endarterectomy was performed under general anaesthesia, using carotid shunt and vein patch arteriotomy repair. Results: All the patients made satisfactory recovery, without major adverse cerebral events in this series. Morbidities included Transient Ischemic Attack (TIA in two, needing only medications in one, and carotid stenting in the other. Minor morbidities included neck hematoma in two and transient hypoglossal paresis in three patients. Yearly follow-up included duplex scan assessment for all the patients. Two patients died of contralateral stroke, two of myocardial events and two were lost to follow up. Thirty three patients are well and free of the disease during the follow up of three to 120 months. Conclusion: Carotid endarterectomy provided near total freedom from adverse cerebral

  10. Acute leukemia of childhood: A single institution's experience

    Directory of Open Access Journals (Sweden)

    Slavković Bojana

    2005-01-01

    Full Text Available The aim of this study was to investigate distribution of immunophenotypic and cytogenetic features of childhood acute leukemia (AL in the cohort of 239 newly diagnosed patients registered at the leading pediatric oncohematology center in the country during a six-year period (1996-2002. With approximately 60-70% of all childhood AL cases in Serbia and Montenegro being diagnosed and treated in this institution the used data represent a valid research sample to draw conclusions for entire country. On the basis of five phenotypic markers, the distribution of immunological subtypes was as follows: 169 (70.7% expressed B-cell marker CD19 (137 were CD10 positive and 32 CD10 negative, 37 (15.5% belonged to T-lineage acute lymphoblastic leukemia (T-ALL (cyCD3 positive, and 33 (13.8% were acute myeloblastic leukemia (AML (CD13 positive and/or CD33 positive in the absence of lymphoid-associated antigens. The ratio of males and females was 1.5:1. Most of the cases were between the ages of 2 and 4, and were predominantly B-lineage acute lymphoblastic leukemia (B-ALL cases. Another peak of age distribution was observed at the age of 7. The frequency of T-ALL (18% of ALL was similar to that reported for Mediterranean countries: France (19.4%, Greece (28.1%, Southern Italy (28.3%, and Bulgaria (28.0%. Cytogenetic analyses were performed in 193 patients: 164 ALL and 29 AML. Normal karyotype was found in 57% of ALL and in 55% of AML patients, while cytogenetic abnormalities including structural, numerical, and complex chromosomal rearrangements were found in 43% of ALL and in 45% of AML patients. Our results represent a contribution to epidemiological aspects of childhood leukemia studies.

  11. Lutetium-177 Labeled Peptides: The European Institute of Oncology Experience.

    Science.gov (United States)

    Carollo, Angela; Papi, Stefano; Chinol, Marco

    2016-01-01

    Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogues has shown encouraging results in various somatostatin receptor positive tumors. Partial remission rates up to 30% have been documented as well as significant improvements in quality of life and survival. This treatment takes advantage of the high specific binding of the radiolabeled peptide to somatostatin receptors overexpressed by the tumors thus being more effective on the tumor cells with less systemic side-effects. The development of macrocyclic chelators conjugated to peptides made possible the stable binding with various radionuclides. In particular 177Lu features favourable physical characteristics with a half-life of 6.7 days, emission of β- with energy of 0.5 MeV for treatment and γ-emissions suitable for imaging. The present contribution describes the learning process achieved at the European Institute of Oncology (IEO) since the first application of 90Y labeled peptides to the therapy of neuroendocrine tumors back in 1997. Continuous improvements led to the preparation of a safe 177Lu labeled peptide for human use. Our learning curve began with the identification of the optimal characteristics of the isotope paying attention to its chemical purity and specific activity along with the optimization of the parameters involved in the radiolabeling procedure. Also the radiation protection issues have been improved along the years and recently more and more attention has been devoted to the pharmaceutical aspects involved in the preparation. The overall issue of the quality has now been completed by drafting an extensive documentation with the goal to deliver a safe and reliable product to our patients. PMID:25771368

  12. Anaplastic large cell lymphoma: A single institution experience from India

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    K C Lakshmaiah

    2013-01-01

    Full Text Available Background: Systemic anaplastic large cell lymphoma (ALCL accounts for 2-8% of non-Hodgkin′s lymphoma in adults and 10-15% in children. While there is ample data in the world literature about the clinical features and outcome of this disease, prognosis in Indian patients is largely unknown. Objective: To study the clinical, pathologic profile and outcome ALCL. Materials and Methods: Fifty patients who had pathologically proven diagnosis of systemic ALCL at our institute from June 2003 to May 2011 were included for retrospective analysis. This included 30 cases of anaplastic lymphoma kinase+ (ALK+, ALCL and 20 cases of anaplastic lymphoma kinase- (ALK−, ALCL. The hospital protocol for treatment of these patients included CHOP chemotherapy regimen in >15 years of age and MCP842 protocol with vinblastine for 1 year in <15 years of age. Event free survival was noted. These outcomes were correlated with ALK status, International Prognostic Index (IPI score, and stage at presentation. Results: At a median follow-up of 36 months (range: 6-72 months ALK− ALCL had a poor outcome. The 3 year event free survival in pediatric ALCL was 66.7%. In adults, this was 60% ALK+ ALCL was 60% and 20% in ALK− ALCL. Conclusions: Systemic ALCL is an aggressive disease. CD3 + positivity is commonly seen in ALK− ALCL and ALK+, epithelial membrane antigen + positivity is seen in ALK+ ALCL. ALK− ALCL, advanced stage III, IV and high IPI score were associated with poor prognosis. The demographic profile and outcome in our study was similar to the world literature. With new drugs like crizotinib and brentuximab vedotin the future looks very promising.

  13. THE AUTHOR’S EXPERIENCE IN USING BEVACIZUMAB PLUS INTERFERON ALFA-2A IN PATIENTS WITH DISSEMINATED RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    A. M. Popov

    2010-01-01

    Full Text Available Target therapy is a main approach to treating metastatic renal cell carcinoma. Bevacizumab plus interferon alfa-2A is now standard first-line options for patients with previously untreated, good or intermediate prognosis (using the Memorial Sloan-Kettering Cancer Center criteria. We have presented our experience in using bevacisumab plus interferon alfa-2A in patients with metastatic renal cell carcinoma. Median progression-free survival and overall survival were 10 months and 22 months, respectively.

  14. THE AUTHOR’S EXPERIENCE IN USING BEVACIZUMAB PLUS INTERFERON ALFA-2A IN PATIENTS WITH DISSEMINATED RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    A. M. Popov

    2014-08-01

    Full Text Available Target therapy is a main approach to treating metastatic renal cell carcinoma. Bevacizumab plus interferon alfa-2A is now standard first-line options for patients with previously untreated, good or intermediate prognosis (using the Memorial Sloan-Kettering Cancer Center criteria. We have presented our experience in using bevacisumab plus interferon alfa-2A in patients with metastatic renal cell carcinoma. Median progression-free survival and overall survival were 10 months and 22 months, respectively.

  15. Institutional Versus Academic Discipline Measures of Student Experience: A Matter of Relative Validity

    OpenAIRE

    Chatman, Steve

    2007-01-01

    The University of California’s census survey of undergraduates, UCUES, presents an opportunity to measure both disciplinary and institutional differences in students’ academic experience. Results from nearly 60,000 responses (38% response rate) from the 2006 administration found greater variance among majors within an institution than between equivalent majors across institutions. Cluster analysis techniques were employed to establish disciplinary patterns, with traditional distinctions b...

  16. Monitoring instrument field experiments at Oregon Institute of Technology

    Energy Technology Data Exchange (ETDEWEB)

    Danielson, M.J.; Smith, R.P.

    1980-09-01

    The field tests were conducted under reducing and oxidizing conditions. Corrosion rates with zero oxygen were about 1.1 mils per year (mpy) for both copper and steel coupons, which is quite low for carbon steel. There was a problem controlling the oxygen level in the oxygenated experiments; however, it was found that corrosion rates increased with the presence of oxygen. Corrosion rates for the steel and copper coupons were 4 and 2 mpy, respectively; copper coupled to cast iron corroded at 8 mpy. Commercial corrosion rate measuring equipment determined the general corrosion rate of carbon steel farily well but overestimated copper corrosion rates. The redox electrode was a very sensitive indicator of the entry of oxygen.

  17. Adjuvant chemo-radiation for gastric adenocarcinoma: an institutional experience

    International Nuclear Information System (INIS)

    Studies have shown that surgery alone is less than satisfactory in the management of early gastric cancer, with cure rates approaching 40%. The role of adjuvant therapy was indefinite until three large, randomized controlled trials showed the survival benefit of adjuvant therapy over surgery alone. Chemoradiation therapy has been criticized for its high toxicity. 24 patients diagnosed between September 2001 and July 2007 were treated with adjuvant chemoradiation. 18 patients had the classical MacDonald regimen of 4500 cGy of XRT and chemotherapy with 5-fluorouracil (5FU) and leucovorin, while chemotherapy consisted of 5FU/Cisplatin for 6 patients. This series consisted of non-metastatic patients, 17 females and 7 males with a median age of 62.5 years. 23 patients (96%) had a performance status of 0 or 1. The full course of radiation therapy (4500 cGy) was completed by 22 patients (91.7%). Only 7 patients (36.8%) completed the total planned courses of chemotherapy. 2 local relapses (10%), 2 regional relapses (10%) and 2 distant relapses (10%) were recorded. Time to progression has not been reached. 9 patients (37.5%) died during follow-up with a median overall survival of 75 months. Patients lost a mean of 4 Kgs during radiation therapy. We recorded 6 episodes of febrile neutropenia and the most frequent toxicity was gastro-intestinal in 17 patients (70.8%) with 9 (36%) patients suffering grade 3 or 4 toxicity and 5 patients (20%) suffering from grade 3 or 4 neutropenia. 4 (17%) patients required total parenteral nutrition for a mean duration of 20 days. 4 patients suffered septic shock (17%) and 1 patient developed a deep venous thrombosis and a pulmonary embolus. Adjuvant chemo-radiation for gastric cancer is a standard at our institution and has resulted in few relapses and an interesting median survival. Toxicity rates were serious and this remains a harsh regimen with only 36.8% of patients completing the full planned courses of chemotherapy. This is due to

  18. Adjuvant chemo-radiation for gastric adenocarcinoma: an institutional experience

    Directory of Open Access Journals (Sweden)

    Ghosn Marwan G

    2010-06-01

    Full Text Available Abstract Background Studies have shown that surgery alone is less than satisfactory in the management of early gastric cancer, with cure rates approaching 40%. The role of adjuvant therapy was indefinite until three large, randomized controlled trials showed the survival benefit of adjuvant therapy over surgery alone. Chemoradiation therapy has been criticized for its high toxicity. Methods 24 patients diagnosed between September 2001 and July 2007 were treated with adjuvant chemoradiation. 18 patients had the classical MacDonald regimen of 4500 cGy of XRT and chemotherapy with 5-fluorouracil (5FU and leucovorin, while chemotherapy consisted of 5FU/Cisplatin for 6 patients. Results This series consisted of non-metastatic patients, 17 females and 7 males with a median age of 62.5 years. 23 patients (96% had a performance status of 0 or 1. The full course of radiation therapy (4500 cGy was completed by 22 patients (91.7%. Only 7 patients (36.8% completed the total planned courses of chemotherapy. 2 local relapses (10%, 2 regional relapses (10% and 2 distant relapses (10% were recorded. Time to progression has not been reached. 9 patients (37.5% died during follow-up with a median overall survival of 75 months. Patients lost a mean of 4 Kgs during radiation therapy. We recorded 6 episodes of febrile neutropenia and the most frequent toxicity was gastro-intestinal in 17 patients (70.8% with 9 (36% patients suffering grade 3 or 4 toxicity and 5 patients (20% suffering from grade 3 or 4 neutropenia. 4 (17% patients required total parenteral nutrition for a mean duration of 20 days. 4 patients suffered septic shock (17% and 1 patient developed a deep venous thrombosis and a pulmonary embolus. Conclusions Adjuvant chemo-radiation for gastric cancer is a standard at our institution and has resulted in few relapses and an interesting median survival. Toxicity rates were serious and this remains a harsh regimen with only 36.8% of patients completing the

  19. Quality Assurance and Its Impact from Higher Education Institutions' Perspectives: Methodological Approaches, Experiences and Expectations

    Science.gov (United States)

    Bejan, Stelian Andrei; Janatuinen, Tero; Jurvelin, Jouni; Klöpping, Susanne; Malinen, Heikki; Minke, Bernhard; Vacareanu, Radu

    2015-01-01

    This paper reports on methodological approaches, experiences and expectations referring to impact analysis of quality assurance from the perspective of three higher education institutions (students, teaching staff, quality managers) from Germany, Finland and Romania. The presentations of the three sample institutions focus on discussing the core…

  20. Alloys compatibility in molten salt fluorides: Kurchatov Institute related experience

    Science.gov (United States)

    Ignatiev, Victor; Surenkov, Alexandr

    2013-10-01

    In the last several years, there has been an increased interest in the use of high-temperature molten salt fluorides in nuclear power systems. For all molten salt reactor designs, materials selection is a very important issue. This paper summarizes results, which led to selection of materials for molten salt reactors in Russia. Operating experience with corrosion thermal convection loops has demonstrated good capability of the “nickel-molybdenum alloys + fluoride salt fueled by UF4 and PuF3 + cover gas” system up to 750 °C. A brief description is given of the container material work in progress. Tellurium corrosion of Ni-based alloys in stressed and unloaded conditions studies was also tested in different molten salt mixtures at temperatures up to 700-750 °C, also with measurement of the redox potential. HN80MTY alloy with 1% added Al is the most resistant to tellurium intergranular cracking of Ni-base alloys under study.

  1. The Experiences of Service Users in Family Focused Institutional Addiction Treatment

    OpenAIRE

    Fritsche, Dietmar; Dhakal, Sara

    2013-01-01

    Dhakal, Sara & Fritsche, Dietmar The Experiences of Service Users in Family Focused Institutional Addiction Treatment. 36 pages, 4 appendices. Language: English. Helsinki, Autumn 2013. Diaconia University of Applied Sciences. Degree Programme in Social Services. Degree: Bachelor of Social Services. The aim of this study was to increase the knowledge about the experiences of service users in family-focused institutional addiction treatment. The research data was collected in a family focuse...

  2. Global competition, institutional context, and regional production networks: Up- and downgrading experiences in Romania's apparel industry

    OpenAIRE

    Plank, Leonhard; Staritz, Cornelia

    2014-01-01

    Regional suppliers still play an important role in the global apparel industry. By studying the experience of Romania's apparel sector, the paper highlights, first, the importance of multiscalar institutional, macro and policy contexts in analyzing the articulation of and up- and downgrading experiences in global production networks. These include the Multi-Fibre Arrangement, EU trade agreements and accession, the global economic crisis, and the specific institutional and policy context of po...

  3. Intraoperative Radiotherapy for Parotid Cancer: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Purpose: Our practice policy has been to provide intraoperative radiotherapy (IORT) at resection to patients with head-and-neck malignancies considered to be at high risk of recurrence. The purpose of the present study was to review our experience with the use of IORT for primary or recurrent cancer of the parotid gland. Methods and Materials: Between 1982 and 2007, 96 patients were treated with gross total resection and IORT for primary or recurrent cancer of the parotid gland. The median age was 62.9 years (range, 14.3–88.1). Of the 96 patients, 33 had previously undergone external beam radiotherapy as a component of definitive therapy. Also, 34 patients had positive margins after surgery, and 40 had perineural invasion. IORT was administered as a single fraction of 15 or 20 Gy with 4–6-MeV electrons. The median follow-up period was 5.6 years. Results: Only 1 patient experienced local recurrence, 19 developed regional recurrence, and 12 distant recurrence. The recurrence-free survival rate at 1, 3, and 5 years was 82.0%, 68.5%, and 65.2%, respectively. The 1-, 3-, and 5-year overall survival rate after surgery and IORT was 88.4%, 66.1%, and 56.2%, respectively. No perioperative fatalities occurred. Complications developed in 26 patients and included vascular complications in 7, trismus in 6, fistulas in 4, radiation osteonecrosis in 4, flap necrosis in 2, wound dehiscence in 2, and neuropathy in 1. Of these 26 patients, 12 had recurrent disease, and 8 had undergone external beam radiotherapy before IORT. Conclusions: IORT results in effective local disease control at acceptable levels of toxicity and should be considered for patients with primary or recurrent cancer of the parotid gland.

  4. Prenatal Diagnosis of Chromosome Abnormalities: A 13-Year Institution Experience

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    Carmen Comas

    2012-11-01

    Full Text Available Objective: To analyze trends in screening and invasive prenatal diagnosis of chromosome abnormalities (CA over a 13-year period and correlate them to changes in the national prenatal screening policy. Methods: We retrospectively reviewed Down syndrome (DS screening tests and fetal karyotypes obtained by prenatal invasive testing (IT in our fetal medicine unit between January 1999 and December 2011. Results: A total of 24,226 prenatal screening tests for DS and 11,045 invasive procedures have been analyzed. Over a 13-year period, utilization of non-invasive screening methods has significantly increased from 57% to 89%. The percentage of invasive procedures has declined from 49% to 12%, although the percentage of IT performed for maternal anxiety has increased from 22% to 55%. The percentage of detected CA increased from 2.5% to 5.9%. Overall, 31 invasive procedures are needed to diagnose 1 abnormal case, being 23 procedures in medical indications and 241 procedures in non-medical indications. Conclusions: Our experience on screening and invasive prenatal diagnostic practice shows a decrease of the number of IT, with a parallel decline in medical indications. There is an increasing efficiency of prenatal screening program to detect CA. Despite the increasing screening policies, our population shows a growing request for prenatal IT. The a priori low risk population shows a not negligible residual risk for relevant CA. This observation challenges the current prenatal screening strategy focused on DS; showing that the residual risk is higher than the current cut-off used to indicate an invasive technique.

  5. Prenatal Diagnosis of Chromosome Abnormalities: A 13-Year Institution Experience

    Science.gov (United States)

    Comas, Carmen; Echevarria, Mónica; Rodríguez, María Ángeles; Rodríguez, Ignacio; Serra, Bernat; Cirigliano, Vincenzo

    2012-01-01

    Objective: To analyze trends in screening and invasive prenatal diagnosis of chromosome abnormalities (CA) over a 13-year period and correlate them to changes in the national prenatal screening policy. Methods: We retrospectively reviewed Down syndrome (DS) screening tests and fetal karyotypes obtained by prenatal invasive testing (IT) in our fetal medicine unit between January 1999 and December 2011. Results: A total of 24,226 prenatal screening tests for DS and 11,045 invasive procedures have been analyzed. Over a 13-year period, utilization of non-invasive screening methods has significantly increased from 57% to 89%. The percentage of invasive procedures has declined from 49% to 12%, although the percentage of IT performed for maternal anxiety has increased from 22% to 55%. The percentage of detected CA increased from 2.5% to 5.9%. Overall, 31 invasive procedures are needed to diagnose 1 abnormal case, being 23 procedures in medical indications and 241 procedures in non-medical indications. Conclusions: Our experience on screening and invasive prenatal diagnostic practice shows a decrease of the number of IT, with a parallel decline in medical indications. There is an increasing efficiency of prenatal screening program to detect CA. Despite the increasing screening policies, our population shows a growing request for prenatal IT. The a priori low risk population shows a not negligible residual risk for relevant CA. This observation challenges the current prenatal screening strategy focused on DS; showing that the residual risk is higher than the current cut-off used to indicate an invasive technique. PMID:26859399

  6. Combined therapy with surgery, radiation and chemotherapy for T3-T4 squamous cell carcinoma of maxillary sinus. National Cancer Center Hospital East experience

    International Nuclear Information System (INIS)

    Since 1960's, many institutes treated carcinoma of maxillary sinus with combined therapy: surgery, radiation, and intra-arterial infusion chemotherapy in Japan. On the other hands, surgery followed by radiation or chemoradiation is the standard option of treatment for sinonasal carcinoma in western countries. This study reports the NCCHE's 14-year experience with maxillary squamous cell cancer, treated with surgical resection followed by radiation, or trimodal combination therapy. Eighty-seven previously untreated, T3-T4 status patients with squamous cell carcinoma of maxillary sinus underwent treatment at our division. During the average follow-up period of 85.9 months, the 5-year overall survival and local control rate were 47.3% and 60%, respectively. The 5-year overall survival among the patients had T3 and T4a tumor were 59.0% and 51.6%. However, all patients with T4b tumor died, their median survival time was 9.1 months. Almost all patients had T3 and T4b were treated with trimodal therapy, a third patient of T4a status underwent treatment with surgery followed by radiation. There was no difference in overall survival according to treatment in T4a patients. We should consider the other approach for treatment, like superselective high-dose cisplatin infusion with concomitant radiotherapy in patients with advanced cancer of maxillary sinus in future. (author)

  7. Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective study

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    Vidali Cristiana

    2012-10-01

    Full Text Available Abstract Background The incidence of ductal carcinoma in situ (DCIS has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy (RT has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very long period of accrual, from February 1985 to March 2000, and a median follow-up longer than 11 years. Methods A collaborative multi-institutional study was conducted in Italy in 10 Radiation Oncology Departments. A consecutive series of 586 women with DCIS histologically confirmed, treated between February 1985 and March 2000, was retrospectively evaluated. Median age at diagnosis was 55 years (range: 29–84; 32 patients were 40 years old or younger. All women underwent conservative surgery followed by whole breast RT. Irradiation was delivered to the entire breast, for a median total dose of 50 Gy; the tumour bed was boosted in 295 cases (50% at a median dose of 10 Gy. Results After a median follow-up of 136 months (range: 16–292 months, 59/586 patients (10% experienced a local recurrence: invasive in 37 cases, intraductal in 20 and not specified in two. Salvage mastectomy was the treatment of choice in 46 recurrent patients; conservative surgery in 10 and it was unknown in three patients. The incidence of local recurrence was significantly higher in women younger than 40 years (31.3% (p= 0.0009. Five patients developed distant metastases. Furthermore 40 patients developed a contralateral breast cancer and 31 a second primary tumour in a different site. The 10-year actuarial overall survival (OS was 95.5% and the 10-year actuarial disease-specific survival (DSS was 99%. Conclusions Our results are consistent with those reported in the literature. In

  8. Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective study

    International Nuclear Information System (INIS)

    The incidence of ductal carcinoma in situ (DCIS) has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy (RT) has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very long period of accrual, from February 1985 to March 2000, and a median follow-up longer than 11 years. A collaborative multi-institutional study was conducted in Italy in 10 Radiation Oncology Departments. A consecutive series of 586 women with DCIS histologically confirmed, treated between February 1985 and March 2000, was retrospectively evaluated. Median age at diagnosis was 55 years (range: 29–84); 32 patients were 40 years old or younger. All women underwent conservative surgery followed by whole breast RT. Irradiation was delivered to the entire breast, for a median total dose of 50 Gy; the tumour bed was boosted in 295 cases (50%) at a median dose of 10 Gy. After a median follow-up of 136 months (range: 16–292 months), 59/586 patients (10%) experienced a local recurrence: invasive in 37 cases, intraductal in 20 and not specified in two. Salvage mastectomy was the treatment of choice in 46 recurrent patients; conservative surgery in 10 and it was unknown in three patients. The incidence of local recurrence was significantly higher in women younger than 40 years (31.3%) (p= 0.0009). Five patients developed distant metastases. Furthermore 40 patients developed a contralateral breast cancer and 31 a second primary tumour in a different site. The 10-year actuarial overall survival (OS) was 95.5% and the 10-year actuarial disease-specific survival (DSS) was 99%. Our results are consistent with those reported in the literature. In particular it has been defined the importance of young age (40

  9. Brachytherapy for T1-T2 floor-of-the-mouth cancers: the Gustave-Roussy Institute experience

    International Nuclear Information System (INIS)

    Purpose: In a retrospective analysis, we evaluated the Gustave-Roussy Institute's experience of locoregional control, survival, and complications of low-dose rate brachytherapy for carcinoma of the floor of the mouth. Methods and Materials: Between 1970 and 1985, 160 patients with previously untreated carcinoma of the floor of the mouth received interstitial brachytherapy as definitive treatment. Of the 160 patients, 79 (49%) had T1 and 81 (51%) had T2 lesions, and 127 (79%) had N0 and 33 (21%) had N1; 84% of tumors arose from the anterior floor of the mouth. Brachytherapy was performed with 192Ir wires, according to the Paris system rules, followed by neck dissection (T2 or N1) or follow-up (T1N0). Results: With a follow-up period of 9-19 years, the observed survival rates were 89% at 2 years and 76% at 5 years, and the local control rates were 93% in T1 and 88% in T2 tumors. A low rate of distant metastases was noticed (5%); 31% of patients developed a second primary cancer. Severe mucosal necrosis was observed in <10% of patients. Any grade of bone necrosis was seen in 18% of cases (only 2.5% had G3 necrosis). This complication occurred more frequently in patients with poor dental status and in those treated without dental protection during implantation (p <0.001). Conclusion: Radical brachytherapy offers excellent local control (89%) and an acceptable rate of complications (<10% severe necrosis) that may be significantly decreased with dental care and the use of protective devices. The high incidence of second malignancies remains a major concern in these patients

  10. Pre-operative Concomitant Radio-chemotherapy in Bulky Carcinoma of the Cervix: A Single Institution Study

    Directory of Open Access Journals (Sweden)

    Anne de la Rochefordiere

    2008-01-01

    Full Text Available Objective: To evaluate the treatment results of patients (pts with FIGO stage IB2, IIA, IIB cervical carcinoma (CC treated with pre-operative radio-chemotherapy, followed by extended radical hysterectomy.Methods: Retrospective study of 148 women treated to the Institut Curie for operable FIGO Stage IB2 to IIB, biopsy proved CC. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio-cisplatinum based chemotherapy, intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test. Results: Complete histological local-regional response was obtained in 56% of the pts (n = 39. Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%. All but one had in-situ microscopic residual CC. Lateral residual disease in the parametria was also present in 9 pts, all with residual CC. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%. Eight of 55 (11% radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40% radiological N1 (p = 0.03. Seventeen pts (25% had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8–141, 38/70 patients (54.1% are still alive and free of disease, 6 (8.6% alive with disease, and 11 (15.8% patients were lost for follow-up but free of disease.In conclusion: The treatment of locally advanced CC needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease.

  11. Thyroid carcinoma: The experience at the Oncology Centre in Nicosia, Cyprus

    International Nuclear Information System (INIS)

    Full text: Carcinoma of the thyroid is usually of follicular cell origin. Four distinct histologic types of follicular cell-derived cancers (FCDC) are recognized. The majority of cases are papillary, with its major sub-type being the follicular variant (FVPTC). The other histological types are follicular, oxyphilic or Hurthle cell, and anaplastic. Each tumour type differs substantially in its initial mode of spread and subsequent pattern of recurrence and metastatic involvement. Although thyroid nodules are extremely common but clinically recognized thyroid carcinomas constitute less than 1% of all human malignant tumours. The annual incidence of thyroid cancer varies worldwide from 0.5 to 10 per 100000 population. In Cyprus, in the year 2000, there were 41 registered cases of newly diagnosed thyroid carcinoma (medullary excluded) in the Cancer Archive. This is an incidence of 5.6 per 100000. A Bank of Cyprus Oncology Center (BOCOC) was established in 1998 and very soon became the referral hospital for oncological patients in Cyprus. The thyroid clinic of the center was also established in that year which in collaboration with the NM department of the Nicosia General Hospital provided follow-up services to thyroid cancer patients. The Nuclear Medicine Department of the BOCOC was established on 1 July 2001 and since then the radioiodine therapy and follow-up thyroid carcinoma patients is done in this center. The patients are referred to the clinic after surgery and confirmed diagnosis of Thyroid Cancer. A total of 34 patients (5 males 29 females, age range 20-79 years) of thyroid carcinoma (medullary excluded) visited the clinic between July 2001 and July 2003. The histopathological form was 32 papillary and 2 follicular thyroid carcinoma. Of the 32 papillary 2 were metastatic, 4 papillary with follicular elements, 1 with papillary at the isthmus and follicular in right lobe and 1 papillary in the thyroglossal cyst. Preoperative diagnosis in most of the patients was

  12. Renal medullary carcinoma response to chemotherapy: a referral center experience in Brazil

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    Marina Cavalcanti Maroja Silvino

    2013-08-01

    Full Text Available Renal medullary carcinoma (RMC is rare, accounting for less than 1% of all renal neoplasms. Case reports suggest RMC is highly aggressive, poorly responsive to chemotherapy, often metastatic at diagnosis, affects young men with sickle cell trait, and median overall survival (mOS is less than 12 months. We report the epidemiological characteristics, treatments performed, response rate to each treatment and mOS of five patients with RMC. All patients had sickle cell trait, four were male, three had metastatic disease at diagnosis and mean age at diagnosis was 25 years. Non-metastatic patients were submitted to nephrectomy. Two patients had partial response to first line chemotherapy including cisplatin and gemcitabine. There was no response to sunitinib or second line chemo - therapy; mOS was 6 months. Due to its rarity, case series are the only evidence available to discuss the treatment for RMC. In our experience, only cisplatin and gemcitabine based regimen offered response.

  13. 18F-FDG PET/CT in the evaluation of gallbladder carcinoma - Initial experience

    International Nuclear Information System (INIS)

    Background: Gallbladder carcinoma, beside gastric and breast cancer, is one of the leading cause of death for cancer in Chilean women reaching a mortality rate of 12.9 per 100.000 women. The global prognosis remains poor, with global lethality around 95%. The most frequent clinical manifestations are: incidental finding in a biopsy of a laparoscopic cholecystectomy, gallbladder mass with or without jaundice and peritoneal carcinomatosis. Usually the diagnosis is too late, most patients show invasion of nearly organs and lymph nodes involvement. Like in other type of tumors, preoperative staging is essential for an adequate treatment selection. Treatment of early stage or locoregional involvement is surgery and chemo-radiotherapy. In advances stage only palliative chemotherapy or palliative cares are indicated. In local disease, imaging tests are useful for detecting lymph nodes, hilar or hepatic involvement, and to rule out spread metastases. Conventional imaging modalities, such as ultrasonography, CT, and MRI may underestimate disease extension. There are few experience of 18FDG PET-CT and gallbladder carcinoma communicated in the medical literature. Most of these publications are dealing with differential diagnosis of gallbladder tumors for detection of malignancy. In this report we present our initial experience evaluating patients suffering from gallbladder carcinoma with 18FDG PET/CT. The goal of this study was to assess the metabolic activity, localization and extension of gallbladder tumor by PET/CT. Methods: We studied prospectively 17 consecutive patients (2 males and 15 females); mean age 56.6 years (range 33 - 77) with histologically proven gallbladder carcinoma. Eleven patients were studied after cholecystectomy. The remaining were unresectable at the time of diagnosis. Clinical indications for 18FDG PET-CT were: to evaluate surgery chance in 8 patients, chemotherapy response in 2, staging and follow up in 3 and to confirm disseminated disease seen in

  14. A short review of critical experiments performed at the Kurchatov Institute

    Energy Technology Data Exchange (ETDEWEB)

    Gagarinski, A.Yu.; Glushkov, Y.S.; Ponomarev-Stepnoi, N.N. [Kurchatov Institute (Russian Federation)

    1997-06-01

    Since the 1950s, the Institute of Atomic Energy (now the Russian Research Center Kurchatov Institute) has investigated nuclear reactors intended for various purposes. A summary of the present state of these assemblies is given in an attachment to the paper. A second attachment provides a brief description of critical experiments for small nuclear power systems intended for decentralized power generation. The critical assemblies for these experiments were moderated by water and zirconium hydride, and fuel elements ranged in enrichment from 5% to 95% uranium 235. 7 refs.

  15. MANAGEMENT EXPERIMENTS ACCORDING TO THE INSTITUTIONAL PROSPECT OF THE JIU VALLEY MINING AFTER 1989

    Directory of Open Access Journals (Sweden)

    MARIANA ANGHEL

    2012-01-01

    Full Text Available The hereby paper approaches certain aspects regarding the present circumstances that regard management experiments in the context of the social, economic, and political changes after 1989. Institutionally, and having as a background such changes, mining activities are continuously transforming and adapting to the requirements of the European Union. Institutional social and economic performance is determined by the assertive potential of the institution as an authority in the field as well as by the competitiveness of the mining units or of subordinated units. Management experience has been both influenced by the restructuring, turning to good account, and endowing with new technologies of the mining units as well as by the process of transition towards a functional market economy.

  16. Concurrent Robot-Assisted Distal Gastrectomy and Partial Nephrectomy for Synchronous Early Gastric Cancer and Renal Cell Carcinoma: An Initial Experience

    OpenAIRE

    Kim, Jieun; Kim, Su Mi; Seo, Jeong Eun; Choi, Min Gew; Lee, Jun Ho; Sohn, Tae Sung; Kim, Sung; Bae, Jae Moon; Seo, Seong Il

    2014-01-01

    We report our experience of a concurrent robot assisted distal gastrectomy and partial nephrectomy for synchronous early gastric cancer and renal cell carcinoma. A 55-year-old female patient was diagnosed with early gastric cancer on screening endoscopy. Abdominal computed tomography showed an incidental right renal cell carcinoma. Robot assisted distal gastrectomy was performed, followed by partial nephrectomy. The final pathological examination showed signet ring cell carcinoma within the l...

  17. Utilizing Factor Analysis to Inform the Development of Institutionally Contrived Experiences to Increase STEM Engagement

    Science.gov (United States)

    Morgan, Micaela V. C.; Gerber, Michael M.

    2016-01-01

    The purpose of this study was to determine what institutionally contrived experiences would engage community college students in STEM (science, technology, engineering, and mathematics) study, regardless of their major. During the 2013-2014 academic year, 373 students at two California community colleges were surveyed, and an exploratory factor…

  18. The Influence of Institutional Experiences on the Development of Creative Thinking in Arts Alumni

    Science.gov (United States)

    Miller, Angie L.; Dumford, Amber D.

    2015-01-01

    Previous research has suggested that several different aspects of one's environment can impact creativity. Using data from the Strategic National Arts Alumni Project (SNAAP), this study explored whether satisfaction with aspects of the institutional experience contributed to the perceived development of creative thinking in arts alumni, and…

  19. Python and Roles of Variables in Introductory Programming: Experiences from Three Educational Institutions

    Science.gov (United States)

    Nikula, Uolevi; Sajaniemi, Jorma; Tedre, Matti; Wray, Stuart

    2007-01-01

    Students often find that learning to program is hard. Introductory programming courses have high drop-out rates and students do not learn to program well. This paper presents experiences from three educational institutions where introductory programming courses were improved by adopting Python as the first programming language and roles of…

  20. Granting Credit for Work Experience: A Guide to Policies and Procedures of Wisconsin Education Institutions.

    Science.gov (United States)

    Wisconsin Univ., Green Bay.

    The ways that Wisconsin colleges, technical institutes and high schools award credit for learning acquired through work experience are described. This guide was written after a statewide study of the policies and procedures of both postsecondary and secondary schools. Data were gathered in interviews with nearly every postsecondary school in…

  1. Examining Students' Perceptions of Their First-Semester Experience at a Major Land-Grant Institution

    Science.gov (United States)

    Thompson, Dale E.; Orr, Betsy; Thompson, Cecelia; Grover, Kenda

    2007-01-01

    This study examined the perceptions of freshmen students regarding their first-semester experiences at a major land-grant institution. A questionnaire was developed based on a review of the literature related to factors that influence students' success. Factors that influence students' success included time management/goal setting, academic…

  2. Experiments on proton-proton interactions at the Institute of High- Energy Physics, Serpukhov, USSR

    CERN Document Server

    Wetherell, Alan M

    1973-01-01

    A summary of the work carried out at the Institute for High-Energy Physics, Serpukhov, USSR, on proton-proton interactions at energies between 10 and 70 GeV is given. The experiments comprise studies of small angle elastic scattering, of total cross-sections and of interactions in a hydrogen bubble chamber. (10 refs).

  3. Exploring Student Affairs Professionals' Experiences with the Campus Racial Climate at a Hispanic Serving Institution (HSI)

    Science.gov (United States)

    Garcia, Gina A.

    2016-01-01

    Although we know that people experience the campus racial climate differently based on their racial/ethnic identity, less is known about how they perceive the climate based on the racial/ethnic diversity of their institution and specifically within their department. Instead, the campus racial climate has largely been studied at Predominantly White…

  4. A Tragic Educational Experience: Academic Injustice in Higher Education Institutions in Yemen

    Science.gov (United States)

    Muthanna, Abdulghani

    2013-01-01

    This article outlines the tragic educational experience of one Yemeni scholar who has been oppressed by the education policy that Yemeni university administrators are accustomed to implementing while employing candidates. The institutions of higher education in Yemen, with the absence of justice, have experienced major ordeals in improving the…

  5. Using Social Networks to Enhance Teaching and Learning Experiences in Higher Learning Institutions

    Science.gov (United States)

    Balakrishnan, Vimala

    2014-01-01

    The paper first explores the factors that affect the use of social networks to enhance teaching and learning experiences among students and lecturers, using structured questionnaires prepared based on the Push-Pull-Mooring framework. A total of 455 students and lecturers from higher learning institutions in Malaysia participated in this study.…

  6. Transformational and Transactional Leadership: An Exploration of Gender, Experience, and Institution Type

    Science.gov (United States)

    Martin, Jason

    2015-01-01

    This exploratory study examined the rates of transformational, transactional, and laissez-faire leadership among academic library deans, directors, and university librarians to see if any differences in leadership styles existed by gender, age and experience of the leaders, and type of institution in which they worked. The study found no…

  7. Metastases of esophageal carcinoma to skeletal muscle:Single center experience

    Institute of Scientific and Technical Information of China (English)

    Jan Cincibuch; Miroslav Myslive(c)ek; Bohuslav Melichar; (C)estmír Neoral; Iva Metelková; Michaela Zezulová; Hana Procházková-(S)tudentová

    2012-01-01

    Metastases of esophageal carcinoma to the skeletal muscle are rare,but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography (PET/CT).A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases.Four patients had skeletal muscle metastases of esophageal carcinoma,including two patients with squamous cell carcinoma.In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases,muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma.In all cases,skeletal muscle metastases were the first manifestation of systemic disease.In three patients palliation was obtained with the combination of external beam radiation therapy,systemic chemotherapy or surgical resection.Skeletal muscle metastases are a rare complication of esophageal carcinoma.

  8. Brachytherapy of penis cancer: experience of the Gustave-Roussy Institute; Curietherapie des cancers de verge: experience de l'Institut Gustave-Roussy

    Energy Technology Data Exchange (ETDEWEB)

    Crevoisier, R. de; Wibault, P.; M' barek, B.; Gerbaulet, A.; Haie-Meder, C. [Institut Gustave-Roussy, 94 - Villejuif (France)

    2006-11-15

    The interstitial brachytherapy is a conservative treatment of epidermoid carcinomas of the penis under 4 centimeters and does not invade the erectile tissue. the great majority of recurrences is under control by a surgery treatment. (N.C.)

  9. APPLICATION OF ISO 9001 AND EFQM EXCELLENCE MODEL WITHIN HIGHER EDUCATION INSTITUTIONS: PRACTICAL EXPERIENCES ANALYSIS

    Directory of Open Access Journals (Sweden)

    Ramune Kasperaviciute

    2013-06-01

    Full Text Available Purpose – to systemise and analyse practical experiences of the application of the EFQM Excellence Model (EM and ISO 9001 standard within Higher education institutions (HEIs. There is an aim to understand: 1 what are the main motives of the application of the analysed quality management (QM means within academic institutions; 2 what are the most common issues occurring during the implementation; 3 what are the most common benefits. Design/methodology/approach – practical experiences of HEIs from various countries are analysed and the data from 30 case studies (17 case studies focus on experiences applying ISO 9001 standard for quality management system (QMS development and 13 case studies focus on experiences implementing EFQM EM summarized. The sample of the research was formed after review of relevant scientific researches between 1995 and 2013 available in EBSCO, Emerald Management Journal Collection, ProQuest, JSTOR, Sage Publications: Sage Journal Online databases. Selection criteria of case studies was application of ISO 9001 and EFQM EM in HEIs from various countries. Research methods: systematic scientific literature analysis, content analysis. Findings – the research revealed that the main motives of HEIs to apply ISO 9001 and the EFQM EM are related the most common to internal institutional needs, competitiveness in the market and requirements of the stakeholders. 18 fundamental issues of the application of the means were identified which are more often related to institutional problems than to standard/model issues. The implementation of both means within academic institutions conditioned the benefits linked with internal institutional changes. The most significant general benefits are related to the goals of the means and cultural changes of the institution. Research limitations/implications – case studies publicised in English and Lithuanian languages only were analysed in the article. The inclusion of available researches

  10. Cancer-specific survival after radical nephroureterectomy for upper urinary tract urothelial carcinoma: proposal and multi-institutional validation of a post-operative nomogram

    OpenAIRE

    Yates, D R; Hupertan, V.; Colin, P.; Ouzzane, A; Descazeaud, A; Long, J. A.; Pignot, G; Crouzet, S; Rozet, F; Neuzillet, Y; Soulie, M.; Bodin, T; Valeri, A.; Cussenot, O; Rouprêt, M

    2012-01-01

    Background: Owing to the scarcity of upper urinary tract urothelial carcinoma (UUT-UC) it is often necessary for investigators to pool data. A patient-specific survival nomogram based on such data is needed to predict cancer-specific survival (CSS) post nephroureterectomy (NU). Herein, we propose and validate a nomogram to predict CSS post NU. Patients and methods: Twenty-one French institutions contributed data on 1120 patients treated with NU for UUT-UC. A total of 667 had full data for nom...

  11. 25 years of IBA teaching experience at the National Institute for Nuclear Science and Technology, France

    International Nuclear Information System (INIS)

    The National Institute for Nuclear Science and Technology (INSTN) is an advanced education institution created within the Commissariat a l'Energie Atomique (CEA) in 1956 and placed under the joint supervision of the Ministry of National Education and the Ministry of Industry. The INSTN provides students with specialised training in all nuclear energy-related disciplines. Since 1978, courses have been developed focusing on ion beam analysis (IBA). We present here the various experiments carried out for university laboratory work [practicals]. Over the past few years, the laboratory has provided IBA users with training courses offering a combined theoretical and experimental approach

  12. Outcome and treatment strategy in female lung cancer: a single institution experience

    International Nuclear Information System (INIS)

    Purpose: To assess the survival rate of female lung cancer treated at the Institute of Oncology of the Vilnius University, Lithuania during the period between 1996-2005. Materials and Methods: During the period between 1996-2005, 471 women diagnosed with lung cancer were treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University. Data on morphology, stage and treatment was collected from the medical records. All lung cancer cases by histology were classified in two groups: non-small cell lung cancer (includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma and other less common types) and small cell lung cancer. The vital status of the study group was assessed as of December 31, 2007, by passive follow-up, using data from the population registry. It was found that 411 (87.3%) of the patients had died. Survival was estimated according to the Kaplan-Meier method. Results: The median survival of female lung cancer diagnosed during 1996-2005 in Lithuania show to be 8.7 months (8.4 (95% CI 7.2-10.8) months with non-small cell lung cancer and 9.3 (95% CI 6.3-13.0) months with small-cell lung cancer). Survival was more than 20 months in resectable non-small cell lung cancer (stages I, II, IIIA). Non-small cell lung cancer survival in advanced stages was less than 7 months. Small-cell lung cancer patients median survival at limited and extended stages of the disease were 9.5 (95% CI 2.9-18.4) compared to 9.2 (95% CI 6.2-13.7) months. Non-small cell lung cancer patients most frequently were treated by surgery (27.0%), surgery and chemotherapy or radiotherapy (19.6%). Small cell lung cancer patient treatment included chemo and radiotherapy (27.0%), chemotherapy (19.0%), radiotherapy (17.5%), surgery (27.9%). Conclusions: The single center study of female lung cancer diagnosed during 1996-2005 in Lithuania show a significantly better chance of survival in resectable non-small cell lung cancer. Advanced stages of

  13. Valuing energy policy attributes for environmental management: Choice experiment evidence from a research institution

    International Nuclear Information System (INIS)

    Many governments, firms, institutions and individuals have become increasingly cognizant of their impact on the environment, most notably with respect to global climate change. Coupled with the possibility of future regulations aimed at curbing greenhouse gas emissions, firms and institutions have begun to critically evaluate their own carbon footprint. This paper examines the preferences of stakeholders within a large academic institution for attributes of alternative greenhouse gas (GHG) reduction strategies. The attributes considered by constituents include: the fuel portfolio mix, effort for conserving energy use, carbon emissions reduction, timeframe for emissions reduction to be achieved and cost. We use a choice experiment technique that enables the examination of greenhouse gas reduction program attribute preferences across three constituent groups. The results show that each of the constituent groups have a positive WTP for carbon emissions reductions and prefer investments in reductions in the shorter- rather than longer-term. The results also suggest differences between the constituent groups in their WTP for types of fuels in the fuel portfolio. Finally, we use the results to examine the welfare implications of different combinations of the policy attributes that coincide with alternative GHG program strategies. - Highlights: → We explore preferences for carbon footprint reduction at an academic institution. → Include several pertinent energy policy attributes in a choice experiment. → Find preference heterogeneity between constituent groups for policy attributes. → Find highest willingness to pay for 'green' energy and emissions reduction amount.

  14. Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA) experience

    Science.gov (United States)

    Coelho, Rafael Corrêa; Reinert, Tomás; Campos, Franz; Peixoto, Fábio Affonso; de Andrade, Carlos Augusto; Castro, Thalita; Herchenhorn, Daniel

    2016-01-01

    ABSTRACT Purpose: The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution. Material and Methods: Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Results: Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Conclusion: Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS. PMID:27564279

  15. Reasons and obstacles to starting a business: Experience of students of Lithuanian higher education institutions

    OpenAIRE

    Kvedaraite, Nida

    2014-01-01

    The paper examines entrepreneurship as a measure for youth inclusion in the labor market, as well as causes, benefits and obstacles to starting a business, based on the experiences of students of Lithuanian higher education institutions. Although Lithuania implements a variety of measures intended for promoting student entrepreneurship, students remain in a worse situation in terms of opportunities for entrepreneurship than the remaining society. The purpose of the research is to study the re...

  16. Treatment outcomes of female germ cell tumors: The Egyptian National Cancer Institute experience

    OpenAIRE

    Saber, Magdy M; Zeeneldin, Ahmed A.; Mosaad M. El Gammal; Salem E. Salem; Amira D. Darweesh; Alshaymaa A. Abdelaziz; Manar Monir

    2014-01-01

    Introduction: Female germ cell tumors (GCTS) are rare tumors that carry a good prognosis. Aim: To report the experience of the Egyptian National Cancer Institute (ENCI) in managing female GCTs. Methods: This retrospective study included 19 females with ovarian GCTs presenting to the ENCI between 2006 and 2010. Results: The median age was 23 years. Ovaries were the primary site in all patients. Dysgerminoma and teratoma were the predominant pathologies followed by mixed GCT in females...

  17. Recognizing and then Using Disciplinary Patterns of the Undergraduate Experience: Getting Past Institutional Standards

    OpenAIRE

    Steve Chatman

    2009-01-01

    The assertion that there are a limited set of generalizable good educational practices (Chickering & Gamson, 1987) with a common model of preferred active student engagement in learning (Kuh, 2001) is appealing to those responsible for simply stated institutional outcomes and to the faculty who teach in fields that espouse the same practices and outcomes (Braxton, 1998). After all, if they are wrong and educational experience and good educational practices differ in important, substantive, an...

  18. Endometrial intraepithelial neoplasia terminology in practice: 4-year experience at a single institution.

    Science.gov (United States)

    Kane, Sarah E; Hecht, Jonathan L

    2012-03-01

    An alternative WHO classification system for endometrial precancers and hyperplasia separates a lesion called endometrial intraepithelial neoplasia (EIN) from diffuse hormonal effects and cancer, resulting in a 3-category system. EIN is a localized lesion with objective histologic criteria, characterized by monoclonal growth of mutated cells, and associated with a 45-fold elevated cancer risk. This study summarizes our department's experience with EIN diagnoses in the 4 years since conversion to the new terminology. We identified all reports from endometrial samples diagnosed as EIN or including the terms "gland crowding" or "atypia" since conversion and obtained follow-up information from subsequent pathology specimens or clinic notes (82%). The diagnoses were reported by a mixture of pathologists, the majority of whom are not subspecialized to gynecologic pathology and the slides were not reviewed. Overall, 17.1% of women with EIN had carcinoma and 34.9% had either carcinoma or persistent EIN. The proportion of women with EIN or cancer on follow-up did not trend with years since adoption of EIN terminology. The median age at the time of diagnosis was 55 years in an overall population of women who underwent sampling at a median age of 47 years. The median follow-up time was 4 months. All cancers were of endometrioid histology; all but 2 were International Federation of Gynecology and Obstetrics grade 1. In comparison with a previous reproducibility study among expert pathologists on a comparable population from our department, these results for general pathologists show a higher false positive rate for subsequent cancer. PMID:22317874

  19. Experiences of African Students in Predominantly White Institutions: A Literature Overview.

    Science.gov (United States)

    Inyama, Davis; Williams, Allison; McCauley, Kay

    2016-01-01

    The objective of this paper is to examine research conducted on the experiences of African health sciences students in predominantly white higher education institutions/environments. The main elements of cross-cultural adaptation models were adopted to discuss the amalgamated themes under the auspices of adjustment, integration, and conditioning. The overview revealed that African students encounter unique experiences, with isolation and "feeling different" being commonly mentioned. Recommendations for future research are presented, including programmatic implications for higher education and student affairs professionals. PMID:27525115

  20. Vulvar carcinoma

    International Nuclear Information System (INIS)

    Purpose: Controversies exist regarding the use of radiation therapy in the treatment of vulvar carcinoma. A retrospective review was performed to evaluate our institution's experience with surgery and radiation for this disease. Methods and Materials: The medical records of 47 patients treated for squamous cell carcinoma of the vulva at our institution (1974-1992) were reviewed for TNM stage (AJCC criteria), treatment modality, and associated 5-year local control and survival based on Kaplan-Meier analysis. Results: Twenty-eight patients (60%) presented with Stage I and II disease and their 5-year survival was 69%. Stage III patients accounted for 12 (25%) of the patients and their 5-year survival was 73%. Seven patients presented with Stage IV disease and five died within 13 months of diagnosis after predominantly palliative therapy. The 40 patients with Stages I, II, and III disease were treated aggressively and were further evaluated for treatment-modality-associated survival and local control. Radiation therapy was used as primary treatment in nine patients, of whom seven were treated with radiation alone and two were treated postoperatively after wide excision. Surgery alone was performed in 31 patients consisting of either radical vulvectomy (20 patients) or wide excision (11 patients). When comparing outcomes of radical vulvectomy vs. radiation therapy, we noted that the 5-year actuarial survivals were comparable (74% for either modality), despite the presence of more favorable prognostic factors in the group treated with radical vulvectomy. Patients treated with wide excision alone had a trend for a poorer 5-year actuarial survival (51%) and local control (50%). Conclusions: Radical vulvectomy offers good locoregional control and survival. This retrospective review further supports the use of radiation therapy with conservative surgery as an alternative treatment option for patients with vulvar carcinoma treated with curative intent. In contrast, the use of

  1. Surgical treatment of breast lesions at a Day Centre: Experience of the European Institute of Oncology.

    Science.gov (United States)

    Ballardini, Bettina; Cavalli, Marta; Manfredi, Giovanni Francesco; Sangalli, Claudia; Galimberti, Viviana; Intra, Mattia; Rossi, Elisabetta Maria Cristina; Seco, Javiera; Campanelli, Giampiero; Veronesi, Paolo

    2016-06-01

    Breast cancer is the commonest malignancy in women worldwide. The reduced aggressiveness of breast cancer surgery has made it possible treat patients in the day surgery setting. The European Institute of Oncology, Milan, opened its new Day Center in May 2010. From May 2010 to December 2014, 17,087 patients with breast conditions were treated by the Institute's Division of Senology, 4132 (24.2%) of these in the day surgery setting, including malignant and benign conditions; 204 (4.9%) were not discharged on the day of surgery, being converted to inpatients; five (0.1%) patients returned to hospital for persistent hematoma. Our experience of performing breast cancer surgery in the day surgery setting is in line that of the literature. It is safe, but requires a well-organized unit and multidisciplinary medical team to function smoothly, with much attention paid to patient comfort and education, so as to ensure maximum patient acceptance and satisfaction. PMID:27123957

  2. Liver Transplantation for Hepatocellular Carcinoma: A Single Center Resume Overlooking Four Decades of Experience

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2016-01-01

    Full Text Available Background. This is a single center oncological resume overlooking four decades of experience with liver transplantation (LT for hepatocellular carcinoma (HCC. Methods. All 319 LT for HCC that were performed between 1975 and 2011 were included. Predictors for HCC recurrence (HCCR and survival were identified by Cox regression, Kaplan-Meier analysis, Log Rank, and χ2-tests where appropriate. Results. HCCR was the single strongest hazard for survival (exp⁡B=10.156. Hazards for HCCR were tumor staging beyond the histologic MILAN (exp⁡B=3.645, bilateral tumor spreading (exp⁡B=14.505, tumor grading beyond G2 (exp⁡B=8.668, and vascular infiltration of small or large vessels (exp⁡B=11.612, exp⁡B=18.324, resp.. Grading beyond G2 (exp⁡B=10.498 as well as small and large vascular infiltrations (exp⁡B=13.337, exp⁡B=16.737, resp. was associated with higher hazard ratios for long-term survival as compared to liver transplantation beyond histological MILAN (exp⁡B=4.533. Tumor dedifferentiation significantly correlated with vascular infiltration (χ2p=0.006 and intrahepatic tumor spreading (χ2p=0.016. Conclusion. LT enables survival from HCC. HCC dedifferentiation is associated with vascular infiltration and intrahepatic tumor spreading and is a strong hazard for HCCR and survival. Pretransplant tumor staging should include grading by biopsy, because grading is a reliable and easily accessible predictor of HCCR and survival. Detection of dedifferentiation should speed up the allocation process.

  3. The outcome and prognosis factors of adolescent nasopharyngeal carcinoma treated in a single institute-analysis of 148 patients

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical characteristics, outcome and prognostic factors of adolescent nasopharyngeal carcinoma. Methods: Between Jan 1990 and Dec 2009, totally 148 pathological confirmed nasopharyngeal carcinoma (NPC) patients with age ≤20 years were treated in our hospital, including stage II 8, stage III 58, stage IV 81, and unknown 1 when restaged by TNM system (UICC 2002), ninety-four (63.5%) patients were treated with radiotherapy alone, 54 (36.5%)patients were treated with radiotherapy combined with cisplatin-based chemotherapy. Results: The median follow-up time for all patients was 44.5 months. The 5-year overall survival (OS), local-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 82.9%, 85.1% and 78.6%. There were 42 patients (28.4%) failed with 16 regional recurrence and 29 distant metastasis, and 3 with both; bone metastasis was the most common site of distant metastasis(22/29). In univariate analysis,the adverse prognostic factors for OS were stage T4(χ2=5.61, P=0.018), radiation dose 2=5.30, P=0.021), for LRC was radiation dose 2=4.24, P=0.039). In multivariate analysis, radiation dose 4 were the independent prognostic factors for OS (χ2=5.73, 5.56, P=0.017, 0.018), for LRC was radiation dose 2=5.81, P=0.016). Conclusions: The outcome of the present series was excellent, total nasopharyngeal radiation dose less than 70 Gy is inappropriate. Reduce the distant metastasis and late toxicities were the future direction for the treatment of adolescent nasopharyngeal carcinoma. (authors)

  4. Definitive Radiotherapy for T1-2 Hypopharyngeal Cancer: A Single-Institution Experience

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Aya, E-mail: anakajima-kyt@umin.ac.jp [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Nishiyama, Kinji; Morimoto, Masahiro; Nakamura, Satoaki; Suzuki, Osamu; Kawaguchi, Yoshifumi; Miyagi, Ken [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Fujii, Takashi; Yoshino, Kunitoshi [Department of Head and Neck Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)

    2012-02-01

    Purpose: To analyze the outcome in T1-2 hypopharyngeal cancer (HPC) patients treated with definitive radiotherapy (RT). Patients and Methods: A total of 103 patients with T1-2 hypopharyngeal squamous cell carcinoma treated with radical RT between March 2000 and June 2008 at our institution were analyzed. Pre-RT neck dissection (ND) was performed in 26 patients with advanced neck disease. Chemotherapy was used concurrently with RT in 14 patients. Sixty patients were associated with synchronous or metachronous malignancies. The median follow-up for surviving patients was 41 months. Results: The 3-year overall and cause-specific survival rates were 70% and 79%, respectively. The 3-year local control rates were 87% for T1 and 83% for T2 disease. The ultimate local control rate was 89%, including 7 patients in whom salvage was successful. The ultimate local control rate with laryngeal preservation was 82%. Tumors of the medial wall of the pyriform sinus tended to have lower control rates compared with tumors of the lateral or posterior pharyngeal wall. Among patients with N2b-3 disease, the 3-year regional control rates were 74% for patients with pre-RT ND and 40% for patients without ND. The 3-year locoregional control rates were as follows: Stage I, 100%; Stage II, 84%; Stage III, 67%; Stage IVA, 43%; Stage IVB, 67%. Forty-two patients developed disease recurrence, with 29 (70%) patients developing recurrence within the first year. Of the 103 patients, 6 developed late complications higher than or equal to Grade 3. Conclusions: Definitive RT accomplished a satisfactory local control rate and contributed to organ preservation.

  5. Ground-facilities at the DLR Institute of Aerospace Medicine for preparation of flight experiments

    Science.gov (United States)

    Hemmersbach, Ruth; Hendrik Anken, Ralf; Hauslage, Jens; von der Wiesche, Melanie; Baerwalde, Sven; Schuber, Marianne

    In order to investigate the influence of altered gravity on biological systems and to identify gravisensitive processes, various experimental platforms have been developed, which are useful to simulate weightlessness or are able to produce hypergravity. At the Institute of Aerospace Medicine, DLR Cologne, a broad spectrum of applications is offered to scientists: clinostats with one rotation axis and variable rotation speeds for cultivation of small objects (including aquatic organisms) in simulated weightlessness conditions, for online microscopic observations and for online kinetic measurements. Own research concentrates on comparative studies with other kinds of methods to simulate weightlessness, also available at the institute: Rotating Wall Vessel (RWV) for aquatic studies, Random Positioning Machine (RPM; manufactured by Dutch Space, Leiden, The Netherlands). Correspondingly, various centrifuge devices are available to study different test objects under hypergravity conditions -such as NIZEMI, a slow rotating centrifuge microscope, and MUSIC, a multi-sample centrifuge. Mainly for experiments with human test subjects (artificial gravity), but also for biological systems or for testing various kinds of (flight-) hardware, the SAHC, a short arm human centrifuge -loaned by ESA -was installed in Cologne and completes our experimental scenario. Furthermore, due to our specific tasks such as providing laboratories during the German Parabolic Flight Experiments starting from Cologne and being the Facility Responsible Center for BIOLAB, a science rack in the Columbus module aboard the ISS, scientists have the possibility for an optimal preparation of their flight experiments.

  6. Coexistence of parathyroid adenoma and papillary thyroid carcinoma: Experience of a single center

    Directory of Open Access Journals (Sweden)

    Ebubekir Gündeş

    2013-01-01

    Full Text Available Objective: The aim of this study was to describe experienceswith concurrent parathyroid adenoma and papillarythyroid carcinoma.Methods: Eight patients with concurrent parathyroid adenomaand papillary thyroid carcinoma were identifiedbetween 2005 and 2012, and their medical records werereviewed retrospectively.Results: Of the eight patients identified, two were maleand six were female; their mean age was 53.6 years.The mean serum calcium concentration was 11.7 mg/dL.Intact parathyroid hormone (iPTH concentrations werehigh in all patients, with a mean concentration of 338 pg/mL. The most frequently used surgical technique was totalthyroidectomy plus parathyroid adenoma excision (n=6.The mean size of the thyroid carcinoma was 1.2 cm, andone case showed metastatic lymph nodes in the centralcompartment. The mean parathyroid adenoma size wasfound to be 2.1(0.6- 3.5 cm, according to the longest sizeof the adenom. Six patients (75% developed postoperativecomplications, including temporary symptomatic hypocalcemiain 4 patients (50%, hematoma developmentin 1 patient (12.5% and temporary vocal cord paralysis inone patient (12.5%.Conclusion: Thyroid carcinoma and parathyroid adenomaare rarely concomitant. Rarely hyperparathyroidismmay be accompanied with thyroid carcinomas so preoperativelythyroid gland should be properly examined. Thyroidwith parathyroid surgery are risk factors of recurrentlaryngeal nerve injury and hypoparathyroidism.Key words: Papillary thyroid cancer; parathyroid adenoma;thyroidectomy

  7. Surgery for cystic pancreatic lesions in the post-Sendai era: a single institution experience

    OpenAIRE

    Erkan, Murat Mert; Kleeff, J.; Michalski, C.; Kong, B.; Roth, S.; Friess, H.; Siveke, J.; Esposito, I.

    2015-01-01

    Research Article Surgery for Cystic Pancreatic Lesions in the Post-Sendai Era: A Single Institution Experience Jörg Kleeff,1 Christoph Michalski,1,2 Bo Kong,1 Mert Erkan,1,3 Susanne Roth,1 Jens Siveke,4 Helmut Friess,1 and Irene Esposito5,6 1Department of Surgery, Technische Universit¨at M¨unchen, Ismaninger Strasse 22, 81675 Munich, Germany 2Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany 3Department of Surgery, Koc Uni...

  8. Experiences of high dose rate interstitial brachytherapy for carcinoma of the mobile tongue

    International Nuclear Information System (INIS)

    Interstitial brachytherapy was conducted for mobile tongue carcinoma using a high dose rate remote afterloading machine with small 192I source. Detailed method, named as 'linked double-botton technique', is to approach from submandibular skin by an open-ended stainless steel needles to the tongue lesion, and to replace each needle into flexible nylon tube from the oral cavity. Delivered dose was 60 Gy/10 Fr./5-6 days at the distance 5 mm from the source plane. Ten patients with mobile tongue carcinoma Tl-2N0 were treated with this method from October 1991 through August 1992. Local was uncontrolled in one patient, in whom the lesion was combined with leukoplakia at both lateral borders of the tongue. This was in accordance with the result in low dose rate treatment. This can be a substitute to low dose rate system for treatment of mobile tongue carcinoma. (author)

  9. Programs of Experiments with Critical Assemblies at the Russian Research Centre 'Kurchatov Institute'

    International Nuclear Information System (INIS)

    The paper gives a brief overview of benchmark experiments that have been performed and are being performed at the Russian Research Centre 'Kurchatov Institutes' (RRC KIs), satisfy requirements of the International Criticality Safety Benchmark Evaluation Project (ICSBEP), and have been published or will be published in the 'International Handbook of Evaluated Criticality Safety Benchmark Experiments'. These experiments include critical experiments in water-moderated facilities pertaining to substantiation of reactor physics for VVER-type light water reactors with uranium enrichments varying from natural uranium to ∼6.5%; in heterogeneous critical assemblies with a widely varying uranium enrichment (from 5 to 96%) for small nuclear power systems of various applications; in critical assemblies with a uranyl sulfate solution core; and in critical assemblies simulating peculiarities of high-temperature gas-cooled reactors (HTGR), RBMK physics, etc.A list of critical assemblies currently in operation at RRC KI is given. Future experimental programs are briefly described; their implementation, if based on the ICSBEP requirements, will be useful for the international community. Using RRC KI as an example, it is demonstrated that Russian nuclear centers maintain capabilities for carrying out a wide range of new critical experiments, including international cooperation in this area

  10. Retrospective Evaluation of Patients with Hepatocellular Carcinoma: Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Tuncer Temel1

    2015-03-01

    Full Text Available Objective: Primary liver cancer is one of the most common and lethal type of tumors in the world. Hepatocellular forms compose about 80% of all primary liver tumors. Our aim is to evaluate the patients with hepatocellular carcinoma admitted to our clinic retrospectively. Methods: First we identified viral hepatitis serology and whether antiviral treatment was administered before the diagnosis and the period until the development of hepatocellular carcinoma for each case with hepatocellular carcinoma. Child-Pugh stage in cirrhotic cases, the stage of viral hepatitis in non-cirrhotic cases, and the treatment method suggested for hepatocellular carcinoma and the average life expectancy (for the patients whose life expectancy is known were evaluated. Alpha-feto protein levels and computerized tomography, ultrasound, magnetic resonance imaging findings were evaluated retrospectively. Correlation between alpha-feto protein levels and tumor numbers were evaluated statistically. Results: Total of 69 patients were evaluated. The median age at presentation was 62.8 (ranging from 25 to 80 years. Median (overall survival OS was 7.0 (ranging from 0 to 145 months in all patients. 18 patients (41.9% were Child-Pugh Class A, 12 (27.9% patients were Child-Pugh Class B and 13 (30.2% patients were Child-Pugh Class C. It was found that patients with severely high alpha-feto protein levels (>200 ng/ml, have 4 fold risk of multiple liver masses (OR: 4.05, 95% CI: 1.22-13.42. For the characterization of a liver mass as hepatocellular carcinoma, the diagnostic effectiveness of computerized tomography was 54.3%, and that of magnetic resonance imaging was 55.8%. Conclusion: As a result the patients with hepatocellular carcinoma can be diagnosed with combination of laboratory findings and imaging techniques. Alpha-feto protein levels are important for follow up of such patients and identifying the multiple mass presences.

  11. Dr Julia King CBE FREng, Chief Executive Designate, Institute of Physics (United Kingdom), visiting the NA48 experiment.

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    Photo 02: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (right) with A. Ceccucci and K. Peach. Photo 05: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (centre) with A. Ceccucci and C. Lazzeroni. Photo 08: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (second from left) with (left to right) R. Barlow, J. Wood, N. McCubbin, K. Peach, A. Ceccucci, C. Lazzeroni, M. Patel and D. Munday.

  12. Brachytherapy of penis cancer: experience of the Gustave-Roussy Institute

    International Nuclear Information System (INIS)

    The interstitial brachytherapy is a conservative treatment of epidermoid carcinomas of the penis under 4 centimeters and does not invade the erectile tissue. the great majority of recurrences is under control by a surgery treatment. (N.C.)

  13. Institutional versus Academic Discipline Measures of Student Experience: A Matter of Relative Validity. Professional File. Number 114, Winter 2009

    Science.gov (United States)

    Chatman, Steve

    2009-01-01

    The census survey of undergraduates attending a major research university system presents an opportunity to measure both disciplinary and institutional differences in students' academic experience. Results from nearly 60,000 responses (38% response rate) from the 2006 administration found greater variance among majors within an institution than…

  14. HISTOMORPHOLOGICAL STUDY OF PAEDIATRIC LIVER TUMOUR S-A SINGLE INSTITUTION EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Radhika Krishna

    2013-05-01

    Full Text Available ABSTRACT: INTRODUCTION: Liver tumours are uncommon in infan cy and childhood, accounting to 1-2% of all paediatr ic neoplasms. Though rare, 2/3rds of cases unfold as malignancies. These neoplasms differ considerably from their coun terparts in the older age group. The present study reflects the Niloufer experience , a well established tertiary referral centre, Hyde rabad. AIMS & OBJECTIVES: To analyze the various paediatric liver tumours ,to review the frequency and histopatholog y of paediatric liver tumours and to review the existing literature on liver tumou rs of infancy and childhood. METHODS AND MATERIALS: A retrospective analysis of children aged between 8 days and 11 years diagnosed with hepatic tumours wa s done over a period of 7 years (Ju ly 2004 –June 2011.The cases were a nalyzed based on clinical, radiological, biochemic al, gross and microscopic findings. RESULTS: Of the 22 cases studied, 16 were mali gnant tumours of which 11 cases were diagnosed as hepatoblastoma and of the remaining 6 cases, 4 were diagnosed as infantile hemangioendothelioma, 2 as mesenchy mal hamartomas. The incidence in males is slightly higher than in females reflected by the ratio of 1.6:1. CONCLUSIONS: The spectrum of liver tumours in paedi atric population is different from t hat of the older age group. From the present study, we can gather that hepatoblast oma by far is the most common childhood hepatic malignancy unlike hepatocellular carcinoma in the adults. This study also throws light on the incidence in different paediatric age group, difference in male to female incidence, clinical presentation and biochemical data.

  15. Carcinoma Verrucoso Oral: Reporte de un Caso Clínico y Revisión de 20 Casos del Instituto de Referencia en Patología Oral (IREPO, Chile Oral Verrucous Carcinoma: A Case Report and Review of 20 Cases of the Oral Pathology Referral Institute (IREPO, Chile

    Directory of Open Access Journals (Sweden)

    D Adorno Farias

    2010-12-01

    Full Text Available El carcinoma verrucoso (CV es una variante rara del carcinoma de células escamosas con características morfológicas y comportamiento específico. El presente estudio relata el caso de una paciente de género femenino, de 68 años de edad, que presenta un carcinoma verrucoso en lengua, indoloro y con 8 meses de evolución. Además, se realizó una breve revisión de casos clínicos del Instituto de Referencia en Patología Oral (IREPO de la Facultad de Odontología de la Universidad de Chile, diagnosticados entre enero de 1984 y octubre de 2010, encontrándose 20 casos, con un promedio de edad de 70 años, localizados con mayor frecuencia en encía inferior y lengua.Verrucous carcinoma (VC, a rare variant of squamous cell carcinoma is an established entity with distinctive morphology and specific clinical behavior. The present study describe a case report of a 68-year-old women who presented a tongue verrucous carcinoma, asymptomatic, that had about 8 months of evolution. A brief review of VC cases diagnosed in Oral Pathology Referral Institute (IREPO, Faculty of Odontology, University of Chile, between 1984 and 2010. It was found 20 cases of verrucous carcinoma with a median age of70-years-old, the most common places were lower gingiva and tongue.

  16. Experience of fontan surgery at armed forces Institute of Cardiology /National Institute of Heart Diseases (AFIC-NIHD)

    International Nuclear Information System (INIS)

    To assess the overall outcome and success of Fontan surgery at our institute. Patients and Methods: For this retrospective study, institute's cardiac surgery database was used. Patients of single ventricle physiology, who had normal Left Ventricular End-diastolic Pressure and pulmonary artery pressures, were included. Data was analyzed using SPSS version 16. Results: A total of 34 Fontan procedures were done. The mean age at operation was 4.83 +- 1.37 years. There were 22(64.7%) males and 12(35.3%) females. Twenty five (73.5%) had a staged Fontan (successful previous Bidirectional Glenn's shunt, BDG). Nine (26.5%) were primary Fontan procedures (no successful previous Bidirectional Glenn's shunt, BDG). Thirty two (94.8%) were Extra Cardiac Conduit Fontan (ECCF) and 2(5.8%) were Intra Cardiac Fontan. Mean Bypass time was 132.65 +- 48.44 minutes. Aorta was cross clamped in intracardiac Fontan and its mean time was 43.31 +- 5.85 minutes. Fenestration was employed in 14(41.2%) patients. Mean pre-operative oxygen saturations were 77.41 +- 10.27%, which significantly increased to 93.94 +- 3.96 % post-operatively (p<0.001). In-hospital mortality was 2(5.8 %). Conclusion: Fontan surgery has acceptable morbidity and mortality in our set up. (author)

  17. Myeloablative therapy against high risk Ewings sarcoma: A single institution experience and literature review

    International Nuclear Information System (INIS)

    Background: Attempts to improve survival outcomes of patients with high risk Ewings sarcoma (ES) have focused on chemotherapy dose intensification strategies. Aim: The objective of this study is to retrospectively evaluate clinical characteristics and outcome of pediatric patients with high risk ES treated at a single institution. Materials and methods: From 1995 to 2008, seventeen patients (male:female, 14:3)were treated with dose-intensive therapy in our institution. Median age at diagnosis was 10 years (range: 2 - 15). Seven patients had metastases at diagnosis (lung in 6 cases and bone in one case). Eleven patients presented with unresectable disease. Fifteen (88.2%) received the Spanish Society of Pediatric Oncology protocol which includes six cycles of vincristine, doxorubicin, ifosfamide and etoposide. Two out of the six cases that were resectable received postoperative radiation. In addition, eleven patients received definitive radiation therapy. Finally, twelve (70.5%) out of 17 patients received myeloablative therapy with melphalan/etoposide. The rest of patients (N= 5) received busulfan/melphalan. Results: Median follow-up was 78 months (range: 15 - 155 months). Initial responses were complete in all patients, but 9 of them developed progression disease. Seven patients became long-term event-free survivors. No patient died of toxicity after transplantation. The 2-and 5-year overall survival rates for all patients were 93% and 73%, respectively. Event-free survival rates were 74% and 54% at 2 and 5 years, respectively. Conclusion: This single-institution experience suggests that myeloablative therapy against high risk ES is effective and safe. (authors)

  18. Adenoid cystic carcinoma of head and neck: A single institutional analysis of 66 patients treated with multi-modality approach

    Directory of Open Access Journals (Sweden)

    Ajeet Kumar Gandhi

    2015-01-01

    Full Text Available Background: Adenoid cystic carcinoma (ACC accounts for 1% of all head and neck (HN cancers. Materials and Methods: Demographic, clinical, treatment, and survival details of 66 patients were collected (1995-2011 and analyzed. Disease-free survival (DFS was estimated by Kaplan-Meier method. Results: Primary disease sites were sinonasal (n = 27, salivary gland (n = 30, and others (n = 9. Median follow-up was 23 months (range: 12-211 months. Estimated DFS at 2- and 5-year were 75% and 67.2%, respectively. On univariate analysis, intra-cranial extension (ICE (hazard ratio [HR]: 3.59, P = 0.0071, lymph node involvement (HR: 4.05, P = 0.0065, treatment modality (others vs. surgery plus adjuvant radiotherapy, HR: 2.39, P = 0.0286 and T stage (T3/4 vs. T1/2, HR: 3.27, P = 0.007 had significant impact on DFS. Lymph node involvement (P = 0.038 and ICE (P = 0.038 continued to have significant impact on DFS on multivariate analysis. Conclusion: Surgery followed by adjuvant radiotherapy remains the treatment of choice for HN ACC. Lymph node involvement and ICE confer poor prognosis.

  19. Recent results of μCF experiments at SIN [Swiss Institute For Nuclear Research

    International Nuclear Information System (INIS)

    Important topics concerning Muon Catalyzed Fusion were investigated in experiments at the Swiss Institute for Nuclear Research (SIN), including transient and steady state rates for the main dμt cycle as well as detailed information about the competing dμd and tμt fusion branches. The basic kinetic parameters were determined and striking features of the resonant dμt formation process were revealed (density effect, epithermal behavior). DT sticking was measured with independent techniques, i.e., detection of fusion neutrons as well as μHe x-rays after fusion. Fusion yields per muon of 113 +- 10 were observed at liquid conditions, yields exceeding 200 are anticipated for optimal conditions from our results. 43 refs., 8 figs., 3 tabs

  20. Experience of prevention of radiation injuries of rectum and urinary bladder in cervical carcinoma patients

    International Nuclear Information System (INIS)

    Methods of preventing radiation injuries of rectum and urinary bladder in cervical carcinoma patients after concomitant radiotherapy are developed; they are based on the bond application of dimenthylsulphoxide (DMSO) and metronidazole (MZ) solved in DMSO. It is show that the application of DMSO in radiotherapy significantly decreases the rate and severity of radiation injuries of rectum and urinary bladder. MZ application entrances radiation injurious effect on the tumor

  1. Everolimus in Metastatic Renal Cell Carcinoma: Preliminary Experience from Chang Gung Memorial Hospital

    OpenAIRE

    Wen-Kuan Huang; Chuang-Chi Liaw; See-Tong Pang; Cheng-Keng Chuang; Yang-Jen Chiang; Chun-Te Wu; Ying-Hsu Chang; Hung-Ming Wang; Yung-Chang Lin; Jia-Juan Hsieh; Li-Ying Ou; Shih-I Tsai; Chih-Hsun Yang; Cheng-Ta Yang; John Wen-Cheng Chang

    2012-01-01

    Background: Everolimus has been approved for second-line treatment of patients with metastatic renal cell carcinoma (mRCC) after failure of sorafenib or sunitinib. The purpose of this retrospective study was to assess the efficacy and safety of everolimus in Taiwanese patients with mRCC.Methods: Between March 2009 and August 2011, 24 mRCC patients treated with everolimus were analyzed. Prior to everolimus, each patient had received therapy with at least one vascular endothelial growth factor ...

  2. Sentinel lymph node biopsy in patients with breast ductal carcinoma in situ: Chinese experiences

    OpenAIRE

    SUN, Xiao; Li, Hao; LIU, YAN-BING; ZHOU, ZHENG-BO; Chen, Peng; Zhao, Tong; WANG, CHUN-JIAN; Zhang, Zhao-Peng; Qiu, Peng-Fei; Wang, Yong-Sheng

    2015-01-01

    The axillary treatment of patients with ductal carcinoma in situ (DCIS) remains controversial. The aim of the present study was to evaluate the roles of sentinel lymph node biopsy (SLNB) in patients with breast DCIS. A database containing the data from 262 patients diagnosed with breast DCIS and 100 patients diagnosed with DCIS with microinvasion (DCISM) who received SLNB between January 2002 and July 2014 was retrospectively analyzed. Of the 262 patients with DCIS, 9 presented with SLN metas...

  3. Use of complementary and alternative medicine by patients with localized prostate carcinoma. Study at a single institute in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, Koji; Ichioka, Kentaro; Terada, Naoki; Terai, Akito [Kurashiki Central Hospital, Okayama (Japan); Arai, Yoichi [Tohoku Univ., Sendai (Japan). Graduate School of Medicine

    2003-02-01

    The use of complementary/alternative medicine (CAM) has recently received considerable attention throughout the world. We evaluated the prevalence and predictors of CAM use among Japanese patients with localized prostate cancer. A total of 177 patients with localized prostate carcinoma underwent radical retropubic prostatecotomy or external beam radiation therapy between January 1994 and January 2001. Of them, 138 (78%) answered a self-administered questionnaire on CAM use and were eligible for this study. The overall prevalence, types of CAM used, and costs of CAM were assessed. The effects of age, prostate-specific antigen (PSA) level, clinical stage, pretreatment Gleason score, patients' income, patients' final educational status, and general health-related quality of life at baseline and 1 year after treatment, as estimated using the European Organization for Research and Treatment of Cancer Prostate Cancer Quality of Life Questionnaire on the prevalence of CAM use, were evaluated. Twenty-seven patients (20%) had once used or had been using some types of CAM. Herbal medicine and vitamins were the most common types of CAM used. Preoperative Gleason score was significantly associated with CAM use, as determined by the {chi}''2 test (P0.0198), and PSA level and posttreatment physical function domain were marginally associated with CAM use, as determined by the Mann-Whitney U-test (P=0.0734 and P=0.0597, respectively). Patient age, income, and final educational status had no impact on CAM use. A relatively small proportion of Japanese patients with localized prostate cancer have tried CAM compared with the proportions of patients described in previous reports from Western countries. (author)

  4. Use of complementary and alternative medicine by patients with localized prostate carcinoma. Study at a single institute in Japan

    International Nuclear Information System (INIS)

    The use of complementary/alternative medicine (CAM) has recently received considerable attention throughout the world. We evaluated the prevalence and predictors of CAM use among Japanese patients with localized prostate cancer. A total of 177 patients with localized prostate carcinoma underwent radical retropubic prostatecotomy or external beam radiation therapy between January 1994 and January 2001. Of them, 138 (78%) answered a self-administered questionnaire on CAM use and were eligible for this study. The overall prevalence, types of CAM used, and costs of CAM were assessed. The effects of age, prostate-specific antigen (PSA) level, clinical stage, pretreatment Gleason score, patients' income, patients' final educational status, and general health-related quality of life at baseline and 1 year after treatment, as estimated using the European Organization for Research and Treatment of Cancer Prostate Cancer Quality of Life Questionnaire on the prevalence of CAM use, were evaluated. Twenty-seven patients (20%) had once used or had been using some types of CAM. Herbal medicine and vitamins were the most common types of CAM used. Preoperative Gleason score was significantly associated with CAM use, as determined by the χ''2 test (P0.0198), and PSA level and posttreatment physical function domain were marginally associated with CAM use, as determined by the Mann-Whitney U-test (P=0.0734 and P=0.0597, respectively). Patient age, income, and final educational status had no impact on CAM use. A relatively small proportion of Japanese patients with localized prostate cancer have tried CAM compared with the proportions of patients described in previous reports from Western countries. (author)

  5. Experiences and Perceptions of Interpersonal, Environmental, and Institutional Racism among African-American Students in Psychology Graduate Training.

    Science.gov (United States)

    Burrell, Tracey

    Racist incidents that graduate students in psychology may experience can be reflective of Eurocentric values and forces which permeate present institutions. To better understand these forces, the experiences and perceptions of racism as experienced by minority graduate students are explored. Seventeen doctoral students in psychology, who…

  6. The experience of Occupational Therapy with storytelling in an educational institution

    Directory of Open Access Journals (Sweden)

    José Henrique da Silva Cunha

    2015-03-01

    Full Text Available Stories are important tools in the educational process and daily lives of children, because they contribute to the teaching practice in early education and to child development in many aspects, especially in learning. The purpose of this report is to present the experience of a storytelling group in an educational institution in the municipality of Uberaba, Minas Gerais state, during an internship supervised by the Occupational Therapy Course - Federal University of Triângulo Mineiro. The group developed strategies to improve psychomotor and cognitive aspects and expressive abilities of the students. Twelve one-hour weekly meetings were held during the morning, and the public were students aged 6 to 12 years old that stayed in school the whole day. In the workshop, entitled “Living the Story”, the group developed actions aimed at the creation and telling of stories, the confection of resources that were linked to the stories, and the concepts of experiences related to psychomotor aspects. As a result, it was possible to observe improvements in cognitive skills, emotional regulation, attention and concentration, problem solving, and general psychomotor aspects. Therefore, it is possible to point out that creating and listening to stories stimulate the imagination, educate, instruct, develop cognitive skills, facilitate the process of reading and writing, and enhance children’s communication skills

  7. An Overview of High-Altitude Balloon Experiments at the Indian Institute of Astrophysics

    CERN Document Server

    Safonova, Margarita; Sreejith, A G; Mathew, Joice; Sarpotdar, Mayuresh; Ambily, S; Nirmal, K; Talnikar, Sameer; Hadigal, Shripathy; Prakash, Ajin; Murthy, Jayant

    2016-01-01

    The High-Altitude Ballooning programme began at Indian Institute of Astrophysics, Bangalore, in the year 2011 with the primary purpose of developing and flying low-cost scientific payloads on a balloon-borne platform. Some of the science goals are studies of the phenomena occurring in the upper atmosphere, of airglow and zodiacal light, and observations of extended astronomical objects such as, for example, comets, from near space (20 to 30 km). A brief summary and results of the tethered flights carried out at CREST campus are given in Ref.~1. Here we present a complete overview of the 9 free-flying balloon experiments conducted from March 2013 to November 2014. We describe the launch procedures, payloads, methods of tracking and recovery of the payloads. Since we fall in the light/medium balloon category, the weight of the payload is limited to less than 5 kg --- we use a 3-D printer to fabricate lightweight boxes and structures for our experiments. We are also developing in-house lightweight sensors and co...

  8. Cisplatin-based chemotherapy: the only alternative in chemoradiation of head and neck cancer? Experience of the Institute of Oncology, Ljubljana, Slovenia

    International Nuclear Information System (INIS)

    Background: Concomitant chemoradiation is a widely used therapeutic concept in intensified locoregional treatment of high risk head and neck cancer patients. In this context, cisplatin monotherapy or in combination with other chemotherapeutics is recognized as the most effective drug to be added to radiotherapy. Aim: The aim of this review is to present the rationale for combining radiotherapy with cisplatin in the treatment of head and neck cancer and to summarize the experience of the Institute of Oncology Ljubljana, Slovenia, gained through two prospective randomized trials on chemoradiation with mitomycin C and bleomycin in operable as well as inoperable head and neck cancer patients. Furthermore, recent developments in technology and biological drug modeling are discussed, which are considered to have a potential to add significantly to the locoregional effectiveness of radiotherapy. Materials/Methods: References were retrieved using the online data base of the National Library of Medicine (PubMed: http://www.ncbi.nlm.nih.gov/PubMed). Terms used included: head and neck carcinoma, squamous cell carcinoma, concomitant chemoradiotherapy, cisplatin, mitomycin C, bleomycin. The results of studies using cisplatin- based chemoradiation regimens in the treatment of patients with inoperable tumors and on postoperative stetting were compared with the results of the studies, conducted at the Institute of Oncology and ENT Department at the Clinical Center Ljubljana, Slovenia. Results; When comparing mitomycin C-bleomycin chemotherapy with other comparable series on exclusively inoperable oropharyngeal cancer, but with cisplatin (or carboplatin) and 5-fluorouracil chemotherapy, and to standard dose cisplatin regimen used in postoperative setting, the effectiveness of our unconventional drug combination appeared to be at least equivalent to the well established platinum based chemotherapy standard. Conclusions: At the moment, concomitant chemoradiation with cisplatin

  9. Curative HDR brachytherapy for endobronchial carcinomas: the Oscar Lambret center experience

    International Nuclear Information System (INIS)

    From May 1993 to October 1995, 26 patients with limited endobronchial carcinomas were treated in a curative intent by HDR endoluminal brachytherapy. Patients were separated into 3 groups: Strictly endobronchial tumors in inoperable patients (group 1, n=21); recurrent lesions in non-previously irradiated patients (group 2, n=3); boost after external radiotherapy (group 3, n=3). Inclusion criteria were squamous cell carcinomas with a diameter less than 1 cm and normal CT scan. 1 patient was treated for 2 successive lesions, so a total of 27 treatments were applied. Patients received fractions of 6 Gy (n=3) or 7 Gy (n=24) specified at 1 cm from the source. 4 to 6 fractions were administered once a week to groups 1 and 2, in group 3 the protocol was limited to 2 fractions. 24 patients were evaluable for response with a median follow-up of 7 months (1-25). We noted 20 endoscopic and histological complete responses and 4 local failures. Median survival was 11 months. 12 patients died; 4 with evolutive neoplasic disease, 3 by hemoptysis, 5 by non-tumoral disease. 26 patients were evaluable for complications. No immediate complications were noted. 18 late complications observed were identified as radiation bronchitis which were symptomatic in 6 patients. The radiation bronchitis was distributed as follows: grade 1 in 7 patients, grade 2 in 4, grade 3 in 4 and grade 4 in 3 according to SPEISER's score. Because of the high rate of complete responses ((20(26))), we consider HDR brachytherapy as an effective treatment of limited endobronchial carcinoma in inoperable patients. However, our study was also marked by a high incidence of radiation bronchitis. So we suggest improving procedures for catheter placement to avoid close contact of the iridium source with the bronchial mucosa and using a lower dose per fraction (5 Gy/fraction with 6 fractions once a week)

  10. Institutions and economic growth: The successful experience of Switzerland (1870 - 1950)

    OpenAIRE

    David, Thomas; Mach, André

    2006-01-01

    This research paper discusses the role of institutions in the rapid growth and successful international integration of Switzerland during the late nineteenth and early twentieth century. In analysing the emergence and consolidation of the institutions whose existence was crucial, the paper looks both at the political institutions that managed conflicts and promoted cooperation between private and public actors and the economic institutions that, on the one hand, compensated the groups that fe...

  11. Market Competition, Public Good and Institutional Governance: Analyses of Portugal's Experience

    Science.gov (United States)

    Amaral, Alberto; Magalhaes, Antonio

    2007-01-01

    The emergence of the market as a regulatory tool for the public sector and the promotion of competition among institutions are based upon the idea that they promote institutions' responsiveness to society and a more efficient use of public funds. However, autonomous institutions forced to compete under market-like conditions may follow strategies…

  12. 131I therapy in differentiated thyroid carcinoma: M. D. Anderson Hospital experience

    Energy Technology Data Exchange (ETDEWEB)

    Maheshwari, Y.K.; Hill, C.S. Jr.; Haynie, T.P.; Hickey, R.C.; Samaan, N.A.

    1981-02-15

    The therapeutic response and survival rates of 352 patients with differentiated thyroid carcinoma who had received radioactive iodine therapy since 1951 were studied. Of these patients, 72% had metastases to the cervical lymph nodes, lungs, bone, or other viscera. Of all patients, 70% showed complete remission, and 30% showed partial response or recurrence of disease or both. Patients with metastases before therapy had a higher incidence of recurrence than those who had localized thyroid disease (32.4% vs. 15.1%). Of these, 97 patients had recurrent disease. In 24 of these patients, the recurrent tumor failed to take iodine, indicating change in its iodine-concentrating characteristics. Of the 352 patients, 44 (12.5%) died of progressive thyroid carcinoma, and all were over 40 years of age at the time of initial diagnosis. Mean survival of patients with metastatic disease who were over 40 years of age at initial diagnosis was significantly lower than that of patients under 40 years of age (6.2 years vs. 11.5 years). Patients with recurrent metastases unresponsive to surgery or radioactive iodine therapy were treated with palliative radiotherapy or chemotherapy or both. They respond poorly and died within a few months.

  13. Spectral CT evaluation of interstitial brachytherapy in pancreatic carcinoma xenografts: preliminary animal experience

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Shudong [Jiangsu University, Department of Radiology, The Affiliated Renmin Hospital, Zhenjiang, Jiangsu (China); Shanghai Jiao tong University, School of Medicine, Department of Radiology, Ruijin Hospital, Shanghai (China); Huang, Wei; Song, Qi; Lin, Xiaozhu; Wang, Zhongmin; Chen, Kemin [Shanghai Jiao tong University, School of Medicine, Department of Radiology, Ruijin Hospital, Shanghai (China); Chen, Yerong [Jiangsu University, Department of Radiology, The Affiliated Renmin Hospital, Zhenjiang, Jiangsu (China)

    2014-09-15

    We sought to evaluate the capability of spectral CT to detect the therapeutic response to {sup 125}I interstitial brachytherapy in a pancreatic carcinoma xenograft nude mouse model. Twenty mice bearing SWl990 human pancreatic cancer cell xenografts were randomly separated into two groups: experimental (n = 10; 1.0 mCi) and control (n = 10; 0 mCi). After a two-week treatment, spectral CT was performed. Contrast-to-noise ratio (CNR) and iodine concentration (IC) in the lesions were measured and normalized to the muscle tissue, and nIC CD31 immunohistochemistry was used to measure microvessel density (MVD). The relationships between the nIC and MVD of the tumours were analysed. The nIC of the experimental group was significantly lower than that of the control group during the multiphase examination. A significant difference in the MVD was observed between the two groups (P <0.001). The nIC values of the three-phase scans have a certain positive correlation with MVD (r = 0.57, p < 0.0001; r = 0.48, p = 0.002; r = 0.63, p = 0.0017 in the 10, 25, and 60 s phase, respectively). Spectral CT can be a useful non-invasive imaging modality in evaluating the therapeutic effect of {sup 125}I interstitial brachytherapy to a pancreatic carcinoma. (orig.)

  14. Incorporating local institutions in irrigation experiments: evidence from rural communities in Pakistan

    Directory of Open Access Journals (Sweden)

    Aneeque Javaid

    2015-06-01

    Full Text Available Many irrigation systems are special cases of common-pool resources (CPRs in which some users have preferential access to the resource, which in theory aggravates collective action challenges such as the under-provision of necessary infrastructure as a result of unequal appropriation of water resources. We present experimental evidence based on an irrigation game played in communities that are dependent on one of the largest contiguous irrigation network: the Indus basin irrigation system in Punjab, Pakistan. Furthermore, we simulate two institutional mechanisms that are neglected in experimental studies, despite their importance in many CPR governance systems: traditional authorities and legal pluralism. In our experiments, Punjabi farmers (N = 160 managed to provide the CPR at a level close to the social optimum, even without communication or enforcement opportunities. The equal investment in water infrastructure seems to be a strong social norm, even though those in disadvantageous positions (tail-users earn less than those who have preferential access (head-users. At the same time, head-users restrain themselves from maximum resource extraction, which could be interpreted either as a norm or a stationary bandit strategy. In contrast to one of the most consistent findings of previous experimental studies, the participants in our experiment increased their earnings over the experimental rounds by using the available resources in a more efficient manner. One explanation for this behavior could be the availability of social information in our game. Starting from a high level of cooperation during baseline rounds, the treatments did not change the group investment significantly. The introduction of external sanctions created additional coordination problems, which led to a decrease in the level of group welfare. More specifically, head-users reduced their water extraction in the face of possible external sanctions to a level that the remaining

  15. Engineering and management experience at Texas A&M Transportation Institute

    Science.gov (United States)

    Chowdhury, Arif Tahjibul

    This manuscript presents the author's engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development. In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI's deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI's project deliverables, the deliverables' shortcomings, and potential enhancements to expand the deliverables' appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations. Participating in the Texas Department of Transportation's (TxDOT's) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the

  16. Dedicated Laboratory Setup for CO2 TEA Laser Propulsion Experiments at Rensselaer Polytechnic Institute

    International Nuclear Information System (INIS)

    Laser propulsion research progress has traditionally been hindered by the scarcity of photon sources with desirable characteristics, as well as integrated specialized flow facilities in a dedicated laboratory environment. For TEA CO2 lasers, the minimal requirements are time-average powers of >100 W), and pulse energies of >10 J pulses with short duration (e.g., 0.1 to 1 μs); furthermore, for the advanced pulsejet engines of interest here, the laser system must simulate pulse repetition frequencies of 1-10 kilohertz or more, at least for two (carefully sequenced) pulses. A well-equipped laser propulsion laboratory should have an arsenal of sensor and diagnostics tools (such as load cells, thrust stands, moment balances, pressure and heat transfer gages), Tesla-level electromagnet and permanent magnets, flow simulation facilities, and high-speed visualization systems, in addition to other related equipment, such as optics and gas supply systems. In this paper we introduce a cutting-edge Laser Propulsion Laboratory created at Rensselaer Polytechnic Institute, one of the very few in the world to be uniquely set up for beamed energy propulsion (BEP) experiments. The present BEP research program is described, along with the envisioned research strategy that will exploit current and expanded facilities in the near future.

  17. Knowledge Creation, Management and Transfer: The Experience of the Korea Institute of Nuclear Safety

    International Nuclear Information System (INIS)

    Regulatory activities are composed of four major functions: authorization, review and assessment, inspection and enforcement, and development of regulations and guidelines. To discharge these regulatory functions, the regulatory body needs to have an appropriate level of competencies rooted in sound knowledge and skills. These competencies can only be established by continuous efforts to absorb and digest the information available and to convert it into useful knowledge. As safety challenges arise from new reactor designs as well as from the ageing of nuclear power plants, the regulatory support organization (RSO)/technical support organization (TSO) should endeavour to develop the technical capacity to address such challenges. Knowledge should be managed to help individuals and groups to share valuable organizational insights and to transfer these insights from senior to junior staff in a systematic way. As an RSO/TSO in the Republic of Korea, the Korea Institute of Nuclear Safety (KINS) has been building up its competencies by creating, managing and transferring the knowledge necessary to perform regulatory functions. The paper describes how an RSO/TSO develops capacity building, taking the experience of KINS as an example. (author)

  18. Living at home or in institution: adolescents' optimal experience and life theme building

    Directory of Open Access Journals (Sweden)

    Antonella Delle Fave

    2000-12-01

    Full Text Available The influence of family relationships on adolescents' behavior and development has been widely investigated. This study examines the relationship between family structure and a adolescents' quality of experience in daily activities and social contexts b adolescents' perceived life influences, challenges and goals. To achieve this aim, Flow Questionnaire and Life Theme Questionnaire were administered to 50 Italian girls (15-21 years of age, 25 living in two-parent families, 25 entrusted to Institutions for Custody of Minors. The findings suggest tha adolescents' perception of a positive and supportive family enviroment fosters the active search for challenges and enjoyment in daily activities, and the involvement in productive and social contexts. On the contrary , negative family perception is related to lack of engagement and motivation, and to the prevalence of low-challenge activities as sources of enjoyment and satisfaction. Although the sample size does not allow us to draw conclusions about causality, the results confirm the crucial role of family in influencing adolescents' psychological and behavioral development.

  19. Factors Influencing Student Gains from Undergraduate Research Experiences at a Hispanic-Serving Institution.

    Science.gov (United States)

    Daniels, Heather; Grineski, Sara E; Collins, Timothy W; Morales, Danielle X; Morera, Osvaldo; Echegoyen, Lourdes

    2016-01-01

    Undergraduate research experiences (UREs) confer many benefits to students, including improved self-confidence, better communication skills, and an increased likelihood of pursuing science careers. Additionally, UREs may be particularly important for racial/ethnic minority students who are underrepresented in the science workforce. We examined factors hypothetically relevant to underrepresented minority student gains from UREs at a Hispanic-serving institution, such as mentoring quality, family income, being Latino/a, and caring for dependents. Data came from a 2013 survey of University of Texas at El Paso students engaged in 10 URE programs (n = 227). Using generalized linear models (GzLMs) and adjusting for known covariates, we found that students who reported receiving higher-quality mentorship, spending more hours caring for dependents, and receiving more programmatic resources experienced significantly greater gains from their URE in all three areas we examined (i.e., thinking and working like a scientist, personal gains, and gains in skills). In two of three areas, duration of the URE was positive and significant. Being Latino/a was positive and significant only in the model predicting personal gains. Across the three models, quality of mentorship was the most important correlate of gains. This suggests that providing training to faculty mentors involved in UREs may improve student outcomes and increase program efficacy. PMID:27521234

  20. An institutional experience of pre-emptive liver transplantation for pediatric primary hyperoxaluria type 1.

    Science.gov (United States)

    Khorsandi, Shirin Elizabeth; Samyn, Marianne; Hassan, Akhila; Vilca-Melendez, Hector; Waller, Simon; Shroff, Rukshana; Koffman, Geoff; Van't Hoff, William; Baker, Alastair; Dhawan, Anil; Heaton, Nigel

    2016-06-01

    Primary hyperoxaluria type 1 (PH1) is an inherited metabolic disease that culminates in ESRF. Pre-emptive liver transplantation (pLTx) treats the metabolic defect and avoids the need for kidney transplantation (KTx). An institutional experience of pediatric PH1 LTx is reported and compared to the literature. Between 2004 and 2015, eight children underwent pLTx for PH1. Three underwent pLTx with a median GFR of 40 (30-46) mL/min/1.73 m(2) and five underwent sequential combined liver-kidney transplantation (cLKTx); all were on RRT at the time of cLKTx. In one case of pLTx, KTx was required eight and a half yr later. pLTx was performed in older (median 8 vs. 2 yr) and larger children (median 27 vs. 7.75 kg) that had a milder PH1 phenotype. In pediatric PH1, pLTx, ideally, should be performed before renal and extrarenal systemic oxalosis complications have occurred, and pLTx can be used "early" or "late." Early is when renal function is preserved with the aim to avoid renal replacement. However, in late (GFR transplant strategy depends on PH1 phenotype, disease stage, child size, and organ availability. PMID:27061278

  1. Treatment outcomes of female germ cell tumors: The Egyptian National Cancer Institute experience

    International Nuclear Information System (INIS)

    Introduction: Female germ cell tumors (GCTS) are rare tumors that carry a good prognosis. Aim: To report the experience of the Egyptian National Cancer Institute (ENCI) in managing female GCTs. Methods: This retrospective study included 19 females with ovarian GCTs presenting to the ENCI between 2006 and 2010. Results: The median age was 23 years. Ovaries were the primary site in all patients. Dysgerminoma and teratoma were the predominant pathologies followed by mixed GCT in females. Unilateral ovariectomy or ovarian tumorectomy were the classic surgical procedures with R0 resection being feasible in most cases. Surveillance was adopted in six patients with stage I disease. Chemotherapy was administered in 63% of ovarian GCTs with BEP being the commonest regimen with reasonable tolerability and good response rates. The median OS and EFS were not reached. The projected 5-year OS rate was 93.8%. Both OS and EFS were better in patients responding to chemotherapy than non-responders (p< 0.002). Stage of disease did not significantly affect OS or EFS. Conclusions: Female GCTs rarely affect Egyptian females. They have good prognosis.

  2. Patient Safety Curriculum for Anatomic Pathology Trainees: Recommendations Based on Institutional Experience.

    Science.gov (United States)

    Samulski, Teresa D; Montone, Kathleen; LiVolsi, Virginia; Patel, Ketan; Baloch, Zubair

    2016-03-01

    Because of the unique systems and skills involved in patient care by the pathologist, it is challenging to design and implement relevant training in patient safety for pathology trainees. We propose a patient safety curriculum for anatomic pathology (AP) residents based on our institutional experience. The Hospital of the University of the Pennsylvania employs a self-reporting safety database. The occurrences from July 2013 to June 2015 recorded in this system that involved the division of AP were reviewed and cataloged as preanalytic, analytic, and postanalytic. The distribution of these occurrences was then used to create a framework for curriculum development in AP. We identified areas in which trainees are involved in the identification and prevention of common patient safety errors that occur in our AP department. Using these data-proven target areas, and employing current Accreditation Council for Graduate Medical Education recommendations and patient safety literature, a strategy for delivering relevant patient safety training is proposed. Teaching patient safety to pathology trainees is a challenging, yet necessary, component of AP training programs. By analyzing the patient safety errors that occur in the AP department, relevant and actionable training can be developed. This provides quality professional development and improves overall performance as trainees are integrated into laboratory systems. PMID:26849817

  3. A multi-institutional survey of the effectiveness of chemotherapy combined with radiotherapy for patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Previous randomized trials have shown a survival advantage of concurrent platinum-based chemoradiotherapy with or without adjuvant chemotherapy for advanced nasopharyngeal cancer. Applicability of these data to a Japanese population is an important issue which remains to be solved. A retrospective survey of treatment of patients with nasopharyngeal cancer in 17 institutions in Japan was done with special reference to the relationship between the type of chemotherapy and survival outcome. Chemotherapy used was classified according to: (i) whether≥2 courses of platinum plus 5-fluorouracil (FP) was given; or (ii) whether platinum was administered concurrently with radiotherapy (RT). This resulted in three groups being produced consisting of (i)/(ii)=YES/YES, other miscellaneous (MISC) and RT alone. Of 333 evaluable replies, 67 patients (20%) corresponded to the YES/YES, 192 (58%) to the MISC and 74 (22%) to the RT alone group. The YES/YES group achieved a better overall survival than RT alone for patients with intermediate stage (T3N0 or T1-3N1, 81.9 versus 60.7% at 5 years, P=0.042) and advanced stage (T4 or N2/3, 56.6 versus 31.5%, P=0.017) disease. The MISC group achieved an almost identical survival rate to that in the YES/YES group for patients with intermediate stage disease (81.9% at 5 years, P=0.968), whereas it was not significantly different from that of the RT alone group for patients with advanced stage disease (44.0%, P=0.261). The results of this survey mirrored the data from previous randomized trials for patients with intermediate and advanced stage nasopharyngeal cancer in Japan. However, confirmatory prospective trials are required to test the efficacy of less toxic approaches for patients with intermediate stage disease. (authors)

  4. Radiation therapy for primary squamous cell carcinoma of the vagina: Stanford University experience

    International Nuclear Information System (INIS)

    A retrospective analysis of 38 patients with primary squamous cell carcinoma of the vagina seen at Stanford University Medical Center from 1958 to 1984 was undertaken. Patients were analyzed with regard to symptoms, stage, treatment techniques, survival, patterns of failure, and complications. Eighteen patients were classified as FIGO Stage I, 5 as Stage II, 10 as Stage III, and 5 as Stage IV. The 5-year disease-free survival was 94% in Stage I, 80% in Stage II, 50% in Stage III, and 0% in Stage IV. Five patients (13%) had eight major complications secondary to treatment. Only 2 of 23 patients with Stage I or Stage II disease developed a recurrence. There was a significant correlation between dose and response in patients treated with radiotherapy

  5. MUSTARDE’S FLAP FOR POST BASAL CELL CARCINOMA EXCISION LOWER EYELID RECONSTRUCTION: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Amit

    2015-06-01

    Full Text Available PURPOSE: To review the role of Mustarde’s flap for post basal cell carcinoma excision lower eyelid reconstruction , its clinical outcomes and complications. METHODS: The Mustarde’s rotational cheek flap has been used to reconstruct the lower eyelids of 16 patients from 2008 to 2015 in proven cases of bcc. RESULT S: Mustarde’s flaps have very high functionally as well as cosmetic acceptability with minimum patient morbidity. The most frequent complications were downward contraction and sagging of the flap and ectropion of the lid margin. To prevent them, the zygomatico - cheek flap must be carefully designed, rotated, and sutured as high as possible so that immediately postoperatively, t he palpebral fissure is only a narrow slit.

  6. The first experience in estimation of basal cell carcinoma cryoresistence using noninvasive spectrophotometry

    Science.gov (United States)

    Andrukhina, V. V.; Litvinova, K. S.; Nikitin, A. A.; Spiridonova, N. Z.; Rogatkin, D. A.

    2010-02-01

    The urgency of BCC study affecting maxillofacial area and neck is not only caused by high prevalence of this disease, but also insufficient efficiency of existing treatment methods which lead to full or partial recovery only in 60-80% of cases. We analyzed the results of 198 BCC cases cryosurgical treatment. 33 (16,6%) patients showed continued tumor growth. It has been hypothesized that the behavior and character of microcirculation changes during patient's testing have to correlate with damaging rate of tumors that will allow to develop indications for surgical treatment with local destruction - cryosurgery or cryolaser treatment. We have tested the new group of 33 patients with primary and recurrence types of basal cell carcinoma (BCC) by means of Laser Doppler Flowmetry, Tissues Reflectance Oximetry, Laser Fluorescence Diagnostics before operation. It was shown that the microcirculatory data indicates the presence of cryoresistance.

  7. Mind the Gap! Moving From Aspiration to Experience in UK Institutional Research Data Management

    OpenAIRE

    Carr, Les

    2011-01-01

    The aim of the Institutional Data Management Blueprint (IDMB) project, funded by JISC in the UK, has been to create a practical and attainable institutional framework for managing research data that facilitates ambitious e-research practice. A candidate tool to support this responsibility is the institutional repository – an information storage and management tool conjoined with extensive social support and advice structures from the library. In order to acknowledge and manage their data mana...

  8. Treatment results for nasopharyngeal carcinoma in the modern era: The Hong Kong experience

    International Nuclear Information System (INIS)

    Purpose: To analyze the treatment results achievable for nasopharyngeal carcinoma in the modern era to identify the key failures for future improvement and to provide an updated baseline for future trials. Methods and materials: The results of 2687 consecutive patients treated at all public oncology centers in Hong Kong during 1996-2000 were retrospectively analyzed. The stage distribution (by American Joint Committee on Cancer and International Union Against Cancer staging system, 1997) was 7% Stage I, 41% Stage II, 25% Stage III, and 28% Stage IVA-B. All patients were irradiated with 6-MV photons and the median total dose was 66 Gy. Only 23% of patients had additional treatment with chemotherapy. Results: The 5-year local, nodal, and distant failure-free rates were 85%, 94%, and 81%, respectively; patients with local failure had significantly higher risk of nodal and distant failures. The 5-year progression-free, overall, and cancer-specific survival rates were 63%, 75%, and 80%, respectively. The presenting stage was the most important prognostic factor for all endpoints: with overall survival decreasing from 90% for Stage I to 58% for Stage IVA-B. The results achieved by the 2070 patients treated by radiotherapy alone were almost identical to that of the whole series, the distant failure-free rate among patients with locoregional control was 89% for Stage I-II and 75% for Stage III-IVB. The 860 patients (32%) staged with magnetic resonance imaging achieved significantly better results than those staged by computed tomography, the overall survival being 93% vs. 83% for Stages I-II, and 72% vs. 63% for Stages III-IVB (p = 0.001). Conclusions: Treatment results for nasopharyngeal carcinoma have substantially improved in the modern era; future trials should be based on updated baseline results. Further reduction of distant failure is important for future breakthrough, particularly for patients with advanced disease

  9. Pure compared with mixed serous endometrial carcinoma: two different entities?

    NARCIS (Netherlands)

    Roelofsen, T.; Ham, M.A. van; Wiersma van Tilburg, J.M.; Zomer, S.F.; Bol, M.; Massuger, L.F.A.G.; Bulten, J.

    2012-01-01

    OBJECTIVE: : To analyze whether mixed compared with pure uterine papillary serous carcinoma histology affects clinical outcome, and to assess uterine papillary serous carcinoma for its association with the precursor lesion endometrial intraepithelial carcinoma. METHODS: : A multi-institution observa

  10. Teaching and Training in Geoinformatics: Experiences from the Cyberinfrastructure Summer Institute for Geoscientists (CSIG)

    Science.gov (United States)

    Smeekens, M.; Baru, C.; Keller, G. R.; Arrowsmith, R.; Crosby, C. J.

    2009-12-01

    audience is also becoming more interested in an introduction to the broader landscape of CI activities in the Geosciences and related areas. In the future, we plan a “demo” session to showcase various CI projects. Attendees will not only hear about such projects but will be able to use and experience the cyber-environments and tools in a hands-on session. The evolution of the CSIG program reflects major changes in the IT landscape since 2004. Where we once discussed Grid Computing, students are now learning about Cloud Computing and related concepts. An institute like CSIG play an important role in providing “cross-training” such that geoscientists gain insight into IT issues and solution approaches, while computer scientist gain a better appreciation of the needs and requirements of geoscience applications. In this presentation, we will summarize and analyze the trends over the years in program as well as audience composition; discuss lessons learnt over the years; and present our plan for future CSIG offerings.

  11. Collaborative Life History: Different Experiences of Spending Time in an Institution in Iceland

    Science.gov (United States)

    Hreinsdottir, Eyglo Ebba; Stefansdottir, Gourun

    2010-01-01

    This article was first written as a presentation to the International Seminar held at the Open University in July 2008. It is based on cooperation between two women, Eyglo Ebba Hreinsdottir and Gudrun Stefansdottir, one who lived at an institution and another who worked there. Ebba moved to an institution in 1969 when she was 19 years old. Gudrun…

  12. Research Experiences of Staff within a Specialist UK Higher Education Institution: Challenges, Opportunities and Priorities

    Science.gov (United States)

    Hemmings, Brian; Hill, Doug; Sharp, John

    2013-01-01

    The study discussed here was based on a collective case approach involving a specialist UK higher education institution. Six individual interviews were carried out with a cross-sectional sample of the institution's staff members. Additional information was gained through observations and examination of relevant documents. These data were…

  13. Vulval and Vaginal Rhabdomyosarcoma in Children: Update and Reappraisal of Institut Gustave Roussy Brachytherapy Experience

    International Nuclear Information System (INIS)

    Purpose: To report the Institut Gustave Roussy brachytherapy (BT) experience in the management of vulval and vaginal rhabdomyosarcoma with special emphasis on long-term outcome. Patients and Methods: Between 1971 and 2005, the data concerning 39 girls who had undergone BT as a part of their treatment were retrospectively analyzed. Of the 39 girls, 20 had been treated before 1990, when the BT volume encompassed the initial tumor extension. After 1990, only residual disease was included in the BT volume. Side effects were classified using the Common Terminology Criteria for Adverse Events, version 3.0. Results: The median age was 16.3 months at diagnosis. Vaginal or vulvar rhabdomyosarcoma was diagnosed in 26 and 6 patients, respectively. The median follow-up was 8.4 years. The 5-year overall survival rate was 91%. Of the 39 patients, 6 developed a relapse. Of the 20 patients treated before 1990, 6 experienced Grade 1-2 renal/genitourinary function symptoms and 75% developed sequelae, in the form of vaginal or urethral sclerosis or stenosis. Four patients received follow-up treatment for psychological disorders. Of the 19 patients treated after 1990, 2 developed acute side effects, with maximal Grade 1-2 renal/genitourinary function symptoms, and 20% developed vaginal or urethral sclerosis or stenosis. Two cases of psychological disturbances were also documented. Conclusion: Reducing the BT volume coverage, better indications for surgery, and more efficient chemotherapy, all combined within a multidisciplinary approach, tended to improve results in terms of both survival and long-term sequelae

  14. Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

    International Nuclear Information System (INIS)

    Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

  15. Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution

    International Nuclear Information System (INIS)

    Critically ill patients with acute circulatory failure cannot be moved to other institutions unless stabilized by mechanical support systems. Extracorporeal heart and lung assist systems are increasingly used as a bridge to end-organ recovery or transplantation, and as an ultimate rescue tool in cardiopulmonary resuscitation. From July 2001 to April 2008, we had 38 requests for extracorporeal support for interhospital transfer carried out by the air medical service. Respiratory failure was present in 29 patients, who were provided with pumpless extracorporeal lung assist (PECLA) or veno-venous extracorporeal membrane oxygenation (ECMO). Cardiac failure dominated in 9 patients, who underwent implantation of extracorporeal life support (ECLS). Underlying diseases were acute respiratory distress syndrome in 15 patients, pneumonia in 7, prior lung transplant status in 4, cardiogenic shock in 7, and septic shock in 4. All assist systems were connected via peripheral vessels by the Seldinger technique. Transport was uneventful in all cases with no technical failures. On arrival at the specialized care hospital, two patients had leg ischemia and underwent relocation of the arterial cannula. After a mean (SD) support of 5.1 (3.0) days for PECLA, 3.5 (2.9) days for ECLS, and 7.3 (5.8) days for ECMO, 60%, 66%, and 66% of patients, respectively, could be successfully weaned from the systems. Discharge rates were 45% for PECLA, 44% for ECLS, and 56% for ECMO. Our experience proves that minimized extracorporeal assist devices allow safe assistance of patients with isolated or combined heart and lung failure in need of interhospital transfer. Critically ill patients get a chance to reach a center of maximum medical care. (author)

  16. Clinical and Histopathological Diagnosis of Glomus Tumor: An Institutional Experience of 138 Cases

    Science.gov (United States)

    Mravic, Marco; LaChaud, Gregory; Nguyen, Alan; Scott, Michelle A.; Dry, Sarah M.; James, Aaron W.

    2015-01-01

    Background Glomus tumors are relatively uncommon subcentimeteric benign perivascular neoplasms usually located on the fingers. With their blue-red color and common subungual location, they are commonly confused for vascular or melanocytic lesions. To date there is no comprehensive review of an institutional experience with glomus tumors. Methods A 14-year retrospective review of all cases within University of California, Los Angeles, with either a clinical or pathological diagnosis of glomus tumor was performed. Data obtained included demographic information, tumor description, pathological diagnoses, immunohistochemical studies, radiographic and treatment information, and clinical course. Rates of concordance between clinical and pathological diagnoses and an evaluation of overlap with other entities were assessed. Results Clinical diagnosis of glomus tumor showed concordance with a histopathological diagnosis (45.4% of cases). The most common alternate clinical diagnoses included lipoma, cyst, or angioma. A pathological diagnosis of glomus tumor was most common in the fourth to seventh decades of life. The most common presentation was a subcentimeter lesion on the digit. Deep-seated tumors had a strikingly increased risk for malignancy (33%). Radiological studies were not relied on frequently (18.2% of cases). Immunohistochemical analysis showed diffuse αSMA and MSA expression in nearly all cases (99% and 95%, respectively), with focal to diffuse CD34 immunostaining in 32% of cases. Discussion Our study illustrates trends in the clinical versus pathologic diagnoses of glomus tumor, common competing diagnoses, a difference in demographics than is commonly reported (older age groups most commonly affected), and important differences in the use adjunctive diagnostic tools including radiology and immunohistochemistry. PMID:25614464

  17. Caring for terminal AIDS patients: The experiences of caregivers in a palliative care institution

    Directory of Open Access Journals (Sweden)

    Essie Ricks

    2009-04-01

    Full Text Available

    This research focused on the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. A qualitative, exploratory, descriptive, and contextual research design with a phenomenological approach to inquiry was utilised. Thirteen unstructured interviews, which were audio-taped, were conducted with caregivers working full-time in a formal institution caring for patients who are dying from AIDS. The transcribed interviews were analysed using Tesch’s method of descriptive analysis (in Creswell 1994:115.

    One central theme emerged, namely that in their daily duty (at their place of work, caregivers experienced various challenges as a result of having to deal with the death of their patients suffering from AIDS, and five sub-themes were formulated from further analysis. The five subthemes were:

    • Caregivers experienced emotional challenges in caring for patients dying of AIDS;

    • Caregivers experienced a difference in death and dying of adults as apposed to children;

    • Caregivers experienced the rationalisation of death and dying differently;

    • Caregivers experienced that faith in God give them strength to cope with death and dying;

    • Caregivers experienced caring for patients as fulfilling and meaningful to them despite the sadness of death and dying.

    The participants face the death of their patients daily, from a disease that causes untold suffering to the patients, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. They described their emotional experiences, which included the various challenges that they face as a result of having to deal with the death and dying of their patients suffering from AIDS. The information shared by these participants formed

  18. How Religious Engagement Shapes the College Experience of African American Christian Males at a Predominantly White Institution: A Phenomenological Approach

    Science.gov (United States)

    Rice, Stephen J.

    2012-01-01

    Understanding the different aspects of the college experience of African American males in a predominantly White institution is an important topic for researchers. This focus directly responds to the despairing statistics surrounding collegiate African American males, who often show lower graduation rates compared to other racial groups. The need…

  19. FACTORS RELATED TO THE GRANTING OF COLLEGE-UNIVERSITY CREDIT FOR TRADE AND INDUSTRIAL EXPERIENCE IN INSTITUTIONS OFFERING INDUSTRIAL EDUCATION.

    Science.gov (United States)

    LAUDA, DONALD PAUL

    THE OBJECTIVES OF THE STUDY WERE TO (1) DETERMINE THE EXTENT OF GRANTING DEGREE CREDIT FOR TRADE AND INDUSTRIAL EXPERIENCE, (2) DETERMINE WHETHER OR NOT CREDIT GRANTING INSTITUTIONS CAN BE CLASSIFIED BY SELECTED TRAITS, (3) INVESTIGATE PROCEDURES, PREREQUISITES, AND TRANSFER REGULATIONS, AND (4) DEVELOP A RECOMMENDED PROCEDURE FOR GRANTING CREDIT.…

  20. The Religious and Spiritual Experiences of Undergraduate Gay Males Attending a Religiously Affiliated Institution of Higher Education

    Science.gov (United States)

    Adams, Melvin D., III

    2013-01-01

    This doctoral thesis studied the religious and spiritual experiences of undergraduate gay males at a Protestant affiliated higher education institution and how undergraduate gay males made sense of their personal journeys. Data was collected from four participants and analyzed using interpretative phenomenological analysis. Five themes emerged…

  1. Concomitant bid radiotherapy with cisplatin and 5-fluorouracil in unresectable carcinoma of the pharynx: 10 year's experience at the Centre Antoine Lacassagne

    International Nuclear Information System (INIS)

    Patients suffering from locally advanced unresectable squamous cell carcinoma of the oropharynx and hypopharynx treated with radiotherapy alone have a poor prognosis. More than 70% of patients die within 5 years mainly due to local recurrences. The aim of this study was to evaluate retrospectively the Antoine Lacassagne Cancer Center's experience in a treatment by concomitant bid radiotherapy and chemotherapy. Evaluation was based on analysis of the toxicity, the response rates, the survival, and the clinical prognostic factors. From 1992 to 2000, 92 consecutive patients were treated in our single institution. All of them had stage IV, unresectable squamous cell carcinoma of the pharynx and they received continuous bid radiotherapy (two daily fractions of 1.2 Gy, 5 days a week, with a 6-h minimal internal between fractions). Total radiotherapy dose was 80.4 Gy on the oropharynx and 75.6 Gy on the hypopharynx. Two or three chemotherapy courses of cisplatin (CP)-5-fluorouracil (5FU) were given during radiotherapy at 21 -day intervals (third not delivered after the end of the radiotherapy). CP dose was 100 mg/m2 (day 1) and 5-FU was given as 6-day continuous infusion (750 mg/m2/day at 1. course; 430 mg/m2/day at 2. and 3. courses). Special attention was paid to supportive care, particularly in terms of enteral nutrition and mucositis prevention by low-level laser energy. Acute toxicity was marked and included WHO grade III/IV mucositis (89%, 16% of them being grade IV), WHO grade III dermatitis (72%) and grade III/IV neutropenia (61%). This toxicity was significant but manageable with optimised supportive care, and never led to interruption of treatment for more than 1 week, although there were two toxic deaths. Complete global response rate at 6 months was 74%. Overall global survival at 1 and 3 years was 72% and 50% respectively, with a median follow-up of 17 months. Prognostic factors for overall were the Karnofsky index (71% survival at 3 years for patients with a

  2. Single-Antenna Microwave Ablation Under Contrast-Enhanced Ultrasound Guidance for Treatment of Small Renal Cell Carcinoma: Preliminary Experience

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the safety, effectiveness, and feasibility of microwave ablation (MWA) of small renal cell carcinomas (RCCs) in selected patients. Institutional review board and informed consent were obtained. From December 2007 to January 2009, 12 patients (8 male, 4 female) were enrolled in a treatment group, in which percutaneous MWA of small RCCs was performed under contrast-enhanced ultrasound guidance. The tumors were 1.7-2.9 cm in diameter (mean diameter, 2.0 cm).Therapeutic effects were assessed at follow-up with computed tomography. All patients were followed up for 3-14 months (mean, 6 months) to observe the therapeutic effects and complications (according to SIR classification). Assessment was carried out with CT imaging. No severe complications or unexpected side effects were observed after the MWA procedures. In all cases technical success was achieved. Clinical effectiveness was 100%; none of the patients showed recurrence on imaging. In conclusion, our preliminary results support the use of MWA for the treatment of small renal tumors. This technology can be applied in select patients who are not candidates for surgery, as an alternative to other ablative techniques.

  3. Radiotherapeutic management of nasopharyngeal carcinoma. A critical review of 601 cases treated at the Cancer Institute in the period 1947 to 1969

    International Nuclear Information System (INIS)

    The results presented in this paper are based upon information obtained from a critical review of 601 records of nasopharyngeal carcinoma retrieved from the files of the Cancer Institute. The records cover a period of 22 years. An analysis of the age and sex distribution revealed a male excess with a ratio of 2.2:1. No other significant age and sex differences were elucidated. About 80% of all the patients were found to manifest Stage II lesions. Early signs and symptoms were usually mild and non-incapacitating, which the patients usually ignored and may have misled the general practitioners. Single biopsy studies were conducted on 429 patients. The results have shown that more than 95% showed the presence of cell types I, III and IV, (36%, 31%, 31%, respectively), and these were mostly seen in patients manifesting Stage II lesions. Whether the cell type/stage relationship as observed is the true picture could not be ascertained, since the majority of the patients manifested Stage II lesions. The cell type(s) may however be an important factor in the evaluation of biologic response to radiotherapy and may further influence the dose/response relationship. Using port sizes of 6cm x 7cm to 6cm x 8cm, 178 patients were irradiated with doses ranging from about 4000 to 7000 rad (40-70Gy). The results have shown that 74 to 78% of the patients showing a 100% response (complete disappearance of the mass) were irradiated with doses in the range 5000 to 7000 rad (50 to 70Gy). 4000 to 5000 rad (40-50Gy) on the average resulted in optimum response rates to whole-neck irradiation. (author)

  4. Clinical experience and critical evaluation of the role of sorafenib in renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Zustovich F

    2011-05-01

    Full Text Available Fable Zustovich1, Giuseppe Lombardi1, Davide Pastorelli1, Patrizia Farina1, Massimo Dal Bianco2, Luca De Zorzi2, Maurizia Dalla Palma1, Ornella Nicoletto1, Vittorina Zagonel11Oncologia Medica 1, Istituto Oncologico Veneto-IRCCS, Padova, Italy; 2UO Urologia, Ospedale Sant'Antonio, ULSS 16, Padova, ItalyAbstract: Renal cell carcinoma (RCC is a common malignancy worldwide with approximately 95,000 new cases per year and ranks as the sixth cause of cancer deaths. Until recently, the slightly active and very toxic cytokines were available for patients with advanced RCC. Advances have been made in understanding the molecular biology of renal cancer. The introduction of targeted agents has led to promising possibilities for treating these highly vascularized tumors. Angiogenesis inhibition is likely to represent the main potential therapeutic target. Sorafenib is an oral multikinase inhibitor with activity against tyrosine kinase receptors that are responsible for blood vessel development and has shown to be active in treating advanced RCC. In this review, we summarize the pharmacology, mode of action, pharmacokinetics, and safety of sorafenib use in therapy for advanced RCC.Keywords: sorafenib, pharmacokinetics, angiogenesis 

  5. [Surgical treatment of insulinoma. Experience at the Salvador Zubiran National Nutrition Institute].

    Science.gov (United States)

    Campuzano Fernández, M; Fernández del Castillo Ancira, C

    1989-01-01

    Eighteen cases of insulinoma treated at the Instituto Nacional de la Nutricion in Mexico City are presented. The cases were operated on between 1959 and 1988, and include 10 women and 8 men with a mean age of 38. The duration of symptoms ranged between 4 and 96 months with a median of 27; 78% of the patients had neuropsychiatric symptoms, 61% seizures, and 55% loss of consciousness. One of the patients had evidence of type I multiple endocrine neoplasia. Diagnosis was established in all the patients with the demonstration of Whipple's triad and also with an elevated insulin determination in the last nine patients. In six cases the insulinoma was enucleated; in two a Whipple procedure was performed; in nine a distal pancreatectomy and in the remaining patient only resection of hepatic metastases; 67% of the tumors were diagnosed as benign solitary adenomas, 16.5% as carcinomas and the same number as hyperplasia. Operative mortality was 5.5%, and morbidity 44%. The three carcinomas survived 6, 8 and 36 months. Disappearance of the hypoglycemic symptoms was obtained in 93% of the cases of adenoma and hyperplasia. PMID:2551025

  6. Treatment of advanced stage ovarian carcinoma with a combination of chemotherapy, radiotherapy, and radiosensitizer: report of a pilot study from the National Cancer Institute

    International Nuclear Information System (INIS)

    Twenty-eight patients with Stage III or IV ovarian carcinoma were treated with combined chemotherapy-radiotherapy employing a unique protocol. Four cycles of cyclophosphamide and hexamethylmelamine alternated with four cycles of concurrent cisplatin, whole abdominal radiotherapy, and intraperitoneal misonidazole. The entire treatment program lasted six months. Clinical complete responses were seen in 50% of the patients with an overall response rate of 61%. Pathologic complete response (PCR) confirmed at second look surgery occurred in 18% of the group (5 patients). Median survival of the entire group was 15.2 months with all PCR's alive NED. This outcome was no different than our previous experience with combination chemotherapy alone. Toxicities seen included leukopenia, thrombocytopenia, nausea, vomiting, and weight loss. However, these side effects were manageable. Two non-tumor deaths occurred. This study demonstrates the feasibility of combining drug and radiation therapy concurrently in the treatment of ovarian cancer; further research is needed to explore different sequencing and dose levels that could improve the outcome

  7. Outcomes in a Multi-institutional Cohort of Patients Treated With Intraoperative Radiation Therapy for Advanced or Recurrent Renal Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Paly, Jonathan J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Biggs, Peter J.; Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Roeder, Falk [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Martínez-Monge, Rafael [Radiation Oncology Division, University of Navarre, Pamplona (Spain); Whitson, Jared [Department of Urology, University of California San Francisco, San Francisco, California (United States); Calvo, Felipe A. [Departamento de Oncología, Hospital General Universitario Gregorio Marañón, Madrid (Spain); Fastner, Gerd; Sedlmayer, Felix [Department of Radiotherapy and Radio-Oncology, Paracelsus Medical University Clinics, Salzburg (Austria); Wong, William W. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States); Ellis, Rodney J. [Department of Radiation Oncology, Seidman Cancer Center University Hospitals Case Medical Center, Cleveland, Ohio (United States); Haddock, Michael G.; Choo, Richard [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Shipley, William U.; Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Efstathiou, Jason A., E-mail: jefstathiou@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose/Objective(s): This study aimed to analyze outcomes in a multi-institutional cohort of patients with advanced or recurrent renal cell carcinoma (RCC) who were treated with intraoperative radiation therapy (IORT). Methods and Materials: Between 1985 and 2010, 98 patients received IORT for advanced or locally recurrent RCC at 9 institutions. The median follow-up time for surviving patients was 3.5 years. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method. Chained imputation accounted for missing data, and multivariate Cox hazards regression tested significance. Results: IORT was delivered during nephrectomy for advanced disease (28%) or during resection of locally recurrent RCC in the renal fossa (72%). Sixty-nine percent of the patients were male, and the median age was 58 years. At the time of primary resection, the T stages were as follows: 17% T1, 12% T2, 55% T3, and 16% T4. Eighty-seven percent of the patients had a visibly complete resection of tumor. Preoperative or postoperative external beam radiation therapy was administered to 27% and 35% of patients, respectively. The 5-year OS was 37% for advanced disease and 55% for locally recurrent disease. The respective 5-year DSS was 41% and 60%. The respective 5-year DFS was 39% and 52%. Initial nodal involvement (hazard ratio [HR] 2.9-3.6, P<.01), presence of sarcomatoid features (HR 3.7-6.9, P<.05), and higher IORT dose (HR 1.3, P<.001) were statistically significantly associated with decreased survival. Adjuvant systemic therapy was associated with decreased DSS (HR 2.4, P=.03). For locally recurrent tumors, positive margin status (HR 2.6, P=.01) was associated with decreased OS. Conclusions: We report the largest known cohort of patients with RCC managed by IORT and have identified several factors associated with survival. The outcomes for patients receiving IORT in the setting of local recurrence compare favorably to

  8. Outcomes in a Multi-institutional Cohort of Patients Treated With Intraoperative Radiation Therapy for Advanced or Recurrent Renal Cell Carcinoma

    International Nuclear Information System (INIS)

    Purpose/Objective(s): This study aimed to analyze outcomes in a multi-institutional cohort of patients with advanced or recurrent renal cell carcinoma (RCC) who were treated with intraoperative radiation therapy (IORT). Methods and Materials: Between 1985 and 2010, 98 patients received IORT for advanced or locally recurrent RCC at 9 institutions. The median follow-up time for surviving patients was 3.5 years. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method. Chained imputation accounted for missing data, and multivariate Cox hazards regression tested significance. Results: IORT was delivered during nephrectomy for advanced disease (28%) or during resection of locally recurrent RCC in the renal fossa (72%). Sixty-nine percent of the patients were male, and the median age was 58 years. At the time of primary resection, the T stages were as follows: 17% T1, 12% T2, 55% T3, and 16% T4. Eighty-seven percent of the patients had a visibly complete resection of tumor. Preoperative or postoperative external beam radiation therapy was administered to 27% and 35% of patients, respectively. The 5-year OS was 37% for advanced disease and 55% for locally recurrent disease. The respective 5-year DSS was 41% and 60%. The respective 5-year DFS was 39% and 52%. Initial nodal involvement (hazard ratio [HR] 2.9-3.6, P<.01), presence of sarcomatoid features (HR 3.7-6.9, P<.05), and higher IORT dose (HR 1.3, P<.001) were statistically significantly associated with decreased survival. Adjuvant systemic therapy was associated with decreased DSS (HR 2.4, P=.03). For locally recurrent tumors, positive margin status (HR 2.6, P=.01) was associated with decreased OS. Conclusions: We report the largest known cohort of patients with RCC managed by IORT and have identified several factors associated with survival. The outcomes for patients receiving IORT in the setting of local recurrence compare favorably to

  9. Fifty years experiences in nuclear engineering education at Tokyo Institute of Technology

    International Nuclear Information System (INIS)

    Nuclear engineering education has been initiated in 1957 at the graduate school of Tokyo Institute of Technology. Educational activities have been conducted for fifty years under the support of the Research Laboratory for Nuclear Reactors. In the past fifty years, about 1000 Master students and 200 Doctoral students and 200 Doctoral students graduated from our Nuclear Engineering Department at Tokyo Institute of Technology. Many of them found their jobs in nuclear industries and institutes. International course of nuclear engineering was initiated in 1994, and so far about 90 students from 15 overseas countries have graduated from our Master and Doctoral Programs. In 2003, our proposal of 'Innovative Nuclear Energy System for the Sustainable World' was adopted as the Center of Excellent Program sponsored by Ministry of Education, Science and Technology. Recently a collaborative education network has been developed among Kanazawa University, Fukui University, Ibaraki University, Okayama University, Tokyo Institute of Technology and Japan Atomic Energy Agency. (author)

  10. Institutional plagiarism policy and Turnitin: perceptions and experiences of staff and students

    OpenAIRE

    Starr, S

    2011-01-01

    Presentation on research at Canterbury Christ Church University to the fifth one-day event on Institutional Policies and Procedures for Managing Student Plagiarism (Input to session: Embedding Turnitin in policy and practice, Gill Rowell, Academic Advisor, Plagiarismadvice.org)

  11. Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience.

    LENUS (Irish Health Repository)

    Burke, D

    2013-09-01

    Stereotactic radiosurgery is frequently used for the treatment of brain metastases. This study provides a retrospective evaluation of patients with secondary lesions of the brain treated with stereotactic radiosurgery (SRS) at our institution.

  12. Experiences of Microfinance Institutions Serving Very Small to Small Enterprises in Latin America

    OpenAIRE

    International Finance Corporation

    2014-01-01

    Very small enterprises (VSEs) in Latin America and the Caribbean (LAC) represent a broad and heterogeneous segment, often underserved by formal financial institutions. They are generally informal and often family businesses. The financial needs of these enterprises are typically overlooked by “downscaling” banks, which find larger and often more formal small and medium enterprises (SMEs) to be a more natural market for their products and services. Microfinance Institutions (MFI...

  13. African American Undergraduate Students' Experiences in Residential Learning Communities at a Predominantly White Institution

    OpenAIRE

    Best, Julia Y.

    2006-01-01

    There is a nationwide decline in enrollment, retention and degree completion for African American students in predominantly White institutions (PWIs) in the United States. Colleges and Universities establish diversity initiatives to address these concerns, yet educational disparities persist. Institutions of higher learning also address ways to enhance the educational development of undergraduate students. One such initiative involves a paradigm shift to extend the curriculum into residential...

  14. Learning to Live with League Tables and Ranking: the Experience of Institutional Leaders

    OpenAIRE

    Hazelkorn, Ellen

    2008-01-01

    This paper draws on the results of an international survey of HE leaders and senior managers which was supported by the OECD Programme on Institutional Management of Higher Education (IMHE) and the International Association of Universities (IAU). It focuses on how HEIs are responding to league tables and rankings (LTRS), and what impact or influence – positive or perverse – they are having on institutional behaviour, decision-making and actions. The growing body of academic research and journ...

  15. The Sub-Saharan Africa Challenge Program: An experiment in mainstreaming institutional learning and change

    OpenAIRE

    Acosta, Anne Starks; Jones, Monty; von Kaufmann, Ralph

    2005-01-01

    The Sub-Saharan Africa Challenge Program (SSA CP) shows how the principles of institutional learning and change (ILAC) can be applied. This Brief outlines the basic components of the SSA CP and highlights various ILAC features of the Program. These include an innovation systems orientation; an approach to ‘thinking globally and acting locally’; the location of research within a broader context of policy, market and institutional change; and an emphasis on collaboration and learning among prog...

  16. Treatment Result in Advanced T3 and T4 Glottic Carcinoma; YUMC Experience

    International Nuclear Information System (INIS)

    Between January 1980 and September 1988, 68 patients with advanced T3 and T4 glottic carcinoma were treated with RT and surgery/RT in the Department of Radiation Oncology, Yonsei Cancer Center and ENT, Yonsei University College of Medicine. The mean age was 60 years old (range 33 to 79 year old). The 34 patients were treated with irradiation alone, and the remaining 34 patients with surgery and irradiation. Initial nodal presentation was 37% (25/68); 31% (11/34) in RT alone group and 41% (14/34) in combined treatment group. The minimum follow-up was 2 years. The local control rate after treatment was 47% in RT alone group and 65% in combined treatment group; 57% for node negative and 27% for node positive patients treated with RT alone; 65% for node negative and 64% for node positive patients treated with combined treatment. The treatment failure was observed in 30 patients; 14 patients for primary local failure, 6 patients for regional nodal failure, 6 patients for local and regional failure, 26 patients for primary failure and/or distant metastasis, and 2 patient for regional failure and/or distant metastasis. The overall 5-year survival rate was 57%; 37% in RT alone group and 76% in combined treatment group; 55% for node negative and 20% for node positive patients treated with RT alone; 73% for node negative and 77% for node positive patients treated with combined treatment. In conclusion, the combined treatment groups in the treatment of advanced T3 and T4 glottic cancer showed the better results in local control rates and 5-year actuarial survival rates than RT alone group. We suggest that total laryngectomy and postoperative RT in the most patients of advanced glottic cancer were performed. However, in cases of node negative patients, RT alone is prefer as a treatment modality over combined surgery and RT since the treatment results were comparable and furthermore functional preservation could be achieved

  17. Percutaneous Cryoablation of Small Hepatocellular Carcinoma with US Guidance and CT Monitoring: Initial Experience

    International Nuclear Information System (INIS)

    The purpose of this study was to retrospectively determine the safety and effectiveness of percutaneous cryoablation, monitored with computed tomography (CT) and ultrasonographic (US) guidance, for the treatment of hepatocellular carcinoma (HCC). Four patients with small HCCs underwent one percutaneous cryoablation treatment session monitored with CT and US guidance. All patients underwent pretreatment blood chemistry testing and imaging evaluation. We treated lesions with simultaneous insertion of multiple 17-G cryoprobes (two or three) and defined technical success when the extension of a visible iceball was beyond 5 mm from the tumor margin. Intralesional enhancement or tumoral size increase was defined as local progression compared with that on images obtained immediately after ablation. We evaluated complications and follow-up (at 1, 3, and 6 months). All patients survived without short- or long-term complications. Cryoablation was technically successful in all patients at the end of the procedure. During follow-up two patients developed disease recurrence. One patient developed local tumor progression on the margin of the lesion; the other, a new HCC. In the case of local tumor progression a new elevation of α-fetoprotein (αFP) levels occurred at first follow-up control. In the other case levels of αFP remained stable during the first 3 months after the procedure, then demonstrated a progressive increase in αFP levels beginning at the fourth month, without tumor evidence during CT control at 3 months. We conclude that percutaneous cryotherapy with US guidance and CT monitoring is a feasible, safe, and effective for treatment of HCC. If local ablative procedures of hepatic lesions are to be performed, percutaneous cryoablation, not laparotomic, should be discussed as an alternative therapeutic measure. Longer follow-up should provide proof of the effectiveness of this technique

  18. A single center experience: post-transplantation adjuvant chemotherapy impacts the prognosis of hepatocellular carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Wu Junyi; Sun Hongcheng; Han Zhongbo; Peng Zhihai

    2014-01-01

    Background The aim of this research was to investigate the impact of post-transplantation adjuvant chemotherapy in the prevention of tumor recurrence and metastasis for hepatocellular carcinoma (HCC) exceeding Milan criteria after liver transplantation.Methods A total of 117 patients with HCC exceeding the Milan criteria who had undergone orthotopic liver transplantation (OLT) from August 2002 to February 2009 were enrolled and retrospectively analyzed.The patients were divided into four groups according to chemotherapy regimens and the impact of different chemotherapy regimens on survival,disease-free survival,and adverse effects were compared.Results One year survival rates for the gemicitabine,conventional chemotherapy,oxaliplatin plus capecitabine and the best supportive care (BSC) group were 87.5%,84.2%,81.6%,and 67.5%.The 3-year survival rates were 48.1%,25.9%,31.6%,and 33.7%,respectively for the four groups.One year disease free survival rates for the four groups were 69.8%,47.4%,53.8%,and 45.7% respectively.And 3-year disease free survival rates were 43.2%,23.7%,23.6%,and 25.1% for the four groups.Stratification analysis showed that the gemcitabine regimen and conventional chemotherapy could significantly improve the survival rate and disease free survival rate for HCC patients who had major vascular invasion and/or microvascular invasion after liver transplantation compared with BSC group.Conclusions For HCC patients beyond Milan criteria,especially who had vascular invasion and/or micorvascular invasion,post-transplantation adjuvant chemotherapy can significantly improve survival.Gemcitabine is a proper regimen for postoperative adjuvant chemotherapy.Conventional chemotherapy can also benefit patients,but the adverse effects are not satisfactory.

  19. Lipiodol Trans-arterial Chemoembolization of Hepatocellular Carcinoma with Idarubicin: First Experience

    Energy Technology Data Exchange (ETDEWEB)

    Favelier, Sylvain [University Hospital of Dijon, Digestive, Thoracic and Oncologic Unit, Department of Diagnostic and Interventional Radiology (France); Boulin, Mathieu, E-mail: mathieu.boulin@chu-dijon.fr [University Hospital of Dijon, Department of Pharmacy (France); Hamza, Samia [University Hospital of Dijon, Department of Hepatology (France); Cercueil, Jean-Pierre; Cherblanc, Violaine [University Hospital of Dijon, Digestive, Thoracic and Oncologic Unit, Department of Diagnostic and Interventional Radiology (France); Lepage, Come; Hillon, Patrick [University Hospital of Dijon, Department of Hepatology (France); Chauffert, Bruno [University Hospital of Dijon, Department of Oncology (France); Krause, Denis; Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr [University Hospital of Dijon, Digestive, Thoracic and Oncologic Unit, Department of Diagnostic and Interventional Radiology (France)

    2013-08-01

    BackgroundThere is still no consensus about the best chemotherapeutic agent for transarterial chemoembolization (TACE). A recent in vitro study demonstrated that idarubicin, an anthracycline, was by far the most cytotoxic drug on human hepatocellular carcinoma (HCC) cell lines. Idarubicin is much more lipophilic than doxorubicin, leading to higher cell penetration through lipidic membranes and greater accumulation of the drug in the lipiodol. Furthermore, idarubicin has the ability to overcome multidrug resistance. Therefore, we designed this pilot human study to evaluate the safety and efficacy of lipiodol TACE using idarubicin.MethodsIn 21 consecutive patients treated by lipiodol TACE with idarubicin (10 mg) for HCC, safety data, tumor response (Response Evaluation Criteria in Solid Tumors, mRECIST), time to treatment failure (TTTF), and overall survival were evaluated.ResultsPostembolization syndrome was observed after 30.9 % (17 of 55) of sessions. No patient died from a TACE-related complication. No hematological grade 3-5 adverse event was observed. At least one grade 3 or higher adverse event occurred in 19 % (4 of 21) of patients. On imaging, no progression was encountered; four patients (24 %) exhibited stable disease, 12 (57 %) exhibited a partial response, and five (19 %) exhibited a complete response. Median TTTF was 16.7 months (Kaplan-Meier analysis). At 6 months, 94.7 % (95 % confidence interval [CI] 68.1-99.2) of patients did not reach treatment failure, whereas treatment failure was not reached in 50.6 % (95 % CI 21.6-73.9) of patients at 1 year. Overall survival was 83.5 % (95 % CI 57-94.4) at 1 year.ConclusionIdarubicin seems safe and effective in lipiodol TACE of HCC. This warrants further study to determine the potential of this drug to replace doxorubicin for TACE.

  20. Conversion to sirolimus immunosuppression in liver transplantation recipients with hepatocellular carcinoma: Report of an initial experience

    Institute of Scientific and Technical Information of China (English)

    Jian Zhou; Yi-Feng He; Yu-Qi Wang; Zhao-You Tang; Jia Fan; Zheng Wang; Zhi-Quan Wu; Shuang-Jian Qiu; Xiao-Wu Huang; Yao Yu; Jian Sun; Yong-Sheng Xiao

    2006-01-01

    AIM: To report a retrospective analysis of preliminary results of 36 patients who received sirolimus (SRL, Rapamune(R), rapamycin) in a consecutive cohort of 248 liver allograft recipients.METHODS: Thirty-six liver transplant patients with hepatocellular carcinoma (HCC) who were switched to SRL-based immunosuppression therapy from tacrolimus were enrolled in this study. The patients who were diagnosed as advanced HCC before orthotopic liver transplantation (OLT) were divided into group A (n = 11), those who were found to have HCC recurrence and/or metastasis after OLT were assigned to group B (n = 18), and those who developed renal insufficiency caused by calcineurin inhibitor (CNI) were assigned to group C (n = 7) after OLT.RESULTS: The patients were followed up for a median of 10.4 mo (range, 3.8-19.1 mo) after conversion to SRL therapy and 12.3 mo (range, 5.1-34.4 mo) after OLT.Three patients developed mild acute cellular rejection 2 wk after initiating SRL therapy, which was fully reversed after prednisolone pulse therapy. In group A, only 1 patient was found to have HCC recurrence and metastasis 12 mo after OLT. In group B, 66.7% (12/18) patients (2 with progressive tumor, 7 with stable tumor and 3 without tumor) were still alive due to conversing to SRL and/or resection for HCC recurrence at the end of a median follow-up of 6.8 mo post conversion and 10.7 mo posttransplant. In group C, no HCC recurrence was demonstrated in 7 patients, and renal function became normal after SRL therapy. Thrombocytopenia (n = 2), anemia (n = 8), and oral aphthous ulcers (n = 7) found in our cohort were easily manageable.CONCLUSION: The conversion to SRL-based immunosuppression may inhibit the recurrence and metastasis of HCC and improve CNI-induced renal insufficiency in OLT patients with HCC.

  1. Relevance of intra operative radiotherapy in the treatment of uterine carcinoma - Lyon preliminary experience

    International Nuclear Information System (INIS)

    Aim: Retrospective analysis of Intra operative Radiotherapy (IORT) in recurrent uterine carcinoma (RUC) and prospective pilot study of IORT in advanced cervix cancer (ACC) with high risk of local failure. Patients-Treatments: (1) RUC: from 1988 to 1991, 34 patients with RUC have been treated. Primary cancer was: cervix uterus: 28, endometrium: six. Site of recurrence: centro pelvis: four, latero pelvis: 25, lombo aortic: five. Total gross resection was only possible in 12 patients. A dose of 15 to 22 Gy was given by IORT according to the residual tumour size. External beam irradiation was added in 16 patients; (2) ACC: January 1991 to November 1992, 20 patients were included in this pilot study, stage IIB: seven, stage III: 12, stage IV: 1. Preoperative retroperitoneal pelviscopy showed 13 pN1 patients and NMR imaging ten tumours of 6 cm or larger in diameter. Treatment started with concomitant pelvic irradiation (44 Gy) and one concomitant cycle of 5 Fu-CDDP, followed by a short course of high dose rate upper vagina brachytherapy (4Gy). Four weeks later a radical Wertheim operation was performed together with IORT on the lateral pelvis. Results: (1) RUC: overall survival (Kaplan Meier) at 4 years is 32% (±8). Local relapse in the field of IORT was observed in six patients. Grade 2-3 complications: six patients (radiation proctitis, neuritis, vertebral collapse, ureteral stenosis); (2) ACC: the median follow up is short (18 months). Four cases of pelvic relapse, no postoperative death. The first line radio chemotherapy was associated with two G3 early complications. Postoperative radiation complication was less than 10% G3. Discussion: promising results of IORT in RUC have been observed especially if no irradiation is given during the primary treatment. Good feasibility of the pilot study of IORT in ACC was also observed. It could be followed by a multicentric feasibility trial. (authors). 38 refs., 4 tabs., 1 fig

  2. Endocavitary radiation for treatment of distal rectal carcinoma and twenty years experience

    International Nuclear Information System (INIS)

    %) of which achieved local control and 6 (15%) achieved good palliation. Conclusion: Approximately 15-20% of all rectal cancer patients may be expected to fulfill the criteria for selection, which are sufficiently strict that local control and five year survival rate can exceed those of surgery for comparable disease and preserve anal sphincter and sexual function of the patient. Endocavitary radiation for rectal carcinoma in an outpatient procedure and cost only one third of the surgical procedure comparatively

  3. Facilitating institutional change in West Africa: the CoS–SIS experience

    OpenAIRE

    Adjei-Nsiah, S.; O. Sakyi-Dawson; Klerkx, L.W.A.

    2014-01-01

    The Convergence of Sciences–Strengthening Innovation Systems (CoS–SIS) programme is based on the premise that the livelihood of the African smallholder farmer is constrained by the existence and/or performance of formal and informal institutions that are not conducive to small-farm development. CoS–SIS employs nine platforms in Ghana, Benin and Mali – “Concertation and Innovation Groups” (CIGs) – that aim to facilitate institutional change above the farm level (e.g. rules and regulations, byl...

  4. Secondary solid tumors following radiation in Hodgkin's disease: experience of the Institut Gustave-Roussy

    International Nuclear Information System (INIS)

    From 1961 to 1984, in the Institut Gustave-Roussy, 893 patients have been treated in Hodgkin's disease. The authors study the solid tumors that they have observed after exclusive radiotherapy and chemo-radiotherapy in order to know the radiation effect in the birth of this type of cancer

  5. EXPERIENCE OF THE CONTINUING PROFESSIONAL EDUCATION ACTIVITY MANAGEMENT AT THE INSTITUTE OF RADIATION HYGIENE

    Directory of Open Access Journals (Sweden)

    T. P. Simonova

    2010-01-01

    Full Text Available Results of the Institute of Radiation Hygiene educational activity during two and a half year since receiving a license are addressed in the article. Possibilities and approaches to the conduction of traditional and some unique training cycles are shown. Possible ways of educational activity enhancement are proposed.

  6. Facilitating institutional change in West Africa: the CoS–SIS experience

    NARCIS (Netherlands)

    Adjei-Nsiah, S.; Sakyi-Dawson, O.; Klerkx, L.W.A.

    2014-01-01

    The Convergence of Sciences–Strengthening Innovation Systems (CoS–SIS) programme is based on the premise that the livelihood of the African smallholder farmer is constrained by the existence and/or performance of formal and informal institutions that are not conducive to small-farm development. CoS–

  7. Institutional Barriers to Doing Public Sociology: Experiences of Feminists in the Academy

    Science.gov (United States)

    Sprague, Joey; Laube, Heather

    2009-01-01

    In recent years, the discipline of sociology has seen an increased discussion of public sociology, but the discussion has focused on whether or not it is a good idea for sociologists to become more engaged with their various publics. A different question motivates this research: What are the institutional arrangements that make doing public…

  8. [Professional Master's in Public Health: from legal precepts to experience in a research and education institution].

    Science.gov (United States)

    dos Santos, Gideon Borges; Hortale, Virginia Alonso

    2014-07-01

    This study is about the discourses that prevailed over the course of time in Brazilian legislation for the Master's Course in Public Health, and how a Brazilian research and education institution in the area of Public Health appropriated these discourses in the creation of its course proposals. Discourse analysis techniques were applied to legal documents and to sixteen master's programs developed in the institution under scrutiny. The results revealed that with respect to legislation, analysis of the historical timeline makes it possible to say that the initial lack of definition progressively gave rise to the understanding that the identity of such post-graduate education presupposes pedagogical practices that promote the strengthening of ties between academia and the workplace. And, in relation to the master's course proposals for public health in the institutions under scrutiny, they still operate with traditionally consolidated training schemes and tend to standardize their proposals with those of the academic model. It was assumed in this study that the series of proposals would clearly mirror the intentions and, above all, the vision of the training institutions in the area of public health on this stricto sensu model, the identity of which also appears poorly defined. PMID:25014294

  9. Assessment and Feedback: Institutional Experiences of Student Feedback, 1996 to 2007

    Science.gov (United States)

    Williams, James; Kane, David

    2009-01-01

    Attention has recently focused on sectoral concern with assessment and feedback as a result of the National Student Survey. Government, the higher education agencies and the NUS have called for urgent action to address this concern. Existing data from institutional student feedback surveys, using the Student Satisfaction Approach, some dating back…

  10. Research Results of Two Personal Learning Environments Experiments in a Higher Education Institution

    Science.gov (United States)

    Marín Juarros, Victoria; Salinas Ibáñez, Jesús; de Benito Crosetti, Bárbara

    2014-01-01

    This paper focuses on institutionally powered personal learning environments (iPLEs). The concept of the iPLE can be seen as a way universities can incorporate learner-centred approach into the architecture of their technology-enhanced learning environments. The aim of this paper is to pose that there are other ways to learn complementary to…

  11. The Social Change Experiences of College Students at an Institution of Higher Learning

    Science.gov (United States)

    New, Kuwihoi; Ghafar, Mohamed Najib Abdul

    2011-01-01

    The sociology of education provides the most effective means to look into in the dynamics of education and the changes it produces in the individual. This research uses in-depth field interviews to study the social change experienced by a group of college students at a private higher learning institution in Malaysia. The results reveal that there…

  12. The Bureaucratic Experience and Post Modern Challenges of Strategic Management in Higher Education Institutions

    Science.gov (United States)

    Thomas, Olusola A.

    2014-01-01

    This study examined the nature of bureaucracy in Higher Education Institutions (HEIs), and the need for strategic management considering the propelling forces of academic revolution meaning that HEIs must perform better with fewer resources and provide innovative solutions. Three research questions guided this study which followed a…

  13. Factors Affecting Postoperative Prognosis in the Solitary-nodule Type of Hepatocellular Carcinoma : Experience of 132 Cases in our Institute

    OpenAIRE

    Asahara, Toshimasa; Dohi, Kiyohiko; KATAYAMA, Koji; ITAMOTO, TOSHIYUKI; Okamoto, Yuzo; Nakahara, Hideki; Ono, Eiji; Sugino, Keizo; Marubayashi, Seiji; Yahata, Hiroshi; Kitamoto, Mikiya; Nakanishi, Toshio; Azuma, Kazuyoshi; Ito, Katsuhide; SHIMAMOTO, FUMIO

    1998-01-01

    A retrospective analysis of clinical and pathological factors was performed on 132 surgical cases with solitary-nodule type HCC in our hospital. The overall cancer-free survival rates after 1, 3 and 5 years were 82.2%, 42.3% and 26.5%, respectively. With univariate analysis, the significant prognostic factors for survival were tumor size, cancer cell infiltration of the fibrous capsule of the tumor (fc-inf), invasion into portal vein (vp), and intrahepatic metastasis (im), while significant p...

  14. Primary adenoid cystic carcinoma of the tracheobronchial tree: A decade-long experience at a health centre in Mexico

    Directory of Open Access Journals (Sweden)

    Arturo Cortés-Télles

    2012-01-01

    Full Text Available Background : Mexico′s National Institute of Respiratory Diseases (NIRD is a third-level national reference center. Primary adenoid cystic carcinoma (PACC is an uncommon neoplastic disorder; hence improvements in the description of this disease are needed. Materials and Methods: This is a retrospective clinical study based on all consecutive patients with pathological diagnoses of PACC seen at the NIRD between January 1, 2000 and December 31, 2009. Results: We identified 9 cases of PACC (67% female out of a total of 2,634 patients with lung cancer seen during the period analyzed. The mean age of those 9 patients was 41 years (IQR 36-57, and the frequency of PACC at our center was 0.3%. It is important to note that 67% of those patients had a history of smoking and that 6 of the 9 had the antecedent of previous exposure to biomass fuel smoke. Baseline arterial blood gas analyses revealed a median of 61 mmHg for pO 2 and 28.5 mmHg for pCO 2 . Median FVC was 78%, while FEV 1 was 77% with an FEV 1 /FVC ratio of 78. Death occurred in 56% of cases, and the median survival time was 17 months (IQR 6-26 after the initial diagnosis. Conclusions: The frequency of tracheobronchial PACC among patients with lung cancer was similar to that previously reported (0.3%. According to our results, lung function has no specific phenotype in this disease; however, some abnormalities could be related to potential risk factors such as tobacco use and exposure to biomass fuel smoke.

  15. Performativity and pluralities of biodiversity offsetting experiments: Towards a synthesis of economy as instituted process and economy asperformativity

    OpenAIRE

    Ferreira, Carlos Eduardo Martins

    2013-01-01

    The University of ManchesterAuthor: Carlos FerreiraDegree title: Doctor of PhilosophyThesis title: Performativity and pluralities of biodiversity offsetting experiments:towards a synthesis of economy as instituted process and economy as performativityDate: September 2013Development and land use change diminish the quantity of natural habitat, impactingnegatively on the number of animal and plant species – biodiversity. Concern about theconsequences of these losses has led to calls for mechani...

  16. The Appalachian Tri-State Node Experiences with the National Institute on Drug Abuse Clinical Trials Network

    OpenAIRE

    Kelly, Thomas M.; Daley, Dennis C; Byrne, Mimmie; DeMarzo, Larry; Smith, Doris; Madl, Stephanie

    2011-01-01

    The National Institute on Drug Abuse (NIDA)-sponsored Clinical Trial Network (CTN) recently celebrated 10 years of conducting “real world” research into the treatment of addiction. This article reviews the history and results of the most recent CTN studies and describes the experiences of one of the 13 participating research affiliates, the Appalachian Tri-State (ATS) Node. We discuss our “bidirectional” collaboration with multiple community treatment programs (CTPs) on research and dissemina...

  17. Achievements and experience in Laboratory for Low Level Measurements, Rudjer Boskovic Institute, Croatia, during the IAEA QA/QC program

    International Nuclear Information System (INIS)

    In this summary we explain our motivation for joining the IAEA Program on Quality Assurance and Quality Control in Nuclear Analytical Techniques, the situation in the Laboratory before joining the program, and achievements during this 2-year program. We also describe our experience and difficulties with implementation of the quality system in the Laboratory, as well as with the quality system at the Rudjer Boskovic Institute. Finally, we present our plans for the future

  18. Initial Experiences Gained and Initiatives employed in the Teaching of Java Programming in the Institute of Technology Tallaght

    OpenAIRE

    Hyland, Eamonn; Clynch, Gary

    2002-01-01

    This paper describes recent experiences gained and initiatives employed in the teaching of Java programming to first and second year students in the Institute of Technology Tallaght from September 2000 to March 2002. It outlines some elearning, technological and pedagogical initiatives that were undertaken within the department and the resultant preliminary outcomes. The outcomes have been determined after detailed analysis of the results of a survey which was commissioned to determine the ef...

  19. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation

  20. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  1. Treatment and outcome in cancer cervix patients treated between 1979 and 1994: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Shyamkishore Shrivastava

    2013-01-01

    Materials and Methods: This is a retrospective study of 6234 patients with carcinoma of the cervix treated with radical intent between 1979 and 1994. All the work-up, staging investigations, treatment details, radiation protocols, outcomes, and toxicities were noted, compiled, and analyzed. Results: With a mean age of 46 years (range: 18-90 years; median: 45 years, 669 (11% patients were in stage Ib, 284 (5% were in stage IIa, 1891 (30% were in stage IIb, 69 (1% were in stage IIIa, and 3321 (53% were in stage IIIb. With a median follow-up of 68 months (57-79 months for the entire group, there was no significant difference in the outcome of 953 patients with international federation of gynecology and obstetrics (FIGO Ib-IIa treated after radical surgery, pre-operative radiation therapy (pre-op RT + Sx or after radical radiation; their disease-free survival (DFS was 60-62% at 8 years. In our series of 1891 patients with stage IIb and 3321 with stage IIIb, a respective DFS of 56% and 40% was achieved at 8 years. Conclusion: Over the last two decades, with the acquisition of newer facilities and inception of Joint Clinics, there has been a significant refinement in the treatment protocols and outcome. Improving radiation strategies to improve therapeutic ratio is the key to success.

  2. Operational safety experience at 14 MW research reactor from Institute for Nuclear Research Pitesti

    International Nuclear Information System (INIS)

    The main challenges identified in TRIGA Research Reactor operated in Institute for Nuclear Research in Pitesti, Romania, are in fact similar with challenges of many other research reactors in the world, those are: Ageing of work forces and knowledge management; Maintaining an enhanced technical and scientific competences; Ensuring adequate financial and human resources; Enhancing excellence in management; Ensuring confidence of stakeholders and public; Ageing of equipment and systems.To ensure safety availability of TRIGA Research Reactor in INR Pitesti, the financial resources were secured and a large refurbishment programme and modernization was undertaking by management of institute. This programme concern the modernization of reactor control and safety systems, primary cooling system instrumentation, radiation protection and releases monitoring with new spectrometric computerized abilities, ventilation filtering system and cooling towers. The expected life extension of the reactor will be about 15 years

  3. Nursing Intervention in adolescence: an institution experience in Public Secondary School

    Directory of Open Access Journals (Sweden)

    Daniel Martínez Esquivel

    2013-04-01

    Full Text Available Adolescence is a key stage of life to the empowerment that must have health, but it has many needs that healthteams still have not resolved. This article presents an analysis of the health situation of a group of teenagersattending a public institution of higher education and intervention by nursing students, focused on creatingconditions for health promotion and disease prevention. This research was conducted from a quantitative,descriptive and was performed in an institution of secondary education in the period from September toNovember 2012. We worked with students and students of eighth and ninth year with a convenience sample. Themain results indicated needs in sexuality, healthy lifestyles and conflict resolution. To address these issuesevolved different strategies planned, organized, directed and controlled by the individual. We conclude that healtheducation in adolescents is a public health problem and that nurses must meet.

  4. What determines patient preferences for treating low risk basal cell carcinoma when comparing surgery vs imiquimod? A discrete choice experiment survey from the SINS trial

    OpenAIRE

    Tinelli Michela; Ozolins Mara; Bath-Hextall Fiona; Williams Hywel C

    2012-01-01

    Abstract Background The SINS trial (Controlled Clinical Trials ISRCTN48755084; Eudract No. 2004-004506-24) is a randomised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5% cream for low risk nodular and superficial basal cell carcinoma (BCC). The trial included a discrete choice experiment questionnaire to explore patient preferences of a cream versus surgery for the treatment of their skin cancer. Methods The self-completed questionnaire was administered a...

  5. Research assessment and institutional financing in Estonia:20 years of experience

    OpenAIRE

    Saluveer, Madis

    2012-01-01

    The Estonian R&D and higher education system have undergone profound changes over the last 20 years. The institutional reforms in 1990s, continuous evaluation of R&D activities at various levels, focus on high-quality research, and recent investments into the development of R&D infrastructure have increased the competitiveness of Estonian research and researchers internationally. The presentation will tackle the issues of types, scope and frequency of research evaluations in Estonia, use ...

  6. Liquidity Risk Management in Financial Institutions: International Best Practices and Experiences

    OpenAIRE

    Miguel Delfiner; Claudia Lippi; Cristina Pailhé

    2007-01-01

    This paper analyzes the best practices related to liquidity risk management in financial institutions, in terms of both the existing standards on the issue and their application in several countries. To this effect, the paper compiles, in the first place, the best practices issued by the Basel Committee on Banking Supervision (BCBS), and then reviews the developments in European countries monitored by the Committee of European Banking Supervisors (CEBS) as well as the sound liquidity risk man...

  7. Data integration in cardiac surgery health care institution: experience at G. Pasquinucci Heart Hospital

    OpenAIRE

    Taddei, Alessandro; Dalmiani, Stefano; Vellani, Antonio; Piccini, Giacomo; Rocca, Emiliano; Carducci, T; Borghini, R; Marcheschi, Paolo; Macerata, Alberto

    2008-01-01

    During last ten years the Hospital Information System (HIS) was developed at Institut e of Clinical Physiology of National Research Council (IFC-CNR), recently reorganized on clinical s ide into the OG. Monasterio Foundationo (FGM) by joint efforts of CNR, Tuscany Region and Universi ties. G. Pasquinucci Heart Hospital (GPH) in Massa, currently one of the two FGMoes sections, i s specialised in Cardiology and Cardiac Surgery (adult and pediatric)

  8. Data Integration in Cardiac Surgery Health Care Institution: Experience at G. Pasquinucci Heart Hospital

    OpenAIRE

    Taddei, Alessandro; Dalmiani, Stefano; Vellani, Antonio; Rocca, E.; Piccini, Giacomo; Carducci, T; Gori, A.; Borghini, R; Marcheschi, Paolo; Mazzarisi, Alessandro; Salvatori, Cristina; Macerata, Alberto; Varanini, Maurizio

    2008-01-01

    During the last ten years the Hospital Information System (HIS) was developed at the Institute of Clinical Physiology of National Research Council (IFC-CNR), recently reorganized on clinical side into the "Gabriele Monasterio Foundation" (FGM) by joint efforts of CNR, Tuscany Region and Universities. At G.Pasquinucci Heart Hospital (GPH), currently FGM's section in Massa, the HIS was adapted and extended to Cardiac Surgery and Pediatric Cardiology. Data archiving and middleware integration th...

  9. A Comprehensive Faculty, Staff, and Student Training Program Enhances Student Perceptions of a Course-Based Research Experience at a Two-Year Institution

    Science.gov (United States)

    Wolkow, Thomas D.; Durrenberger, Lisa T.; Maynard, Michael A.; Harrall, Kylie K.; Hines, Lisa M.

    2014-01-01

    Early research experiences must be made available to all undergraduate students, including those at 2-yr institutions who account for nearly half of America's college students. We report on barriers unique to 2-yr institutions that preclude the success of an early course-based undergraduate research experience (CURE). Using a randomized study…

  10. Small cell cancer of the bladder: The Leon-Berard cancer centre experience

    OpenAIRE

    Ismaili, Nabil; Elkarak, Fadi; Heudel, Pierre Etienne; Flechon, Aude; Droz, Jean Pierre

    2008-01-01

    Background: Small cell bladder carcinoma is an uncommon tumor. In this retrospective study we report our experience dealing with this disease at the Leon-Berard Cancer Centre. Materials and Methods: We retrospectively analyzed various characteristics of small cell bladder carcinoma: patient demographics, histological diagnosis, disease stage, treatment effects and outcome, in 14 non-metastatic small cell bladder carcinoma patients treated at our institution between 1995 and 2006. Results: The...

  11. The preliminary experience in the emergency department of a newly opened penitentiary institution hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Bora Koc

    2014-01-01

    Full Text Available Background: Emergency cases become a widespread problem in prisons across Turkey. The opening of a new prison hospital in January 2012 within the catchment of Silivri Penitentiary Institution gave a unique opportunity to treat the inmates quickly. Aims: The study was to conduct an extensive review for documentation of prisoners′ healthcare problems leading to emergency admission following the first year after the opening of Penitentiary Institution Hospital and point to decrease redundant hospital transfers of this individual cohort. Materials and Methods: A cross-sectional study was carried out where 12,325 visits to the Silivri Penitentiary Institution Hospital for emergency visits from the period of 1 st January 2012 to the 31 st December 2012 were identified from electronic medical records. After obtaining consent from the local IRB, data including details of the type, cause and nature of the complaints of the illnesses were processed. Results: In the 12-month period, there were 12,325 visits to the emergency department, of which 4328 for surgical conditions (35.1%, 2684 for medical disorders (21.8%, 1867 for sports injuries (15.2%, 1327 for Ear Nose Throat (ENT problems (10.8%, 827 for psychiatric disorders (6.70%, 396 for violence injury (3.2%, 169 for self harm (1.4%, and 727 for miscellaneous (5.8%. The most common cause of emergency visits was sports injuries, followed by non-specific abdominal pain and ENT problems. Eighteen prisoners re-attended 243 times, ranging from 8 visits to a maximum of 56 visits. Conclusion: Inmates in prison have a wide range of complaints, and sometimes these complaints do not suggest an illness. Prison population exhibited substantially higher prevalence rates of diseases than the civilian population. We conclude that this new healthcare system in prisons will prevent redundant hospital transfers and guarantee detainees have access to the same health care that is offered to non-detained population.

  12. Residency training programs in veterinary clinical pathology: a comparison of experiences at two institutions.

    Science.gov (United States)

    Raskin, Rose E

    2007-01-01

    Two institutions with different residency training formats in clinical pathology are compared with respect to application procedures, learning and teaching opportunities, learning resources, research training, publication requirements, and assessment methods of the program and trainees. The University of Florida and Purdue University programs are both based on an emphasis in morphologic recognition and interpretation of disease processes as well as training in basic science and applied research principles. The progress of trainees through each program is carefully monitored to meet individual needs as well as to meet the training requirements to allow candidates to sit for the certifying examination in clinical pathology. Periodic mock board exams are a critical tool to assess trainee progress and learning. The differences in format focus on coursework and publication requirements as well as on program assessment tools. While one program provides training in the form of 75% clinical diagnostic service, the other uses a mixture of 50% coursework and 50% clinical diagnostic training. Despite the contrast between a pure residency training program and one combining residency training with an MS degree, both institutions provide a solid program structure, ample learning resources, and adequate faculty mentorship to produce a high pass rate of board-certified specialists, the major focus for both programs. Numbers of post-training employment positions for both institutions are similar for those selecting faculty positions at veterinary schools. During the period studied, however, the combined residency and MS graduate program at Purdue University produced more graduates employed in pharmaceutical and biotechnology companies, while the residency program at the University of Florida produced more graduates employed by diagnostic laboratories. PMID:18287476

  13. Experiments in Laboratory of Nuclear Problems of Joint Institute for Nuclear Research in 1994-1995

    International Nuclear Information System (INIS)

    This book is a complication of the short status reports on current experiments on intermediate energy physics and on high energy physics. The projects of new facilities and the results of radiobiological researches are presented

  14. Time of flight and the MUSE experiment in the PIM1 Channel at the Paul Sherrer Institute

    Science.gov (United States)

    Lin, Wan; MUSE Collaboration

    2015-10-01

    The MUSE experiment in the PIM1 Channel at the Paul Sherrer Institute in Villigen, Switzerland, measures scattering of electrons and muons from a liquid hydrogen target. The intent of the experiment is to deduce from the scattering probabilities whether the radius of the proton is the same when determined from the scattering of the two different particle types. An important technique for the experiment is precise timing measurements, using high precision scintillators and a beam Cerenkov counter. We will describe the motivations for the precise timing measurement. We will present results for the timing measurements from prototype experimental detectors. We will also present results from a simulation program, Geant4, that was used to calculate energy loss corrections to the time of flight determined between the beam Cherenkov counter and the scintillator. This work is supported in part by the U.S. National Science Foundation Grant PHY 1306126 and the Douglass Project for Women in Math, Science, and Engineering.

  15. ISSUES AND ECONOMIC ROLE OF WAQF IN HIGHER EDUCATION INSTITUTION: MALAYSIAN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Farra Munna Harun

    2016-02-01

    Full Text Available As early as 1980, the Malaysian federal government’s spending on education, was the highest in East Asia and higher than the OECD average of 3.4% of GDP. This demonstrates that the Malaysian Government has big expenses from educational sector and respectively is amenability for Malaysian economic budget. In other side Waqf in Malaysia is one of large financial source that has not been fully explored.  By using qualitative methodology through content analysis this paper attempt to explore the issues and economic role of Waqf in Malaysia, especially in Higher Education Institution (HEI and attempt to study how Waqf fund empowering the education. This study found that taking the que from the institutions of Waqf, the exploration and development of waqf fund can be exalarate through the formation of formal organizations at state and federal level and rearrange the Malaysian educational budget and policy to support the better quality of HEI.DOI: 10.15408/aiq.v8i1.1997

  16. ISSUES AND ECONOMIC ROLE OF WAQF IN HIGHER EDUCATION INSTITUTION: MALAYSIAN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Farra Munna Harun

    2016-02-01

    Full Text Available As early as 1980, the Malaysianfederal government’s spending on education, was the highest in East Asia andhigher than the OECD average of 3.4% of GDP. This demonstrates that theMalaysian Government has big expenses from educational sector and respectivelyis amenability for Malaysian economic budget. In other side Waqf in Malaysia isone of large financial source that has not been fully explored. By using qualitative methodology through content analysis this paper attempt to explore the issues andeconomic role of Waqf in Malaysia, especially in Higher Education Institution(HEI and attempt to study how Waqf fund empowering the education. Thisstudy found that taking the que from the institutions of Waqf, the explorationand development of waqf fund can be exalarate through the formation of formalorganizations at state and federal level and rearrange the Malaysian educationalbudget and policy to support the better quality of HEI.DOI: 10.15408/aiq.v8i1.2514 

  17. Human resources development: capabilities and experience of CNEA and its institutes in Argentina

    International Nuclear Information System (INIS)

    Full text: The Argentinean Atomic Energy Commission (Comision Nacional de Energia Atomica - CNEA) was created in 1950. CNEA and its related companies of the nuclear sector are presently active in several fields: operation of two nuclear power plants, construction of a third one, operation of several research reactors and critical facilities, production of Mo-99 from low enrichment targets (having world leadership in that field). Argentina has also exported, in the last twenty-five years, four research reactors (the last one, OPAL in Australia, attained criticality last year), and is active in the fuel cycle (having attained maturity in high-density and very high-density fuel for research reactors, among others), in radioisotope production and in nuclear medicine. The successful attainment of these achievements has always been supported by an active policy of human resources development, either through 'on the job' training activities guided by experienced professionals and sustained on a fellowship programme, or via institutes for under and postgraduate studies. This programme not only satisfies CNEA demands, but also helps providing highly qualified personnel to the local industry and research institutions. Nowadays, the perspective for nuclear energy is promising, but for many years nuclear activities had been loosing momentum worldwide. The nuclear sector became weaker, and CNEA was not an exception. However, it never stopped its activities in educational areas, knowing that many years are needed to form a solid professional in the nuclear field, and having the conviction that, for a sustainable development of the country, nuclear energy should necessarily be part of the supply. Nuclear engineers, material scientists and technologists, physicists, radio chemists, etc., ended up working in industries, universities and R and D institutions after finishing their education, instead of joining CNEA. In 2006 the Argentinean government re-launched nuclear energy

  18. The role of r[iotherapy in the conservative treatment of rectal carcinoma. The Lyon experience

    International Nuclear Information System (INIS)

    The purpose of this study was to present the Lyon experience using r[iotherapy alone or with surgery, with intent to cure rectal cancer and to avoid rectal amputation. Two groups of patients were treated between 1980 and 1996: Group I with r[iotherapy alone with contact X-ray for T1 N0 (101 patients) or with a combination of external beam r[iation therapy (EBRT), contact X-ray and I92 iridium implant in inoperable T2-3 N0-1 patients (43 patients); Group II with preoperative EBRT either as a pilot study (158 patients) or in a randomized trial (210 patients). With contact X-ray alone it was possible to control T1 N0 in 90% of cases, and with the combined approach 70% of the inoperable patients were controlled. In Group II, anterior resection was performed in 60% to 70% of the patients. Local recurrence was seen in 11% of cases. Surgery is the basic treatment used for rectal cancer but r[iotherapy is playing an increasing role in the conservative treatment of this cancer. (orig.)

  19. Cervical Lymph Node Metastases From Unknown Primary Cancer: A Single-Institution Experience With Intensity-Modulated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Villeneuve, Hugo, E-mail: hugo.villeneuve@umontreal.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Despres, Philippe; Fortin, Bernard; Filion, Edith; Donath, David [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos [Department of Head and Neck Surgery, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada)

    2012-04-01

    Purpose: To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Methods and Materials: Between February 2005 and November 2008, 25 patients with an unknown primary cancer underwent IMRT, with a median radiation dose of 70 Gy. The bilateral neck and ipsilateral putative pharyngeal mucosa were included in the target volume. All patients had squamous cell carcinoma, except for 1 patient who had adenosquamous differentiation. They were all treated with curative intent. Of the 25 included patients, 20 were men and 5 were women, with a median age of 54 years. Of these patients, 3 had Stage III, 18 had Stage IVa, and 4 had Stage IVb. Of the 25 patients, 18 (72%) received platinum-based chemotherapy in a combined-modality setting. Neck dissection was reserved for residual disease after definitive IMRT. Overall survival, disease-free survival, and locoregional control were calculated using the Kaplan-Meier method. Results: With a median follow-up of 38 months, the overall survival, disease-free survival, and locoregional control rates were all 100% at 3 years. No occurrence of primary cancer was observed during the follow-up period. The reported rates of xerostomia reduced with the interval from the completion of treatment. Nine patients (36%) reported Grade 2 or greater xerostomia at 6 months, and only 2 (8%) of them reported the same grade of salivary function toxicity after 24 months of follow-up. Conclusion: In our institution, IMRT for unknown primary cancer has provided good overall and disease-free survival in all the patients with an acceptable rate of complications. IMRT allowed us to address the bilateral neck and ipsilateral putative pharyngeal mucosa with minimal late salivary function toxicity. The use of concurrent chemotherapy and IMRT for more advanced disease led to good clinical results with reasonable toxicities.

  20. Patient specific IMRT quality assurance with film, ionization chamber and detector arrays: Our institutional experience

    International Nuclear Information System (INIS)

    Purpose: This study was conducted to review patient specific IMRT QA delivered at our institution using Varian LINACs and TomoTherapy Hi-Art system and categorized according to the anatomical site, type of treatment machine, and treatment planning systems (TPS). Material and methods: Three thousand and three hundred seven patient data were evaluated for a time ranging from 2006 to 2011; these data were gauged using several methods used in the QA process. Ion chambers and film were used in 1738 patient plan QA in the earlier years followed by ion chamber arrays in 1569 patient plan QA in the latter years. Patients were grouped according to several parameters including TPS, site of treatment, and type of treatment machine in comparing the measured versus computed dose differences. From 2006 through early 2009, 736 TomoTherapy plans, 651 Pinnacle3 plans, and 351 Corvus plans were evaluated using ion chambers and films. The pass criterion at the institution at the time of these measurements was 3% dose difference and 3 mm distance to agreement. For the years ranging from 2009 to 2011, 1569 patient IMRT QAs were performed and evaluated on the institution's pass criteria of 90% γ value on Varian linacs with Millennium 80, 120 and High-Definition 120 multileaf collimators. Results: Average point dose difference between measured and calculated plans for Pinnacle3, Hi-ART TomoTherapy, and Corvus TPS were 0.1205%, −0.0042%, and −0.0178%. Among the QA plans measured using a 2D array, average gamma values for brain, head and neck, thorax, abdomen, and pelvis were 97.2%, 95.7%, 96.2%, 97.0%, and 96.2%, respectively. Average gamma values based on 80, 120, HD 120 and TomoTherapy MLC configurations were 96.5%, 96.2%, 96.3%, and 97%, respectively. A 2-tailed paired Student's T-test did not reveal the presence of statistically significant differences based on either TPS, anatomical sites, number of beams or arcs, number of control points, or the MLC configuration (p

  1. From Nanostructure to Nano Biosensor: Institute of Nano Electronic Engineering (INEE, UniMAP Experience

    Directory of Open Access Journals (Sweden)

    U Hashim

    2012-02-01

    Full Text Available Nanostructure is defined as something that has a physical dimension smaller than 100 nanometers, ranging from clusters and/or to dimensional layers of atoms. There are three most important nanostructures that are extensively studied and researched in various organizations including Institute of Nano Electronic Engineering (INEE in UniMAP. These include quantum dot, nanowire, and nanogap, which have been successfully designed and fabricated using in-house facilities available. These are subsequently used as a main sensing component in nanostructures based biosensor. This fabrication, characterization and testing job were done within four main interlinked laboratories namely microfabrication cleanroom, nanofabrication cleanroom, failure analysis laboratory and nano biochip laboratory.  Currently, development of Nano Biosensor is the main research focus in INEE. In principle, biosensor is an analytical device which converts a biological response into an electrical signal.   Keywords: Nanostructure, INEE , nanowire , nanogap and Nano Biosensor

  2. Outcome of postoperative radiotherapy following radical prostatectomy: a single institutional experience

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sea Won; Chung, Mi Joo; Jeong, Song Mi; Kim, Sung Hwan; Lee, Jong Hoon [Dept.of Radiation Oncology, St. Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of); Hwang, Tae Kon; Hong, Sung Hoo; Lee, Ji Youl; Jang, Hong Seok [Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Yoon, Sei Chul [Dept.of Radiation Oncology, Bucheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of)

    2014-09-15

    This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.

  3. Language, Institutional Identity and Integration: Lived Experiences of ESL Teachers in Australia

    Science.gov (United States)

    Fotovatian, Sepideh

    2015-01-01

    Globalisation and increased patterns of immigration have turned workplace interactions to arenas for intercultural communication entailing negotiation of identity, membership and "social capital". For many newcomer immigrants, this happens in an additional language and culture--English. This paper presents interaction experiences of four…

  4. 76 FR 66698 - Postsecondary Educational Institutions Invited To Participate in Experiments Under the...

    Science.gov (United States)

    2011-10-27

    ... Sites Initiative (ESI). The first, published in the Federal Register on October 28, 2009 (74 FR 55542... abroad students. Experiment 4--Direct Loan Program--Early disbursement for study abroad students and for... of a one-- term loan for study abroad students. Background: Section 428G(a) of the HEA provides...

  5. The Learning Experiences of Students with Dyslexia in a Greek Higher Education Institution

    Science.gov (United States)

    Stampoltzis , Aglaia; Tsitsou, Elisavet; Plesti, Helen; Kalouri, Rani

    2015-01-01

    Dyslexia is the most common declared disability at universities which primarily affects reading, writing, speed of processing and organization. Many students with dyslexia have "invisible" difficulties that require different types of accommodations. The aim of this study is to give voice to the learning experiences of ten students with…

  6. Faculty Experiences of Internet Filtering at a Proprietary Higher Education Institution

    Science.gov (United States)

    Rzemyk, Thomas J.

    2011-01-01

    Despite widespread acknowledgement that Internet access in libraries and schools is filtered, the effects of that filtering on faculty who must utilize such a system for research, teaching, and curriculum development in American higher education are not known. This qualitative case study explored faculty experiences of Internet filtering in terms…

  7. Malignant minor salivary gland tumors: A retrospective study of 28 cases: Clinical experience of a single institution

    Directory of Open Access Journals (Sweden)

    Abeer Hussien Anter

    2015-03-01

    Full Text Available Purpose: This retrospective study was done to report our experience with the management of patients with primary malignant tumors of minor salivary glands that were treated with various combinations of surgery, radiation, and chemotherapy and to review treatment outcome. Methods: The records of all patients with malignant minor salivary gland tumors presenting for treatment at our department between 2000 and 2010 were retrospectively reviewed. Variables were collected and outcome measures were defined in terms of overall survival, disease-free survival. Descriptive statistics were compiled and statistically evaluated. Survival was described using the Kaplan-Meier method. Results: Twenty eight patients (10 males and 18 females ranging in age from 18 to 80 years (median, 64 years met the criteria for inclusion in the study. The majority of tumors were located in the oral cavity (n = 20, followed by nasal cavity and paranasal sinuses (n = 8. Adenoid cystic carcinoma was the most common neoplasm (n = 18. All patients were treated with surgery as the primary modality. Neck dissection was performed in 18% of patients, and all patients (n = 28 were treated with adjuvant external beam radiation therapy to a dose of 50 to 60 Gy. The disease-free survival rate and overall survival at 5 years were 80% and 85%, respectively. Conclusion: Postoperative radiation therapy is effective in preventing local recurrence in most patients with minor salivary gland tumors after gross total excision.

  8. Students' experiences and perspectives on secondary education institutions, transitions and policy

    CERN Document Server

    Smyth, Emer

    2016-01-01

    This book explores the experiences of young people as they move through the Irish secondary educational system. Drawing on a rich study which combines survey data with in-depth interviews with students, it addresses the key facets of schooling which influence young people’s experiences. With chapters organised thematically, including ability grouping, school climate and the impact of high stakes examinations, the central dimensions of school structure and process is explored. Placing young people’s voices centre stage, it explores how they respond to the school context and make decisions that will profoundly affect their future. This book contrasts different types of school settings and examines how gender and social class play out at the school level. .

  9. Langerhans cell histiocytosis of the cervical spine: a single institution experience in four patients.

    Science.gov (United States)

    Tan, Grace; Samson, Ignace; De Wever, Ivo; Goffin, Jan; Demaerel, Philippe; Van Gool, Stefaan W

    2004-03-01

    When Langerhans cell histiocytosis (LCH) occurs at critical sites, such as in the cervical spine, there is a substantial risk for morbidity. Therefore, reports on clinical experiences with those patients remain important. We summarize the history of four patients with unifocal LCH at the cervical spine. All four patients received a biopsy to prove the histopathological diagnosis of LCH by demonstration of CD1a+cells. They were treated with oral prednisolone. All patients recovered completely and kept a normal function of the cervical spine. No reactivation of the disease occurred with an observation time of 3.4-7.3 years. This report contributes to the clinical experience for the treatment of LCH at critical sites. PMID:15076592

  10. Patterns and predictors of in-hospital aneurysmal rebleed: An institutional experience and review of literature

    Directory of Open Access Journals (Sweden)

    Menon Girish

    2007-01-01

    Full Text Available Background: Rebleeding is an important cause for mortality following aneurysmal subarachnoid hemorrhage. Early intervention is believed to reduce the risk of rebleeding. However, in developing countries such as India, early intervention is often difficult due to various reasons. The knowledge about the risks and predictors for rebleeding is essential to prioritize the management policy. Aims: To describe the frequency and impact of rebleeding in the modern era of aneurysm care, to study the clinical profile of patients with rebleed and to review the controversial aspects on aneurysmal rebleed. Materials and Methods: This observational study is based on the retrospective analysis of the case records of all patients admitted with aneurysmal subarachnoid hemorrhage (SAH since January 1999 in our institute. Twenty patients rebled after admission before surgical clipping, and these patients formed our study group. The findings were compared with all the major series on rebleeding published in literature. Results: Since January 1999, 952 patients underwent treatment for aneurysmal subarachnoid hemorrhage in our institute. Twenty patients rebled while awaiting surgery following the admission with an incidence of 2.14%. The study group included nine males and eleven females. The age of the patients ranged from 31 to 69 years, but the majority were in the sixth decade. Mean bleed to admission days was 7.9 days (range: 1-27 days, the mean admission to rebleed was 1.42 days (Range: 0-4 and the mean first bleed to rebleed was 9.26 days. The history of loss of consciousness at the time of bleeding was observed in 16 patients. Four patients bled before an angiogram could be performed. Two patients had giant aneurysms, while the rest had small aneurysms; two patients had multiple aneurysms. Angiographic spasm was observed in eight patients. In three patients, rebleeding was precipitated by angiogram. Twelve patients rebled while taking rest or in sleep, while

  11. Prognostic factors in glioblastoma multiforme. 10 years experience of a single institution

    International Nuclear Information System (INIS)

    Background: To analyze prognostic factors in patients with a glioblastoma multiforme treated in an academic institute over the last 10 years. Patients and method: From 1988 to 1998, 198 patients with pathologically confirmed glioblastoma multiforme were analyzed. Five radiation schedules were used mainly based on pretreatment selection criteria: 1. 60 Gy in 30 fractions followed by an interstitial iridium-192 (Ir-192) boost for selected patients with a good performance and a small circumscribed tumor, 2. 66 Gy in 33 fractions for good performance patients, 3. 40 Gy in eight fractions or 4. 28 Gy in four fractions for poor prognostic patients and 5. no irradiation. Results: Median survival was 16 months, 7 months, 5.6 months, 6.6 months and 1.8 months for the groups treated with Ir-192, 66 Gy, 40 Gy, 28 Gy and the group without treatment, respectively. No significant improvement in survival was encountered over the last 10 years. At multivariate analysis patients treated with a hypofractionated scheme showed a similar survival probability and duration of palliative effect compared to the conventionally fractionated group. The poor prognostic groups receiving radiotherapy had a highly significant better survival compared to the no-treatment group. Patients treated with an Ir-192 boost had a better median survival compared to a historical group matched on selection criteria but without boost treatment (16 vs 9.7 months, n.s.). However, survival at 2 years was similar. Analysis on pretreatment characteristics at multivariate analysis revealed age, neurological performance, addition of radiotherapy, total resection, tumor size post surgery and deterioration before start of radiotherapy (borderline) as significant prognostic factors for survival. Conclusion: Despite technical developments in surgery and radiotherapy over the last 10 years, survival of patients with a glioblastoma multiforme has not improved in our institution. The analysis of prognostic factors

  12. Success Against the Odds: The Experience of At-Risk Students Who Graduate Fom Postseconday Institutions

    OpenAIRE

    Banks, Felecia Moore

    2000-01-01

    Over the years, dramatic changes in retention and attrition rates have given rise to extensive studies on the academically at-risk college student (Nisbet, Ruble, and Schurr 1982; Levin and Levin, 1991, White & Salacek, 1986). Yet, most of these studies have focused on statistical measures identifying predictors of success using traditional quantitative methodology, with only sparse attention given to the amorphous phenomenon of the "student's experience." Against the odds, some at-risk s...

  13. Trends in the Management of Patients With Left Ventricular Assist Devices Presenting for Noncardiac Surgery: A 10-Year Institutional Experience.

    Science.gov (United States)

    Stone, Marc; Hinchey, Joseph; Sattler, Christopher; Evans, Adam

    2016-09-01

    In our institution, the vast majority of patients presenting for noncardiac surgery (NCS) while supported by a left ventricular assist device (LVAD) are now cared for by noncardiac-trained anesthesiologists as the result of a decade of educational intervention to effect this transition. This represents a significant departure from the published experiences of other institutions. With institutional review board approval, we queried the database of our anesthesia record keeping system (CompuRecord) to determine various aspects of the perioperative management of these patients from July 1, 2003, through June 30, 2013, during which time 271 NCS procedures were performed on adult patients supported by LVADs. Over the entire study period (2003-2013), anesthetic care was provided by a cardiac anesthesiologist 47% of the time and by a noncardiac anesthesiologist 53% of the time. However, by the time period 2012-2013, 88% of the NCS procedures were staffed by a noncardiac anesthesiologist. Despite the prevalence of continuous flow devices in this series, the use of invasive blood pressure monitoring decreased dramatically by the later years of the study. Vasoactive and inotropic medications were rarely required intraoperatively. No intraoperative cardiac arrests, thromboembolic complications, or device malfunctions occurred. Our conclusion is that NCS procedures on LVAD-supported patients can be safely managed by educated noncardiac anesthesiologists. PMID:26685184

  14. Cost comparison of curative therapies for localized prostate cancer in Japan. A single-institution experience

    International Nuclear Information System (INIS)

    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, 192Ir high-dose-rate brachytherapy, and 125I 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)

  15. Adrenalectomy for adrenal-mediated hypertension: National Surgical Quality Improvement Program analysis of an institutional experience.

    Science.gov (United States)

    Shada, Amber L; Stokes, Jayme B; Turrentine, Florence E; Simpson, Virginia B; Padia, Shetal H; Carey, Robert M; Hanks, John B; Smith, Philip W

    2014-11-01

    Adrenal-mediated hypertension (AMH) has been increasingly treated by laparoscopic adrenalectomy (LA). Metabolic derangements in patients with AMH could result in perioperative complications and mortality. Long-term operative and clinical outcomes after laparoscopic treatment of AMH have not been evaluated using large clinical databases. The institutional National Surgical Quality Improvement Program (NSQIP) data for patients undergoing adrenalectomy for AMH between 2002 and 2012 were reviewed. Patient demographics, perioperative variables, and outcomes were analyzed and compared with national NSQIP adrenalectomy data. Improvement in AMH was recorded when discontinuation or reduction of antihypertensive medication occurred or with a decrease of blood pressure on the preoperative antihypertensive regimen. Ninety-four patients underwent adrenalectomy. There were 48 patients with pheochromocytoma (PHE) and 46 patients with aldosterone-producing adenoma (APA). Eighty-five patients (90%) were taking antihypertensive medications preoperatively compared with 36 patients (38%) postoperatively (P cerebral vascular accident, 0 per cent for myocardial infarction, and 0.5 per cent for transfusions compared with the national NSQIP data of 0.2, 0, and 6.7 per cent, respectively. Patients presenting with significant AMH including PHE and APA can be effectively and safely treated with LA with minimal complications and with a significant number of patients eliminating or decreasing their need for antihypertensive medications. PMID:25347508

  16. Liposomal cytarabine in neoplastic meningitis from primary brain tumors: a single institutional experience.

    Science.gov (United States)

    Gaviani, P; Corsini, E; Salmaggi, A; Lamperti, E; Botturi, A; Erbetta, A; Milanesi, I; Legnani, F; Pollo, B; Silvani, A

    2013-12-01

    Neoplastic meningitis (NM) is diagnosed in 1-2 % of patients with primary brain tumors. Standard treatment of NM includes single-agent or combination chemotherapy, with compounds such as methotrexate, thiotepa, and cytarabine (Ara-C) or its injectable, sustained-release formulation Depocyte(®). In this Report, we reported the data of efficacy and tolerability of an intrathecal Depocyte(®) regimen for patients presenting with NM from primary brain tumors. We described 12 patients with NM confirmed at magnetic resonance imaging (MRI) and with a positive cerebrospinal fluid (CSF) cytology. Patients were treated with repeated courses of intrathecal Depocyte(®) (once every 2 weeks for 1 month of induction therapy and as consolidation therapy on a monthly base in responding patients). Twelve patients (10 males and 2 females) were treated by our Institution. The diagnosis of primitive brain tumor was medulloblastoma in six patients, germinoma in two patients, pylocitic astrocytomas with spongioblastic aspects, teratocarcinoma, meningeal melanoma, and ependimoma in the other four patients. The total number of Depocyte(®) cycles ranged from one to nine. In 7/12 patients, there was clinical and/or radiological response after Depocyte(®), and the toxicity was moderate and transient, mainly due to the lumbar puncture procedure. In the two patients with germinoma, we observed a normalization of MRI Imaging and negativization of CSF with disappearance of the tumor cells. OS was 180 days (range 20-300, CI 95 %). PMID:23525755

  17. Computer aided instruction. Preliminary experience in the Radiological Sciences Institute of the University of Milan

    International Nuclear Information System (INIS)

    Computerised instruction means teaching by computer using a program that alternates information with self-checking multiple choice questions. This system was used to create a fully computerized lesson on the diagnosis and treatment of breast cancer which was then tested on a small group of madical students attending the Radiology School of the Milan University Institute of Radiological Sciences. At the end of the test, the students were asked to complete a questionnaire which was then analysed. The computer lesson consisted of 66 text messages and 21 self-checking questions. It aroused considerable interest, though the most common reason was curiosity about a novel system. The degree of fatigue caused was modest despite the fact that the computer lesson was at least as demanding as a traditional lesson, if not more so. The level of learning was considered high and optimised by the use of self-checking questions that were considered an essential element. However no student agreed to sit an official examination, even interactively, using the computer

  18. Re-challenge with pemetrexed in advanced mesothelioma: a multi-institutional experience

    Directory of Open Access Journals (Sweden)

    Bearz Alessandra

    2012-09-01

    Full Text Available Abstract Background Although first-line therapy for patients affected by advanced mesothelioma is well established, there is a lack of data regarding the impact of second-line treatment. Methods We retrospectively collected data of patients affected by advanced mesothelioma, already treated with first-line therapy based on pemetrexed and platin, with a response (partial response or stable disease lasting at least 6 months, and re-treated with a pemetrexed-based therapy at progression. The primary objective was to describe time to progression and overall survival after re-treatment. Results Overall across several Italian oncological Institutions we found 30 patients affected by advanced mesothelioma, in progression after a 6-month lasting clinical benefit following a first-line treatment with cisplatin and pemetrexed, and re-challenged with a pemetrexed-based therapy. In these patients we found a disease control rate of 66%, with reduction of pain in 43% of patients. Overall time to progression and survival were promising for a second-line setting of patients with advanced mesothelioma, being 5.1 and 13.6 months, respectively. Conclusions In our opinion, when a patient has a long-lasting benefit from previous treatment with pemetrexed combined with a platin compound, the same treatment should be offered at progression.

  19. Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

    Directory of Open Access Journals (Sweden)

    John Monagle

    2015-01-01

    Full Text Available Background: Pulmonary hypertension (PH in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%. Aim: To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case reports, a few small case series and 2 meta-analyses. Materials and Methods: A review of all patients admitted to our institution for management of PH in pregnancy between 1994 and February 2009 was undertaken. Cases were identified from the high-risk pregnancy database within the department of anesthesia and from the hospital medical records. Severity of PH, type of PH, NYHA functional status at presentation and delivery, mode of delivery, peripartum monitoring and APGAR scores were noted. Patients were reviewed by a multidisciplinary team and management planned accordingly. Results: 19 eligible patients were identified. Patients who were significantly sick due to their PH were aggressively managed during pregnancy. Overall there was an improvement in NYHA functional status at the time of delivery. Epidural analgesia and anesthesia for labor and operatively delivery seem to be the ideal choice. Conclusion: Multidisciplinary approach is a key to the successful management of these patients. Secondary PH results in higher morbidity and mortality, in particular, older the age higher the maternal morbidity and mortality.

  20. Conformal Radiotherapy in the Treatment of Advanced Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension: An Institutional Experience

    International Nuclear Information System (INIS)

    Purpose: To describe the results of conformal radiotherapy in advanced juvenile nasopharyngeal angiofibroma in a tertiary care institution. Methods and Materials: Retrospective chart review was conducted for 8 patients treated with conformal radiotherapy between 2006 and 2009. The median follow-up was 17 months. All patients had Stage IIIB disease with intracranial extension. Radiotherapy was considered as treatment because patients were deemed inoperable owing to extensive intracranial/intraorbital extension or proximity to optic nerve. All but 1 patient were treated with intensity-modulated radiotherapy using seven coplanar fields. Median (range) dose prescribed was 39.6 (30-46) Gy. Actuarial analysis of local control and descriptive analysis of toxicity profile was conducted. Results: Despite the large and complex target volume (median planning target volume, 292 cm3), intensity-modulated radiotherapy achieved conformal dose distributions (median van't Reit index, 0.66). Significant sparing of the surrounding organs at risk was obtained. No significant Grade 3/4 toxicities were experienced during or after treatment. Actual local control at 2 years was 87.5%. One patient died 1 month after radiotherapy secondary to massive epistaxis. The remaining 7 patients had progressive resolution of disease and were symptom-free at last follow-up. Persistent rhinitis was the only significant toxicity, seen in 1 patient. Conclusions: Conformal radiotherapy results in good local control with minimal acute and late side effects in juvenile nasopharyngeal angiofibromas, even in the presence of advanced disease.

  1. Adult Supratentorial Low-Grade Glioma: Long-Term Experience at a Single Institution

    International Nuclear Information System (INIS)

    Purpose: To report the long-term follow-up of a cohort of adult patients with supratentorial low-grade glioma treated at a single institution. Methods and Materials: A cohort of 145 adult patients treated at the London Regional Cancer Program between 1979 and 1995 was reviewed. Results: With a median follow-up of 105 months, the median progression-free survival was 61 months (95% confidence interval, 53-77), and the median overall survival was 118 months (95% confidence interval, 93-129). The 10- and 20-year progression-free and overall survival rate was 18% and 0% and 48% and 22%, respectively. Cox regression analysis confirmed the importance of age, histologic type, presence of seizures, Karnofsky performance status, and initial extent of surgery as prognostic variables for overall and cause-specific survival. Function among long-term survivors without tumor progression was good to excellent for most patients. Conclusion: Low-grade glioma is a chronic disease, with most patients dying of their disease. However, long-term survival with good function is possible. Survival is determined primarily by the disease factors with selection and timing of adjuvant treatments having less influence on outcome.

  2. Intensity-modulated radiation treatment for head-and-neck squamous cell carcinoma-the University of Iowa experience

    International Nuclear Information System (INIS)

    Purpose: To review the University of Iowa experience with intensity-modulated radiotherapy (IMRT) in the treatment of head-and-neck squamous cell carcinoma. Methods and Materials: From October 1999 to April 2004, 151 patients with head-and-neck squamous cell carcinoma were treated with IMRT for curative intent. One patient was lost to follow-up 2 months after treatment and therefore excluded from analysis. Of the remaining 150 patients, 99 were treated with definitive IMRT, and 51 received postoperative IMRT. Sites included were nasopharynx, 5; oropharynx, 56; larynx, 33; oral cavity, 29; hypopharynx, 8; nasal cavity/paranasal sinus, 8; and unknown primary, 11. None of the patients treated with postoperative IMRT received chemotherapy. Of 99 patients who had definitive IMRT, 68 patients received concurrent cisplatin-based chemotherapy. One patient received induction cisplatin-based chemotherapy, but no concurrent chemotherapy was given. Three clinical target volumes (CTV1, CTV2, and CTV3) were defined. The prescribed doses to CTV1, CTV2, and CTV3 in the definitive cohort were 70-74 Gy, 60 Gy, and 54 Gy, respectively. For high-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 64-66 Gy, 60 Gy, and 54 Gy, respectively. For intermediate-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 60 Gy, 60 Gy, and 54 Gy. Results: The median follow-up was 18 months (range, 2-60 months). All living patients were followed for at least 6 months. There were 11 local-regional failures: 7 local failures, 3 regional failures, and 1 failure both in the primary tumor and regional lymph node. There were 16 patients who failed distantly, either with distant metastasis or new lung primaries. The 2-year overall survival, local progression-free survival, locoregional progression-free survival, and distant disease-free survival rates were 85%, 94%, 92%, and 87%, respectively. The median time from treatment completion to local-regional recurrence

  3. LABLE: A multi-institutional, student-led, atmospheric boundary layer experiment

    Energy Technology Data Exchange (ETDEWEB)

    Klein, P.; Bonin, T. A.; Newman, J. F.; Turner, D. D.; Chilson, P. B.; Wainwright, C. E.; Blumberg, W. G.; Mishra, S.; Carney, M.; Jacobsen, E. P.; Wharton, Sonia; Newsom, Rob K.

    2015-10-23

    This paper presents an overview of the Lower Atmospheric Boundary Layer Experiment (LABLE), which included two measurement campaigns conducted at the Atmospheric Radiation Measurement (ARM) Southern Great Plains site in Oklahoma during 2012 and 2013. LABLE was conducted as a collaborative effort between the University of Oklahoma (OU), the National Severe Storms Laboratory, Lawrence Livermore National Laboratory (LLNL), and the ARM program. LABLE can be considered unique in that it was designed as a multi-phase, low-cost, multi-agency collaboration. Graduate students served as principal investigators and took the lead in designing and conducting experiments aimed at examining boundary-layer processes. The main objective of LABLE was to study turbulent phenomena in the lowest 2 km of the atmosphere over heterogeneous terrain using a variety of novel atmospheric profiling techniques. Several instruments from OU and LLNL were deployed to augment the suite of in-situ and remote sensing instruments at the ARM site. The complementary nature of the deployed instruments with respect to resolution and height coverage provides a near-complete picture of the dynamic and thermodynamic structure of the atmospheric boundary layer. This paper provides an overview of the experiment including i) instruments deployed, ii) sampling strategies, iii) parameters observed, and iv) student involvement. To illustrate these components, the presented results focus on one particular aspect of LABLE, namely the study of the nocturnal boundary layer and the formation and structure of nocturnal low-level jets. During LABLE, low-level jets were frequently observed and they often interacted with mesoscale atmospheric disturbances such as frontal passages.

  4. Hydrodynamic instability experiments on the HIPER laser facility at the Institute of Laser Engineering, Osaka University

    International Nuclear Information System (INIS)

    We present recent results on the hydrodynamic instability experiments on the HIPER (High Intensity Plasma Experimental Research) laser facility at ILE, Osaka University. We measured the Rayleigh-Taylor growth rate on the HIPER laser. Also measured were all parameters that determine the RT growth rate. We focused on the measurements of the ablation density of laser-irradiated targets, which had not been experimentally measured. The experimental results were compared with calculations with one dimensional simulation coupled with Fokker-Planck equation for electron transport. (author)

  5. Carcinomas of the Paranasal Sinuses and Nasal Cavity Treated With Radiotherapy at a Single Institution Over Five Decades: Are We Making Improvement?

    International Nuclear Information System (INIS)

    Purpose: To compare clinical outcomes of patients with carcinomas of the paranasal sinuses and nasal cavity according to decade of radiation treatment. Methods and Materials: Between 1960 and 2005, 127 patients with sinonasal carcinoma underwent radiotherapy with planning and delivery techniques available at the time of treatment. Fifty-nine patients were treated by conventional radiotherapy; 45 patients by three-dimensional conformal radiotherapy; and 23 patients by intensity-modulated radiotherapy. Eighty-two patients (65%) were treated with radiotherapy after gross total tumor resection. Nineteen patients (15%) received chemotherapy. The most common histology was squamous cell carcinoma (83 patients). Results: The 5-year estimates of overall survival, local control, and disease-free survival for the entire patient population were 52%, 62%, and 54%, respectively. There were no significant differences in any of these endpoints with respect to decade of treatment or radiotherapy technique (p > 0.05, for all). The 5-year overall survival rate for patients treated in the 1960s, 1970s, 1980s, 1990s, and 2000s was 46%, 56%, 51%, 53%, and 49%, respectively (p = 0.23). The observed incidence of severe (Grade 3 or 4) late toxicity was 53%, 45%, 39%, 28%, and 16% among patients treated in the 1960s, 1970s, 1980s, 1990s, and 2000s, respectively (p = 0.01). Conclusion: Although we did not detect improvements in disease control or overall survival for patients treated over time, the incidence of complications has significantly declined, thereby resulting in an improved therapeutic ratio for patients with carcinomas of the paranasal sinuses and nasal cavity

  6. Management of ductal carcinoma in situ of the breast--experiences from National Naval Medical Center during last 10 years.

    OpenAIRE

    Park, S. T.; Hamilton, M.; Ghosh, B. C.

    1997-01-01

    Seventy-one ductal carcinoma in situ (DCIS) patients were reported to the tumor registry at the National Naval Medical Center between 1986 and 1995. This number represents 6.5% of all breast cancer patients. We did not include the patients with microinvasion or infiltrating ductal carcinoma with extensive DCIS in this study. After excluding 16 cases because of inaccessable clinical records, 55 cases of pure DCIS were analyzed. The mean age at presentation was 52.0 years (32 year-old to 74 yea...

  7. Delivery of institutional long-term care under two social insurances: Lessons from the Korean experience.

    Science.gov (United States)

    Kim, Hongsoo; Jung, Young-Il; Kwon, Soonman

    2015-10-01

    Little is known about health and social care provision for people with long-term care (LTC) needs under multiple insurances. The aim of this study is to compare the profile, case-mix, and service provision to older people at long-term care hospitals (LTCHs) covered by the national health insurance (NHI) with those of older people at long-term care facilities (LTCFs) covered by the public long-term care insurance (LTCI) in Korea. A national LTC survey using common functional measures and a case-mix classification system was conducted with a nationally representative sample of older people at LTCFs and LTCHs in 2013. The majority of older people in both settings were female and frail, with complex chronic diseases. About one fourth were a low-income population with Medical-Aid. The key functional status was similar between the two groups. As for case-mix, more than half of the LTCH population were categorized as having lower medical care needs, while more than one fourth of the LTCF residents had moderate or higher medical care needs. Those with high medical care needs at LTCFs were significantly more likely to be admitted to acute-care hospitals than their counterparts at LTCHs. The current delivery of institutional LTC under the two insurances in Korea is not coordinated well. It is necessary to redefine the roles of LTCHs and strengthen health care in LTCFs. A systems approach is critical to establish person-centered, integrated LTC delivery across different financial sources. PMID:26305121

  8. Optic pathway glioma in children: 10 years of experience in a single institution.

    Science.gov (United States)

    Doganis, Dimitrios; Pourtsidis, Apostolos; Tsakiris, Kleonikos; Baka, Margarita; Kouri, Agathi; Bouhoutsou, Despina; Varvoutsi, Maria; Servitzoglou, Marina; Dana, Helen; Kosmidis, Helen

    2016-03-01

    Optic pathway glioma (OPG) is a rare brain tumor that occurs more commonly during early childhood and is frequently associated with neurofibromatosis type 1 (NF1). In this study, our aim was to describe the characteristics, management, and outcome of patients with OPG. We retrospectively analyzed the clinical charts of all children diagnosed with OPG at our institution from 2003 to 2013. Twenty children (11 boys and 9 girls, median age: 5 and 3/12 years; NF1: 15/20) were diagnosed with OPG. The diagnosis was based on magnetic resonance imaging (MRI) findings. A biopsy was useful in 3 patients. The main reason for seeking medical advice was decreased vision (7/20 patients), whereas in 10/20 patients, the diagnosis was established during the routine follow-up for their NF1. Fifteen patients demonstrated MRI findings of optic nerve involvement and/or chiasmal tumor, whereas in 5 children, postchiasmal structures were also involved. Sixteen patients (16/20) received carboplatin-based regimens, whereas 4/20 patients were only under close observation. Six patients showed deterioration of visual acuity and/or imaging findings at the end of treatment and/or during their follow-up. Three of them (3/6) underwent tumor resection, whereas 1 (1/6) received radiation treatment. None of our patients had total blindness from both eyes. Half of our patients were diagnosed during follow-up for their NF1, the incidence of which was high in our group. Our data suggest that chemotherapy helps in the preservation of vision in the majority of children. PMID:27007263

  9. Head and Neck Schwannomas: 20-Year Experience of a Single Institution Excluding Cutaneous and Acoustic Sites.

    Science.gov (United States)

    Butler, Randall T; Patel, Rajiv M; McHugh, Jonathan B

    2016-09-01

    While head and neck sites comprise the most common location of schwannomas, clinicopathologic data regarding those tumors occurring in non-acoustic and non-cutaneous locations are relatively sparse. In this study, therefore, we sought to examine retrospectively the clinical and pathologic features of head and neck schwannomas excised at our institution over a 20-year period. During this period, we identified a total cohort of 85 patients, which included 36 males (42.4 %) and 49 females with average age of 41.3 years, the majority of which presented asymptomatically with a mass. Localized symptoms were, however, associated with all of the schwannomas that arose in the oral cavity and larynx, while tumors within or adjacent to bone were often associated with neurologic complaints (7 of 15 such tumors [46.7 %]). Clinical follow-up data was available in 86.4 % of all cases and demonstrated no recurrences or mortality. Pathologically, the microscopic features were characteristic of those well-described for schwannomas in other sites, including alternating Antoni A and B areas and the presence of degenerative changes. Tumor encapsulation, however, was variable and was completely absent in schwannomas of the nasal cavity, paranasal sinuses, and larynx. Additionally, a significant minority of the tumors (28.2 %) exhibited foci that resembled neurofibroma. Non-acoustic, non-cutaneous schwannomas of the head and neck appear to have clinicopathologic features similar to their soft tissue counterparts with some subsite variation in presentation and/or microscopic features. PMID:26747460

  10. Combined use of the RPI [Rensselaer Polytechnic Institute] reactor for training and critical experiments

    International Nuclear Information System (INIS)

    The Rensselaer Polytechnic Institute (RPI) reactor critical facility (RCF) has provided educational and research opportunities for RPI and other students for >25 yr. The RCF was built by the American Locomotive Company (ALCO) in the 1950s as a critical facility in support of the army package power reactor program, and, when ALCO went out of business in 1964, the RCF was acquired by RPI. Since that time, RPI has operated the RCF primarily in a teaching mode in the nuclear engineering department, although reactor research, activation analyses, and reactivity assays have been carried out as well. Until recently, the RCF was fueled by plates containing highly enriched uranium as a cermet in stainless steel. This highly enriched uranium (HEU) fuel was replaced recently by 4.81 wt% enriched UO2 high-density pellets clad in stainless steel rods. The use of these SPERT (F1) fuel rods in the RCF provided a cost-effective method for conversion of the core from HEU to low-enriched uranium and for enhancement of the RCF training and research program. The RCF is the only facility in the United States that provides reactor training on a core containing fuel that is similar to that used in power industry light water reactors (LWRs). Moreover, the RCF is the only facility in the United States currently available for supplying critical experimental data in support of the LWR power industry. Thus, the RCF is in a unique position to carry out important training and research services consistent with RPI's nuclear engineering objectives

  11. Activity and toxicity of 2-CDA in Langerhans cell histiocytosis: A single institutional experience

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    Biswas G

    2007-01-01

    Full Text Available Background : Langerhans cell histiocytosis (LCH is a rare disorder characterized by clonal proliferation of immature and abnormal bone marrow derived langerhans cells. Treatment is usually multimodal. Potent anti-monocyte as well as immunomodulatory activity of 2-CDA and its proven efficacy in many lymphoproliferative disorders has made 2-CDA a rational choice in treatment of LCH. Aim : To evaluate the efficacy and toxicity profile of 2-CDA in children with relapsed or refractory LCH. Setting and Design : This is a pilot study and we present the initial data of the first seven patients treated at our institution. Materials and Methods : Seven patients of relapsed and refractory LCH were enrolled from July 2000 to June 2004. The cohort of seven patients included six males and one female with a median age at initiation of cladribine was 2.25 years (range, 1.67 to 7.0 years. Three patients had received one prior chemotherapy regimen while the rest were heavily pretreated. Cladribine was administered over two hours IV daily for five days and repeated every four weeks. Results : After a median of six courses of cladribine (range, 2 to 9, two (33% patients achieved PR and two (33% patients have SD on imaging but are clinically better. None experienced grade 3 or 4 hematologic toxicity. At a median follow-up of 19 months (range, 8 to 52 months, five patients remain alive and one patient has died. Conclusion : Our study shows that single agent 2-CDA is active and well-tolerated in children with relapsed or refractory LCH.

  12. Endobronchial Ultrasound Changed the World of Lung Cancer Patients: A 11-Year Institutional Experience.

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    Chia-Hung Chen

    Full Text Available The role of advanced bronchoscopic diagnostic techniques in the detection and staging of lung cancer has increased sharply in recent years. The development of endobronchial ultrasound (EBUS improved minimally invasive mediastinal staging and diagnosis of peripheral lung lesions (PLLs. We investigated the impact of using EBUS as a diagnostic method for tissue acquisition in lung cancer patients.In a single center observational retrospective study, 3712 subjects were diagnosed with lung cancer from 2003 to 2013 (EBUS was introduced in 2008. Thus, we divided the data into two periods: the conventional bronchoscopy period (2003 to 2007 and the EBUS period (2008 to 2013.A total of 3712 patients were included in the analysis. Comparing the conventional bronchoscopy period with the EBUS period data, there has been a significant reduction in the use of diagnostic modalities: CT-guided biopsy (P < 0.0001 and pleural effusion cytology (P < 0.0001. The proportion of subjects diagnosed using bronchoscopy significantly increased from 39.4% in the conventional period to 47.4% in the EBUS period (P < 0.0001. In the EBUS period, there has also been a significant increase in the proportion of patients proceeding directly to diagnostic surgery (P < 0.0001. Compared to bronchoscopy, the incidence of complications was higher in those who underwent CT guide biopsy. The incidence of iatrogenic pneumothorax significantly decreased in the EBUS period.Advanced bronchoscopic techniques are widely used in the diagnosis of lung cancer. At our institution, the increasing use of EBUS for providing lung cancer diagnosis has led to a significant reduction in other diagnostic modalities, namely CT-guided biopsy and pleural effusion cytology. These changes in practice also led to a reduction in the incidence of complications.

  13. The 1951-98 experience of the Paris Institut Curie Radiopathology Unit: a preliminary report

    International Nuclear Information System (INIS)

    From 1 January 1951 to 30 June 1998, 696 patients presented spontaneously or were referred to the French Institut Curie Radiopathology Unit following a more or less severe accidental irradiation. Of these, 568 patients came from France, while 128 were sent by various foreign countries. The very great majority of irradiation accidents occurred in the workplace, particularly in industry. Interestingly, 'non-nuclear' industry was responsible for three times more events than the nuclear industry. While incidental irradiation of the public by lost radioactive sources was exceedingly rare in France, it seemed to be more frequent in our cohort of foreign patients. Radiation phobia accounted for about 10% of cases in the French cohort, but the number of cases did not seem to increase with time. Overall, the accrual of patients over time appears to be stable, with 10 to 25 new cases consulting each year. Fortunately, a majority of cases corresponded to low-level irradiation (and even no irradiation at all). In the French cohort, only 21.6% of patients, showing deterministic effects, required some form of treatment, with 4.9% considered as 'severe' cases. Not unexpectedly, more patients required treatment in the foreign cohort (35.2%), with 24.2% of severe cases, including four deaths. The main features of this database are consistent with the data previously reported by the IAEA, UNSCEAR and REAC/TS. Although the number of severe cases is small, it should still be considered to be too high, especially as most of these accidents could have been easily avoided if a few basic radioprotection rules had been fully respected. (abstract)

  14. Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience

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    Daniela Hespanha Marinho

    2015-08-01

    Full Text Available OBJECTIVE: Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution.METHODS: A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test.RESULTS: This study included 118 patients (46.8% who received bone marrow and 134 (53.2% who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value < 0.001. Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value = 0.653. Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value = 0.007. Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value = 0.117. Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value = 0.4666.CONCLUSION: Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.

  15. A Decade of Change: An Institutional Experience with Breast Surgery in 1995 and 2005

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    Amber A. Guth

    2008-01-01

    Full Text Available Introduction: With the adoption of routine screening mammography, breast cancers are being diagnosed at earlier stages, with DCIS now accouting for 22.5% of all newly diagnosed breast cancers. This has been attributed to both increased breast cancer awareness and improvements in breast imaging techniques. How have these changes, including the increased use of image-guided sampling techniques, influenced the clinical practice of breast surgery?Methods: The institutional pathology database was queried for all breast surgeries, including breast reconstruction, performed in 1995 and 2005. Cosmetic procedures were excluded. The results were analysed utilizing the Chi-square test.Results: Surgical indications changed during 10-year study period, with an increase in preoperatively diagnosed cancers undergoing definitive surgical management. ADH, and to a lesser extent, ALH, became indications for surgical excision. Fewer surgical biopsies were performed for indeterminate abnormalities on breast imaging, due to the introduction of stereotactic large core biopsy. While the rate of benign breast biopsies remained constant, there was a higher percentage of precancerous and DCIS cases in 2005. The overall rate of mastectomy decreased from 36.8% in 1995 to 14.5% in 2005. With the increase in sentinel node procedures, the rate of ALND dropped from 18.3% to 13.7%. Accompanying the increased recognition of early-stage cancers, the rate of positive ALND also decreased, from 43.3% to 25.0%.Conclusions: While the rate of benign breast biopsies has remained constant over a recent 10-year period, fewer diagnostic surgical image-guided biopsies were performed in 2005. A greater percentage of patients with breast cancer or preinvasive disease have these diagnoses determined before surgery. More preinvasive and Stage 0 cancers are undergoing surgical management. Earlier stage invasive cancers are being detected, reflected by the lower incidence of axillary nodal

  16. The lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution

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    E. Bimenyimana

    2009-09-01

    Full Text Available Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch’s (Creswell, 2004:256 method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT; and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an “I don’t care” attitude.

  17. A cooperative effort to exchange age reading experience and protocols between European fish institutes

    DEFF Research Database (Denmark)

    Appelberg, M.; Formigo, N.; Geffen, A.J.;

    2005-01-01

    In Europe, research to improve age estimation methods is often limited to small-scale studies and thus it has been difficult to integrate innovations into routine protocols. There has even been a lack of pilot scale studies and implementation of control mechanisms in the age reading process. This...... Europe. EFAN improved awareness and sensitivity towards the quality of age reading, however, this did not always deliver changes in the routine age reading processes. The present project, Towards Accreditation and Certification of Age Determination of Aquatic Resources (TACADAR); 2002-2006 aims to submit...... was recognised and addressed by European Fish Ageing Network (EFAN; 1997-2000). EFAN was established as an active, independent and informal network for exchange of ideas and experience for improving age estimation. For the first time, age reading problems were addressed on a common platform across...

  18. 60. Mid-term outcome of cardiac resynchronization therapy in pediatrics: single institution experience

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    T. Jawadi

    2016-07-01

    Full Text Available Cardiac resynchronization therapy (CRT has become an increasingly important therapeutic option for patients (pts to treat dyssynchrony associated moderate and severe heart failure. Few reports however, determined the beneficial effects of CRT in pediatrics and midterm outcome following this therapy. Our aim is to assess the mid-term outcomes of CRT in children with evidence of dyssynchrony associated heart failure. Cardiac resynchronization therapy is beneficial in treating congenital heart disease patients who have evidence of dyssynchrony associated heart failure. Retrospective review of 18 consecutive pediatric patients who underwent CRT at our institution between January 2002 and August 2011 Cardiac resynchronization pacemaker was implanted in 18 pts the majority of pts (14 with congenital heart disease. Fourteen pts had preexisting complete heart block and chronic right ventricular pacing. Epicardial left ventricular leads were implanted in all pts while the atrial and right ventricular leads approach varied according to the pt size and anatomy. Indication for CRT was symptomatic dilated cardiomyopathy with evidence of electrical and/or mechanical dyssynchrony demonstrated by M-mode, 3-D echo, or tissue Doppler. The median age of this cohort was 14 years (range 6 months–16 years, the median follow-up time was 7.2 years (range 1–10 years. Subjectively, 16 out of 18 pts reported symptomatic improvement with decreased hospitalizations. The left ventricular ejection fraction improved from mean of 27% (SD 13% to mean of 50% (SD 13% (P value <0.001. Additionally, cardiomegaly improved significantly in during follow up (P value <0.001. The QRS duration with CRT was less but the change is not significant (P value = 0.1 suggesting that electrical resynchronization is not a prerequisite for clinical improvement in this cohort. Children including those with congenital heart disease patients who have evidence of dyssynchrony associated heart

  19. FDG-PET scanning in patients with differentiated thyroid cancers. Institutional experience

    International Nuclear Information System (INIS)

    Full text: Patient with detectable serum thyroglobulin (Tg) and negative radioiodine whole body (RAI-WB) scan should have FDG-PET scan to locate tumor tissue. Sometimes scan fail to detect any pathologic accumulation of FDG. Some well-differentiated thyroid cancers do not accumulate FDG. In addition, tumor burden could be so small that imaging becomes impossible. To explore this possibility, several studies explored relationship between serum Tg level and result of FDG-PET scans. Results were inconclusive and it is not clear if there is some low level of serum Tg below which PET scanning is not cost effective. We examined all cases of thyroid cancer patients who underwent FDG-PET scanning in our institution (N-33) for relationship between Tg level and results of the scan. There were 16 females, 17 males. Age was 19-81 years. Follicular cancer was present in 2 patients while 31 had papillary cancer. 14 patients had PET scan while withdrawn from T4 therapy, and 19 patients were scanned while TSH was suppressed. Overall, 20 scans were considered positive, while 12 were negative. One patient was considered to have positive scan but after scan was repeated interpretation was changed into - positive uptake due to inflammation. In patients whose PET scan was positive, Tg level was in a range 6.6-7,108 ng/ml, while those with negative scan had Tg level in 1.7-36.5 ng/ml range. In group withdrawn from T4 therapy and positive scan Tg level ranged from 13.8-7,108 ng/ml, and with negative scan 2.8-36.5 ng/ml. In PET positive patients in euthyroid group Tg ranged 6.6-432 ng/ml and in negative 1.7-13.3 ng/ml. Conclusion: These results suggest that patients who have negative RAI scan and low Tg level may not benefit from PET scanning. In our study Tg level less than 6.6 ng/ml for the whole group, and below 13.8 ng/ml for patient withdrawn from T4 therapy did not result in positive FDG-PET scan result. Our group is small and more data need to be collected to clarify these

  20. Intractable trigeminal neuralgia: A single institution experience in 26 patients treated with stereotactic gamma knife radiosurgery

    International Nuclear Information System (INIS)

    Purpose: In patients with trigeminal neuralgia, severe pain can persist, or recur despite aggressive medical management and open surgery. Recently, Gamma Knife radiosurgery has been used with promising results. We report on our series of 26 patients with intractable trigeminal neuralgia treated with stereotactic Gamma Knife radiosurgery. Materials and Methods: Between 1991 and 1995, 26 patients with intractable trigeminal neuralgia were treated at our institution using stereotactic Gamma Knife radiosurgery. Medical management had failed in all cases. In addition, 13 patients underwent a total of 20 open surgeries, with transient, or no pain relief. There were 19 females, and 7 males. Patient ages ranged from 37 to 87 years, with a median of 74 years. All patients were treated with a 201 source Cobalt-60 Gamma Knife unit. All patients underwent placement of the Leksell frame, followed by MRI scanning and computer treatment planning. The target in all patients was the fifth cranial nerve root entry zone into the brainstem. Twenty-five patients received between 64.3 to 70 Gy prescribed to Dmax in one shot. One patient received 120 Gy to Dmax in one shot. The 4 mm collimator was used in 22 cases, and the 8 mm in 4 cases. Follow-up ranged from 5 to 55 months, with a median of 19 months. Complete resolution (CR) of pain was scored when the patient reported being pain free off all medication. Partial resolution (PR) was scored when the patient reported > 50% pain reduction after Gamma Knife treatment. Results: At last follow-up, 84.6% ((22(26))) reported CR or PR of pain after Gamma Knife treatment. Forty-two percent ((11(26))) of patients reported CR, and 42%((11(26))) reported PR of pain. There was a dose response. In patients receiving < 70 Gy, 25% ((3(12))) reported CR, while 57% ((8(14))) of those receiving ≥ 70 Gy reported CR. Complications occurred in two (8%) patients. One patient developed transient numbness of the face after 70 Gy, and a second patient

  1. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute

    International Nuclear Information System (INIS)

    Purpose: To assess the efficacy and complications of Gamma Knife radiosurgery for trigeminal neuralgia. Methods and Materials: The Barrow Neurological Institute (BNI) Gamma Knife facility has been operational since March 17, 1997. A total of 557 patients have been treated, 89 for trigeminal neuralgia (TN). This report includes the first 54 TN patients with follow-up exceeding 3 months. Patients were treated with Gamma Knife stereotactic radiosurgery (RS) in uniform fashion according to two sequential protocols. The first 41 patients received 35 Gy prescribed to the 50% isodose via a single 4-mm isocenter targeting the ipsilateral trigeminal nerve adjacent to the pons. The dose was increased to 40 Gy for the remaining 13 patients; however, the other parameters were unvaried. Outcome was evaluated by each patient using a standardized questionnaire. Pain before and after RS was scored as level I-IV per our newly-developed BNI pain intensity scoring criteria (I: no pain; II: occasional pain, not requiring medication; III: some pain, controlled with medication; IV: some pain, not controlled with medication; V: severe pain/no pain relief). Complications, limited to mild facial numbness, were similarly graded by a BNI scoring system. Results: Among our 54 TN patients, 52 experienced pain relief, BNI score I in 19 (35%), II in 3 (6%), III in 26 (48%), and IV in 4 (7%). Two patients (4%) reported no relief (BNI score V). Median follow-up was 12 months (range 3-28). Median time to onset of pain relief was 15 days (range 0-192), and to maximal relief 63 days (range 0-253). Seventeen (31%) noted immediate improvement (≤ 24 h). Prior to RS, all patients were on pharmacologic therapy felt to be optimal or maximal. Twenty-two (41%) were able to stop medications entirely (BNI score I or II). Another 16 (30%), with BNI Score III relief, decreased medication intake by at least 50%. Patients with classical TN pain symptoms were more likely to stop medications than those with

  2. Learning style preferences of medical students: a single-institute experience from Saudi Arabia

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    Ayesha Nuzhat

    2011-08-01

    Full Text Available Objectives: The purpose of this study was to examine preferred learning styles of undergraduate medical students at King Saud Bin Abdul Aziz University for Health Sciences, King Fahad Medical College, Saudi Arabia. Methods: A cross sectional study of preclinical students with 74 male and 72 female (n= 146 was performed. The validated VARK questionnaire was used to categorize the learning styles of students. The questionnaire consists of 16 items which identify four different learning styles: visual, aural, reading/writing and kinesthetic. Descriptive statistics were used to identify the learning styles of students. Results: The response rate was 70 The results showed that 5.5 11.6 2.1 and 8.2of students only preferred the visual, aural, reading/writing and kinesthetic modes, respectively. A further analysis showed that 72.6of students preferred multiple learning styles. Conclusions: The results of this study can provide useful information for improving the quality of the teaching and learning experiences of students. However, more research on this topic needs to be undertaken before the association between learning style preferences and teaching and learning strategies is more clearly understood.

  3. Sources of Institutional Integrity and Contradictions of County Governance: Analyzing the Estonian Experience

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    Georg SOOTLA

    2015-10-01

    Full Text Available The article focuses on the analysis of internal dynamics and controversies of patterns of county-level governance. Seven alternating confi gurations of county governance in Estonia are taken as an empirical case. We also intend to develop further a conceptual framework for analysis of county governance, drawing on the experience of developing county governance in Europe in the last decades. We reveal that dual and fused patterns of county governance have rather different roles in balancing intergovernmental relations. Hence, when combining dual pattern with elements of fused pattern, it should be done very carefully in order to avoid deep tensions in the intergovernmental system. This was ignored in Estonia where, in the 1920s and the beginning of the 1990s, a strong political mandate of county governor and its role as representative of the state were combined. In the 1930s the crisis of county governance was solved with a perfectly balanced fused pattern, established by an authoritarian regime. In the 2000s, Estonia faced a political as well as a structural deadlock in the development of the intergovernmental system because of the deconstruction of county governance. As a result, the crisis in one link would require a complete reorganization of central- local relations in Estonia in the second half of the 2010s.

  4. High-dose-rate brachytherapy for soft tissue sarcoma in children: a single institution experience

    International Nuclear Information System (INIS)

    To report our experience treating soft tissue sarcoma (STS) with high dose rate brachytherapy alone (HBRT) or in combination with external beam radiotherapy (EBRT) in pediatric patients. Eighteen patients, median age 11 years (range 2 – 16 years) with grade 2–3 STS were treated with HBRT using Ir-192 in a interstitial (n = 14) or intracavitary implant (n = 4). Eight patients were treated with HBRT alone; the remaining 10 were treated with a combination of HBRT and EBRT. After a median follow-up of 79.5 months (range 12 – 159), 14 patients were alive and without evidence of disease (5-year overall survival rate 84.5%). There were no local or regional failures in the group treated with HBRT alone. One patient developed distant metastases at 14 months and expired after 17 months. In the combined HBRT and EBRT group, there was 1 local failure (22 months), and 3 patients developed pulmonary metastatic disease 18, 38 and 48 months after diagnosis and no these patients were alive at the time of this report. The overall local control to HBRT alone and HBRT plus EBRT were 100 and 90%, respectively. The acute affects most common were local erythema and wound dehiscence in 6 (33%) and 4 (22%) patients. Late effects were observed in 3 patients (16.5%). Excellent local control with tolerable side effects have been observed in a small group of paediatric patients with STS treated by HBRT alone or in combination with EBRT

  5. Yttrium-90 Radioembolization for Colorectal Cancer Liver Metastases: A Single Institution Experience

    Science.gov (United States)

    Nace, Gary W.; Steel, Jennifer L.; Amesur, Nikhil; Zajko, Albert; Nastasi, Bryon E.; Joyce, Judith; Sheetz, Michael; Gamblin, T. Clark

    2011-01-01

    Purpose. We sought to evaluate our experience using yttrium-90 (90Y) resin microsphere hepatic radioembolization as salvage therapy for liver-dominant metastatic colorectal cancer (mCRC). Methods. A retrospective review of consecutive patients with unresectable mCRC who were treated with 90Y after failing first and second line systemic chemotherapy. Demographics, treatment dose, biochemical and radiographic response, toxicities, and survival were examined. Results. Fifty-one patients underwent 90Y treatments of which 69% were male. All patients had previously undergone extensive chemotherapy, 31% had undergone previous liver-directed therapy and 24% had a prior liver resection. Using RECIST criteria, either stable disease or a partial response was seen in 77% of patients. Overall median survival from the time of first 90Y treatment was 10.2 months (95% CI = 7.5–13.0). The absence of extrahepatic disease at the time of treatment with 90Y was associated with an improved survival, median survival of 17.0 months (95% CI = 6.4–27.6), compared to those with extrahepatic disease at the time of treatment with 90Y, 6.7 months (95% CI = 2.7–10.6 Conclusion: 90Y therapy is a safe locoregional therapy that provides an important therapeutic option to patients who have failed first and second line chemotherapy and have adequate liver function and performance status. PMID:22312513

  6. Yttrium-90 Radioembolization for Colorectal Cancer Liver Metastases: A Single Institution Experience

    Directory of Open Access Journals (Sweden)

    Gary W. Nace

    2011-01-01

    Full Text Available Purpose. We sought to evaluate our experience using yttrium-90 (90Y resin microsphere hepatic radioembolization as salvage therapy for liver-dominant metastatic colorectal cancer (mCRC. Methods. A retrospective review of consecutive patients with unresectable mCRC who were treated with 90Y after failing first and second line systemic chemotherapy. Demographics, treatment dose, biochemical and radiographic response, toxicities, and survival were examined. Results. Fifty-one patients underwent 90Y treatments of which 69% were male. All patients had previously undergone extensive chemotherapy, 31% had undergone previous liver-directed therapy and 24% had a prior liver resection. Using RECIST criteria, either stable disease or a partial response was seen in 77% of patients. Overall median survival from the time of first 90Y treatment was 10.2 months (95% CI = 7.5–13.0. The absence of extrahepatic disease at the time of treatment with 90Y was associated with an improved survival, median survival of 17.0 months (95% CI = 6.4–27.6, compared to those with extrahepatic disease at the time of treatment with 90Y, 6.7 months (95% CI = 2.7–10.6 Conclusion: 90Y therapy is a safe locoregional therapy that provides an important therapeutic option to patients who have failed first and second line chemotherapy and have adequate liver function and performance status.

  7. Management of Pancreatic Injuries after Blunt Abdominal Trauma. Experience at a Single Institution

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    Ker-Kan Tan

    2009-11-01

    Full Text Available Context Pancreatic injuries after blunt abdominal trauma could result in significant morbidity, and even mortality if missed. Objective Our aim was to review our institution’s experience with blunt pancreatic trauma. Setting Our study included all cases of blunt traumatic pancreatic injuries. Patients Sixteen patients (median age 41 years; range: 18-60 years were treated for blunt pancreatic trauma from December 2002 to June 2008. Main outcome measure Pancreatic injuries were graded according to the definition of the American Association for the Surgery of Trauma (AAST. Results CT scans were performed on 10 (62.5% patients, with the remaining 6 (37.5% sent to the operating theatre immediately due to their injuries. Of the 12 (75.0% patients who underwent exploratory laparotomy, 2 (12.5% had a distal pancreatectomy (AAST grade III, 1 (6.3% underwent a Whipple procedure (AAST grade IV while another 2 (12.5% were too hemodynamically unstable for any definitive surgery (AAST grade IV and V; the remaining 7 (43.8% pancreatic injuries were managed conservatively. Four (25.0% patients had their injuries managed non-operatively. Some of the associated complications included intra-abdominal collection (n=2, 12.5% and chest infection (n=2, 12.5%. Conclusion Blunt pancreatic trauma continues to pose significant diagnostic and therapeutic challenges. In view of the numerous associated injuries, priority must be given to stabilizing the patient before any definitive management of the pancreatic injuries is carried out. Mortality in these patients is usually a result of the magnitude of their associated injuries.

  8. Methotrexate based chemotherapy and deferred radiotherapy for primary central nervous system lymphoma (PCNSL): single institution experience.

    Science.gov (United States)

    Silvani, A; Salmaggi, A; Eoli, M; Lamperti, E; Broggi, G; Marras, C E; Fariselli, L; Milanesi, I; Fiumani, A; Gaviani, P; Erbetta, A; Giovagnoli, A R; Pollo, B; Botturi, A; Boiardi, A

    2007-05-01

    In the following study, we present our experience in the treatment of PCNSL patients using a multi-step schedule combining chemotherapy and deferred radiotherapy. Patients were treated with two modified M-BACOD cycles and then differently according to radiological response For PR, SD and PD patients, chemotherapy was interrupted and radiotherapy initiated immediately (45 Gy Whole-brain RT). With CR patients, chemotherapy was continued with a combination of HMTX, VCZ, PCB and HD Ara-C up to a total of nine cycles. In 36 patients suitable for evaluation (2 patients had undergone tumour resection): 69.4% (25 of 36) had a complete response (CR), 19.4% (7 of 36) had a partial response(PR), 8.3% (3 of 36) had stable disease(SD), and 2.7% (one of 36) had progressive disease (PD). The PR, SD and PD patients were immediately treated by radiotherapy. In this cohort of patients, we observed 6 CR, 4 PR and 2 PD, respectively, following radiotherapy. At first relapse, a total of 16 CR patients were treated by radiotherapy for a total dose of 45 Gy. The OS was 42.1 months for the entire group of patients. In CR patients treated at the moment of recurrence by salvage radiotherapy, the TTP (time lasting from histological diagnosis until recurrence of disease before RT) was 28.3 months, with a 43.4% of disease free patients observed at 2 years. The median disease-free time observed after complete response to radiotherapy was 10.5 months. In 16 patients (34%), further progression of disease was observed following radiotherapy. Two patients developed extra-CNS disease in the breast and testis. When taking into account the patients with radiotherapy delayed at recurrence, the OS was 48 months and the survival rates were 70% and 60% at 2 years and 5 years, respectively. PMID:17111190

  9. CORRELATION OF CRISES, CRISIS EXPERIENCES AND ORIENTATION OF TIME PERSPECTIVE AT THE INITIAL STAGE OF TRAINING IN HIGHER EDUCATION INSTITUTION

    Directory of Open Access Journals (Sweden)

    Irina A. Kurus

    2016-03-01

    Full Text Available The purpose of article is identification of an actual problem of psychological science: correlation of crises and a crisis experiences with and orientation of time perspective at the initial stage of training in institution of higher education.Methods. During the research the following psychodiagnostic methods are applied: the questionnaire of crisis experiences for student by V. R. Manukyan; a questionnaire of time perspective by F. Zimbardo in adaptation of A. Syrtsova, E. T. Sokolova, O. V. Mitina (ZTPI.Results and scientific novelty. Data on interrelation of crises and crisis experiences with an orientation of temporary prospect are obtained and analysed on the basis of representative selection of students in Novosibirsk State Medical University. Gender distinctions of crises behaviour of students are shown. It is established that temporary prospects «The negative past» and «The fatalistic present» correlate with all the crisis experiences of students at the initial stage of training in higher education institution. The temporary prospect «Future» has the return correlation with crisis experience «absence of the appreciably attractive purposes in the future», and the interrelation with crises is absent. In this regard the author proposes the correction procedure of psychological escort of first-year students.Practical significance. The research findings can be used by educational psychologists for psychological diagnostics of pupils, to search the reasons of their poor progress, during the developing and correction of programs of psychology and pedagogical escort of first-year students, in particular when writing the program of adaptive training in the centers of psychosocial maintenance of the trainees. Guidelines for a choice of the techniques and methods promoting overcoming of the problems connected with crisis of identity and biographic crises are given.

  10. Primary subglottic carcinoma

    International Nuclear Information System (INIS)

    Primary subglottic carcinoma is rare with a uniformly poor prognosis. We present our experience of eight such cases treated over a period of ten years. One patient had a mucoepidermoid carcinoma while the rest has a squamous cell carcinoma. A combination of surgery and radiotherapy was employed in five cases, while one case underwent radiotherapy only, surgery only and salvage surgery following radical irradiation. Three cases died of locoregional failure within a year. The remaining five patients have been disease-free for six months to 3.5 years. (author). 15 refs., 1 tab

  11. Proton therapy of uveal melanomas in Berlin. 5 years of experience at the Hahn-Meitner Institute

    International Nuclear Information System (INIS)

    Background and purpose: in June 1998, proton-beam therapy of ocular tumors started at the Hahn-Meitner Institute Berlin, Germany. The purpose of the present study is to evaluate treatment outcome for uveal melanomas. Patients and methods: 245 consecutive patients with primary melanoma of the uvea were treated from June 1998 to April 2003 with a 68-MeV proton beam. In 96.2% of all patients, a uniform fractionation scheme was applied: single dose 15 CGE (cobalt gray equivalent), total dose 60 CGE on 4 consecutive days. Follow-up is available in 229 patients. Results: at the time of median follow-up (18.4 months), local control is 96.4% and 95.5% at 3 years. Eye retention rate is 92.6% at 20 months (median follow-up) and 87.5% at 3 years. Conclusion: proton-beam irradiation of uveal melanomas at the Hahn-Meitner Institute after the first 5 years of its initiation reveals local tumor control and eye retention rates in the range of other centers with larger experience. Delivering high treatment quality in hadron therapy from the beginning has been achieved. (orig.)

  12. Curriculum development for an advanced regional anesthesia education program: one institution's experience from apprenticeship to comprehensive teaching.

    Science.gov (United States)

    Ouanes, Jean-Pierre P; Schwengel, Deborah; Mathur, Vineesh; Ahmed, Omar I; Hanna, Marie N

    2014-02-01

    Results of recent attitude survey studies suggest that most practicing physicians are inadequately treating postoperative pain. Residents in anesthesia are confident in performing lumbar epidural and spinal anesthesia, but many are not confident in performing the blocks with which they have the least exposure. Changes need to be made in the training processes to a comprehensive model that prepares residents to perform a wider array of blocks in postgraduate practice. Here, we describe one institution's approach to creating a standardized, advanced regional anesthesia curriculum for residents that follows the six core competencies of the ACGME. Residents received training in anatomy dissection, ultrasound-guided regional anesthesia, traditional nerve stimulation techniques, problem-based learning and simulation sessions, oral board presentation sessions, and journal club sessions. Residents kept a detailed log for their use of peripheral nerve block procedures. We have now redesigned and implemented an advanced regional anesthesia program within our institution to provide residents with experience in regional anesthesia at a competent level. Resident's knowledge in regional anesthesia did improve after the first year of implementation as reflected in improvements between the pre- and post-tests. As the advanced regional anesthesia education program continues to improve, we hope to demonstrate levels of validity, reliability, and usability by other programs. PMID:25007696

  13. PUVA treatment of alopecia areata partialis, totalis and universalis: audit of 10 years' experience at St John's Institute of Dermatology

    International Nuclear Information System (INIS)

    Our 10-year experience with PUVA treatment for alopecia areata, partialis, totalis and universalis was retrospectively reviewed using charts and follow-up questionnaires for 70 patients at St John's Institute of Dermatology. In all cases, several previous therapies were judged to be unsatisfactory prior to starting PUVA, and many cases were already deemed clinically refractory prior to referral for PUVA. If cases of vellus hair growth are excluded, and those who lost their PUVA-induced regrowth rapidly on follow-up, the effective success rate was at best 6.3% for alopecia areata partialis, 12.5% for alopecia areata totalis and 13.3% for alopecia areata universalis. We affirm that PUVA is generally not an effective treatment for alopecia areata. (Author)

  14. St. Joseph's Hospital Barrow Neurological Institute stereitatic radiotherapy experience comparison of Gamma Knife and CyberKnife

    International Nuclear Information System (INIS)

    The clinical utilisation stereotactic radiotherapy continues to increase in breadth and scope within the medical community. However, no single standard treatment platform exists for the delivery of stereotactic radiotherapy treatments. This is because although there are several commercially available platforms capable of delivering stereotactic radiotherapy treatments, each platform has unique abilities and limitations. The most widely used stereotactic radiotherapy system for intracranial treatments is the Gamma Knife. The first image guided robotic stereotactic radiotherapy system enabling body stereotactic radiotherapy is the CyberKnife. Both are available at the Barrow Neurological Institute. We describe our experience with the complementary use of these two distinct treatment platforms. This permits us to make a meaningful comparison and to detail their contrasting advantages and disadvantages for state of the art for stereotactic radiotherapy. (author)

  15. The predictive value of serum squamous cell carcinoma antigen in patients with cervical cancer who receive neoadjuvant chemotherapy followed by radical surgery: a single-institute study.

    Directory of Open Access Journals (Sweden)

    Xiong Li

    Full Text Available Neoadjuvant chemotherapy (NACT could affect the levels of squamous cell carcinoma antigen (SCC-Ag. This study evaluates the predictive value of pre- and posttreatment SCC-Ag levels in patients with cervical cancer who were treated with NACT followed by radical surgery.A total of 286 patients with Stage IB1-IIIB squamous cell carcinoma of the uterine cervix who were treated with NACT followed by radical hysterectomy were analyzed retrospectively. The relationship between SCC-Ag levels, the clinicopathologic parameters, the response to NACT and the three-year survival rate was investigated.The levels of SCC-Ag were elevated (>3.5 ng/mL in 43.8% of patients before NACT, and 13.0% of patients after NACT. Pre- and posttreatment levels of SCC-Ag correlated with the response to NACT (P = 0.010, and P3.5 ng/mL (P3.5 ng/mL indicated a poor response to NACT and a higher risk of lymph node metastases. Elevated posttreatment levels of SCC-Ag were correlated with poor DFS and OS.

  16. Predictive factors for response and prognostic factors for long-term survival in consecutive, single institution patients with locally advanced and/or metastatic transitional cell carcinoma following cisplatin-based chemotherapy

    DEFF Research Database (Denmark)

    Jessen, Christian; Agerbaek, Mads; Von Der Maase, Hans

    2009-01-01

    PURPOSE: The study was undertaken to identify pre-treatment clinical and histopathological factors of importance for response and survival after cisplatin-based combination chemotherapy, in patients with locally advanced or metastatic transitional cell carcinoma of the urothelium. PATIENTS AND...... METHODS: Clinical, laboratory and histopathological data from 178 consecutive patients, representing all patients treated between 1991 and 2001 in a single institution, were collected. Correlations between these data and response and survival after chemotherapy were analysed using univariate and...... multivariate analyses. RESULTS: Absence of visceral metastasis was the only parameter with independent correlation to the response to chemotherapy. Two of the analysed parameters were independently associated with increased survival: good performance status (PS< or =1) and absence of visceral metastases...

  17. Exploring the experiences of female students in introductory project-based engineering courses at two- and four-year institutions

    Science.gov (United States)

    Swan, Amy K.

    2011-12-01

    This qualitative study explored the experiential and contextual factors that shaped female students' pathways into introductory project-based engineering classes at two community colleges and one four-year institution, as well as female students' experiences within and outside of these classes. The study was framed by Social Cognitive Career Theory (SCCT) (Lent, Brown & Hackett, 1996) and Bronfenbrenner's (1979) ecological systems theory. Findings were based on analyses of data gathered through multiple methods: observations; individual interviews with female students; focus group interviews with project teams; and document collection. The findings of this study revealed that while positive experiences with math or science were a likely pre-cursor to engineering interest, experiential learning appeared to be a more powerful force in fostering students' engineering interest. Specifically, participants developed an interest in engineering through academic, professional, and extracurricular engineering- and design-related activities that familiarized them with the tasks and skills involved in engineering work and helped them develop a sense of selfefficacy with regard to this work. Interest and self-efficacy, in turn, played a role in students' postsecondary educational decision-making processes, as did contextual factors including families and finances. This study's findings also showed that participants' project teams were a critically important microsystem within participants' ecological environments. Within this sometimes "chilly" microsystem, female students negotiated intrateam processes, which were in some cases affected by gender norms. Intrateam processes that influenced female students' project-based learning experiences included: interpersonal dynamics; leadership; and division of labor. This study also identified several ways in which the lived experiences of participants at the community colleges were different from, or similar to, those of participants

  18. Radiotherapy of anal carcinomas

    International Nuclear Information System (INIS)

    Report is given on radiotherapy of anal carcinomas. Own experiences and a review of the recent literature are presented. Prior to surgery radiotherapy with high energy electrons in combination with chemotherapy is in the foreground. Especially in cloacogenous carcinoma no residual tumor was found after preliminary irradiation. Our recommended conception of post-operative radiotherapy of the regional lymphatic draining vessels is outlined. (orig./MG)

  19. Primary signet ring cell carcinoma of the appendix: A rare case report and our 18-year experience

    Institute of Scientific and Technical Information of China (English)

    Yoon Ho Ko; Young Seon Hong; Chan-Kwon Jung; Soon Nam Oh; Tae Hee Kim; Hye Sung Won; Jin Hyoung Kang; Hyung Jin Kim; Won Kyung Kang; Seong Taek Oh

    2008-01-01

    Primary adenocarcinoma of the appendix is a rare malignancy that constitutes < 0.5% of all gastrointestinal neoplasms.Moreover,primary signet ring cell carcinoma of the appendix is an exceedingly rare entity.We have encountered 15 cases of primary appendiceal cancer among 3389 patients who underwent appendectomy over the past 18 years.In the present report,we describe a rare case of primary signet ring cell carcinoma of the appendix with ovarian metastases and unresectable peritoneal dissemination occurring in a 67-year-old female patient.She underwent appendectomy and bilateral salpingo-oophorectomy with a laparoscopy procedure.She then received palliative systemic chemotherapy with 12 cycles of oxaliplatin,5-flurorouracil,and leucovorin (FOLFOX-4).The patient currently is well without progression of disease 12 mo after beginning chemotherapy.

  20. The Experience of a Distance Learning Organization in a Private Higher Educational Institution in the Republic of Tatarastan (Russia): From Idea to Realization

    Science.gov (United States)

    Akhmetova, Daniya; Vorontsova, Liliya; Morozova, Ilona Gennadyevna

    2013-01-01

    The article is devoted to the unique experience of distance learning development in the conditions of Russian reality. The model of distance learning in the Institute of Economics, Management and Law (Kazan city, Russia) is created on the basis of educational sphere diagnosis taking into account foreign and Russian experience. The specificity of…

  1. Superselective intra-arterial infusion of high-dose cisplatin combined with radiation therapy for head and neck carcinoma. Experience of Yamagata University Hospital

    International Nuclear Information System (INIS)

    Local effectiveness and complication of superselective intra-arterial infusion of high-dose cisdiamminedichloroplatinum (CDDP) (SIC) combined with radiation therapy (RT) were investigated. Between 1998 and 2000, 18 head and neck carcinomas including 10 maxillary carcinomas (T3; 1, T4; 9), 3 oral cavity carcinomas (T2; 1, T4; 2), and 5 oropharyngeal carcinomas (T2; 2, T4; 3) were treated with SIC and RT with or without surgery. CDDP of 100-150 mg/body was administered weekly in principle for 2-9 weeks (mean: 4.9) with the simultaneous administration of sodium thiosulfate. Radiation doses ranged from 40 Gy to 70 Gy (mean: 56.8 Gy). Complete response was obtained in 7 of 10 maxillary carcinomas, 2 of 3 oral-cavity carcinomas, and 2 of 5 oropharyngeal carcinomas, respectively. When surgical intervention was performed if necessary, 2-year local control rates for maxillary carcinoma, and other carcinoma including oral-cavity carcinoma and oropharyngeal carcinoma were 80% and 63% respectively. Two-year local control rates for T4 maxillary carcinoma, and other T4 carcinoma including oral-cavity carcinoma and oropharyngeal carcinoma were 78% and 40% respectively. Two-year overall survival rates for all cases, maxillary carcinoma, and oral-cavity/oropharyngeal carcinoma were 88%, 90% and 86% respectively. All local recurrences occurred within 6 months from the initiation of treatment. The systemic toxicity of weekly SIC was comparatively mild; however, a total CDDP dose of 1,000 mg or more and/or RT of 70 Gy induced complications of local soft tissue such as mucosal ulcer and fistula. SIC combined with RT is useful to improve the local control/survival rates and to avoid the aggressive surgery for locally advanced head and neck carcinoma. A high total dose of CDDP and/or RT of a comparatively high dose may be risk factors for local soft tissue complications. (author)

  2. Tratamento com radio e quimioterapia do carcinoma epidermóide do canal anal: experiência do hospital Barão de Lucena Radiochemotherapy for squamous cell carcinoma of the anal canal: Barao de Lucena hospital experience

    Directory of Open Access Journals (Sweden)

    Maurilio Toscano de Lucena

    2010-06-01

    Full Text Available Objetivos: Apresentar os resultados e analisar as variáveis implicadas no tratamento e prognóstico do carcinoma epidermóide do canal anal tratado através da radio e quimioterapia no Hospital Barão de Lucena-SUS-PE. Metodologia: Análise dos prontuários de pacientes com diagnóstico de câncer do canal anal submetidos a tratamento radioquimioterápico. O período de acompanhamento foi de junho de 1989 a junho de 2005. Foram incluídos os pacientes com diagnóstico histológico de câncer de canal anal, enquadrados nos estadios I, II, IIIa e IIIb, submetidos a dois ciclos de quimioterapia com 5-fluorouracil (5-FU na dose de 1g/m²/dia em infusão contínua de 96 horas e cisplatino na dose de 100mg/m² administrado em 6 horas no segundo dia de infusão de cada ciclo, administrados na primeira e terceira semanas do esquema de tratamento radioterápico. Resultados: Avaliamos 108 prontuários de pacientes que preencheram os critérios do protocolo. O tempo médio de seguimento foi de 51 meses (1-182 meses. Houve predomínio do gênero feminino (81,5% dos pacientes. A idade variou de 33 a 83 anos (média de 59 anos. O tipo histológico mais freqüente foi o carcinoma de células escamosas (80,6% dos casos. Em 21 pacientes, foi diagnosticado carcinoma basalóide. Quanto ao grau de diferenciação, prevaleceu o tipo moderadamente diferenciado (61% dos pacientes com carcinoma de células escamosas. O índice de resposta inicial completa foi de 89,8%. Onze pacientes persistiram com tumor após o tratamento radio e quimioterápico. O índice de resposta inicial completa foi menor nos estadios IIIa e IIIb em relação aos estadios I e II com significância estatística (pObjectives: To present the results and analyze the variables involved in the treatment and prognosis of squamous cell carcinoma of the anal canal treated by radiotherapy and chemotherapy at the Hospital Barao de Lucena-SUS-PE. Methodology: Analysis of medical records of patients

  3. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  4. Engaging Students and Teachers in Immersive Learning Experiences Alongside NASA Scientists and With Support from Institutional Partnerships

    Science.gov (United States)

    Jones, A. P.; Bleacher, L.; Glotch, T. D.; Heldmann, J. L.; Bleacher, J. E.; Young, K. E.; Selvin, B.; Firstman, R.; Lim, D. S. S.; Johnson, S. S.; Kobs-Nawotniak, S. E.; Hughes, S. S.

    2015-12-01

    The Remote, In Situ, and Synchrotron Studies for Science and Exploration (RIS4E) and Field Investigations to Enable Solar System Science and Exploration (FINESSE) teams of NASA's Solar System Exploration Research Virtual Institute conduct research that will help us more safely and effectively explore the Moon, Near Earth Asteroids, and the moons of Mars. These teams are committed to making their scientific research accessible and to using their research as a lens through which students and teachers can better understand the process of science. In partnership with the Alan Alda Center for Communicating Science at Stony Brook University, in spring of 2015 the RIS4E team offered a semester-long course on science journalism that culminated in a 10-day reporting trip to document scientific fieldwork in action during the 2015 RIS4E field campaign on the Big Island of Hawaii. Their work is showcased on ReportingRIS4E.com. The RIS4E science journalism course is helping to prepare the next generation of science journalists to accurately represent scientific research in a way that is appealing and understandable to the public. It will be repeated in 2017. Students and teachers who participate in FINESSE Spaceward Bound, a program offered in collaboration with the Idaho Space Grant Consortium, conduct science and exploration research in Craters of the Moon National Monument and Preserve. Side-by-side with NASA researchers, they hike through lava flows, operate field instruments, participate in science discussions, and contribute to scientific publications. Teachers learn about FINESSE science in the field, and bring it back to their classrooms with support from educational activities and resources. The second season of FINESSE Spaceward Bound is underway in 2015. We will provide more information about the RIS4E and FINESSE education programs and discuss the power of integrating educational programs within scientific programs, the strength institutional partnerships can

  5. Exploring the Academic and Social Experiences of Latino Engineering Community College Transfer Students at a 4-Year Institution: A Qualitative Research Study

    Science.gov (United States)

    Hagler, LaTesha R.

    As the number of historically underrepresented populations transfer from community college to university to pursue baccalaureate degrees in science, technology, engineering, and mathematics (STEM), little research exists about the challenges and successes Latino students experience as they transition from 2-year colleges to 4-year universities. Thus, institutions of higher education have limited insight to inform their policies, practices, and strategic planning in developing effective sources of support, services, and programs for underrepresented students in STEM disciplines. This qualitative research study explored the academic and social experiences of 14 Latino engineering community college transfer students at one university. Specifically, this study examined the lived experiences of minority community college transfer students' transition into and persistence at a 4-year institution. The conceptual framework applied to this study was Schlossberg's Transition Theory, which analyzed the participant's social and academic experiences that led to their successful transition from community college to university. Three themes emerged from the narrative data analysis: (a) Academic Experiences, (b) Social Experiences, and (c) Sources of Support. The findings indicate that engineering community college transfer students experience many challenges in their transition into and persistence at 4-year institutions. Some of the challenges include lack of academic preparedness, environmental challenges, lack of time management skills and faculty serving the role as institutional agents.

  6. Experience with combination of nimotuzumab and intensity-modulated radiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Zhai RP

    2015-11-01

    Full Text Available Rui-ping Zhai, Hong-mei Ying, Fang-fang Kong, Cheng-run Du, Shuang Huang, Jun-jun Zhou, Chao-su Hu Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China Aim: To evaluate the efficacy and safety of using nimotuzumab in combination with intensity-modulated radiotherapy (IMRT in the primary treatment of locoregionally advanced nasopharyngeal carcinoma.Methods: Between December 2009 and December 2013, 38 newly diagnosed patients with stage III–IV nasopharyngeal carcinoma were treated with IMRT and nimotuzumab concomitantly. The distribution of disease was stage III in 20 (52.6%, stage IV A in 9 (23.7%, and stage IV B in 9 (23.7%. All the patients received at least two cycles of cisplatin-based neoadjuvant chemotherapy followed by nimotuzumab 200 mg/week concurrently with IMRT. Acute and late radiation-related toxicities were graded according to the Acute and Late Radiation Morbidity Scoring Criteria of Radiation Therapy Oncology Group.Results: With a median follow-up of 39.7 months (range, 13.3–66.5 months, the estimated 3-year local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, progression failure-free survival, and overall survival rates were 92.8%, 92.9%, 89.5%, 78.7%, and 87.5%, respectively. The median cycle for nimotuzumab addition was 6 weeks. Grade 3 radiation-induced mucositis accounted for 36.8% of treated people. No skin rash and infusion reaction were observed, distinctly from what is reported in cetuximab-treated patients.Conclusion: Nimotuzumab plus IMRT showed promising outcomes in terms of locoregional control and survival, without increasing the incidence of radiation-related toxicities for patients. Keywords: nasopharyngeal carcinoma, intensity-modulated radiotherapy, nimotuzumab

  7. Experience in immunoscintigraphy with 131I-labelled OC-125 F(ab')2 in patients with ovarian carcinoma

    International Nuclear Information System (INIS)

    In the specialized postoperative follow-up of patients with epithelial ovarian carcinoma, radioimmunoscintigraphy could usefully complete computed tomography and ultrasound results. Restrictions concerning the use of 131I labelled antibody fragments result, however, from radiation dosimetry and protection aspects: Although not more than 140 MBq of the 131I agent is administered because of the high thyroid and whole-body radiation exposure, for some days substantial excretion of 131I into urine occurs. This prevents us drastically from applying the method to the same extent as recommended in the literature. These limitations are expected to be overcome with 99mTc or 111In antibodies. (author)

  8. Visualization of human colon carcinoma with 131I-antibodies to β1MA colonic antigen in experiment

    International Nuclear Information System (INIS)

    131I-antibodies to human β1 colonic antigen was administrated i.v. to nude mice with transplanted human colon carcinoma. Injections were followed by mouse whole-body investigation with the help of a gamma-camera and scanner. The distribution of radioactivity in murine tissues was investigated with a gamma-counter. Sharp images of tumor were obtained with the help of the gamma-camera and scanner. The results of visualization were in accord with radioimmunometric data. A conclusion was made of effective visualization of human colon carcinima transplanted to nude mice using iodinated antibodies to specific β1MA epithelial colonic antigen

  9. Needle Tract Implantation after Percutaneous Interventional Procedures in Hepatocellular Carcinomas: Lessons Learned from a 10-year Experience

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Sam Uel; Kim, S. H.; Lim, H. K.; Kim, S. H.; Lee, W. J.; Choi, D. I.; Kim, Y. S.; Rhim, H. C. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2008-06-15

    Percutaneous interventional procedures under image guidance, such as biopsy, ethanol injection therapy, and radiofrequency ablation play important roles in the management of hepatocellular carcinomas. Although uncommon, the procedures may result in tumor implantation along the needle tract, which is a major delayed complication. Implanted tumors usually appear as one or a few, round or oval-shaped, enhancing nodules along the needle tract on CT, from the intraperitoneum through the intercostal or abdominal muscles to the subcutaneous or cutaneous tissues. Radiologists should understand the mechanisms and risk factors of needle tract implantation, minimize this complication, and also pay attention to the presence of implanted tumors along the needle tract during follow-up.

  10. Underrepresented Racial/Ethnic Minority Graduate Students in Science, Technology, Engineering, and Math (STEM) Disciplines: A Cross Institutional Analysis of their Experiences

    OpenAIRE

    Figueroa, Tanya

    2015-01-01

    Considering the importance of a diverse science, technology, engineering, and math (STEM) research workforce for our country’s future, it is troubling that many underrepresented racial minority (URM) students start graduate STEM programs, but do not finish. However, some institutional contexts better position students for degree completion than others. The purpose of this study was to uncover the academic and social experiences, power dynamics, and programmatic/institutional structures URM st...

  11. Parotid carcinoma

    DEFF Research Database (Denmark)

    Sørensen, Kristine Bjørndal; Godballe, Christian; de Stricker, Karin;

    2006-01-01

    OBJECTIVES: Our aim is to investigate the expression of kit protein (KIT) and epidermal growth factor receptor (EGFR) in parotid carcinomas in order to correlate the expression to histology and prognosis. Further we want to perform mutation analysis of KIT-positive adenoid cystic carcinomas....... PATIENTS AND METHODS: Formalin-fixed paraffin-embedded sections from 73 patients with parotid gland carcinomas were used for the study. The sections were stained with both KIT and EGFR polyclonal antibodies. Twelve KIT-positive adenoid cystic carcinomas were examined for c-kit mutation in codon 816....... RESULTS: Of all carcinomas 25% were KIT-positive and 79% were EGFR-positive. Ninety-two percentage of the adenoid cystic carcinomas were KIT-positive. None of the adenoid cystic carcinomas had mutations in codon 816 of the c-kit gene. CONCLUSION: Neither KIT- nor EGFR-expression seem to harbour...

  12. Clinical experience with radiolabelled monoclonal antibodies in the detection of colorectal and ovarian carcinoma recurrence and review of the literature.

    Science.gov (United States)

    Pinkas, L; Robins, P D; Forstrom, L A; Mahoney, D W; Mullan, B P

    1999-08-01

    A retrospective study was carried out to determine the diagnostic value of OncoScint CR/OV immunoscintigraphy in assessing patients with suspected recurrence of carcinoma of the colon and ovary. The scintigraphic results of 31 patients were compared with surgical and histopathological findings, conventional radiological examinations and clinical disease outcome over an average 3-year follow-up. Detected lesions were divided by location into hepatic or extrahepatic and the latter group was classified as local recurrence at the resection site, pelvic or abdominal regional lymph node involvement and distant metastatic disease. The combined sensitivity and accuracy of immunoscintigraphy in the detection of extra-hepatic disease was significantly higher than that of cross-sectional radiological imaging (87% and 83% vs 44% and 53% respectively) with equal specificity of 74%. Scintigraphy identified 14 (36%) of 39 extra-hepatic malignant lesions not diagnosed by conventional radiological techniques and influenced therapeutic planning in 8 (26%) of 31 patients studied. In the liver, conventional imaging had a significantly higher detection rate than immunoscintigraphy (sensitivity 93% vs 28%). In conclusion, these results show that OncoScint scintigraphy is a sensitive method for the detection of local recurrence and extra-hepatic metastases in colorectal and ovarian carcinoma and has an important role in the therapeutic decision-making process. PMID:10451876

  13. Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979)

    International Nuclear Information System (INIS)

    From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (NO), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4 T3) developed local recurrences. Three patients developed post-therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which required surgical treatment in three of the cases. Twenty-one percent of the patients died of their disease. The authors advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does no exceed 4 cm. When regular follow-up can be assurred, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis

  14. Analysis of bone metastasis in head and neck squamous cell carcinoma: Experience of a regional cancer center

    Directory of Open Access Journals (Sweden)

    Akhil Kapoor

    2015-01-01

    Full Text Available Background: Bone metastasis is a rare occurrence in head and neck squamous cell carcinoma (HNSCC. This retrospective study was performed to analyze the frequency and patterns of skeletal metastasis in HNSCC. Materials and Methods : We analyzed records of 8326 HNSCC patients attending our oncology outpatient department from January 2000 to December 2013. All statistical calculations were performed using MedCalc software for windows, version 12.5.0 (Osterd, Belgium. Results : Bone metastasis was found in 25 patients (0.3% of total HNSCC patients, nasopharynx excluded. 10 patients (0.66% of carcinoma tonsil had skeletal metastasis. The patients of younger age groups had higher frequency of bone metastasis; 1.56% patients of age group 20-29 years while 0.26% patients of 60-69 years age group had skeletal metastasis (P 70 years age was found to have bone metastasis. Most common site of metastasis was spine (56% followed by pelvis (32%. Isolated involvement of a single bony site was present in 64% of the metastatic cases. Conclusion: Bone metastasis though very rare, should be considered for evaluation in patients of HNSCC especially in younger patients.

  15. Hepatic transplantation outcomes for carefully selected cirrhotic patients with hepatocellular carcinoma: experience at a small- to medium-volume centre.

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

    BACKGROUND: Hepatic transplantation outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) at a small- to medium-volume centre are not fully known due to relative novelty of patient selection criteria. AIM: To determine hepatic transplantation outcomes for HCC at a small- to medium-volume centre. Patients and methods Hepatocellular carcinoma patients were listed for transplantation according to the International Guideline and further categorized as those fulfilling or exceeding Milan or University of San Francisco (UCSF) criteria on explanted liver morphology. Outcomes including mortality, retransplantation, and tumour recurrence rate were analysed. RESULTS: Twenty-six patients had HCC and on explanted liver morphology, Milan and UCSF criteria met 15 and 18 patients, respectively. Patients and graft survival at 3 months, 1 and 5 years were 100, 96, 84, and 88, 84, 77%, respectively. Outcomes favoured Milan criteria but did not reach statistical significance. CONCLUSIONS: Hepatic transplantation for HCC at a small-to medium-volume transplant centre had comparable survival outcomes to high-volume centres.

  16. Risk-factors and strategies for control of carcinoma cervix in India: Hospital based cytological screening experience of 35 years

    Directory of Open Access Journals (Sweden)

    J S Misra

    2009-01-01

    Full Text Available Purpose: Role of risk factors in cervical carcinogenesis and strategies for control of the disease have been assessed from the accumulated cytological data, derived from 35 years of hospital-based screening in Lucknow, North India. Materials and Methods: A total of 36,484 women have been cytologically screened during a span of 35 years (April 1971 - June 2005 in the Gynaecology out patient department (OPD of Queen Mary′s Hospital. Results: The frequency of Squamous Intraepithelial Lesion (SIL and carcinoma was found to be 7.2% and 0.6%, respectively, in the present study. The study revealed high age and parity as a predominant factor in cervical carcinogenesis, while viral sexually transmitted disease (STDs -human papilloma virus (HPV and Herpes simplex virus (HSV were also largely associated with SIL cases. The study emphasized great value of clinically downstaging the cervical cancer by detecting cervical cancer in the early stage. The study also revealed a significant difference in the frequency of SIL in symptomatic and asymptomatic women. Conclusion: Based on the analyzed data, it was felt that single lifetime screening, which appears to be the most feasible and affordable mode for control of carcinoma cervix in developing countries like India, should be carried out in all women of high parity irrespective of age (with three or more children and in older women above the age of 40 years irrespective of parity.

  17. All-Russia Thermal Engineering Institute experience in using difficult to burn fuels in the power industry

    Science.gov (United States)

    Tugov, A. N.; Ryabov, G. A.; Shtegman, A. V.; Ryzhii, I. A.; Litun, D. S.

    2016-07-01

    This article presents the results of the research carried out at the All-Russia Thermal Engineering Institute (VTI) aimed at using saline coal, municipal solid waste and bark waste, sunflower husk, and nesting/ manure materials from poultry farms. The results of saline coal burning experience in Troitsk and Verkhny Tagil thermal power plants (TPP) show that when switching the boiler to this coal, it is necessary to take into account its operating reliability and environmental safety. Due to increased chlorine content in saline coal, the concentration of hydrogen chloride can make over 500 mg/m3. That this very fact causes the sharp increase of acidity in sludge and the resulting damage of hydraulic ash removal system equipment at these power stations has been proven. High concentration of HCl can trigger damage of the steam superheater due to high-temperature corrosion and result in a danger of low-temperature corrosion of air heating surfaces. Besides, increased HCl emissions worsen the environmental characteristics of the boiler operation on the whole. The data on waste-to-energy research for municipal solid waste (MSW) has been generalized. Based on the results of mastering various technologies of MSW thermal processing at special plants nos. 2 and 4 in Moscow, as well as laboratory, bench, and industrial studies, the principal technical solutions to be implemented in the modern domestic thermal power plant with the installed capacity of 24 MW and MSW as the primary fuel type has been developed. The experience of the VTI in burning various kinds of organic waste—bark waste, sunflower husk, and nesting/manure materials from poultry farms—has been analyzed.

  18. Graduate Medical Education as a Lever for Collaborative Change: One Institution's Experience with a Campuswide Patient Safety Initiative

    Science.gov (United States)

    Vath, Richard J.; Musso, Mandi W.; Rabalais, Lauren S.; Dunbar, Alston; Hosea, Stephen; Johnson, Angela C.; Bolton, Michael; Rhynes, Vernon K.; Caffery, Terrell S.; Tynes, L. Lee; Mantzor, Savarra; Miller, Bahnsen; Calongne, Laurinda L.

    2016-01-01

    Background: The 2013 closure of a public hospital in Baton Rouge, LA transformed graduate medical education (GME) at Our Lady of the Lake Regional Medical Center (OLOL). Administrators were tasked with incorporating residents into patient safety and quality improvement initiatives to fulfill regulatory obligations. This report outlines our experiences as we built these patient safety and quality improvement initiatives in a rapidly expanding independent academic medical center. Methods: We joined the Alliance of Independent Academic Medical Centers (AIAMC) to meet and learn from national peers. To fulfill the scholarly activity requirement of the AIAMC's National Initiative IV, we formed a multidisciplinary team to develop a patient safety education project. Prioritized monthly team meetings allowed for project successes to be celebrated and circulated within the organization. Results: The public-private partnership that more than quadrupled the historic size of GME at OLOL has, in the past 2 years, led to the development of an interdisciplinary team. This team has expanded to accommodate residency program leadership from across the campus. Our National Initiative IV project won a national award and inspired several follow-up initiatives. In addition, this work led to the formation of a Patient Safety and Clinical Quality Improvement fellowship that matched its first fellow in 2015. Conclusion: Through the commitment and support of hospital and medical education leaders, as well as a focus on promoting cultural change through scholarly activity, we were able to greatly expand patient safety and quality improvement efforts in our institution. PMID:27046411

  19. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

    Science.gov (United States)

    Dakkuri, Adnan; Abrons, Jeanine P.; Williams, Dennis; Ombengi, David N.; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O’Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-01-01

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

  20. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

    Science.gov (United States)

    Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-04-25

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

  1. ONE STEP NUCLEIC ACID AMPLIFICATION IN BREAST CANCER SENTINEL LYMPH NODE.A SINGLE INSTITUTIONAL EXPERIENCE AND A SHORT REVIEW.

    Directory of Open Access Journals (Sweden)

    Tatiana eBrambilla

    2015-06-01

    Full Text Available Sentinel lymph node (SLN examination is a standard in breast cancer patients, with several methods employed along its 20-years history, the last one represented by OSNA. The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3-years experience with OSNA (1122 patients showed results overlapping those recorded in the same Institution with a morphological evaluation (930 patients of SLN. In detail the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30% and micrometastatic/macrometastatic involvement of SLN (respectively 38-45% and 62-55%. By contrast when OSNA was compared to the standard intra-operatory procedure it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid and reproducible for intra-operative evaluation of SLN.Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metatastis and molecular bio-banking.

  2. Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution

    Directory of Open Access Journals (Sweden)

    Gustavo Machado Badan

    2016-02-01

    Full Text Available Abstract Objective: To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB and vacuum-assisted biopsies (VABB of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH or ductal carcinoma in situ (DCIS subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. Materials and Methods: Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations. Results: The underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%. Conclusion: The diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation.

  3. Hepatic Arterial Therapy with Drug-Eluting Beads in the Management of Metastatic Pancreatic Carcinoma to the Liver: A Multi-Institutional Registry

    OpenAIRE

    Raffi Kotoyan; Tiffany Metzger; Cliff Tatum; Ken Robbins; Martin, Robert C.G.

    2012-01-01

    Introduction. There has been limited reporting on the use of hepatic-directed therapy in liver dominant hepatic metastases arising from pancreatic cancer. Methods. An IRB-approved prospective multi-institutional treatment registry of 885 patients undergoing 1458 treatments for primary or secondary cancers in the liver was evaluated from January 2007 to January 2011. Results. Ten patients underwent a total of 17 treatment sessions with drug-eluting beads (DEBs). Six patients received concurren...

  4. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas?

    Energy Technology Data Exchange (ETDEWEB)

    Flynt, Kelsey A.; Dillman, Jonathan R.; Smith, Ethan A.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Davenport, Matthew S.; Caoili, Elaine M. [University of Michigan Health System, Division of Abdominal Imaging, Department of Radiology, Ann Arbor, MI (United States); Else, Tobias [University of Michigan Health System, Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Ann Arbor, MI (United States)

    2015-08-15

    There is a paucity of literature describing and comparing the imaging features of adrenocortical adenomas and carcinomas in children and adolescents. To document the CT and MRI features of adrenocortical neoplasms in a pediatric population and to determine whether imaging findings (other than metastatic disease) can distinguish adenomas from carcinomas. We searched institutional medical records to identify pediatric patients with adrenocortical neoplasms. Pre-treatment CT and MRI examinations were reviewed by two radiologists in consensus, and pertinent imaging findings were documented. We also recorded relevant histopathological, demographic, clinical follow-up and survival data. We used the Student's t-test and Wilcoxon rank sum test to compare parametric and nonparametric continuous data, and the Fisher exact test to compare proportions. We used receiver operating characteristic (ROC) curve analyses to evaluate the diagnostic performances of tumor diameter and volume for discriminating carcinoma from adenoma. A P-value ≤0.05 was considered statistically significant. Among the adrenocortical lesions, 9 were adenomas, 15 were carcinomas, and 1 was of uncertain malignant potential. There were no differences in mean age, gender or sidedness between adenomas and carcinomas. Carcinomas were significantly larger than adenomas based on mean estimated volume (581 ml, range 16-2,101 vs. 54 ml, range 3-197 ml; P-value = 0.003; ROC area under the curve = 0.92) and mean maximum transverse plane diameter (9.9 cm, range 3.0-14.9 vs. 4.4 cm, range 1.9-8.2 cm; P-value = 0.0001; ROC area under the curve = 0.92). Carcinomas also were more heterogeneous than adenomas on post-contrast imaging (13/14 vs. 2/9; odds ratio [OR] = 45.5; P-value = 0.001). Six of 13 carcinomas and 1 of 8 adenomas contained calcification at CT (OR = 6.0; P-value = 0.17). Seven of 15 children with carcinomas exhibited metastatic disease at diagnosis, and three had inferior vena cava invasion. Median

  5. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas?

    International Nuclear Information System (INIS)

    There is a paucity of literature describing and comparing the imaging features of adrenocortical adenomas and carcinomas in children and adolescents. To document the CT and MRI features of adrenocortical neoplasms in a pediatric population and to determine whether imaging findings (other than metastatic disease) can distinguish adenomas from carcinomas. We searched institutional medical records to identify pediatric patients with adrenocortical neoplasms. Pre-treatment CT and MRI examinations were reviewed by two radiologists in consensus, and pertinent imaging findings were documented. We also recorded relevant histopathological, demographic, clinical follow-up and survival data. We used the Student's t-test and Wilcoxon rank sum test to compare parametric and nonparametric continuous data, and the Fisher exact test to compare proportions. We used receiver operating characteristic (ROC) curve analyses to evaluate the diagnostic performances of tumor diameter and volume for discriminating carcinoma from adenoma. A P-value ≤0.05 was considered statistically significant. Among the adrenocortical lesions, 9 were adenomas, 15 were carcinomas, and 1 was of uncertain malignant potential. There were no differences in mean age, gender or sidedness between adenomas and carcinomas. Carcinomas were significantly larger than adenomas based on mean estimated volume (581 ml, range 16-2,101 vs. 54 ml, range 3-197 ml; P-value = 0.003; ROC area under the curve = 0.92) and mean maximum transverse plane diameter (9.9 cm, range 3.0-14.9 vs. 4.4 cm, range 1.9-8.2 cm; P-value = 0.0001; ROC area under the curve = 0.92). Carcinomas also were more heterogeneous than adenomas on post-contrast imaging (13/14 vs. 2/9; odds ratio [OR] = 45.5; P-value = 0.001). Six of 13 carcinomas and 1 of 8 adenomas contained calcification at CT (OR = 6.0; P-value = 0.17). Seven of 15 children with carcinomas exhibited metastatic disease at diagnosis, and three had inferior vena cava invasion. Median

  6. Institutional versus Academic Discipline Measures of Student Experience: A Matter of Relative Validity. A Student Experience in the Research University (SERU) Project Research Paper. Research & Occasional Paper Series: CSHE.8.07

    Science.gov (United States)

    Chatman, Steve

    2007-01-01

    The University of California's census survey of undergraduates, UCUES [University of California Undergraduate Experience Survey], presents an opportunity to measure both disciplinary and institutional differences in students' academic experience. Results from nearly 60,000 responses (38% response rate) from the 2006 administration found greater…

  7. Evaluation of nephron sparing surgery for renal tumors: a single institution experience%肾脏肿瘤保留肾单位手术的评价:单一机构的经验

    Institute of Scientific and Technical Information of China (English)

    Hytham Abd-elkareem Ahmed; Abdelhamid Hussein Ezzat; Ismael Mourad

    2011-01-01

    Objective: The aim of the study was to report the experience of National Cancer Institute (NCI), Cairo University, Egypt, in managing various benign and malignant renal tumors with nephron sparing surgery (NSS), and to assess its safety and feasibility. Methods: Reviewing the literature for NSS, and records of patients who underwent NSS in the period from January 2000 to December 2009 at National Cancer Institute, Cairo University regarding the patient and tumor related characteristics, the indication for NSS, operative technique, postoperative complications, full histopathological data, and follow up results. Results: The total number of patients was 17. Mean age at surgery was 30.7 years (range 1.5-65 years). Five patients had bilateral tumors during surgery. The mean tumor size was 4.5 cm (range 1-9 cm). All patients had normal preoperative kidney functions. Seven patients had an absolute indication for NSS, 6 patients had a relative indication, and 4 patients had an elective indication. All the 5 patients with bilateral tumors underwent bilateral simultaneous surgery. Cold ischemia was used in 8 patients, 1 patient was exposed to warm ischemia, manual compression was used in 2 patients, and no vascular control was applied in 6 patients. Complications were encountered in 2 patients, one of them had urinary leakage which needed reoperation, and the other had subcutaneous hematoma which was treated conservatively. Histopathological analysis revealed Wilm's tumor (8 patients), angiomyolipoma (4 patients), renal cell carcinoma (4 patients), and hydatid cyst (1 patient). All patients had negative surgical margin. For patients with Wilm's tumor, the mean follow up was 21.4 months (range 0-94 months), 2 patients had local recurrence, and 1 patient had distant metastasis. For patients with RCC, the mean follow up was 15.3 months (5-33 months), no patients had local recurrence or distant metastasis. All patients had normal kidney functions during postoperative and follow

  8. Results of radical radiotherapy of oropharyngeal squamous cell carcinoma: experience at the clinical Puerta de Hierro (Spain)

    International Nuclear Information System (INIS)

    We have reviewed the records of 251 patients with oropharyngeal squamous cell carcinoma treated with radical radiotherapy at the Department of Radiation Oncology of Clinica Puerta de Hierro between 1964 and 1989. The 3-year actuarial local control probability was 85% for the 29 T1-staged patients, 59% for the 89 T2-staged patients, 45% for the 71 T3-staged patients, and 43% for the 62 T4-staged patients. The 3-year actuarial nodal control probability was 86% for the 103 NO-staged patients treated electively, 66% for the 42 N1-staged patients, 60% for the 77 N2-staged patients, and 51% for the 20 N3-staged patients. The actuarial adjusted survival was 68% for the 17 stage I patients, 69% for the 48 stage II patients, 34% for the 57 stage III patients, and 33% for the 129 stage IV patients. Author (50 refs.)

  9. Clinical experience of MRI in two dogs with muscle-invasive transitional cell carcinoma of the urinary bladder.

    Science.gov (United States)

    Lee, Kija; Choi, Sooyoung; Choi, Hojung; Lee, Youngwon

    2016-09-01

    This study described high-field magnetic resonance imaging (MRI) and computed tomography (CT) characteristics of muscle-invasive bladder transitional cell carcinoma (TCC) in two dogs. Ultrasonography revealed a urinary bladder mass with ambiguous result about invasion to the muscular layer. Contrast-enhanced CT showed that the bladder wall in which the mass was attached was more intensely enhanced than the normal bladder walls, supporting invasion to the muscular layer. The mass revealed an intermediate signal intensity with interruption of the hypointense muscular layer on T2-weighted MRI and showed greater enhancement compared with the normal bladder wall on postcontrast T1-weighted images. T2-weighted MRI, postcontrast T1-weighted MRI and contrast-enhanced dual-phasic CT were useful for evaluating muscle-invasive bladder TCC in dogs. PMID:27149892

  10. Impact of institutional experience on survival outcome of patients undergoing combined chemoradiation therapy for inoperable non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Purpose: Clinical experience of both physicians and institutions has been shown to significantly influence the outcome of patients. We conducted this retrospective cohort study to examine its impact on the outcome of patients undergoing combined chemoradiation therapy for the treatment of locally advanced inoperable non-small-cell lung cancer. Methods and Materials: We compared the clinical data from 239 patients who were enrolled in two consecutive Radiation Therapy Oncology Group (RTOG) trials (RTOG 91-06, RTOG 92-04) according to the number of patients enrolled from each institution in either trial alone or the two trials combined. Results: Overall, patients treated at the institutions that enrolled ≥5 patients survived longer than those treated at the institutions that enrolled <5 patients (median survival 20.5 vs. 13.4 months, p=0.0006) with a more than doubling of the 2- and 3-year survival rates (45% and 31% vs. 20% and 13%, respectively). Multivariate analyses confirmed that the number of patients enrolled from each institution was an important prognostic factor for the entire group (p=0.001) and also for RTOG 91-06 (p=0.05) and RTOG 92-04 (p=0.004) when the data were analyzed separately. Conclusion: Institutional experience has a significant impact on the survival outcome of patients undergoing combined chemoradiation therapy for inoperable non-small cell lung cancer

  11. Institutional Design and Utilization of Evaluation: A Contribution to a Theory of Evaluation Influence Based on Swiss Experience

    Science.gov (United States)

    Balthasar, Andreas

    2009-01-01

    Growing interest in the institutionalization of evaluation in the public administration raises the question as to which institutional arrangement offers optimal conditions for the utilization of evaluations. "Institutional arrangement" denotes the formal organization of processes and competencies, together with procedural rules, that are…

  12. Primary non-Hodgkin's lymphomas of the breast: 23 years of experience at the Colombian national cancer institute

    International Nuclear Information System (INIS)

    Primary non- Hodgkin's lymphomas of the breast (PNHLB) are an infrequent malignancy. In a review of the literature, in which six Latin American journals are included, approximately 450 cases have been reported during the past two decades. in this paper we present the experience of the national cancer institute of Colombia during the last 23 years. Objective: to carry out a retrospective analysis of the characteristics, natural history, prognostic factors, and outcome of patients with PNHLB at the NCI of Colombia. Methods: the medical histories of patients diagnosed with PNHLB between 1980 and 2003 were reviewed; likewise, the clinical characteristics, treatment protocols, and final outcomes were analyzed. Results: 25 patients were identified as PNHLB. The average follow-up was 57 months. The medium age was 58, ranging from 26 to 83. 84% had diffused large cell lymphoma. The Karnofsky index was over 80 in 92% of the patients. 72% received chop chemotherapy. Two patients received a combination without doxorubicin. 68% received combined chemo- and radiation therapy. Two patients refused therapy. Two patients died before receiving any type of treatment. CNS compromise was observed in 20% of patients during the evolution of their disease. The youngest patient, whose case deserves special comment, obtained a second complete remission with simple mastectomy, after having relapsed after conventional chemotherapy, radiotherapy, and autologous bone marrow transplant. No significant prognostic variables were found using the univariate analysis. Conclusions: a high rate of complete remission can be achieved by using combined treatment in patients with PNHLB. The medium overall survival was not reached after 71 months of follow-up. The most frequent relapse site was the CNS

  13. Understanding the Doctoral Experience of Asian International Students in the Science, Technology, Engineering, and Mathematics (STEM) Fields: An Exploration of One Institutional Context

    Science.gov (United States)

    Le, Tam; Gardner, Susan K.

    2010-01-01

    In this study, we explored the experience of Asian international doctoral students in the Science, Technology, Engineering, and Mathematics (STEM) fields at one research-extensive university. We found that Asian international doctoral students in the STEM fields at this institution were often isolated from their peers and faculty, faced an array…

  14. Web server of the Centre for Photonuclear Experiments Data of the Scientific Research Institute for Nuclear Physics, Moscow State University: Hypertext version of the nuclear physics database

    International Nuclear Information System (INIS)

    The nuclear databases which have been developed at the Centre for Photonuclear Experiments Data of the D.V. Skobel'tsyn Scientific Research Institute for Nuclear Physics, M.V. Lomonosov Moscow State University, and put on the Centre's web server, are presented. The possibilities for working with these databases on the Internet are described. (author)

  15. Water scarcity and institutional change: lessons in adaptive governance from the drought experience of Perth, Western Australia.

    Science.gov (United States)

    Bettini, Y; Brown, R; de Haan, F J

    2013-01-01

    Urban water systems will be increasingly challenged under future climates and global pressures. Meeting challenges by reconfiguring water systems to integrate supplies and deliver multifunctional uses is technically well described. Adjusting the institutions that frame the management of these systems is not well operationalized in practice or conceptualized in theory. This study seeks to address this gap through an institutional analysis of Perth, Australia, a city where drought crisis has put under pressure both management practices and the institutional setting that underlies them. The study found that while trusted practices moderated water scarcity, the stability of the institutional setting may not facilitate a shift toward adaptable institutional configurations suited to future conditions. The results identified three key ingredients for a flexible institutional setting: (i) feedbacks in the system through better information management, (ii) reflexive dialogue and strategic use of projects to generate greater learning opportunities, and (iii) policy level support for sector-wide collaboration through progressive agendas, incentives for innovation and capacity building in stakeholder and community engagement. Further, the results suggest that a deeper understanding of institutional dynamics is needed to enable adaptive governance. The paper provides an analytical framework for diagnosing how greater adaptive capacity might be mobilized through influencing these dynamics. PMID:23676383

  16. Basisquamous Carcinoma

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    Yesudian Devakar P

    1997-01-01

    Full Text Available A 50 year old woman presented with an ulceroproliferative mass in the value of 4 month duration. Biopsy of the lesion showed features of a basisquamous cell carcinoma. This is a rare tumour showing histopathological features of both basal cell and squamous cell carcinomas. The clinical, histopathological and histogenetic status of this tumour are discussed.

  17. The cytological diagnosis of nasopharyngeal carcinoma from exfoliated cells collected by suction method. An eight-year experience.

    Science.gov (United States)

    Hanji, D; Shujing, S; Shuwei, H; Gohao, L

    1983-08-01

    A specially designed metallic tube, which is connected to a suction-pump and passed through the oral cavity into the nasopharynx for collecting exfoliative cells by negative pressure suction, is recommended in the diagnosis of nasopharyngeal carcinoma (NPC). From the beginning of 1973 through October 1976, among 458 cases of NPC, 405 cases were cytologically positive (with a positive rate of 88.4 per cent), and 433 cases were biopsy positive (with a positive rate of 94.3 per cent). In 1977, from January to October, among 116 cases of NPC, 103 cases were cytologically positive (with a positive rate of 88.8 per cent), and 108 cases were biopsy positive (with a positive rate of 93.1 per cent). The cytopathological features of the exfoliative NPC cells were correlated with the histopathological types of NPC. The degree of lymphocytic infiltration among the cancer cells in smears was compared with that in biopsies. They coincided roughly with each other. It indicates that one might interpret the immunological lymphocytic reaction by the number and typing of lymphocytes in smears too. The authors conclude that this cytological method is fairly dependable, less traumatic to the mucosa, convenient, and easily managed. A large number of tumor cells can be collected. It can also reflect the histologic typing of cancer cells. It can be used as a routine procedure in the clinico-pathological diagnosis of NPC, as well as in a mass screening program. PMID:6350514

  18. Six Years of Experience in Photodynamic Therapy for Basal Cell Carcinoma: Results and Fluorescence Diagnosis from 191 Lesions

    Directory of Open Access Journals (Sweden)

    M. Fernández-Guarino

    2014-01-01

    Full Text Available Background. Photodynamic therapy (PDT has become a therapeutic option for basal cell carcinoma (BCC in the last decade. Objectives. To study the results and predictors of BCC response to treatment with PDT and to evaluate fluorescence diagnosis of BCC. Methods. A descriptive, retrospective, and observational study was carried out. Patients with biopsy-confirmed BCC who were treated with methyl aminolevulinate and red light according to standard treatment protocols (2 sessions separated by 2 weeks, 630 nm, 37 J/cm2, 8 minutes, Aktilite were selected. Response was scored as clinically complete and incomplete and the patients were followed up every three months. Results. Data from 191 BCC in 181 patients with a mean age of 69.55 years and a mean follow-up period of 34.4 months were collected. The overall response was 74% of the BCC treated, with the best response in superficial BCC with a 95% of complete response. The regression analysis revealed that the superficial histological type was the primary factor predictive of a complete response. Conclusions. In the treatment of BCC with PDT, the most significant factor for predicting response is the histological type.

  19. Trans-arterial chemoembolization (TACE in patients with unresectable Hepatocellular carcinoma: Experience from a tertiary care centre in India

    Directory of Open Access Journals (Sweden)

    Shashi Bala Paul

    2011-01-01

    Full Text Available Aims: To evaluate the outcome following transarterial chemoembolization (TACE and to identify the predictors of survival in patients with unresectable hepatocellular carcinoma (HCC. Material and Methods: HCC patients reporting to our hospital (2001-2007 were subjected to clinical, biochemical, and radiological examination. TACE was performed in those who fulfilled the inclusion criteria. Follow-up assessment was done with multiphase CT scan of the liver at 1, 3, and 6 months. Tumor response and survival rate were estimated. Univariate and multivariate analyses were done for determinants of survival. Results: A total of 73 patients (69 males, 4 females; mean age 49±13.4 years were subjected to 123 sessions of TACE. The Child′s classification was: A - 56 patients and B - 17 patients. Barcelona Clinic staging was: A - 20 patients, B - 38 patients, and C - 15 patients. Tumor size was ≤5cm in 28 (38% patients, >5-10 cm in 28 (38% patients, and >10 cm in 17 (23% patients. Median follow-up was for 12 months (range: 1-77 months. No significant postprocedure complications were encountered. Overall survival rate was 66%, 47%, and 36.4% at 1, 2, and 3 years, respectively. Tumor size emerged as an important predictor of survival. Conclusion: TACE offers a reasonable palliative therapy for HCC. Initial tumor size is an independent predictor of survival.

  20. Prophylactic cranial irradiation in patients with small-cell lung cancer: the experience at the Institute of Oncology Ljubljana:

    OpenAIRE

    Stanic, Karmen; Kovac, Viljem

    2010-01-01

    Background Prophylactic cranial irradiation (PCI) has been used in patients with small-cell lung cancer (SCLC) to reduce the incidence of brain metastases (BM) and thus increase overall survival. The aim of this retrospective study was to analyze the characteristics of patients with SCLC referred to the Institute of Oncology Ljubljana, their eligibility for PCI, patterns of dissemination, and survival. Patients and methods Medical charts of 357 patients with SCLC, referred to the Institute of...

  1. Market seeking orientation and performance in China : the impact of institutional environment, subsidiary ownership structure and experience.

    OpenAIRE

    He, Xinming; Zhang, Jianhong; Wang, Jinmeng

    2015-01-01

    Many foreign firms tend to follow the market-seeking mandate in China. However this orientation alone does not guarantee superior performance. From the perspectives of strategic fit and institutional theory, this research seeks to reveal several conditions under which market-seeking MNEs can achieve superior performance in China. We identify three performance contributors to marketing seeking FDI: the host country’s favorable formal institutions towards FDI, the subsidiaries’ operational expe...

  2. Building institutions at the micro-level: Results from a field experiment in property dispute and conflict resolution

    OpenAIRE

    Christopher Blattman; Alexandra Hartman; Robert Blair

    2012-01-01

    How to promote local order and property rights under weak rule of law? States commonly use education campaigns to influence citizen behavior and, ultimately, change generalized practices and norms (or informal institutions). But can education alone influence behavior, let alone “institutions”? In Liberia, property disputes are endemic, but access to formal legal institutions is scant. An intervention trained residents of 68 towns in mediation and advocated informal resolution practices and fo...

  3. What determines patient preferences for treating low risk basal cell carcinoma when comparing surgery vs imiquimod? A discrete choice experiment survey from the SINS trial

    Directory of Open Access Journals (Sweden)

    Tinelli Michela

    2012-10-01

    Full Text Available Abstract Background The SINS trial (Controlled Clinical Trials ISRCTN48755084; Eudract No. 2004-004506-24 is a randomised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5% cream for low risk nodular and superficial basal cell carcinoma (BCC. The trial included a discrete choice experiment questionnaire to explore patient preferences of a cream versus surgery for the treatment of their skin cancer. Methods The self-completed questionnaire was administered at baseline to 183 participants, measuring patients’ strength of preferences when choosing either alternative ‘surgery’ or ‘imiquimod cream’ instead of a fixed ‘current situation’ option (of surgical excision as standard practice in UK. The treatments were described according to: cost, chance of complete clearance, side effects and appearance. Participants had to choose between various scenarios. Analysis was performed using a mixed logit model, which took into account the impact of previous BCC treatment and sample preference variability. Results The analysis showed that respondents preferred ‘imiquimod cream’ to their ‘current situation’ or ‘surgery’, regardless of previous experience of BCC symptoms and treatment. Respondents were more likely to be worried about their cosmetic outcomes and side effects they might experience over and above their chance of clearance and cost. Those with no experience of surgery (compared with experience valued more the choice of ‘imiquimod cream’ (£1013 vs £781. All treatment characteristics were significant determinants of treatment choice, and there was significant variability in the population preferences for all of them. Conclusions Patients with BCC valued more ‘imiquimod cream’ than alternative ‘surgery’ options, and all treatment characteristics were important for their choice of care. Understanding how people with a BCC value alternative interventions may better inform the

  4. Safety Evaluation Report, related to the renewal of the operating license for the critical experiment facility of the Rensselaer Polytechnic Institute (Docket No. 50-225)

    International Nuclear Information System (INIS)

    This Safety Evaluation Report for the application filed by the Rensselaer Polytechnic Institute (RPI) for a renewal of operating license CX-22 to continue to operate a critical experiment facility has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by Rensselaer Polytechnic Institute and is located at a site in the city of Schenectady, New York. The staff concludes that this critical facility can continue to be operated by RPI without endangering the health and safety of the public

  5. Breast-conserving therapy for ductal carcinoma in situ of the breast: the French Cancer Centers' experience

    International Nuclear Information System (INIS)

    Purpose: To assess the long-term outcome for women with ductal carcinoma in situ of the breast treated in current clinical practice by conservative surgery with or without definitive breast irradiation. Methods and Materials: We analyzed 705 cases of ductal carcinoma in situ treated between 1985 and 1995 in nine French regional cancer centers; 515 underwent conservative surgery and radiotherapy (CS+RT) and 190 CS alone. The median follow-up was 7 years. Results: The 7-year crude local recurrence (LR) rate was 12.6% (95% confidence interval [CI] 9.4-15.8) and 32.4% (95% CI 25-39.7) for the CS+RT and CS groups, respectively (p<0.0001). The respective 10-year results were 18.2% (95% CI 13.3-23) and 43.8% (95% CI 30-57.7). A total of 125 LRs occurred, 66 and 59 in the CS+RT and CS groups, respectively. Invasive or microinvasive LRs occurred in 60.6% and 52% of the cases in the same respective groups. The median time to LR development was 55 and 41 months. Nine (1.7%) and 6 (3.1%) nodal recurrences occurred in the CS+RT and CS groups, respectively. Distant metastases occurred in 1.4% and 3% of the respective groups. Patient age and excision quality (final margin status) were both significantly associated with LR risk in the CS+RT group: the LR rate was 29%, 13%, and 8% among women aged ≤40, 41-60, and ≥61 years (p<0.001). Even in the case of complete excision, we observed a 24% rate of LR (6 of 25) in women <40 years. Patients with negative, positive, or uncertain margins had a 7-year crude LR rate of 9.7%, 25.2%, and 12.2%, respectively (p=0.008). RT reduced the LR rate in all subgroups, especially in those with comedocarcinoma (17% vs. 59% in the CS+RT and CS groups, respectively, p<0.0001) and mixed cribriform/papillary tumors (9% vs. 31%, p<0.0001). In the multivariate Cox regression model, young age and positive margins remained significant in the CS+RT group (p=0.00012 and p=0.016). Finally, the relative LR risk in the CS+RT group compared with the CS group

  6. Initial Experience of 3-Tesla Apparent Diffusion Coefficient Values in Characterizing Squamous Cell Carcinomas of the Head and Neck

    International Nuclear Information System (INIS)

    Background: With the increased clinical use of 3-Tesla (3T) magnets, it becomes important to identify the potential applications of advanced magnetic resonance (MR) imaging techniques such as diffusion-weighted imaging in head and neck pathologies. Purpose: To establish the 3T apparent diffusion coefficient (ADC) values for normal neck structures, and to examine the utility of ADC values in distinguishing head and neck squamous cell carcinomas (HNSCC) from normal neck anatomy. Material and Methods: 3T diffusion-weighted imaging was performed on 10 normal volunteers and 10 patients with known HNSCC. In the volunteers, mean ADC was calculated in the parotid gland, submandibular gland, base of the tongue, pterygoid muscle, masseter muscle, paraspinal muscles, true vocal cord, thyroid gland, thyroid cartilage, cricoid cartilage, and lymph nodes. The mean tumor ADC value was calculated from the 10 patients with HNSCC and compared with the normal ADC values from various neck structures. Results: The mean ADC value measured in the HNSCC was 1.101 (±0.214)x10-3mm2/s. This was significantly lower than ADC values of paraspinal muscles, pterygoid muscle, masseter muscle, thyroid gland, and base of the tongue (P=0.0006, 0.0002, 0.0001, 0.001, and 0.002, respectively). The tumor ADC values were not significantly different from ADC values of parotid and submandibular glands (P=0.057 and 0.14, respectively). Conclusion: 3T ADC values show potential for distinguishing HNSCC from normal extracranial head and neck structures

  7. Radiotherapy and Sorafenib in the Management of Patients with Hepatocellular Carcinoma Have Led to Improved Survival: A Single Center Experience

    Science.gov (United States)

    Moore, Assaf; Cohen-Naftaly, Michal; Benjaminov, Ofer; Braun, Marius; Issachar, Assaf; Mor, Eitan; Tovar, Anna; Sarfaty, Michal; Gordon, Noa; Stemmer, Salomon M.

    2016-01-01

    Background & Aims: Hepatocellular Carcinoma (HCC) is the sixth most common malignancy and the third most common cause of cancer mortality worldwide. We aimed to assess the effect of novel treatment options on the survival of HCC patients. Methods: This retrospective study included all HCC patients diagnosed between 2000 and 2013 referred to the Davidoff center and treated by a multidisciplinary team. Results: The analysis included 321 patients (median age, 64 years; 74.8% males; 74.1% viral carriers; 76.0% cirrhosis; 56.7% diagnosis at an early stage). The estimated hazard ratio by multivariate analysis for the effect of the period of diagnosis (2007-2013 vs. 2000-2006) on survival was 0.72 (95% CI: 0.54-0.96; p=0.027). There was no difference in the distribution by CP score, by BCLC stage at diagnosis or in the proportion of patients undergoing surgical procedures (liver transplantation or resection). In the later time frame, there was a significant decrease in the proportion of patients undergoing percutaneous treatments (14.6% vs.4.2%, p=0.004) and embolization (46.9% vs.24.6%, p=0.001), and a significant increase in radiotherapy (1.5% vs. 8.4%, p=0.009) and treatment with sorafenib (6% vs. 18.3%, p=0.002). Conclusion: Technological/pharmaceutical innovations have led to advancement in HCC treatment. Since there was no significant difference in the proportion of patients undergoing surgical procedures during the evaluated timeframe, the improved survival may stem from better management of advanced stage patients by a multidisciplinary team. PMID:27313777

  8. Warming Effect on Miriplatin-Lipiodol Suspension as a Chemotherapeutic Agent for Transarterial Chemoembolization for Hepatocellular Carcinoma: Preliminary Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Kora, Shinn-ichi; Urakawa, Hiroshi; Mitsufuji, Toshimichi; Osame, Akinobu [Fukuoka University, Department of Radiology, Faculty of Medicine (Japan); Higashihara, Hideyuki [Fukuoka University Chikushi Hospital, Department of Radiology (Japan); Yoshimitsu, Kengo, E-mail: kengo@fukuoka-u.ac.jp [Fukuoka University, Department of Radiology, Faculty of Medicine (Japan)

    2013-08-01

    PurposeTo retrospectively elucidate the preliminary clinical impact of warmed miriplatin-lipiodol suspension (MPT-LPD) when used as a chemotherapeutic agent for transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Materials and MethodsBetween June and December 2010, TACE was performed with MPT-LPD at room temperature (RT group), and after January 2011, TACE with MPT-LPD warmed to 40 Degree-Sign C was performed (W group). The intraarterial appearance of MPT-LPD immediately after injection through microcatheters at the second-order branches was compared between the two groups with a 5-point grading system. Local therapeutic effects of HCCs as assessed by follow-up computed tomography (CT) obtained 1-3 months after TACE were compared between the groups with a 4-point grading system (TE1-TE4). After April 2011, angiography-assisted CT was routinely performed at TACE, and HCCs that revealed apparent corona enhancement (CE) were retrospectively selected. The degree of concordance between CE and MPT-LPD accumulation as assessed by CT immediately after TACE was assessed with a 3-point grading scale.ResultsMPT-LPD therapy resulted in a smooth and continuous appearance in the W group (grades 1, 2, 3, 4, and 5 were, respectively, 1, 2, 11, 18, and 4) compared to the RT group (4, 0, 1, 2, and 0). The W group (TE1, TE2, TE3, and TE4 were 1, 9, 11, and 12) revealed better local therapeutic effects than the RT group (6, 3, 9, and 0) (p < 0.05). CE was found in 26 HCC nodules, and concordance between CE and MPT-LPD accumulation was observed in 66 % (grades 1, 2, and 3 were, respectively, 2, 8, and 19).ConclusionWarmed MPT-LPD flowed more smoothly within vascular lumen, passed through tumor sinusoid of HCC, and had better local therapeutic effects at short-term observation than MPT-LPD at room temperature.

  9. Experience with combination of docetaxel, cisplatin plus 5-fluorouracil chemotherapy, and intensity-modulated radiotherapy for locoregionally advanced nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Our aim was to evaluate the efficacy and toxicity of cisplatin, fluorouracil, and docetaxel chemotherapy plus intensity-modulated radiotherapy (IMRT) for locoregionally advanced nasopharyngeal carcinoma (NPC). Sixty patients with locoregionally advanced NPC were enrolled. Patients received IMRT plus three courses of neoadjuvant chemotherapy and two courses of adjuvant chemotherapy consisting of docetaxel (60 mg/m2/day on day 1), cisplatin (25 mg/m2/day on days 1-3), and 5-fluorouracil (500 mg/m2/day on days 1-3). The overall response rate to neoadjuvant chemotherapy was 89%. Three months after the completion of radiotherapy, 53 (93%) patients achieved complete regression, 3 (5%) achieved partial response (PR), and 1 experienced liver metastasis. However, among the 3 PR patients, 2 patients had no evidence of relapse in the follow-up. With a median follow-up of 27 months (range, 6-43), the 2-year estimated locoregional failure-free survival, distant failure-free survival, progression-free survival, and overall survival were 96.6, 93.3, 89.9, and 98.3%, respectively. Leukopenia was the main adverse effect in chemotherapy; 14 patients experienced grade 3 or grade 4 neutropenia, and 1 patient developed febrile neutropenia. The nonhematological adverse events included alopecia, nausea, vomiting, anorexia, and diarrhea. The incidence of grade 3 acute radiotherapy-related mucositis was 28.3%; no grade 4 acute mucositis was observed. No grade 3 or grade 4 hematological toxicity occurred during radiotherapy. None of the patients had interrupted radiotherapy. The common late adverse effects included xerostomia and hearing impairment. Neoadjuvant-adjuvant chemotherapy using cisplatin, fluorouracil, plus docetaxel combined with IMRT was an effective and well-tolerated alternative for advanced NPC. (author)

  10. The Failure Patterns of Oral Cavity Squamous Cell Carcinoma After Intensity-Modulated Radiotherapy-University of Iowa Experience

    International Nuclear Information System (INIS)

    Purpose: Determine the failure patterns of oral cavity squamous cell carcinoma (SCC) treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Between May 2001 and July 2005, 55 patients with oral cavity SCC were treated with IMRT for curative intent. Forty-nine received postoperative IMRT, 5 definitive IMRT, and 1 neoadjuvant. Three target volumes were defined (clinical target CTV1, CTV2, and CTV3). The failure patterns were determined by coregistration or comparison of the treatment planning computed tomography to the images obtained at the time of recurrence. Results: The median follow-up for all patients was 17.1 months (range, 0.27-59.3 months). The median follow-up for living patients was 23.9 months (range, 9.3-59.3 months). Nine patients had locoregional failures: 4 local failures only, 2 regional failures only, and 3 had both local and regional failures. Five patients failed distantly; of these, 3 also had locoregional failures. The 2-year overall survival, disease-specific survival, local recurrence-free survival, locoregional recurrence-free survival, and distant disease-free survival was 68%, 74%, 85%, 82%, and 89%, respectively. The median time from treatment completion to locoregional recurrence was 4.1 months (range, 3.0-12.1 months). Except for 1 patient who failed in contralateral lower neck outside the radiation field, all failed in areas that had received a high dose of radiation. The locoregional control is strongly correlated with extracapsular extension. Conclusions: Intensity-modulated RT is effective for oral cavity SCC. Most failures are in-field failures. Further clinical studies are necessary to improve the outcomes of patients with high-risk features, particularly for those with extracapsular extension

  11. From Clinical Trials to the Front Line: Vinflunine for Treatment of Urothelial Cell Carcinoma at the National Cancer Institute of Naples

    Science.gov (United States)

    Facchini, Gaetano; Della Pepa, Chiara; Cavaliere, Carla; Cecere, Sabrina C.; Di Napoli, Marilena; D'Aniello, Carmine; Crispo, Anna; Iovane, Gelsomina; Maiolino, Piera; Tramontano, Teresa; Piscitelli, Raffaele; Pisconti, Salvatore; Montella, Maurizio; Berretta, Massimiliano; Sorrentino, Domenico; Perdonà, Sisto; Pignata, Sandro

    2016-01-01

    Background: The efficacy of Vinflunine, after failure of platinum-based chemotherapy in patients with metastatic or recurrent Transitional Cell Cancer of the Urothelial Tract, TCCU, has been demonstrated in an international, randomized, phase III trial comparing Vinflunine plus Best Supportive Care, BSC, with BSC alone. On the basis of that study vinflunine has been approved by the European Medicine Association, EMA, for treatment of TCCU patients after failure of a platinum treatment. However, since data in clinical trials often differ from routine clinical practice due to unselected population and less strict monitoring, “real life” experiences are very helpful to verify the efficacy of a new therapy. Methods: This was a spontaneous, observational, retrospective study involving 43 patients with metastatic TCCU treated with vinflunine at our cancer center, data about demographics, disease characteristics, and previous treatments were collected and outcome and toxicities of vinflunine were analyzed. Results: 41 of 43 patients were eligible for RR analysis, the Overall RR was 12%, the Disease Control Rate was 29%; when including only patients treated in II line the DCR rose to 33%; the median PFS and the median OS were 2.2 and 6.9 months, respectively. Conclusion: Our findings were consistent with the outcome data emerged in the phase III randomized trial and in the other observational studies conducted all around Europe in the last 2–3 years. This experience supports the use of vinflunine in patients with advanced TTCU as effective and manageable antineoplastic drug. PMID:27199753

  12. Sclerosing Mucoepidermoid Carcinoma; A unique case

    Directory of Open Access Journals (Sweden)

    Keshava Bhat

    2014-05-01

    Full Text Available Sclerosing mucoepidermoid carcinoma is an unusual type of mucoepidermoid carcinoma with special histological features which differ from those of the classic type of mucoepidermoid carcinoma. We report the case of a 32-year-old male, who reported to the Vydehi Institute of Dental Sciences, Bangalore, India, with an asymptomatic swelling over the right parotid region which had been present for the previous two and a half years. Histopathological sections of the tumour mass showed mucous and epidermoid cell nests in a dense, hyalinised, sclerotic stroma. A diagnosis of sclerosing mucoepidermoid carcinoma was made. A superficial parotidectomy was performed on the patient and he has remained disease free to date.

  13. First Experiences in Intensity Modulated Radiation Surgery at the National Institute of Neurology and Neurosurgery: A Dosimetric Point of View

    Science.gov (United States)

    Lárraga-Gutiérrez, José M.; Celis-López, Miguel A.

    2003-09-01

    The National Institute of Neurology and Neurosurgery in Mexico City has acquired a Novalis® shaped beam radiosurgery unit. The institute is pioneer in the use of new technologies for neuroscience. The Novalis® unit allows the use of conformal beam radiosurgery/therapy and the more advanced modality of conformal therapy: Intensity Modulated Radiation Therapy (IMRT). In the present work we present the first cases of treatments that use the IMRT technique and show its ability to protect organs at risk, such as brainstem and optical vias.

  14. Approaches of Integrated Watershed Management Project: Experiences of the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT)

    Science.gov (United States)

    Mula, Rosana P.; Wani, Suhas P.; Dar, William D.

    2008-01-01

    The process of innovation-development to scaling is varied and complex. Various actors are involved in every stage of the process. In scaling the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT)-led integrated watershed management projects in India and South Asia, three drivers were identified--islanding approach,…

  15. Enhancing Student Learning Experiences and Providing Value to the Agribusiness Industry by Building the Industry-Institution Interface

    OpenAIRE

    Foltz, John C.; Devadoss, Stephen

    2008-01-01

    This paper addresses agribusiness industry-institution interfaces, research-education linkages, and improving agribusiness education with opportunities such as agricultural students’ internships with agribusiness companies, conducting applied research, and finding opportunities for agribusiness educational seminars conducted by universities. The rationale for agribusiness internships is discussed, and agribusiness internship structure and planning is outlined. The potential benefits of a De...

  16. Can existing institutions protect biodiversity in areas beyond national jurisdiction? Experiences from two on-going processes

    NARCIS (Netherlands)

    Freestone, D.; Johnson, D.; Ardron, J.; Unger, S.; Killerlain Morrison, K.

    2014-01-01

    United Nations discussions on the governance of marine areas beyond national jurisdiction have questioned, but not yet reached a decision, on whether existing institutional agreements and structures are sufficient to meet global commitments to protect marine biodiversity, or if additional mechanisms

  17. Surgical Excision with Forehead Flap as Single Modality Treatment for Basal Cell Cancer of Central Face: Single Institutional Experience of 50 Cases

    Directory of Open Access Journals (Sweden)

    Jagdeep Rao

    2014-01-01

    Full Text Available Basal cell carcinoma (BCC is the most common skin cancer worldwide. The WHO has defined it as “a locally invasive, slowly spreading tumor which rarely metastasizes, arising in the epidermis or hair follicles and in which the peripheral cells usually simulate the basal cells of the epidermis.” Here we discuss the management of BCCs of central face with surgical excision and reconstruction with forehead flap as single modality treatment. Material and Methods. This is a retrospective review of 50 patients who underwent surgical excision of BCC involving the facial region followed by primary reconstruction using forehead flaps at a single institution. There were 20 males and 30 females, mean age of 59 years. Results. No recurrence at primary site was observed during the follow-up of 1–4 yrs. There was no ectropion or exposure sequela. However, epiphora was evident. Size of lesions ranged from 2 to 6 cm. Keloid formation was seen in 2 (4% patients. Functional and cosmetic outcomes were satisfactory. Conclusion. For the face, the best reconstructive effort eventually fails in the face of tumor recurrence. The forehead flap represents one of the best methods for repair of extensive facial defects. Complete tumor extirpation, the primary event, is the key.

  18. Análise de sobrevida global em pacientes diagnosticados com carcinoma de células escamosas de boca no INCA no ano de 1999 Overall survival analysis in oral squamous cell carcinoma patients diagnosed at the National Cancer Institute in 1999

    Directory of Open Access Journals (Sweden)

    Julia Honorato

    2009-03-01

    Full Text Available O carcinoma de células escamosas de boca compreende cerca de 90 a 95% de todas as neoplasias malignas da boca e é um dos tipos de câncer mais frequentes no Brasil. O índice de sobrevida em 5 anos é baixo e permaneceu estável nas últimas décadas, apesar dos avanços nas terapias. O objetivo deste estudo foi analisar o perfil e a sobrevida global dos pacientes diagnosticados com carcinoma de células escamosas de boca no ano de 1999 no Instituto Nacional de Câncer. Dos 320 pacientes incluídos no estudo, 79,4% eram homens. A idade média foi de 56,7 anos, e 82,2% deles fumavam e/ou bebiam. A língua, seguida do assoalho de boca foram os locais mais acometidos. A maioria (68,9% dos pacientes foi diagnosticada em estádios tardios e submetida à radioterapia exclusiva (53,6%. A sobrevida média no período do estudo foi de 29,4 meses. Os pacientes dos estádios iniciais apresentaram maior sobrevida, assim como aqueles submetidos apenas à cirurgia como forma de tratamento e os que não apresentaram linfonodos acometidos ao diagnóstico. Tumores localizados em palato duro e mucosa jugal apresentaram pior prognóstico. Foram fatores preditivos independentes de melhor sobrevida os tumores T1 ou T2 (p=0,001, sem acometimento de linfonodos (p=0,012 e não localizados em mucosa jugal (p=0,021. O diagnóstico do câncer oral ainda se faz em estádios tardios, o que influencia negativamente a sobrevida global dos pacientes. Maior ênfase deve ser dada à capacitação dos profissionais para o reconhecimento precoce do câncer e à conscientização da população de risco.Oral squamous cell carcinoma accounts for 90 to 95% of all malignant neoplasms of the mouth and it is one of most common cancers in Brazil. Five-year survival rates remain low and have not improved over the past decades, despite advances in therapy. The purpose of this study was to analyze the features and overall survival of patients diagnosed with oral squamous cell carcinoma in

  19. Can concomitant-boost accelerated radiotherapy be adopted as routine treatment for head-and-neck cancers? A 10-year single-institution experience

    OpenAIRE

    Allal, Abdelkarim Said; Taussky, Daniel; Mach, Nicolas; Becker, Minerva; Bieri, Sabine; Dulguerov, Pavel

    2004-01-01

    Accelerated schedules are effective in overcoming repopulation during radiotherapy (RT) for head-and-neck cancers, but their feasibility is compromised by increased toxicity. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the 10-year experience of a single institution in the routine use of concomitant boost RT as standard radical treatment in all but the most favorable stage patients.

  20. Learning Curve of a Young Surgeon's Video-assisted Thoracic Surgery Lobectomy during His First Year Experience in Newly Established Institution

    OpenAIRE

    Ra, Yong Joon; Ahn, Hyo Yeong; Kim, Min Su

    2012-01-01

    Background The purpose of this paper is to present a guideline for beginning video-assisted thoracic surgery (VATS) lobectomy to junior surgeons, and to review the first year experience of a new surgeon performing VATS lobectomies who had not performed a VATS lobectomy unassisted during his training period. Materials and Methods A young surgeon opened a division of general thoracic surgery at a medical institution. The surgeon had performed about 100 lobectomies via conventional thoracotomy d...

  1. Organization of project activity within continuous pedagogical education (from the experience of the Institute of continuous education of the Buryat State university)

    OpenAIRE

    Tsyrenova Marina Gennadiyevna; Khantueva

    2015-01-01

    This article is devoted to the relevant forms of teachers’ professional development within the frameworks of continuous education. A project activity in educational expeditions is considered as an area showing considerable promise of the regional continuous education system development, and the establishment of innovative educational environment for retraining professional development of teachers and principals. The article is based on the experience of the Institute of continuous education, ...

  2. Role of {sup 131}I-metaiodobenzylguanidine (MIBG) in the treatment of neuroendocrine tumours. Experience of the National Cancer Institute of Milan

    Energy Technology Data Exchange (ETDEWEB)

    Castellani, M.R.; Chiti, A.; Seregni, E.; Bombardieri, E. [Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan (Italy). Nuclear Medicine Division

    2000-03-01

    45 patients with neuroendocrine tumours (22 neuroblastomas, 10 phaeochromocytomas, 3 paragangliomas, 6 medullary thyroid carcinomas and 4 carcinoids) underwent {sup 131}I-MIBG therapy. All patients, with the exception of 5 phaeochromocytoma cases with nonoperable disease, had previously been treated with conventional therapies. Patients had a previous diagnostic scintigraphy with {sup 131}I-MIBG (activity 20-44.4 MBq) or with {sup 123}I-MIBG (activity 74-222 MBq). All treatments were repeated at not less than 4-weekly intervals. The neuroblastoma patients were divided into two groups: the first included 14 patients with advanced metastatic disease not responding to previous treatments; the second included 8 patients with documented residual neuroblastoma tissue that could not be surgically removed after first-line therapy. In neuroblastoma patients with advanced disease resistant to previous therapies 2 out of 14 showed a partial response, 9 stable disease and 3 progression of cancer. In neuroblastoma patients with residual disease (7 evaluable out of 8) it was obtained 3 partial responses; a stable response was observed in 3 patients. The result of MIBG therapy in the group of phaechromocytoma patients (9 evaluable out of 10) consisted of 3 partial responses, 5 stable disease and 1 progression. Evaluation of the response carried out on the basis of the biochemical parameters increased the responses and MIBG therapy showed good effectiveness in controlling the functional symptoms. In the group of paraganglioma patients it was observed 1 complete, 1 partial and 1 stable response. In patients with medullary thyroid carcinoma a partial response was observed in 1 patient with mediastinal metastases and 2 disease stabilizations were seen in another 2 patients. On the basis of personal experience it can be concluded that {sup 131}I-MIBG therapy is effective and also well tolerated.

  3. Sebaceous Carcinoma

    Science.gov (United States)

    ... of the Year Award Arnold P. Gold Foundation Humanism in Medicine Award Diversity Mentorship Program Eugene Van ... What causes sebaceous carcinoma? SC is rare, so scientists still have much to learn, including what causes ...

  4. The Experience of a Distance Learning Organization in a Private Higher Educational Institution in the Republic of Tatarastan (Russia: From Idea to Realization

    Directory of Open Access Journals (Sweden)

    Daniya Akhmetova,

    2013-07-01

    Full Text Available The article is devoted to the unique experience of distance learning development in the conditions of Russian reality. The model of distance learning in the Institute of Economics, Management and Law (Kazan city, Russia is created on the basis of educational sphere diagnosis taking into account foreign and Russian experience. The specificity of the model is the permanent diagnosis of the components of the educational environment such as teacher qualifications, level of students’ actual knowledge, filling the educational process with information technologies, availability and quality of electronic resources, the correct choice of learning technologies, and policy in the field of the computerization of the professional education process.

  5. Feasibility of laparoscopic abdomino - perineal resection for large - sized anorectal cancers : A single - institution experience of 59 cases

    Directory of Open Access Journals (Sweden)

    Shukla Parul

    2009-03-01

    Full Text Available Background: Laparoscopic surgery for anorectal carcinoma is steadily gaining acceptance. While feasibility has already been reported, there are no reports addressing the impact of the actual size of large tumors on laparoscopic resectability . Aim: To assess the feasibility and short-term results (including oncological surrogate end points of performing laparoscopic abdomino-perineal resection (APR for large rectal cancers. Materials And Methods: Data of 59 patients undergoing laparoscopic APR (LAPR for anorectal malignancies were reviewed retrospectively. Outcomes were evaluated considering the surgical procedure, surface area of the tumor and short-term outcomes. Results: Of the 59 cases, LAPR could be completed in 53 (89.8% patients. Thirty-one (58.4% patients had Astler-Coller C2 stage disease. The mean surface area of the tumors was 24±17.5 (4-83 cm2. The number of median lymph nodes harvested per case was 12 (1-48. Circumferential resection margin (CRM was positive in 11 (20.7% patients. No mortality was reported. Conclusion: This appears to be the first report analyzing the impact of the size of the rectal tumor in LAPR. The data clearly indicates that LAPR is not hampered by the size of the tumor. There appears to be a need for preoperative radiotherapy and chemotherapy before undertaking surgery on larger tumors in view of the higher circumferential resection margin positivity.

  6. Multi-subject atlas-based auto-segmentation reduces interobserver variation and improves dosimetric parameter consistency for organs at risk in nasopharyngeal carcinoma: A multi-institution clinical study

    International Nuclear Information System (INIS)

    Background and purpose: To assess whether consensus guideline-based atlas-based auto-segmentation (ABAS) reduces interobserver variation and improves dosimetric parameter consistency for organs at risk (OARs) in nasopharyngeal carcinoma (NPC). Materials and methods: Eight radiation oncologists from 8 institutes contoured 20 OARs on planning CT images of 16 patients via manual contouring and manually-edited ABAS contouring. Interobserver variation [volume coefficient of variation (CV), Dice similarity coefficient (DSC), three-dimensional isocenter difference (3D-ICD)] and dosimetric parameters were compared between the two methods of contouring for each OAR. Results: Interobserver variation was significant for all OARs in manual contouring, resulting in significant dosimetric parameter variation (P < 0.05). Edited ABAS significantly improved multiple metrics and reduced dosimetric parameter variation for most OARs; brainstem, spinal cord, cochleae, temporomandibular joint (TMJ), larynx and pharyngeal constrictor muscle (PCM) obtained most benefit (range of mean DSC, volume CV and main ICD values was 0.36–0.83, 12.1–84.3%, 2.2–5.0 mm for manual contouring and 0.42–0.86, 7.2–70.6%, 1.2–3.5 mm for edited ABAS contouring, respectively; range of dose CV reduction: 1.0–3.0%). Conclusion: Substantial objective interobserver differences occur during manual contouring, resulting in significant dosimetric parameter variation. Edited ABAS reduced interobserver variation and improved dosimetric parameter consistency, particularly for brainstem, spinal cord, cochleae, TMJ, larynx and PCM

  7. Bone metastases in patients with small cell lung carcinoma: rate of development, early versus late onset, modality of treatment, and their impact on survival. A single-institution retrospective cohort study.

    Science.gov (United States)

    Charpidou, Andriani; Tsagouli, Sofia; Gkiozos, Ioannis; Grapsa, Dimitra; Moutsos, Michalis; Kiagia, Maria; Syrigos, Konstantinos

    2016-06-01

    The aim of the present study was to further explore the impact of bone metastases (BMs) and their therapeutic management on the overall prognosis of patients with small cell lung carcinoma (SCLC). We performed a retrospective analysis of medical records of 363 patients with histologically or cytologically confirmed SCLC, diagnosed and treated in the Oncology Unit of Sotiria Athens General Hospital, between January 2003 and December 2012. Demographic and clinicopathological features, including BMs, their time point of development (early onset/at diagnosis versus late onset/at a subsequent time point), treatment modality for BMs (radiotherapy, bisphosphonates or both) and the presence of skeletal-related events (SREs), were correlated with overall survival (OS). Survival analysis was performed using the Kaplan-Meier method, log-rank tests and Cox regression analysis. Overall, 130/363 patients (35.8 %) were diagnosed with either early-onset (97/363 cases, 26.7 %) or late-onset BMs (33/363 cases, 9.1 %). Patients with early-onset BMs had a reduced OS as compared to those with late-onset BMs [Hazard ratio (HR) 0.61; 95 % Confidence interval (CI) 0.41-0.91; p = 0.015) or those without BMs (HR 0.76; 95 % CI 0.6-0.96; p = 0.024). SREs and treatment modality of BMs had no impact on OS. Multiple Cox regression analysis showed that increased age, poor performance status (PS), presence of BMs and early onset BMs were independently associated with reduced OS. The results of our single-institution study suggest that the development of early-onset BMs may represent an independent predictor of a worse prognosis among patients with SCLC, in addition to well-established adverse prognostic factors such as poor PS. PMID:27209468

  8. Wide-bore 1.5 Tesla MR imagers for guidance and monitoring of radiofrequency ablation of renal cell carcinoma: initial experience on feasibility

    International Nuclear Information System (INIS)

    This study was conducted to test and demonstrate the feasibility of magnetic resonance (MR)-guided radiofrequency (RF) ablation of renal cell carcinoma (RCC) using a 1.5 T whole-body scanner equipped with a wide-bore superconductive magnet. Two patients with contrast-enhancing renal masses were treated with multipolar RF ablation (Celon ProSurge). Applicator navigation and near real-time ablation monitoring were performed in a wide-bore 1.5 T scanner using adapted fluoroscopic and diagnostic sequences. In addition to T2-weighted imaging for ablation monitoring, perfusion-weighted images acquired with an arterial spin-labeling technique (FAIR-TrueFISP) were applied. Results were compared to a previous study on 12 patients performed at 0.2 T. Navigation and monitoring of RF ablation using the wide-bore system operating at 1.5 T were clearly improved compared to former experiences on a 0.2 T MR unit. Fluoroscopic and diagnostic images for MR guidance could be acquired with distinctly higher image quality and shorter acquisition time resulting in higher accuracy of applicator placement and shorter treatment time. Spin-labeling perfusion imaging exhibited good image quality, potentially providing additional clinically important information. MR-guided RF ablation of RCC can safely be performed in a 1.5 T wide-bore scanner offering higher image quality, shorter acquisition time, and new monitoring modalities not feasible at 0.2 T. (orig.)

  9. Leaving Elsevier's "big deal": an evaluation of the Italian National Institute of Health experience inside the Bibliosan Consortium

    OpenAIRE

    Toni, Franco

    2012-01-01

    In 2011 the Istituto Superiore di Sanità (ISS), the Italian National Institute of Health, has been forced, due to economic reason, to leave the Bibliosan Consortium contract with the publisher Elsevier. The contract, following the “big deal” model, provided for the maintenance of paper subscriptions and the payment of an additional fee for the whole electronic collection (more than 2,000 journal titles). The continuous increase of annual costs has led to unsustainable growth in costs and...

  10. Successful Treatment in Children with Hodgkin Lymphoma in Greece; A 20-Year Experience in a Single Institution

    OpenAIRE

    Apostolos Pourtsidis; Dimitrios Doganis; Margarita Baka; Despina Bouhoutsou; Maria Varvoutsi; Maria Synodinou; Katerina Strantzia; Helen Kosmidis

    2012-01-01

    During the last 30 years, combined chemotherapy regimens with radiotherapy or not significantly improved the prognosis for patients with Hodgkin lymphoma. We retrospectively studied 58 children (35 boys and 23 girls) with Hodgkin lymphoma who were treated at our institution during the period 1987–2006 and we correlated age, sex, stage, histology, and therapy with the outcome of patients. Of our patients, 9 children were 8 years old or younger. Nodular sclerosis was the predominant histology s...

  11. Market power and the sale of Ontario residential natural gas: An institutional analysis and a laboratory experiment

    Science.gov (United States)

    Bloemhof, Barbara Lynn

    2005-11-01

    The Ontario residential natural gas market underwent a significant institutional change in 1986, after the federal government decontrolled natural gas prices. Currently, consumers may sign up for fixed-cost natural gas from a broker, or they may continue to be served by the regulated distribution company. This thesis examines the economic effects on consumers of the institutional change, and particularly whether or not market power was enhanced by the change. In the thesis, I first present the industrial organization of the residential natural gas sector, and explain the institutional evolution using an institutional economic approach. I then construct a model of the market environment, with sellers acting as middlemen in a well-defined Bertrand oligopoly setting with no production constraints and single-unit consumer demands. In this model, the only Nash equilibrium in the one-period game is the joint profit maximizing price, and its likelihood of obtaining depends on the nature of the cost of signing up new customers. I then take a version of this model into the laboratory with human subject sellers and simulated buyers and run six replications each of a balanced treatment design under a unique information mechanism that parallels individual customer canvassing used by sellers in the naturally-occurring market. Treatment variables are: number of sellers, number of simulated at-cost sellers present, and presence of input cost uncertainty for sellers. I find that adding any seller to the market has about the same impact on market price, irrespective of whether it is a human subject or a simulated at-cost seller. Although increasing the number of sellers does decrease the market price somewhat, it does not bring about the competitive outcome predicted by the benchmark microeconomic model. This research contributes to the literature on policy making and energy market design, as well as to experimental methodology aimed at policy evaluation.

  12. Fast neutron therapy of bronchus carcinoma: the pooled results from two european centres; Utilisation de neutrons rapides dans le traitement des carcinomes bronchiques. Experience de deux centres europeens

    Energy Technology Data Exchange (ETDEWEB)

    Lessel, A. [Humboldt-Universitaet, Berlin (Germany)

    1996-12-31

    The Berlin-Buch and Heidelberg centres used fast neutron therapy in bronchial carcinomas. The neutron source was a cyclotron in Berlin-Buch/Rossendorf and a d-t generator in Heidelberg. Three hundred twelve patients with inoperable bronchial carcinoma were treated with fast neutron therapy alone or in combination with photons. The results were then compared with those obtained from 594 patients treated only with photons. Altogether, 788 were treated in Berlin-Buch and 188 in Heidelberg. The results suggest that neutron therapy for bronchial carcinoma can be a good alternative in curative and palliative situations in the early stages. (author). 14 refs.

  13. Treatment results and prognostic factors of advanced T3-4 laryngeal carcinoma: the University of California, San Francisco (UCSF) and Stanford University Hospital (SUH) experience

    International Nuclear Information System (INIS)

    Purpose: To review the UCSF-SUH experience in the treatment of advanced T3-4 laryngeal carcinoma and to evaluate the different factors affecting locoregional control and survival. Methods and Materials: We reviewed the records of 223 patients treated for T3-4 squamous cell carcinoma of the larynx between October 1, 1957, and December 1, 1999. There were 187 men and 36 women, with a median age of 60 years (range, 28-85 years). The primary site was glottic in 122 and supraglottic in 101 patients. We retrospectively staged the patients according to the 1997 AJCC staging system. One hundred and twenty-seven patients had T3 lesions, and 96 had T4 lesions; 132 had N0, 29 had N1, 45 had N2, and 17 had N3 disease. The overall stage was III in 93 and IV in 130 patients. Seventy-nine patients had cartilage involvement, and 144 did not. Surgery was the primary treatment modality in 161 patients, of which 134 had postoperative radiotherapy (RT), 11 had preoperative RT, 7 had surgery followed by RT and chemotherapy (CT), and 9 had surgery alone. Forty-one patients had RT alone, and 21 had CT with RT. Locoregional control (LRC) and overall survival (OS) were estimated using the Kaplan-Meier method. Log-rank statistics were employed to identify significant prognostic factors for OS and LRC. Results: The median follow-up was 41 months (range, 2-367 months) for all patients and 78 months (range, 6-332 months) for alive patients. The LRC rate was 69% at 5 years and 68% at 10 years. Eighty-four patients relapsed, of which 53 were locoregional failures. Significant prognostic factors for LRC on univariate analysis were primary site, N stage, overall stage, the lowest hemoglobin (Hgb) level during RT, and treatment modality. Favorable prognostic factors for LRC on multivariate analysis were lower N stage and primary surgery. The overall survival rate was 48% at 5 years and 34% at 10 years. Significant prognostic factors for OS on univariate analysis were: primary site, age, overall

  14. Childhood and adolescent tracheobronchial mucoepidermoid carcinoma (MEC): a case-series and review of the literature.

    Science.gov (United States)

    Jaramillo, Sergio; Rojas, Yesenia; Slater, Bethany J; Baker, Michael L; Hicks, M John; Muscal, Jodi A; Vece, Timothy J; Wesson, David E; Nuchtern, Jed G

    2016-04-01

    Tracheobronchial mucoepidermoid carcinomas (MEC) are rare in the pediatric population with literature limited primarily to case reports. Here we present our institutional experience treating MEC in three patients and review the literature of 142 pediatric cases previously published from 1968 to 2013. Although rare, tracheobronchial MEC should be included in the differential diagnosis in a child with recurrent respiratory symptoms. Conservative surgical management is often sufficient to achieve complete resection and good outcomes. PMID:26790674

  15. The National Institute of Research and Development for Isotopic and Molecular Technologies at Cluj - Napoca - Fifty Years of Experience

    International Nuclear Information System (INIS)

    The life of an institute represents knitting of tens and hundreds of threads of professional achievements, human striving, aspirations, enthusiast endeavouring sparks and often enough defeats. The history of an institute can be narrated from different angles of view but perhaps the most beautiful and correct presentation would be that the institute itself would narrate if it could be able to do that. In 1950 the Physics Division of the Institut for Physics at Bucharest - Magurele created at Cluj - Napoca a subsidiary section later operating under the aegis of Cluj - Napoca subsidiary of Romanian Academy. The research programs were mainly addressing at that time applicative items as required by the local industry. A new technology for obtaining acetylene by cracking methane under electric arc discharge was obtained and it became basic for producing row material for synthetic rubber industry. In order to perform measurements in isotope separation procedures a series of analytical methods for gas mixtures was developed as well as the analytic equipment for both laboratory and industrial uses. Starting from 1956 the Cluj - Napoca Division of the Atomic Physics Institute in Bucharest focused its research programs on stable isotope physics and chemistry. These programs aimed at solving in Romania the deuterium related problems, namely, the deuterium separation and analysis and heavy water preparation, the nuclear ingredients of major importance for CANDU type nuclear power reactors, moderated and cooled with heavy water. Initial research for deuterium analysis developed new densitometric, optical and gas-chromatographic methods. Another direction of research was the problem of light element separation. A new method based on thermal diffusion was work out and studies were conducted, relating to separation factors and equilibrium time establishing for different gaseous isotopic mixtures (H/D, 12 C / 13 C, 14 N / 15 N, 16 O / 18 O). In 1967-1968 the heavy nitrogen isotope

  16. MOOCs and their Effect on the Institution: Experiences in Course Design, Delivery and Evaluation; Research; Faculty Development; Unbundling and Credits for MOOCs

    Directory of Open Access Journals (Sweden)

    Janine Kiers

    2016-07-01

    Full Text Available Four years after the introduction of MOOCs – which were proclaimed to be «the end of education as we know it» in 2012 – the role and effect of these free, online courses is becoming clearer. The online means of delivery to the heterogeneous audiences of MOOCs have enabled and compelled instructors and course teams to develop innovative and flexible learning materials. We can analyse the data on the study behaviour of learners to identify which course elements are effective. In addition, the integration of elements of MOOCs in campus education has resulted in promising outcomes and positive reactions from both students and teachers. On the level of the institution, we also see the effect of MOOCs: ranging from new possibilities in communication and branding, to new needs for faculty development and the support organisation. Furthermore, MOOCs play a role in the unbundling of education, e.g. the learning experience and the assessment tasks now can be uncoupled and may be delivered by different institutions and by different means: the learning experience may be in the form of a MOOC and the assessment may be a written exam at an institution.

  17. Deciding medical problems in radiation protection for thirty years in the Boris Kidric Institute - Experimental and epidemiological experiences

    International Nuclear Information System (INIS)

    This paper deals with some research work carried out in the Medical Protection Laboratory of the Boris Kidric Institute of Nuclear Sciences - Vinca. Four research fields have been chosen: the analysis of contribution of collaborators Medical Protection Laboratory on symposium Yugoslav Radiation Protection Association (IRPA); from 1963 to 1989 years; the appearance on the meeting IAEA, International seminars, symposium and Congress, including European and international congress IRPA with presentation the most important obtained results; the activity in the frame research projects and contribution for solving important problems in the field of medical aspects of radiation protection in developing and applicable research; the survey current and practical trends in the future (author)

  18. Underrepresented Racial/Ethnic Minority Graduate Students in Science, Technology, Engineering, and Math (STEM) Disciplines: A Cross Institutional Analysis of their Experiences

    Science.gov (United States)

    Figueroa, Tanya

    Considering the importance of a diverse science, technology, engineering, and math (STEM) research workforce for our country's future, it is troubling that many underrepresented racial minority (URM) students start graduate STEM programs, but do not finish. However, some institutional contexts better position students for degree completion than others. The purpose of this study was to uncover the academic and social experiences, power dynamics, and programmatic/institutional structures URM students face within their graduate STEM programs that hinder or support degree progression. Using a critical socialization framework applied in a cross-comparative qualitative study, I focused on how issues of race, ethnicity, and underrepresentation within the educational contexts shape students' experiences. Data was collected from focus group interviews involving 53 URM graduate students pursuing STEM disciplines across three institution types -- a Predominately White Institution, a Hispanic-Serving Institution, and a Historically Black University. Results demonstrate that when students' relationships with faculty advisors were characterized by benign neglect, students felt lost, wasted time and energy making avoidable mistakes, had less positive views of their experiences, and had more difficulty progressing through classes or research, which could cause them to delay time to degree completion or to leave with a master's degree. Conversely, faculty empowered students when they helped them navigate difficult processes/milestones with regular check-ins, but also allowed students room to make decisions and solve problems independently. Further, faculty set the tone for the overall interactional culture and helping behavior in the classroom and lab contexts; where faculty modeled collaboration and concern for students, peers were likely to do the same. International peers sometimes excluded domestic students both socially and academically, which had a negative affect on

  19. Learner Experiences of Online Pre-lecture Resources for an Introductory Chemistry Course at an Irish Higher Education Institution

    OpenAIRE

    McDonnell, Claire

    2011-01-01

    The principal aim of this case study was to investigate students’ experiences of using online pre-lecture resources and their perceptions of their learning environment for the Introductory Chemistry module concerned. A subsidiary aim was to probe the experience of the lecturer involved of designing and piloting these resources and his perception of their impact on students’ learning. The student cohort who participated were a group of 49 first year level 8 undergraduate chemistry students at ...

  20. Role of radiation therapy in the treatment of carcinoma of the penis

    Energy Technology Data Exchange (ETDEWEB)

    Ravi, R.; Chaturvedi, H.K.; Sastry, D.V.L.N. (Cancer Inst., Madras (India))

    1994-11-01

    Radiation therapy (RT) has been used for many years in the treatment of squamous cell carcinoma of the penis, both for the primary tumour and for lymph node involvement in the groin. The main advantage of RT is preservation of the penis, which eliminates the psychological distress associated with amputation. Further, the proponents of RT claim that it is curative and allows surgical salvage without affecting the ultimate disease-free survival (DFS). Cancer of the penis is a common disease in southern India with a crude incidence of 1.9 per 100 000 men (population-based cancer registry, Cancer Institute, Madras). At the centre an average of 70 patients with penile carcinoma are treated every year. This study reports our experience with the use of RT for patients with penile carcinoma. (author).

  1. Role of radiation therapy in the treatment of carcinoma of the penis

    International Nuclear Information System (INIS)

    Radiation therapy (RT) has been used for many years in the treatment of squamous cell carcinoma of the penis, both for the primary tumour and for lymph node involvement in the groin. The main advantage of RT is preservation of the penis, which eliminates the psychological distress associated with amputation. Further, the proponents of RT claim that it is curative and allows surgical salvage without affecting the ultimate disease-free survival (DFS). Cancer of the penis is a common disease in southern India with a crude incidence of 1.9 per 100 000 men (population-based cancer registry, Cancer Institute, Madras). At the centre an average of 70 patients with penile carcinoma are treated every year. This study reports our experience with the use of RT for patients with penile carcinoma. (author)

  2. Salvageability of kidney in Grade IV renal trauma by minimally invasive treatment methods: A tertiary care single institute experience

    Directory of Open Access Journals (Sweden)

    Surya V Prakash

    2015-01-01

    Full Text Available Context: Renal trauma is increasingly being managed conservatively. Grade I-III injuries are managed conservatively whereas Grade V injuries may end in surgery. Managing Grade IV renal trauma is individualized and managed accordingly. Aims: To evaluate retrospectively all Grade IV renal injuries managed in our institute over five years and to review the available literature. Settings and Design: Reviewing the records of patients who sustained renal trauma and study all Grade IV renal injuries. Materials and Methods: We retrospectively analyzed all Grade IV renal injuries (16 managed at our institute between July 2008-August 2013. All patients were treated conservatively initially by hemodynamic stabilization, strict bed rest, if required endoscopic procedures. These patients were followed up with CECT. Statistical analysis: Descriptive statistics was performed using Microsoft excel spreadsheet 2007. Continuous data were described as mean and range. Categorical data was described as percentages. Results: Sixteen patients with Grade IV renal injury were included in the study. All patients had gross hematuria and 15 had urinary extravasation. D-J Stenting was done in 7 patients; perinephric tube drainage with D-J stentingwas done in 2 patients. One required selective upper pole arterial embolisation. Nephrectomy was not required in any of the patients. In the follow-up period, no patient had delayed complications. Conclusions: Successful conservative management of Grade IV renal trauma requires constant monitoring both clinically and radiologically, and if properly managed, kidneys can be salvaged in all stable patients as reinforced by our study.

  3. Patterns of Resection among Patients with Hepatic-Only Metastatic Colorectal Cancer a Single Institution Experience and Review

    Directory of Open Access Journals (Sweden)

    K. I. Quintyne

    2012-01-01

    Full Text Available Problem statement: Hepatic-only metastasis in colorectal cancer is not a rare clinical finding and can account for 30% of cases. However, only 10-25% of cases are suitable for hepatic resection as part of their treatment pathway. We sought to document our own findings by reviewing patients with hepatic-only disease. Approach: A retrospective analysis was designed to include all patients seen at our institution from 1st January 2000 until 30th June 2010 and information as derived from the patients� records. Results: Forty-four (44 patients were found, with an average age of 60.8 years and a male preponderance. The majority of patients (approximately 57% with hepatic-only metastases developed their disease following adjuvant therapy. Better overall survival was seen when a primary tumor had a low grade of histological differentiation and fewer than 3 hepatic lesions appreciated on conventional radiology. Better outcome was seen in patients who underwent hepatic resection. Conclusion: Patients with hepatic-only metastases are not uncommon within our institution. Hepatic resection afforded better outcome and compares favorably with published literature.

  4. The Importance of Institutional Asymmetries to the Development of Binational Aquifer Assessment Programs: The Arizona-Sonora Experience

    Directory of Open Access Journals (Sweden)

    Sharon B. Megdal

    2011-09-01

    Full Text Available Setting water policy depends fundamentally on the location of the supply and demand for water and the legal/institutional framework for water management. Within and across nations, laws and structures for water management decision making vary, often significantly. Recognizing these differences can aid in overcoming challenges inherent to the assessment and management of transboundary waters. This paper examines current binational efforts to develop the scientific information to support water management decision making along the United States-Mexico border. The particular focus is on transboundary aquifers along the border shared by the states of Arizona in the United States and Sonora in Mexico. Legislation enacted in the United States (Public Law 109–448 established a governmental-academic partnership to assess transboundary aquifers. The paper discusses the establishment of a working partnership between Mexico and the United States, which led to an official binational cooperative framework for transboundary assessment. It explains how the extensive effort to recognize and accommodate asymmetries in the underlying legal and regulatory frameworks for water management was essential to meeting the objectives of both countries. The focus of the binational investigations is briefly discussed. The paper concludes by noting the opportunities for additional cross-border scientific and water management collaboration should funding and institutional commitments continue.

  5. Institutional provisions for administration of rural development programmes: experience from Fadama 111 development programme in Taraba state, Nigeria

    Directory of Open Access Journals (Sweden)

    M.U. Dimelu

    2014-12-01

    Full Text Available The study examined institutional provisions in the implementation of Fadama 111 Development Project in Taraba State, Nigeria during 2008-2013. All the staff of the project (57 from eight out of 16 local government areas participated in the programme was used in the study. Data were collected with questionnaire and analysed using descriptive statistics. The results showed strong linkages of the state Fadama coordinating office with government parastaltals and organizations at different levels of the project implementation. There were strong adherence to rules and regulations guiding staff recruitment, financial management, preparation of local development plan, environmental compliance and friendliness, and group formation. The project was constrained by several institutional factors namely delay in the payment of counterpart fund by the government (M=3.39, lack of transport and other logistic supports (M=3.06, lack of payment of counterpart fund by the government (M=3.04 and others. The study recommends that policy makers and development planner should ensure functional mechanisms that could foster and enhance linkages, and support adherence to rules and regulations prescribed for implementation of development programmes.

  6. Radiation therapy with or without primary limited surgery for operable breast cancer: A 20-year experience at the Marseilles Cancer Institute

    International Nuclear Information System (INIS)

    At the Marseilles Cancer Institute, the authors' first source of radioactive cesium was promptly applied to the treatment of breast cancer, to which it seemed ideally suited because of good superficial and intermediate penetration. Their favorable early experience led them to embark on a program of conservative treatment of operable breast cancer, which has supplanted the routine use of radical mastectomy at our institution. Since June 1960, more than 3000 consecutive operable breast cancers were treated primarily with radiation therapy with or without initial limited surgery. This paper presents the treatment results in 1440 cases eligible for five-year analysis, including 320 ten-year cases, thus representing the largest series of breast cancer patients treated with modern radiation therapy techniques thus far reported in the literature

  7. Spectrum of High Resolution Computed Tomography Findings in Occupational Lung Disease: Experience in a Tertiary Care Institute

    Directory of Open Access Journals (Sweden)

    Satija Bhawna

    2013-01-01

    Full Text Available Objective: To study the spectrum of high resolution computed tomography (HRCT findings in occupational lung disease in industrial workers and to assess the utility of International classification of HRCT for occupational and environmental respiratory diseases (ICHOERD. Materials and Methods: Retrospective analysis of radiological data (radiographs and computed tomography chest scans gathered over a period of 3 years (January 2010- December 2012 of industrial workers in an organised sector who presented with respiratory complaints. The HRCT findings were evaluated using ICHOERD. Results: There were 5 females and 114 males in the study, with a mean age of 49 years. These workers were exposed to different harmful agents including silica, asbestos, cotton dust, metal dust, iron oxide, organic dust, rubber fumes, plastic fumes, acid fumes, and oil fumes. There were 10 smokers in the study. The radiograph of chest was normal in 53 patients. 46% of these normal patients (21.8% of total demonstrated positive findings on HRCT. When the radiograph was abnormal, HRCT provided more accurate information and excluded the other diagnosis. The HRCT findings were appropriately described using the ICHOERD. Bronchiectasis was the most common finding (44.5% with mild central cylindrical bronchiectasis as the most common pattern. Pleural thickening was seen in 41 patients (34.5%. Enlarged hilar or mediastinal lymphnodes were seen in 10 patients (8.4% with egg-shell calcification in 1 patient exposed to silica. Bronchogenic carcinoma was seen in 1 patient exposed to asbestos. Conclusions: Occupational lung disease is a common work related condition in industrial workers even in the organized sector. Though chest radiograph is the primary diagnostic tool, HRCT is the undisputed Gold Standard for evaluation of these patients. Despite the disadvantage of radiation exposure, low dose CT may serve as an important tool for screening and surveillance. The ICHOERD is a

  8. Radiotherapy with or without chemotherapy in the treatment of anal cancer. 20-year experience from a single institute

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrian, K.; Sauer, T.; Klemm, S.; Bayer, C.; Haller, B.; Molls, M.; Geinitz, H. [Technische Univ. Muenchen (Germany). Klinikum rechts der Isar

    2013-01-15

    Purpose: To report the efficacy and toxicity of radio(chemo)therapy (RCT) in the management of squamous cell anal carcinoma (SQ-AC) and to evaluate the prognostic factors influencing the outcomes. Patients and methods: A consecutive cohort of 138 patients with cT1-4, cN0-3, cM0 SQ-AC were treated with RCT between 1988 and 2011 at our department. Median follow-up time for surviving patients from the start of RCT was 98 months (range, 1-236 months). Patients were treated with a median radiation dose of 56 Gy (range, 4-61 Gy). Concurrent chemotherapy was administered to 119 patients (86%). Results: The survival rates at 2, 5, and 10 years were 88 {+-} 3, 82 {+-} 4, and 59 {+-} 6%, respectively, with a median overall survival (OS) of 167 months. The cumulative incidence for local recurrence at 2 and 5 years was 8 {+-} 2 and 11 {+-} 3%, respectively. The median disease-free survival (DFS) and colostomy-free survival (CFS) times were 132 and 135 months, respectively. In 19 patients (14%), a distant metastasis was diagnosed after a median time of 19 months. In the multivariate analysis, UICC (International Union Against Cancer) stage I-II, female gender, Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and good/moderate histologic differentiation (G1-2) were significantly associated with a better OS, DFS, and CFS. Conformal radiotherapy planning techniques were significantly associated with a lower cumulative incidence of local recurrence (11 {+-} 3% vs. 38 {+-} 19% at 5 years, p = 0.006). A higher radiation dose beyond 54 Gy was not associated with an improvement in outcome, neither for smaller - (T1/T2) nor for larger tumors (T3/T4). Conclusion: RCT leads to excellent outcomes - especially in patients with stage I/II and G1/G2 tumors - with acceptable toxicity. The probable advantages of high-dose radiotherapy should be considered carefully against the risk of a higher rate of toxicity. Future studies are needed to investigate the role of a more

  9. Carcinoma multiplex

    International Nuclear Information System (INIS)

    Multiple primaries in a single patient are uncommon, though not very rare. The existence of such cancers in two un-related, non-paired organs is even more un-common. Here, we present a case of 55 years old male who presented to us with a mucoepidermoid carcinoma of the parotid gland and was operated. Later on, he presented with a large cystic swelling in the pelvis which turned out to be pseudomyxoma peritonei. A review of slides and immunohistochemistry indicated it to be adenocarcinoma colon. He presented again with recurrent mucoepidermoid carcinoma of the parotid which was operated successfully with the use of myocutaneous flap for wound closure. He is currently undergoing chemotherapy. In order to establish a separate mono-clonal etiology of both tumours, immunohistochemistry was performed. To the best of our knowledge, carcinoma multiplex in the colon and the parotid has never been reported before. (author)

  10. Parotid carcinoma

    DEFF Research Database (Denmark)

    Godballe, Christian; Schultz, Joyce H; Krogdahl, Annelise;

    2003-01-01

    OBJECTIVE: To analyze clinical data and possible prognostic factors of patients with primary carcinoma of the parotid gland. STUDY DESIGN: A retrospective study was made of 85 patients with suspected parotid cancer who were admitted to the Center of Head and Neck Oncology at Odense University...... guidelines from the World Health Organization. Five tumors (6%) did not fulfill the criteria of malignancy and were reclassified as benign. In another five cases the assumed primary parotid carcinomas were found to be metastatic disease from cancers of the breast, prostate, skin, and lungs. Ten patients (12...... significant influence on survival. CONCLUSIONS: A thorough histological revision is pivotal in retrospective parotid carcinoma studies, and tumor size; histological appearance; T, N, and M status; stage; facial nerve dysfunction; and pain from the face and/or neck seem to be significant prognostic indicators...

  11. Acute renal failure--etiologic and therapeutic considerations. A five-year experience at a single institution.

    Science.gov (United States)

    Dimitrakov, D; Despotov, T; Kumtchev, E; Tzekov, V; Tilkian, E; Manev, E; Stavrev, P; Velitchkova, E; Pandeva, S; Nikolov, D

    1997-01-01

    In the present study we highlight the epidemiology, etiologic spectrum, and evaluation of ARF in adults. We then expand on the pathophysiologic mechanisms of renal failure and discuss the rationale for current therapeutic strategies in ARF patients. A total of 79 patients (45 male, female 34), aged 18-75 years (median age 51.2 +/- 17.7 years) with acute renal failure were studied in 5 years (January 1990 through October 1995). Emergency hemodialysis sessions following an acute anuric episode were instituted in 39 cases (49.3% of all patients). The median number of hemodialysis procedures per patient treated at our institution was 3.2 +/- 1.9. The total number of acute interstitial nephritis-associated ARF was 40. In 30 of them (75%) the acute renal insult included a combination of several therapeutic antimicrobial agents, in 2 cases (5%) ARF followed the administration of nonsteroidal anti-inflammatory drugs, in 1 (2.5%) it resulted from a combined therapeutic regimen and in the remaining 5 (12.5%) from the application of a single drug. Acute interstitial nephritis developed in 2 patients following a viral infection. In the hemodialysis-treated ARF group 12 patients (29.77%) had interstitial nephritis and 2 patients (5.13%) presented with renal impairment for an unspecified period of time preceding the development of overt ARF. In a subset of this group of patients, ARF occurred in 7 patients (17.95%) following an urologic intervention, in 8 patients (20.51%) as a consequence of thermal or mechanical trauma or intoxication and in 3 cases (7.69%) it resulted from fever of unknown origin. Three patients with postoperative peritonitis and 4 other (10.26%) with postoperative complications were encountered in our series. No cases of septic abortion-related or obstetric-related ARF were recorded. 92.3% of all hemodialysis-treated patients seen at our Institution had received a combination of antibiotics and only 2 patients had been pre-treated with a single antimicrobial

  12. Changes in the types of liver diseases requiring hepatic resection: a single-institution experience of 9016 cases over a 10-year period

    Science.gov (United States)

    Cho, Hwui-Dong; Lee, Young-Joo; Park, Kwang-Min; Kim, Ki-Hun; Kim, Jin Cheon; Ahn, Chul-Soo; Moon, Deok-Bog; Ha, Tae-Yong; Lee, Sung-Gyu

    2016-01-01

    Backgrounds/Aims To understand the changing demands for hepatic resection (HR), we collected data regarding HR performed in a tertiary centre over a period of 10 years. Methods We carried out extensive search of institutional databases to identify HR cases performed between January 2005 and December 2014. A study cohort of 9,016 patients were divided into 5 disease categories, namely hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), intrahepatic duct stone disease (IHDS), colorectal cancer liver metastasis (CRLM), and uncommon/rare diseases (URD). Results There were 5,661 (62.8%) HCC cases, followed by 1441 (16.0%) CRLM, 942 (10.5%) ICC, 638 (7.1%) IHDS and 334 (3.7%) URD. The number of annual HR cases gradually increased from 443 in 2005 to 1,260 in 2015. Annual HCC cases also gradually increased, but the annual proportion of HCC cases fluctuated narrowly between 58.3% and 70.2%. Annual CRLM cases increased rapidly, and their proportion increased progressively from 4.7% to 20.5%. Annual ICC cases increased slowly, and their annual proportion fluctuated between 7.2% and 15.6%. Annual IHDS cases decreased slowly, and their annual proportion decreased progressively from 17.2% to 3.4%, while annual URD cases fluctuated, with annual proportions varying between 2.3% and 5.6%. Conclusions Annual cases of HR increased over the last 10 years in a tertiary center probably due to a center-specific centralization effect. The number of CRLM cases increased rapidly; those of HCC and ICC increased gradually, and those of IHDS declined gradually. We believe that these results reflect real changes in the types of liver disease requiring HR. PMID:27212990

  13. Experience in using radioactive waste management technologies during the remediation of RRC Kurchatov Institute facilities and areas

    International Nuclear Information System (INIS)

    The paper describes the work carried out to remediate the historic radioactive waste repositories at the Kurchatov Institute in Moscow. The sites are located in close proximity to densely populated urban areas and, therefore, special care was required during the work in order to protect the local population. The approaches and technologies applied are described, with particular emphasis on the use of modern techniques for remote waste handling and for remote monitoring and visualization of the most radioactive active materials. Work on disposition of old radioactive waste repositories has been conducted at the site of the Russian Research Centre 'Kurchatov Institute' since 2002. These repositories were constructed in 1943-1963 when the Kurchatov Institute was involved in the creation of nuclear weapons and the development of the nuclear power industry. Eight of the ten repositories contained low and intermediate level waste in a form that allowed its easy extraction. In 2004-2005, work was performed on the disposition of repository No.4, which was not easily accessible for the extraction of radwaste since it contained high level waste encased in concrete. From the start of the remediation activities, over 2400 cubic metres of solid radwaste were extracted and removed from the Kurchatov Institute site to the site of the specialized MosNPO Radon enterprise. In specific cases, a technology of electric discharge destruction of concrete structures was used for the demolition of the concrete roofing of the repositories. Intermediate- and high-level waste management operations were performed using remotely controlled robots Brokk-110 and Brokk-330. In the case of high radiation fields, this equipment was used for sorting the waste, and cutting and packing it into special containers. New devices for the measurement of radioactive waste specific activity and the detection of intense gamma radiation sources, and devices for radiation monitoring in working areas and at the

  14. Prophylactic cranial irradiation in patients with small-cell lung cancer: the experience at the Institute of Oncology Ljubljana

    International Nuclear Information System (INIS)

    Prophylactic cranial irradiation (PCI) has been used in patients with small-cell lung cancer (SCLC) to reduce the incidence of brain metastases (BM) and thus increase overall survival. The aim of this retrospective study was to analyze the characteristics of patients with SCLC referred to the Institute of Oncology Ljubljana, their eligibility for PCI, patterns of dissemination, and survival. Medical charts of 357 patients with SCLC, referred to the Institute of Oncology Ljubljana between January 2004 and December 2006, were reviewed to determine characteristics of patients chosen for PCI. The following data were collected: age, gender, performance status (PS), extent of the disease, smoking status, type of primary treatment with outcome, haematological and biochemical parameters, PCI use, and finally brain metastases (BM) status at diagnoses and after treatment. PCI was performed in 24 (6.7%) of all patients. Six (25%) patients developed brain metastases after they were treated with PCI. Brain was the only site of metastases in 4 patients, two progressed to multiple organs. Median overall survival of patients with PCI was 21.9 months, without PCI 12.13 months (p = 0.004). From the collected data there were good prognostic factors: age under 65 years, limited disease (LD), performance status, normal levels of lactate dehydrogenase (LDH) and normal levels of C-reactive protein levels (CRP). Other prognostic factors did not show statistical significant values. Survival of patients with LD, who have had PCI, was significantly better than those who had not. We decided to perform PCI in patients with LD, in those with complete or near complete response, and those with good performance status (≥ 80). We did not use PCI in extended disease (ED). The reason for that shall be addressed in the future. Doses for PCI were not uniform, therefore more standard approach should be considered

  15. Concomitant bid radiotherapy with cisplatin and 5-fluorouracil in unresectable carcinoma of the pharynx: 10 year's experience at the Centre Antoine Lacassagne; Radiotherapie bifractionnee et chimiotherapie par cisplatine et 5-fluoro-uracile concomitantes dans les carcinomes epidermoides localement evolues non resecables du pharynx: dix ans d'experience au centre Antoine Lacassagne

    Energy Technology Data Exchange (ETDEWEB)

    Magne, N.; Pivot, X.; Marcy, P.Y.; Chauvel, P.; Courdi, A.; Dassonville, O.; Possonnet, G.; Vallicioni, J.; Ettore, F.; Falewee, M.N.; Milano, G.; Santini, J.; Lagrange, J.L.; Schneider, M.; Demard, F.; Bensadoun, R.J. [Centre Antoine-Lacassagne, 06 - Nice (France)

    2001-08-01

    Patients suffering from locally advanced unresectable squamous cell carcinoma of the oropharynx and hypopharynx treated with radiotherapy alone have a poor prognosis. More than 70% of patients die within 5 years mainly due to local recurrences. The aim of this study was to evaluate retrospectively the Antoine Lacassagne Cancer Center's experience in a treatment by concomitant bid radiotherapy and chemotherapy. Evaluation was based on analysis of the toxicity, the response rates, the survival, and the clinical prognostic factors. From 1992 to 2000, 92 consecutive patients were treated in our single institution. All of them had stage IV, unresectable squamous cell carcinoma of the pharynx and they received continuous bid radiotherapy (two daily fractions of 1.2 Gy, 5 days a week, with a 6-h minimal internal between fractions). Total radiotherapy dose was 80.4 Gy on the oropharynx and 75.6 Gy on the hypopharynx. Two or three chemotherapy courses of cisplatin (CP)-5-fluorouracil (5FU) were given during radiotherapy at 21 -day intervals (third not delivered after the end of the radiotherapy). CP dose was 100 mg/m{sup 2} (day 1) and 5-FU was given as 6-day continuous infusion (750 mg/m{sup 2}/day at 1. course; 430 mg/m{sup 2}/day at 2. and 3. courses). Special attention was paid to supportive care, particularly in terms of enteral nutrition and mucositis prevention by low-level laser energy. Acute toxicity was marked and included WHO grade III/IV mucositis (89%, 16% of them being grade IV), WHO grade III dermatitis (72%) and grade III/IV neutropenia (61%). This toxicity was significant but manageable with optimised supportive care, and never led to interruption of treatment for more than 1 week, although there were two toxic deaths. Complete global response rate at 6 months was 74%. Overall global survival at 1 and 3 years was 72% and 50% respectively, with a median follow-up of 17 months. Prognostic factors for overall were the Karnofsky index (71% survival at 3

  16. Using ICT at an Open Distance Learning (ODL) Institution in South Africa: The Learning Experiences of Students with Visual Impairments

    Science.gov (United States)

    Mokiwa, S. A.; Phasha, T. N.

    2012-01-01

    For students with visual impairments, Information and Communication Technology (ICT) has become an important means through which they can learn and access learning materials at various levels of education. However, their learning experiences in using such form of technologies have been rarely documented, thus suggests society's lack of…

  17. Stages III and IV squamous cell carcinoma of the mouth: Three-year experience with superselective intraarterial chemotherapy using cisplatin prior to definitive treatment

    International Nuclear Information System (INIS)

    Purpose: This study was designed to assess the 3-year experience with superselective intraarterial chemotherapy prior to definitive treatment for stages III and IV squamous cell carcinomas of the mouth.Methods: Twenty-two patients prospectively received superselective intraarterial chemotherapy using relatively low-dose cisplatin via a transfemoral approach. The locations of the tumors were the tongue (n=12), gingiva (n=5), buccal mucosa (n=2), hard palate (n=1), floor of the mouth (n=1), and lip (n=1). After intraarterial chemotherapy, 21 patients underwent surgery (n=14), radiation therapy (n=6), or both (n=1). The survival rate of 25 patients who underwent surgery with/without radiationtherapy until 1992 at Kumamoto University Hospital was also evaluated as a historical control. The survival curve was calculated with the Kaplan-Meier method, and the statistical difference between survival curves was determined with the generalized Wilcoxon test.Results: The overall response rate was 95% [complete response (tumor completely resolved), 24%; partial response (tumor reduction ≥50%), 71%]. Fifty-two intraarterial infusions were performed without any catheter-related complications. Mild and transient local toxicity such as edema or mucositis of the infused area was relatively common. One patient died of renal failure from cisplatin. After a median follow-up of 20 months (range 2-41 months), the estimated 3-year survival rate for patients who underwent intraarterial chemotherapy plus surgery was 91%. The survival of the patients who underwent intraarterial chemotherapy plus surgery tended to be longer than that of the historical control.Conclusions: Early tumor reduction without delay of subsequent treatments can be obtained by intraarterial chemotherapy while minimizing complications and possibly improving survival. Further investigations of long-term survival with larger series need to be performed.

  18. Clinico-pathological pattern, classification and staging of urinary bladder carcinomas - a five years experience at a tertiary care hospital in central punjab

    International Nuclear Information System (INIS)

    In Pakistan, urinary bladder carcinoma is the 8th commonest malignancy while being the fourth commonest cancer in men. The relative occurrence of a particular histological type of bladder carcinoma depends on the clinical setting. Both grade and stage of these cancers are highly correlated with recurrence, progression and patient survival rates. Methods: This cross-sectional study comprised of 122 patients with newly diagnosed operable primary bladder carcinomas who underwent cystoscopy associated transurethral resection of bladder tumour at the Urology Department of Punjab Employees Social Security Hospital, Lahore. All participants completed a detailed questionnaire and underwent an in-depth interview to obtain data. The surgical specimens were referred to the Pathology department. Gross observations of the tumour recorded. Result: A total of 114 cases, classified according to WHO/ISUP criteria, low-grade papillary lesions, comprising Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) and Papillary Low Grade carcinomas, accounted for 43% of tumours. Male to female ratio being 5.3:1 (74%). Lateral walls were involved in 44%, posterior wall in 25.3%, trigone in 10.7%, bladder neck in 7.2%, dome in 5.8%, ureteric orifice in 4.13%, anterior wall in 2% and left ureter in 0.87% cases. Tumour staging revealed an overall 11.5% of tumours with stage Ta and 31.5% with stage T3-4. About 29% tumours were non invasive. About n=13 of low-grade carcinomas and n=68 of high-grade carcinomas were invasive. For tumours classified by WHO/ISUP criteria, the percentage of women was larger for PUNLMP than for the other categories of urothelial tumours (p-value 0.006); no statistically significant difference was found by age or gender with respect to tumour stage (p-value 0.138 and 0.452). Conclusion: Transitional Cell Carcinoma (TCC) is the commonest among middle aged men. (author)

  19. Helical tomo-therapy for axial and para-spinal tumours: Experience of Institut Bergonie (14 cases); Experience de l'institut Bergonie a propos de 14 cas de tomotherapie helicoidale de tumeurs axiales et para-axiales

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, H.; Dejean, C.; Henriques de Figueiredo, B.; Sargos, P.; Caron, J. [Departement de radiotherapie, institut Bergonie, centre regional de lutte contre le cancer de Bordeaux et du Sud-Ouest, 229, cours de l' Argonne, 33076 Bordeaux cedex (France); Stoeckle, E. [Departement de chirurgie, institut Bergonie, centre regional de lutte contre le cancer de Bordeaux et du Sud-Ouest, 229, cours de l' Argonne, 33076 Bordeaux cedex (France); Bui, B.N.; Italiano, A. [Departement d' oncologie medicale, institut Bergonie, centre regional de lutte contre le cancer de Bordeaux et du Sud-Ouest, 229, cours de l' Argonne, 33076 Bordeaux cedex (France); Gille, O. [Service d' orthopedie, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amelie-Raba-Leon, 33076 Bordeaux cedex (France); Kantor, G. [Departement de radiotherapie, institut Bergonie, centre regional de lutte contre le cancer de Bordeaux et du Sud-Ouest, 229, cours de l' Argonne, 33076 Bordeaux cedex (France); Universite Victor-Segalen Bordeaux 2, 146, rue Leo-Saignat, 33076 Bordeaux cedex (France)

    2011-08-15

    Purpose. - To evaluate the feasibility of helical tomo-therapy intensity-modulated radiotherapy for the treatment of axial and para-spinal tumours. Patients and methods. - Fourteen consecutive patients with axial and para-spinal tumours at the Bergonie Institute between June 2007 and June 2009 were analysed. Various localizations were observed: four paravertebral tumours, five primitive vertebral tumours and six ilio-sacral or sacral tumours. Results. - The dose prescribed to the median of the planning target volume (PTV) varied from 45 to 68 Gy depending on histology. The maximum dose delivered to the PTV (D near max or D 2%) was 60.6 Gy (range 46.3-69.1). In the five cases where the tumour was located close to the spinal cord, the median value of D near max was 40.1 Gy (range 37.8-45.4). In the seven where the tumour was situated close to the cauda equina, the median value of D near max was 46.5 Gy (range 39.2-60). For two cases in whom the sciatic nerve was the nervous structure at risk, the D near max was 64.4 and 67 Gy. Six patients were in complete remission, six patients suffered a relapse at a median follow-up of 14.5 months (4-24), two died following local tumour progression and metastasis, tumoral stabilisation had been obtained in two patients. Treatment was well tolerated and was never interrupted in all patients. Conclusions. - Results from this preliminary series are encouraging, particularly concerning the good tolerance of this new intensity-modulated radiotherapy presently more available than proton therapy. (authors)

  20. The Experience Of The Meteorological Support By The National Institute Of Meteorology During The XV Pan-american Games

    Science.gov (United States)

    Seabra, M.; Gonçalves, P.; Braga, A.; Raposo, R.; Ito, E.; Gadelha, A.; Dallantonia, A.

    2008-05-01

    emitted in Portuguese, English and Spanish, and sent to the INMET homepage, organizing committee, and specific area (intranet) accessed only by the athletes and technical commissions. Direct interaction with the game organizers allowed for a more efficient and precise decision-making process regarding meteorological effects in some sport modalities. As an example we can mention the fact that during the women marathon competition a low humidity alert was forecasted and the organizers took care to increase hydratation to prevent problems. INMET's participation during the XVth Pan-American Games, which took place in Rio de Janeiro in July 2007, represented a good opportunity for the institute to provide a tailor-made short range forecast with specific application. INMET's performance was recognized by the organizing committee and the occasion helped to divulge products and services provided by the institution.

  1. EXPERIENCE SANITARY-EPIDEMIOLOGICAL EXAMINATION PROJECT OF PLACING A SOURCE OF IONIZING RADIATION (GENERATING IN HEALTH CARE INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    I. A. Rakitin

    2015-10-01

    Full Text Available The article reviews the results of long-term sanitary-epidemiological examination of projects of placing of ionizing radiation (generating sources in health care institutions of Saint-Petersburg. The majority among the placed sources presented for examination was X-ray diagnostic units and sets – 35.7%, dentist X-rays – 39.4% and fluorography units – 10.8%. Mammography units and computer tomographs made 6.7% each, accelerants – 0.7%.The most frequent reasons of primary refusals to accept design documentation were: absence of calculations of protection against all placed diagnostic X-ray devices (23.6% – at placing of diagnostic X-ray sets, 16.2% – at placing of dentist devices, absence of the upper floors layouts (26.5% – at placing of dentist X-rays and absence of permitting documentation for X-ray devices (at placing of dentist X-ray devices – 22.2%.At carrying out of design activity of special importance is creation of medical and technical projects which were absent in 22.9% of presented projects and in 34.6% were replaced with technical projects. Significant drawbacks of the projects were ignoring the necessity to consider the distance from the personnel workplaces and the width of technical passes (34.0%. That was caused by the absence of corresponding documentation from suppliers of equipment for X-ray rooms.At calculation of protection against X-ray radiation in 11.3% of projects of placing X-ray diagnostic devices (sets and in 7.7% of projects of placing dentist X-ray devices, radiation directivity factors (N were determined incorrectly.Of importance is the issue of adequate choice of building and finishing materials. In 50.0% of projects of placing of diagnostic X-ray devices (sets and 37.6% of projects of placing dentist X-ray devices there were no sanitary-epidemiological conclusions regarding the building and finishing materials to confirming their feasibility for healthcare institutions.Analysis of the main stages

  2. Librarians as Part of Cross-Disciplinary, Multi-Institutional Team Projects: Experiences from the VIVO Collaboration

    OpenAIRE

    GARCIA-MILIAN, ROLANDO; NORTON, HANNAH F.; Auten, Beth; Davis, Valrie I.; Kristi L. Holmes; Johnson, Margeaux; Tennant, Michele R.

    2013-01-01

    Cross-disciplinary, team-based collaboration is essential for addressing today’s complex research questions, and librarians are increasingly entering into such collaborations. This study identifies skills needed as librarians integrate into cross-disciplinary teams, based on the experiences of librarians involved in the development and implementation of VIVO, a research discovery and collaboration platform. Participants discussed the challenges, skills gained, and lessons learned throughout t...

  3. Salvage Fractionated Stereotactic Radiotherapy with or without Chemotherapy and Immunotherapy for Recurrent Glioblastoma Multiforme: A Single Institution Experience

    OpenAIRE

    Hasan, Shaakir; Chen, Eda; Lanciano, Rachelle; Yang, Jun; Hanlon, Alex; Lamond, John; Arrigo, Stephen; Ding, William; Mikhail, Michael; Ghaneie, Arezoo; Brady, Luther

    2015-01-01

    Background The current standard of care for salvage treatment of glioblastoma multiforme (GBM) is gross total resection and adjuvant chemoradiation for operable patients. Limited evidence exists to suggest that any particular treatment modality improves survival for recurrent GBM, especially if inoperable. We report our experience with fractionated stereotactic radiotherapy (fSRT) with and without chemo/immunotherapy, identifying prognostic factors associated with prolonged survival. ...

  4. Interval colorectal carcinoma: An unsolved debate.

    Science.gov (United States)

    Benedict, Mark; Galvao Neto, Antonio; Zhang, Xuchen

    2015-12-01

    Colorectal carcinoma (CRC), as the third most common new cancer diagnosis, poses a significant health risk to the population. Interval CRCs are those that appear after a negative screening test or examination. The development of interval CRCs has been shown to be multifactorial: location of exam-academic institution versus community hospital, experience of the endoscopist, quality of the procedure, age of the patient, flat versus polypoid neoplasia, genetics, hereditary gastrointestinal neoplasia, and most significantly missed or incompletely excised lesions. The rate of interval CRCs has decreased in the last decade, which has been ascribed to an increased understanding of interval disease and technological advances in the screening of high risk individuals. In this article, we aim to review the literature with regard to the multifactorial nature of interval CRCs and provide the most recent developments regarding this important gastrointestinal entity. PMID:26668498

  5. Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

    Directory of Open Access Journals (Sweden)

    Eun-Kyung Woo

    2013-09-01

    Full Text Available Background This paper discusses the treatment protocol for patients with frostbite.Methods We performed a retrospective analysis of a series of 17 patients with second- andhigher-degree frostbite who had been treated at our medical institution between 2010 and2012.Results Our clinical series of patients (n=17 included 13 men and four women, whosemean age was 42.4±11.6 years (range, 22-67 years. The sites of injury include the foot in sixpatients (35.3%, the hand in six patients (35.3% and the facial region in five patients (29.4%.Seven patients with second-degree frostbite were completely cured with only conservativetreatment during a mean period of 12.7±3.3 days (range, 8-16 days. Of the five patients withthird-degree frostbite, two underwent skin grafting following debridement, and the remainingthree achieved a complete cure with conservative treatment during a mean period of 35±4.3days (range, 29-39 days. Five patients with fourth-degree frostbite were treated with surgicalprocedures including amputation.Conclusions With the appropriate conservative management in the early stage of onset,surgeons should decide on surgery after waiting for a sufficient period of time until thedemarcation of the wound. Continuous management of patients is also needed to achievefunctional recovery after a complete cure has been achieved. This should also be accompaniedby patient education for the avoidance of re-exposure to cold environments.

  6. Successful Treatment in Children with Hodgkin Lymphoma in Greece; A 20-Year Experience in a Single Institution

    Directory of Open Access Journals (Sweden)

    Apostolos Pourtsidis

    2012-01-01

    Full Text Available During the last 30 years, combined chemotherapy regimens with radiotherapy or not significantly improved the prognosis for patients with Hodgkin lymphoma. We retrospectively studied 58 children (35 boys and 23 girls with Hodgkin lymphoma who were treated at our institution during the period 1987–2006 and we correlated age, sex, stage, histology, and therapy with the outcome of patients. Of our patients, 9 children were 8 years old or younger. Nodular sclerosis was the predominant histology subtype (69%, whereas 26 patients (45% had advanced disease (stage III or IV. Chemotherapy (CT with various drug combinations, according to the period of treatment plus low-dose involved field radiation therapy (IFRT, was used in all patients. Five children experienced relapse and in 3 other patients second or third malignancies were documented. The overall survival was found to be 98%. No factors related to the outcome could be detected. The prognosis of children with Hodgkin lymphoma is excellent with CT combined with low dose IFRT but in long-time survivors late effects of the combined modality treatment are still issues of major concern. Longer followup of a greater number of patients is necessary to detect prognostic factors related to the outcome of children with Hodgkin lymphoma and to identify some patients who would be treated without radiation.

  7. DEMOGRAPHIC AND CLINICOPATHOLOGIC FEATURES OF PATIENTS WITH PRIMARY BREAST CANCER TREATED BETWEEN 1997 AND 2010: A SINGLE INSTITUTION EXPERIENCE.

    Science.gov (United States)

    Žitnjak, Daniela; Soldić, Željko; Kust, Davor; Bolanća, Ante; Kusić, Zvonko

    2015-09-01

    Breast cancer accounted for 28% of all new cancers and 18% of female cancer deaths in Europe in 2010. It is the most common type of cancer in women in Croatia, with an incidence rate of 56.9/100 000 in the year 2010, and the highest number of newly diagnosed women aged between 60 and 64. Multiple factors are associated with an increased risk of breast cancer: advancing age, family history, exposure to endogenous and exogenous reproductive hormones, dietary factors, benign breast disease, and environmental factors. To assess demographic and clinicopathologic features of primary breast cancer, we retrospectively analyzed 870 patients treated in our institution between 1997 and 2010. Data were obtained from medical documentation and a printed questionnaire regarding life habits. Most of our patients presented with a breast lump and were self-diagnosed by breast examination. This fact highlights the need of regular breast self-examination, although it should also be taken into account that most of our patients did not attend regular mammography screening (only 31%). One of the most concerning facts is that the mean time from observing the first symptom to visiting a physician was 4 months. Previous studies have identified ignorance, fear and fatalistic attitudes, poor socioeconomic conditions, and illiteracy as important factors resulting in delay. Considering these facts, education and raising awareness about the disease in the general population is one of the key weapons for lowering breast cancer mortality. PMID:26666098

  8. A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England

    Directory of Open Access Journals (Sweden)

    Hallsworth Michael

    2011-03-01

    Full Text Available Abstract Background The National Institute for Health Research (NIHR was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS. NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR. Method Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR's strategic goals, which could be reported to NIHR's leadership team on a quarterly basis via an oversight dashboard. Results Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting. Conclusions The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives.

  9. Clinical features and outcomes of plasma cell leukemia: a single-institution experience in the era of novel agents

    Directory of Open Access Journals (Sweden)

    Giampaolo Talamo

    2012-06-01

    Full Text Available Plasma cell leukemia (PCL is a rare hematologic malignancy with aggressive clinical and biologic features. Data regarding its prognosis with the use of the novel agents, i.e., the immunomodulatory drugs thalidomide and lenalidomide, and the proteasome inhibitor bortezomib, are limited. We retrospectively reviewed clinical outcomes, response to therapy, and survival of 17 patients seen at the Penn State Hershey Cancer Institute since the availability of novel agents (2006-2011. Twelve patients had primary PCL (pPCL, and 5 second- ary PCL (sPCL. PCL was associated with aggressive clinicobiological features, such as high-risk cytogenetics, elevated serum beta-2-microglobulin and lactate dehydrogenase, International Staging System stage III, and rapid relapse after therapy. With the use of thalidomide, lenalidomide, and bortezomib in 53%, 53%, and 88% patients, respectively, median overall survival (OS was 18 months in the whole group (95% confidence interval, 11-21 months, and 21 and 4 months in pPCL and sPCL, respectively (P=0.015. OS was inferior to that of 313 consecutive patients with multiple myeloma (MM treated in the same period, even when compared with a subset of 47 MM with high-risk cytogenetics. Although our data are limited by the small sample size, we conclude that novel agents may modestly improve survival in patients with PCL, when compared to historical controls. Novel therapies do not seem to overcome the negative prognosis of PCL as compared with MM.

  10. Carcinoma vulvar

    Directory of Open Access Journals (Sweden)

    Yamit Peñas Zayas

    2015-11-01

    Full Text Available El carcinoma de la vulva tiene una incidencia de aproximadamente un 3-5% dentro de todas las enfermedades ginecológicas malignas. El 90% de los tumores malignos de la vulva está constituido por carcinoma epidermoide, el resto son adenocarcinomas, carcinomas de células basales y melanomas. Se realiza la presentación de un caso de una paciente femenina de 25 años de edad con antecedentes  de Diabetes Mellitus tipo II y trombopatia, que ingresa en el servicio de ginecología con un cuadro cutáneo polimorfo, localizado en labios mayores y menores, dado por lesiones eritematoerosivas y vegetante, sospechándose clínicamente el diagnóstico  de un carcinoma epidermoide, corroborándose el mismo histológicamente al realizarse biopsia de piel. Se indicó tratamiento con quimioterapia. Por la edad de la paciente y ser menos frecuente en mucosa que en la piel,  motivo la presentación del caso.

  11. Parathyroid carcinoma

    DEFF Research Database (Denmark)

    Qvist, N; Krøll, L; Ladefoged, C;

    1986-01-01

    Parathyroid carcinoma is a slow growing tumor, and the patients most often die from complications to the hypercalcemia. Therefore, any attempt should be made to remove local recurrence and metastasis surgically, as medical treatment is disappointing. A case treated with extensive vascular surgery...

  12. Results and experience of 10 years of US-Ukraine cooperation in the MPC and A field at the Kiev Institute for Nuclear Research

    International Nuclear Information System (INIS)

    The Institute for Nuclear Research of the Academy of Sciences of Ukraine was the first Ukrainian organization to begin the implementation of Agreements of October 25 and December 18, 1993 between Ukraine and the US. Over a relatively short period of time and with the financial, technical and methodological assistance of the US DOE, the Institute for Nuclear Research was able to develop a modern system of physical protection of nuclear materials and its Research Reactor. The rapid progress of this work was aided by the diligence of the US-Ukraine group (Argonne and Sandia National Labs and the Institute for Nuclear Research) under the supervision of George Kuzmycz, a US DOE employee, and prompt resolution of numerous issues by the government authorities of the USA and Ukraine. The fresh fuel and nuclear materials storage were established in full compliance with international requirements. A modern MC and A system was developed at the Institute for Nuclear Research with the US assistance as well. The experience gained during the work with the Institute for Nuclear Research was used successfully by the US and Ukrainian parties at other nuclear facilities of Ukraine. The advanced training of Ukrainian specialists organized by the US DOE has played a very important role in the efficient use of the US Government assistance. Later on the Training Center for Physical Protection, Control and Accounting of Nuclear Material, named in honor of the late George Kuzmycz, was established at the Institute for Nuclear Research with the US assistance as well. The example of KINR allows us to say that US-Ukrainian cooperation and US MPC and A assistance to Ukraine has been implemented successfully and significant contributions have been made to the non-proliferation of nuclear weapons. Along with this, we, at the KINR and its GKTC realize, that there is great deal of work ahead of us that we need to do in order to make our modest contribution into the implementation of the nuclear

  13. Thermoradiotherapy for colorectal carcinoma

    International Nuclear Information System (INIS)

    The Japanese Society for Therapeutic Radiology and Oncology conducted a survey of the present state of thermoradiotherapy for colorectal carcinomas in Japan. In this survey, 105 cases at the 9 institutions were registered which had been treated from January 1981 to December 1992. From this data, we analyzed the trend of hyperthermia for the colorectal carcinoma and the treatment parameters which might have an influence on the treatment results. Ninety-four of 105 cases were recurrent or metastatic lesions. Mainly, the RF capacitive heating equipment was applied for the colorectal carcinoma. The number of cases in which hyperthermia were given once or twice a week were almost equal, and there was no significant difference in the treatment response rate. The mean duration of hyperthermia at therapeutic temperature was 42 min. Measurements of temperature in lesions were performed in 86% of sessions, and the mean tumor temperature was 43.1degC. Higher maximum tumor temperature and longer treatment time have brought significantly better response. Responder groups have shown better survival than non-responder groups. Acute reactions associated with hyperthermia were as follows: pain in 35 cases, burn and/or skin erosion in 12 cases, abscess formation in 3 cases and others in 3 cases. Late effects of treatment were ileus in 9 cases, ulcer of intestinal tract in 5 cases, subcutaneous fibrosis in 3 and others in 6. In conclusion, the application of thermoradiotherapy for reflactory colorectal carcinoma may contribute to the improvement of prognosis and quality of life of patients. (author)

  14. Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

    Institute of Scientific and Technical Information of China (English)

    Massimo GIUSTI; Mara DOLCINO; Lara VERA; Carla GHIARA; Francesca MASSARO; Laura FAZZUOLI; Diego FERONE; Michele MUSSAP; Francesco MINUTO

    2009-01-01

    Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyper-parathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45%, 30%, 17%, 4%, and 4% of cases, respectively. In 47% of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94% for FNAB and 71% for scintigraphy, while sen-sitivity was 83% and 69%, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.

  15. Single Fraction Versus Fractionated Linac-Based Stereotactic Radiotherapy for Vestibular Schwannoma: A Single-Institution Experience

    Energy Technology Data Exchange (ETDEWEB)

    Collen, Christine, E-mail: ccollen@uzbrussel.be [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Ampe, Ben [Department of Neurosurgery, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Gevaert, Thierry [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Moens, Maarten [Department of Neurosurgery, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Linthout, Nadine; De Ridder, Mark; Verellen, Dirk [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); D' Haens, Jean [Department of Neurosurgery, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium); Storme, Guy [Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels (Belgium)

    2011-11-15

    Purpose: To evaluate and compare outcomes for patients with vestibular schwannoma (VS) treated in a single institution with linac-based stereotactic radiosurgery (SRS) or by fractionated stereotactic radiotherapy (SRT). Methods and Materials: One hundred and nineteen patients (SRS = 78, SRT = 41) were treated. For both SRS and SRT, beam shaping is performed by a mini-multileaf collimator. For SRS, a median single dose of 12.5 Gy (range, 11-14 Gy), prescribed to the 80% isodose line encompassing the target, was applied. Of the 42 SRT treatments, 32 treatments consisted of 10 fractions of 3-4 Gy, and 10 patients received 25 sessions of 2 Gy, prescribed to the 100% with the 95% isodose line encompassing the planning target volume. Mean largest tumor diameter was 16.6 mm in the SRS and 24.6 mm in the SRT group. Local tumor control, cranial nerve toxicity, and preservation of useful hearing were recorded. Any new treatment-induced cranial nerve neuropathy was scored as a complication. Results: Median follow-up was 62 months (range, 6-136 months), 5 patients progressed, resulting in an overall 5-year local tumor control of 95%. The overall 5-year facial nerve preservation probability was 88% and facial nerve neuropathy was statistically significantly higher after SRS, after prior surgery, for larger tumors, and in Koos Grade {>=}3. The overall 5-year trigeminal nerve preservation probability was 96%, not significantly influenced by any of the risk factors. The overall 4-year probability of preservation of useful hearing (Gardner-Robertson score 1 or 2) was 68%, not significantly different between SRS or SRT (59% vs. 82%, p = 0.089, log rank). Conclusion: Linac-based RT results in good local control and acceptable clinical outcome in small to medium-sized vestibular schwannomas (VSs). Radiosurgery for large VSs (Koos Grade {>=}3) remains a challenge because of increased facial nerve neuropathy.

  16. Severe accident research at the Transuranium Institute Karlsruhe: A review of past experience and its application to future challenges

    International Nuclear Information System (INIS)

    Highlights: • Severe accident research at the Transuranium Institute, Karlsruhe has been reviewed. • Large (Phébus, TMI-2) and smaller tests have improved understanding of core degradation. • Cladding/structural materials interaction and attack of fuel are important in degradation. • Formation and composition of molten fuel pool in the lower bundle was reproducible. • This mechanistic knowledge has greatly assisted severe accident modelling. - Abstract: With the current situation in Japan one should examine previous research into severe accidents and the current state of European severe accident research to assess what are the priorities for research for existing and future nuclear reactors. The European Commission’s SARNET 2 (Severe Accident NETwork of Excellence) programme and its SARP (Severe Accident Research Priorities) assessments have been made and have outlined the future needs as seen from the EU point of view. There is already considerable research that will be very valuable in analysing and guiding the investigation and remediation activities at Fukushima Dai-ichi. This includes investigations into previous major accidents and international severe fuel damage projects. Facilities using analogue materials are able to analyse large-scale behaviour of materials, while smaller-scale testing of irradiated fuel for detailed property measurements are important for mechanistic studies. The final (and very important) aspect is application of this information to formulate codes to model the identified mechanisms and also to have their predictions validated by the data. This paper will take examples from the Transuranium Institute’s (ITU Karlsruhe’s) contribution to projects such as the TMI-2 accident investigation and the Phébus PF bundle and fission product deposit investigations as well as some of the smaller scale testing and modelling support that ITU has performed over the last 20 years. This will show what has been learnt about fuel and

  17. Single Fraction Versus Fractionated Linac-Based Stereotactic Radiotherapy for Vestibular Schwannoma: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Purpose: To evaluate and compare outcomes for patients with vestibular schwannoma (VS) treated in a single institution with linac-based stereotactic radiosurgery (SRS) or by fractionated stereotactic radiotherapy (SRT). Methods and Materials: One hundred and nineteen patients (SRS = 78, SRT = 41) were treated. For both SRS and SRT, beam shaping is performed by a mini-multileaf collimator. For SRS, a median single dose of 12.5 Gy (range, 11–14 Gy), prescribed to the 80% isodose line encompassing the target, was applied. Of the 42 SRT treatments, 32 treatments consisted of 10 fractions of 3–4 Gy, and 10 patients received 25 sessions of 2 Gy, prescribed to the 100% with the 95% isodose line encompassing the planning target volume. Mean largest tumor diameter was 16.6 mm in the SRS and 24.6 mm in the SRT group. Local tumor control, cranial nerve toxicity, and preservation of useful hearing were recorded. Any new treatment-induced cranial nerve neuropathy was scored as a complication. Results: Median follow-up was 62 months (range, 6–136 months), 5 patients progressed, resulting in an overall 5-year local tumor control of 95%. The overall 5-year facial nerve preservation probability was 88% and facial nerve neuropathy was statistically significantly higher after SRS, after prior surgery, for larger tumors, and in Koos Grade ≥3. The overall 5-year trigeminal nerve preservation probability was 96%, not significantly influenced by any of the risk factors. The overall 4-year probability of preservation of useful hearing (Gardner-Robertson score 1 or 2) was 68%, not significantly different between SRS or SRT (59% vs. 82%, p = 0.089, log rank). Conclusion: Linac-based RT results in good local control and acceptable clinical outcome in small to medium-sized vestibular schwannomas (VSs). Radiosurgery for large VSs (Koos Grade ≥3) remains a challenge because of increased facial nerve neuropathy.

  18. Quality Improvement in the National Cancer Institute Community Cancer Centers Program: The Quality Oncology Practice Initiative Experience

    Science.gov (United States)

    Siegel, Robert D.; Castro, Kathleen M.; Eisenstein, Jana; Stallings, Holley; Hegedus, Patricia D.; Bryant, Donna M.; Kadlubek, Pam J.; Clauser, Steven B.

    2015-01-01

    Purpose: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. Methods: A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. Results: QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). Conclusion: Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives. PMID:25538082

  19. Clinical results of stereotactic body radiotherapy for Stage I small-cell lung cancer. A single institutional experience

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the treatment outcomes of stereotactic body radiotherapy (SBRT) for Stage I small-cell lung cancer (SCLC). From April 2003 to September 2009, a total of eight patients with Stage I SCLC were treated with SBRT in our institution. In all patients, the lung tumors were proven as SCLC pathologically. The patients' ages were 58-84 years (median: 74). The T-stage of the primary tumor was T1a in two, T1b in two and T2a in four patients. Six of the patients were inoperable because of poor cardiac and/or pulmonary function, and two patients refused surgery. SBRT was given using 7-8 non-coplanar beams with 48 Gy in four fractions. Six of the eight patients received 3-4 cycles of chemotherapy using carboplatin (CBDCA) + etoposide (VP-16) or cisplatin (CDDP) + irinotecan (CPT-11). The follow-up period for all patients was 6-60 months (median: 32). Six patients were still alive without any recurrence. One patient died from this disease and one died from another disease. The overall and disease-specific survival rate at three years was 72% and 86%, respectively. There were no patients with local progression of the lesion targeted by SBRT. Only one patient had nodal recurrence in the mediastinum at 12 months after treatment. The progression-free survival rate was 71%. No Grade 2 or higher SBRT-related toxicities were observed. SBRT plus chemotherapy could be an alternative to surgery with chemotherapy for inoperable patients with Stage I small-cell lung cancer. However, further investigation is needed using a large series of patients. (author)

  20. Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

    Directory of Open Access Journals (Sweden)

    Gullapalli N Rao

    2012-01-01

    Full Text Available Blindness is a major global public health problem and recent estimates from World Health Organization (WHO showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP. It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.

  1. Strengthening the role of universities in addressing sustainability challenges: the Mitchell Center for Sustainability Solutions as an institutional experiment

    Directory of Open Access Journals (Sweden)

    David D. Hart

    2015-06-01

    Full Text Available As the magnitude, complexity, and urgency of many sustainability problems increase, there is a growing need for universities to contribute more effectively to problem solving. Drawing upon prior research on social-ecological systems, knowledge-action connections, and organizational innovation, we developed an integrated conceptual framework for strengthening the capacity of universities to help society understand and respond to a wide range of sustainability challenges. Based on experiences gained in creating the Senator George J. Mitchell Center for Sustainability Solutions (Mitchell Center, we tested this framework by evaluating the experiences of interdisciplinary research teams involved in place-based, solutions-oriented research projects at the scale of a single region (i.e., the state of Maine, USA. We employed a multiple-case-study approach examining the experiences of three interdisciplinary research teams working on tidal energy development, adaptation to climate change, and forest vulnerability to an invasive insect. Drawing upon documents, observations, interviews, and other data sources, three common patterns emerged across these cases that were associated with more effective problem-solving strategies. First, an emphasis on local places and short-term dynamics in social-ecological systems research provides more frequent opportunities for learning while doing. Second, iterative stakeholder engagement and inclusive forms of knowledge co-production can generate substantial returns on investment, especially when researchers are dedicated to a shared process of problem identification and they avoid framing solutions too narrowly. Although these practices are time consuming, they can be accelerated by leveraging existing stakeholder relationships. Third, efforts to mobilize interdisciplinary expertise and link knowledge with action are facilitated by an organizational culture that emphasizes mutual respect, adaptability, and solutions

  2. A single-institution experience with bevacizumab in the treatment of metastatic colorectal cancer and in conjunction with liver resection

    Directory of Open Access Journals (Sweden)

    Osterlund P

    2014-07-01

    Full Text Available Pia Osterlund,1,2 Reetta Peltonen,2,3 Tuomo Alanko,1 Petri Bono,1,2 Helena Isoniemi2,3 1Department of Oncology, Helsinki University Central Hospital, Helsinki, 2Institute of Clinical Medicine, University of Helsinki, Helsinki, 3Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland Background: Bevacizumab is active in the treatment of metastatic colorectal cancer (mCRC. However, efficacy of bevacizumab has predominantly been evaluated on selected patients with relatively good performance status and minor comorbidities. We evaluated the efficacy and safety of bevacizumab in unselected patients with mCRC, some of whom underwent liver resection. Material and methods: All patients with inoperable mCRC, fit for combination chemotherapy (n=180, who were initially not resectable, not included into studies and without contraindications to bevacizumab, and initiated on bevacizumab at the Helsinki University Central Hospital between April 2004 and December 2005 were included (n=114. Most (n=70 received 5-fluorouracil/leucovorin/irinotecan plus bevacizumab as first-line therapy. The remainder (n=44 of the patients received bevacizumab in combination with oxaliplatin or irinotecan with or without 5-fluorouracil or capecitabine. Minimum follow-up was 7 years. Treatment response was evaluated every 8–10 weeks according to RECIST criteria. Results: Median age was 59.6 years (range 35–79; male/female ratio was 54%/46%; World Health Organization performance status 0/1/2–3 was 33%/55%/11%, respectively; and the number of metastatic sites, one/two/three or more, was 31%/21%/48%, respectively. Median duration of bevacizumab therapy was 7.8 months (range 0.5–70.5 with pauses. In first-line (n=40, response rate (RR was 62%, progression-free survival (PFS 11.7 months, and overall survival (OS 22.1 months. In second-line (n=43, RR was 44%, PFS 8.7 months, and OS 18.7 months. In later lines (n=31, RR was 14%, PFS 6.7 months, and OS 14

  3. Pre-Service Teachers’ Experiences during Off-Campus Observation: Basis for Improving the Roles of Teacher Education Institutions and Cooperating Schools

    Directory of Open Access Journals (Sweden)

    Maripaz C. Abas

    2016-05-01

    Full Text Available Observing experienced teachers is an indispensable part of practicum studies in teacher education.  This paper examined the perceptions of pre-service teachers from five major fields of teacher education program on their experiences during off-campus observation in selected secondary schools. This used qualitative content analysis method in order to “subjectively interpret the content of text data through the systematic classification process of coding and identifying themes or patterns” (Hsieh & Shanon, 2005 p. 1278 . Data were taken from 136 pre-service teachers  through open-ended questions and two high school principals, 10 cooperating teachers, six student supervisors and 12 pre-service teachers through Focus Group Interview (FGI and Key Informant Interview (KII. Codes and emerging themes were derived using content analysis.  Results showed 18 themes for desirable experiences and 24 themes for undesirable experiences. Pre-service teachers’ experiences mostly focused on students’ attitudes and behaviors. Suggestions to improve off-campus observation from multi-level participants of the study concentrated on preparedness,  orientation programs, supervision and monitoring,  personal attributes and roles, values, attitudes and behaviors, deployment, post conferences,  supervisory plan, observation policies and guidelines,  required documents, seminars, time management, evaluation, coordination, and cultural diversity. To sustain the desirable experiences, both cooperating teachers and student supervisors believed that their roles were to serve as model, guide, leader, monitor, planner, and motivator. The varied experiences of pre-service teachers imply that Teacher Education Institutions (TEIs and cooperating schools should provide opportunities, develop competencies, take responsibilities and strengthen partnership to enhance off-campus observation.

  4. Medullary carcinoma of thyroid

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC ... The cause of medullary carcinoma of the thyroid (MTC) is unknown. Unlike other types of thyroid cancer, MTC is less likely to be caused by radiation therapy to the neck given ...

  5. Basal Cell Carcinoma (BCC)

    Science.gov (United States)

    ... epithelioma, is the most common form of skin cancer. Basal cell carcinoma usually occurs on sun-damaged skin, especially ... other health issues. Infiltrating or morpheaform basal cell carcinomas: Infiltrating basal cell carcinomas can be more aggressive and locally destructive ...

  6. Endoscopic management of third ventricular colloid cysts: Eight years′ institutional experience and description of a new technique

    Directory of Open Access Journals (Sweden)

    Mishra Shashwat

    2010-01-01

    Full Text Available Background : The operative approaches for colloid cyst excision are varied with open microsurgical excision still being considered as the "gold standard". Endoscopic removal of these cysts is gaining in popularity. Aims : To document the efficacy and safety of the endoscope for colloid cyst excision. Materials and Methods : Retrospective study of all the patients who underwent endoscopic colloid cyst excision between January 2000 and March 2009. Patient records, radiological images and operative notes were assessed. Follow-up data including clinical and radiological details were retrieved. Results : Fifty-nine cases underwent endoscopic surgery during the study period. Gross total excision of cyst (with small residual nubbin could be achieved in 46 (78% patients. Others patients underwent: near-total excision (seven; partial excision (five; and cyst aspiration (one. A two-port technique for achieving excision was used in 18 patients. There was one death due to fulminant meningitis. No patients had recurrence, follow-up till 99 months. Two patients required ventriculo peritonealshunt for persistent hydrocephalus. Conclusions : Endoscopic excision is a safe and effective, minimally invasive method for colloid cyst removal. Even a subtotal excision of these slow-growing cysts may be acceptable when experience with the endoscope is limited.

  7. Role of 18F- FDG PET-CT in detection of primary tumors in carcinoma of unknown primary site: an Indian experience

    International Nuclear Information System (INIS)

    Full text: The management of the patients with carcinoma of an unknown primary represents a difficult challenge in oncology. Metastatic cancers of unknown primary origin are characterised by a poor prognosis. Conventional radiological imaging allows only detection of 20%-27% of primary cancers. To evaluate the role of 18F-FDG PET/CT in detection of primary tumors in carcinoma of unknown primary site. Methods: In the present study, a total of 31 patients (22 males, 9 females; mean age 53.1 years) with biopsy or cytopathology proven metastatic carcinoma and negative conventional diagnostic procedures (CT, MRI or Panendoscopy) were included. All patients underwent whole body 18F-FDG PET/CT study. Patient data was retrospectively analysed. Histopathological diagnosis is kept as the gold standard. Hypermetabolic areas at the site of CT changes were considered as positive and rate of detection of primary site is evaluated. Among 31 patients, 18F-FDG PET/CT detected primary site in 14 patients. 18F-FDG PET/CT was negative in remaining 17 patients and could not localise primary. Among the 14 positive PET-CT patients, the results of 2 patients became false positive. The detection rate of 18F-FDG PET/CT in localising primary site was 38%. It is concluded that 18F-FDG PET/CT was found to be useful diagnostic procedure for the evaluation of patients with metastatic carcinoma and primary of unknown origin

  8. The Experience of Pilot Studies of Lymph Capillaries Pathomorphology of Thyroid Papillary Carcinoma According to the Data from the Images Stained by D2-40 Marker

    Directory of Open Access Journals (Sweden)

    Sprindzhuk M.V.

    2011-09-01

    Full Text Available The aim of the work is to study the growth and development regularities of lymph vascular bed of thyroid papillary carcinomas according to the results of image processing of pathohistological specimens. Materials and Methods. The objects of the research were microslides (n=40 stained by D2-40 marker, prepared from surgically removed tumours (thyroid papillary carcinoma of patients with sporadic thyroid carcinoma. The tumour specimens were stored frozen. The majority of patients were female (82.5%, age varying from 9 to 18 years. An average tumour size was 10 mm. There was used special software that processed images and calculated 5 parameters: relative area of vessels; relative fraction of small objects of vessels (noise; relative fraction of great vessels; average colority of distinguished vessels. Results. There was revealed the relationship between the infiltration growth of thyroid papillary carcinomas and the relative area of capillary lymph bed measured on digital images (Pearson correlation — 0.32; 2-tailed — 0.43; p<0.05.

  9. Improved outcome for children with acute lymphoblastic leukemia after risk-adjusted intensive therapy: a single institution experience

    International Nuclear Information System (INIS)

    Because of need for more comprehensive information on the least toxic and most effective forms of therapy for children with acute lymphoblastic leukemia (ALL), we reviewed our experience in the treatment of children with ALL at King Faisal Specialist Hospital and Research Centre (KFSHRC) and King Fahd National Center for Children's Cancer and Research (KFNCCCR) over a period of 18 years with a focus on patient characteristics and outcome. During the period of 1981 to 1988, records of children with ALL were retrospectively reviewed with respect to clinical presentation, laboratory findings, risk factors, stratification, therapy and outcome. The protocols used in treatment included 4 local protocols (KFSH 81, 84, 87 and 90) and subsequently. Children's Cancer Group (CCG) protocols and these were grouped as Era (1981-1992) and Era 2 (1993-1998). Of 509 children with ALL treated during this period, 316 were treated using local protocols and 193 using CCG protocols. Drugs used in Era 1 included a 4-drug induction using etoposid (VP-16) instead of L-asparaginase. Consolidation was based on high dose methotexate (MTX) 1g/m2 and maintenance was based on oral mercaptopurine (6-MP) and MTX with periodic pulses using intravenous teniposide (VM-26), Ara-C, L-asparaginase, adriamycin, prednisone, VP-16 cyclophosphamide .International protocols were introduced in Era 2, which was also marked by intensification of early treatment, a wider selection of cytoreductive agents, and the alternating use of non-cross-resistant pairs of drugs using the post-remission period. The end of induction remission rate improved from 90% in Era 1 to 95% in Era 2, which was of borderline statistical significance (P=0.49). The 5-year event-free survival (EFS) improved from 30.6% in Era 1 to 64.2% in Era 2 (P<.001). Improvement in outcome was achieved without any significant increase in morbidity or mortality, due to improvement in both systemic therapy and supportive care. The most important

  10. Large cell neuroendocrine carcinoma of the ampulla of Vater.

    LENUS (Irish Health Repository)

    Beggs, Rachel E

    2012-09-01

    Large cell neuroendocrine carcinomas of the ampulla of Vater are rare and confer a very poor prognosis despite aggressive therapy. There are few case reports of large cell neuroendocrine carcinomas of the ampulla of Vater in the literature and to date no studies have been done to establish optimal management. We describe a pooled case series from published reports of neuroendocrine carcinomas of the ampulla of Vater including a case which presented to our institution.

  11. The Clinical and Pathological Presentation of Thyroid Nodules in Children and the Comparison with Adult Population: Experience of a Single Institution.

    Science.gov (United States)

    Solymosi, Tamas; Lukacs Toth, Gyula; Budai, Laszlo; Gal, Istvan

    2016-01-01

    The clinical and pathological presentation of thyroid nodules among younger and adult patients was compared in an iodine-deficient (ID) region. Data of 3,010 consecutive patients younger than 20 years and 3,010 patients older than 20 years were compared. The proportion of nodular goiters (22.8% versus 39.3%), the ratio of surgically treated nodules (33.2% versus 15.2%), and the proportion of malignant nodules (4.3% versus 2.1%) among diseased patients differed significantly between the two groups (younger versus adult). Nine papillary and 1 medullary carcinoma were found among children, while 15 papillary, 2 follicular, 1 insular, 1 anaplastic, and 1 medullary carcinomas occurred among adults. The ratio of follicular adenoma to hyperplastic nodules (3 : 1 to 1 : 1.67), the proportion of follicular variant (77.8% versus 26.7%), T4 tumors (77.8% versus 33.3%), and tumors with lymph node metastasis (88.9% versus 66.7%) were significantly higher among younger papillary carcinoma patients. No malignancies occurred among spongiform and central type cysts. Similarly to iodine-sufficient regions, more nodules are malignant and carcinomas have a clinically more aggressive presentation in children in comparison with adult patients in ID. Taking the significantly greater proportion of adenomas and the lack of follicular carcinoma into account, a conservative approach has to be considered in follicular tumors among children. PMID:27087807

  12. The Clinical and Pathological Presentation of Thyroid Nodules in Children and the Comparison with Adult Population: Experience of a Single Institution

    Directory of Open Access Journals (Sweden)

    Tamas Solymosi

    2016-01-01

    Full Text Available The clinical and pathological presentation of thyroid nodules among younger and adult patients was compared in an iodine-deficient (ID region. Data of 3,010 consecutive patients younger than 20 years and 3,010 patients older than 20 years were compared. The proportion of nodular goiters (22.8% versus 39.3%, the ratio of surgically treated nodules (33.2% versus 15.2%, and the proportion of malignant nodules (4.3% versus 2.1% among diseased patients differed significantly between the two groups (younger versus adult. Nine papillary and 1 medullary carcinoma were found among children, while 15 papillary, 2 follicular, 1 insular, 1 anaplastic, and 1 medullary carcinomas occurred among adults. The ratio of follicular adenoma to hyperplastic nodules (3 : 1 to 1 : 1.67, the proportion of follicular variant (77.8% versus 26.7%, T4 tumors (77.8% versus 33.3%, and tumors with lymph node metastasis (88.9% versus 66.7% were significantly higher among younger papillary carcinoma patients. No malignancies occurred among spongiform and central type cysts. Similarly to iodine-sufficient regions, more nodules are malignant and carcinomas have a clinically more aggressive presentation in children in comparison with adult patients in ID. Taking the significantly greater proportion of adenomas and the lack of follicular carcinoma into account, a conservative approach has to be considered in follicular tumors among children.

  13. Learning to "Swim" with the Experts: Experiences of Two Patient Co-Investigators for a Project Funded by the Patient-Centered Outcomes Research Institute.

    Science.gov (United States)

    Robbins, Michele; Tufte, Janice; Hsu, Clarissa

    2016-01-01

    The Patient-Centered Outcomes Research Institute (PCORI), established in 2010, launched a new model of incorporating stakeholder perspectives into health care research. To ensure that PCORI-funded studies address issues important to health care consumers, all projects must fully involve patients and other stakeholders in every step of the research process: from planning and design to implementation and dissemination of results.As members of the first cohort of PCORI-funded researchers, our team was on the forefront of developing new approaches to engaging patients in research. One innovation we pioneered was the creation of a "patient co-investigator" role for two nonscientists who were recruited to be active members of the research team throughout the project. This commentary, based on our experiences, aims to help other research teams to 1) understand how to effectively collaborate with stakeholder team members such as patients; 2) anticipate possible challenges; and 3) offer tools for the orientation, training, and integration of patients into a scientific team. Written from the perspective of two PCORI patient co-investigators, our commentary provides lessons learned and recommendations about incorporating nonscientists into research teams.Specifically, we suggest recruiting people with a record of relevant volunteer experience and commitment; establishing a formal application process that provides candidates with details about expectations and responsibilities; and providing comprehensive orientation with ongoing training, encouragement, and support. We hope the points in this commentary help research teams that are incorporating patient co-investigators move toward a positive and productive experience. PMID:27083011

  14. Learning to “Swim” with the Experts: Experiences of Two Patient Co-Investigators for a Project Funded by the Patient-Centered Outcomes Research Institute

    Science.gov (United States)

    Robbins, Michele; Tufte, Janice; Hsu, Clarissa

    2016-01-01

    The Patient-Centered Outcomes Research Institute (PCORI), established in 2010, launched a new model of incorporating stakeholder perspectives into health care research. To ensure that PCORI-funded studies address issues important to health care consumers, all projects must fully involve patients and other stakeholders in every step of the research process: from planning and design to implementation and dissemination of results. As members of the first cohort of PCORI-funded researchers, our team was on the forefront of developing new approaches to engaging patients in research. One innovation we pioneered was the creation of a “patient co-investigator” role for two nonscientists who were recruited to be active members of the research team throughout the project. This commentary, based on our experiences, aims to help other research teams to 1) understand how to effectively collaborate with stakeholder team members such as patients; 2) anticipate possible challenges; and 3) offer tools for the orientation, training, and integration of patients into a scientific team. Written from the perspective of two PCORI patient co-investigators, our commentary provides lessons learned and recommendations about incorporating nonscientists into research teams. Specifically, we suggest recruiting people with a record of relevant volunteer experience and commitment; establishing a formal application process that provides candidates with details about expectations and responsibilities; and providing comprehensive orientation with ongoing training, encouragement, and support. We hope the points in this commentary help research teams that are incorporating patient co-investigators move toward a positive and productive experience. PMID:27083011

  15. Safety of cardiac magnetic resonance and contrast angiography for neonates and small infants: a 10-year single-institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Rangamani, Sheela; Li, Ling; Harvey, Lisa; Fletcher, Scott E.; Danford, David A.; Kutty, Shelby [University of Nebraska College of Medicine/Creighton University School of Medicine, Joint Division of Pediatric Cardiology, Omaha, NE (United States); Varghese, Joby [Children' s Hospital and Medical Center, Division of Pediatric Cardiac Anesthesia, Omaha, NE (United States); Hammel, James M.; Duncan, Kim F. [Children' s Hospital and Medical Center, Division of Cardiothoracic Surgery, Omaha, NE (United States)

    2012-11-15

    With increasing applications of cardiac magnetic resonance (CMR) and magnetic resonance angiography (MRA) for evaluation of congenital heart disease (CHD), safety of this technology in the very young is of particular interest. We report our 10-year experience with CMR in neonates and small infants with particular focus on the safety profile and incidence of adverse events (AEs). We reviewed clinical, anesthesia and nursing records of all children {<=}120 days of age who underwent CMR. We recorded variables including cardiac diagnosis, study duration, anesthesia type and agents, prostaglandin E1 (PGE1) dependence and gadolinium (Gd) use. Serially recorded temperature, systemic saturation (SpO{sub 2}) and cardiac rhythm were analyzed. Primary outcome measure was any AE during or <24 h after the procedure, including minor AEs such as hypothermia (axillary temperature {<=}95 F), desaturation (SpO{sub 2} drop {>=}10% below baseline) and bradycardia (heart rate {<=}100 bpm). Secondary outcome measure was unplanned overnight hospitalization of outpatients. Children (n = 143; 74 boys, 69 girls) had a median age of 6 days (1-117), and 98 were {<=}30 days at the time of CMR. The median weight was 3.4 kg (1.4-6 kg) and body surface area 0.22 m{sup 2} (0.13-0.32 m{sup 2}). There were 118 (83%) inpatients (108 receiving intensive care) and 25 (17%) outpatients. Indications for CMR were assessment of aortic arch (n = 57), complex CHD (n = 41), pulmonary veins (n = 15), vascular ring (n = 8), intracardiac mass (n = 8), pulmonary artery (n = 7), ventricular volume (n = 4), and systemic veins (n = 3). CMR was performed using a 1.5-T scanner and a commercially available coil. CMR utilized general anesthesia (GA) in 86 children, deep sedation (DS) in 50 and comforting methods in seven. MRA was performed in 136 children. Fifty-nine children were PGE1-dependent and 39 had single-ventricle circulation. Among children on PGE1, 43 (73%) had GA and 10 (17%) had DS. Twelve children (9%) had

  16. Introducing Hands-on, Experiential Learning Experiences in an Urban Environmental Science Program at a Minority Serving Institution

    Science.gov (United States)

    Duzgoren-Aydin, N. S.; Freile, D.

    2013-12-01

    several laboratory facilities. Furthermore, authors have applied to the NSF-TUES grant program to purchase a particle size analyzer. Currently, the grant is pending. We have defined 4 curricular goals to enhance student learning by providing hands-on, inquiry-based learning and research experiences. 1- Develop technical/analytical knowledge and skills by using advanced analytical instrumentation; 2- Improve quantitative reasoning skills to assess the quality of data; 3- Have comprehensive educational training to improve problem solving skills; and 4- use their quantitative reasoning (Goal # 2) and problem solving skills (Goal #3) to evaluate real-world geological and environmental problems. We also give special emphasis to expected measurable outcomes for individual courses. An external evaluator will assess the effectiveness of integrating advance instrumentation into the Earth and Environmental Science curricula. We will work closely with the evaluator to ensure successful implementation of the learning objectives. Examples from the impacted courses will be presented.

  17. Safety of cardiac magnetic resonance and contrast angiography for neonates and small infants: a 10-year single-institution experience

    International Nuclear Information System (INIS)

    With increasing applications of cardiac magnetic resonance (CMR) and magnetic resonance angiography (MRA) for evaluation of congenital heart disease (CHD), safety of this technology in the very young is of particular interest. We report our 10-year experience with CMR in neonates and small infants with particular focus on the safety profile and incidence of adverse events (AEs). We reviewed clinical, anesthesia and nursing records of all children ≤120 days of age who underwent CMR. We recorded variables including cardiac diagnosis, study duration, anesthesia type and agents, prostaglandin E1 (PGE1) dependence and gadolinium (Gd) use. Serially recorded temperature, systemic saturation (SpO2) and cardiac rhythm were analyzed. Primary outcome measure was any AE during or 2 drop ≥10% below baseline) and bradycardia (heart rate ≤100 bpm). Secondary outcome measure was unplanned overnight hospitalization of outpatients. Children (n = 143; 74 boys, 69 girls) had a median age of 6 days (1-117), and 98 were ≤30 days at the time of CMR. The median weight was 3.4 kg (1.4-6 kg) and body surface area 0.22 m2 (0.13-0.32 m2). There were 118 (83%) inpatients (108 receiving intensive care) and 25 (17%) outpatients. Indications for CMR were assessment of aortic arch (n = 57), complex CHD (n = 41), pulmonary veins (n = 15), vascular ring (n = 8), intracardiac mass (n = 8), pulmonary artery (n = 7), ventricular volume (n = 4), and systemic veins (n = 3). CMR was performed using a 1.5-T scanner and a commercially available coil. CMR utilized general anesthesia (GA) in 86 children, deep sedation (DS) in 50 and comforting methods in seven. MRA was performed in 136 children. Fifty-nine children were PGE1-dependent and 39 had single-ventricle circulation. Among children on PGE1, 43 (73%) had GA and 10 (17%) had DS. Twelve children (9%) had adverse events (AEs) - one major and 11 minor. Of those 12, nine children had GA (10%) and three had DS (6%). The single major AE was

  18. Experiences with the realisation of a multimedial computer-aided instruction for acting persons from external companies and institutions according the German radiation protection ordinance

    International Nuclear Information System (INIS)

    At the Rossendorf location persons from external companies and institutions are acting in the scope of the decommissioning of the nuclear facilities. In addition to an individual monitoring in radiation protection an instruction is required for those persons before starting the work. The aim of this instruction is to give among important directives the actual facts about the location an their facilities. A system with particular selecting components seems to be the best solution with regard to effectiveness and available knowledge. The instruction takes place with a computer-added multimedia presentation. In the present paper should be presented in a short view the contents of the components and first experiences in handling this instruction. (orig.)

  19. Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications.

    Science.gov (United States)

    Constantino, Edson Rocha; Leal, Rafael; Ferreira, Christian Cândido; Acioly, Marcus André; Landeiro, José Alberto

    2016-05-01

    Objective In this study, we investigate our institutional experience of patients who underwent endoscopic endonasal transsphenoidal approach for treatment of large and giant pituitary adenomas emphasizing the surgical results and approach-related complications. Method The authors reviewed 28 consecutive patients who underwent surgery between March, 2010 and March, 2014. Results The mean preoperative tumor diameter was 4.6 cm. Gross-total resection was achieved in 14.3%, near-total in 10.7%, subtotal in 39.3%, and partial in 35.7%. Nine patients experienced improvement in visual acuity, while one patient worsened. The most common complications were transient diabetes insipidus (53%), new pituitary deficit (35.7%), endonasal adhesions (21.4%), and cerebrospinal fluid leak (17.8%). Surgical mortality was 7.1%. Conclusions Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for large or giant pituitary adenomas, which results in high rates of surgical decompression of cerebrovascular structures. PMID:27191235

  20. PUVA treatment of alopecia areata partialis, totalis and universalis: audit of 10 years` experience at St John`s Institute of Dermatology

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, C.R.; Hawk, J.L.M. [St Thomas` Hospital, London (United Kingdom). St John`s Institute of Dermatology

    1995-12-01

    Our 10-year experience with PUVA treatment for alopecia areata, partialis, totalis and universalis was retrospectively reviewed using charts and follow-up questionnaires for 70 patients at St John`s Institute of Dermatology. In all cases, several previous therapies were judged to be unsatisfactory prior to starting PUVA, and many cases were already deemed clinically refractory prior to referral for PUVA. If cases of vellus hair growth are excluded, and those who lost their PUVA-induced regrowth rapidly on follow-up, the effective success rate was at best 6.3% for alopecia areata partialis, 12.5% for alopecia areata totalis and 13.3% for alopecia areata universalis. We affirm that PUVA is generally not an effective treatment for alopecia areata. (Author).

  1. Squamous Cell Carcinoma of the Pancreas

    Directory of Open Access Journals (Sweden)

    Andre Luiz De Souza

    2014-11-01

    Full Text Available We previously published our and Johns Hopkins data titled: "Platinum-based therapy in adenosquamous pancreatic cancer: experience at two institutions” [1]. We will here like to submit a related case report as a letter to the editor to JOP in reference to the above paper. Squamous cell carcinoma of the pancreas has various reported incidence rates, ranging from 0.5% to as high as 5% of pancreatic ductal carcinomas [2, 3]. Of the 1300 cases of pancreatic cancers observed at autopsy in a survey in Japan in 1992, 0.7% were squamous cell carcinoma [4]. A Mayo clinic review of very rare exocrine tumors showed an even rarer incidence of squamous cell carcinoma when compared to acinar and small cell carcinoma of the pancreas [5]. This discrepancy in the reported incidence rates related to the fact that some of the cases represent adenosquamous carcinoma rather than pure squamous cell carcinoma of pancreas. In an analysis of 25 patients, mean age at diagnosis of pancreatic squamous cell carcinoma was 62 years (range: 33–80 years and there was no gender difference [6]. There is no study about the molecular profile of squamous carcinoma of the pancreas. There are no retrospective or prospective studies about the best therapy for these tumors

  2. Clinical and socio-demographic characteristics of college students exposed to traumatic experiences: a census of seven college institutions in Northeastern Brazil.

    Directory of Open Access Journals (Sweden)

    Liana R Netto

    Full Text Available BACKGROUND: Epidemiological studies show that most of the adult population will be exposed to at least one potentially traumatic event in the course of his/her life; adolescence and early adulthood are the most vulnerable periods of life for exposure to traumatic experiences (70% of their deaths are due to external causes. Posttraumatic Stress Disorder is characterized by the development of dysfunctional symptoms that cause distress or social, academic, or occupational impairment, as result of exposure to a traumatic event. The aim of this multicentric study is to establish the proportion of college students, within seven institutions in Northeastern Brazil, who were exposed to traumatic experience and met PTSD criteria. METHODS/DESIGN: A one-phase census protocol of seven college institutions in three metropolitan regions in Northeastern Brazil was performed (April to July 2011. All students aged 18 years or older, matriculated and attending their first or final semester were eligible. The self-applied protocol consisted of a socio-demographic questionnaire and the following scales adjusted to Brazilian Portuguese standards Trauma History Questionnaire (THQ, PTSD Checklist-Civilian (PCL-C, Impulsivity Scale (BIS-11. Data were entered into SPSS 17.0. RESULTS: 2213 (85.5% students consented to participate, and completely filled in the protocols. Of these, 66.1% were woman, mean age 23.9 (SD 6.3, 82.7% were single, and 57.3% attended university outside their native cities. The total PTSD prevalence was 14%, and the median for frequency of trauma exposure was 5 events. CONCLUSION: A high frequency of exposure to violence, as well as a high rate of PTSD, suicide attempts, and high-risk sexual behavior was found in Brazilian college students. This highlights the importance of effective public health actions in relation to the prevention and treatment of PTSD and other dysfunctional behaviors resulting from traumatic exposure in young individuals

  3. Toward standard HER2 testing of endometrial serous carcinoma: 4-year experience at a large academic center and recommendations for clinical practice.

    Science.gov (United States)

    Buza, Natalia; English, Diana P; Santin, Alessandro D; Hui, Pei

    2013-12-01

    HER2 overexpression and/or amplification have been reported in endometrial serous carcinoma, suggesting that HER2 may be a promising therapeutic target. However, there is considerable variation in the reported rates of HER2 overexpression and amplification, likely--at least in part--resulting from variability in the testing methods, interpretation, and scoring criteria used. Unlike in breast and gastric cancer, currently there are no established guidelines for HER2 testing in endometrial carcinoma. A total of 108 endometrial carcinoma cases--85 pure serous carcinomas and 23 mixed endometrial carcinomas with serous component--were identified over a 4-year period. All H&E and HER2 immunohistochemical slides were reviewed and HER2 FISH results (available on 52 cases) were retrieved from pathology reports. HER2 immunohistochemical scores were assigned according to the FDA criteria and the current breast ASCO/CAP scoring criteria. Clinical information was retrieved from the patients' medical records. Thirty-eight cases (35%) showed HER2 overexpression and/or gene amplification, 20 of which (53%) had significant heterogeneity of protein expression by immunohistochemistry. Lack of apical membrane staining resulting in a lateral/basolateral staining pattern was observed in the majority of HER2-positive tumors. Five of the HER2-positive cases (13%) demonstrated discrepant immunohistochemical scores when using the FDA versus ASCO/CAP scoring system. The overall concordance rate between HER2 immunohistochemistry and FISH was 75% (39/52) when using the FDA criteria, compared with 81% (42/52) by the ASCO/CAP scoring system. In conclusion, in this largest comprehensive study, 35% of endometrial serous carcinoma harbors HER2 protein overexpression and/or gene amplification, over half of which demonstrate significant heterogeneity of protein expression. The current breast ASCO/CAP scoring criteria provide the highest concordance between immunohistochemistry and FISH. Assessment of

  4. Prediction of disease status by recombinant human TSH-stimulated serum Tg in the post surgical follow-up of differentiated thyroid carcinoma. Two-year experience

    International Nuclear Information System (INIS)

    Aim: Recombinant human TSH (rhTSH) is now available to facilitate monitoring for differentiated thyroid carcinoma. Initial experiences seem to indicate that rhTSH can modify the guidelines for this disease. Our study reports 2-year experience with rhTSH on 27 consecutive patients undergone total removal of the thyroid for differentiated cancer followed by radioiodine therapy. Aim of the study was to evaluate the accuracy of the thyroglobulin (Tg) in predicting of disease status after primary therapies. Sensitivity and specificity of rhTSH testing was compared with neck ultrasound (US) and whole body scan (WBS) after 131I and 99mTc-Sestamibi (MIBI). Materials and Methods: Forty-eight cycles of rhTSH administration (0.9 mg i.m. in two consecutive days) were performed on l-T4 therapy. Favourable results were considered Tg levels <1 g/l after rhTSH, no image indicative of thyroid tissue or suspect neck nodes, negative WBS after 131I and 99mTc-MIBI. 24 h after the second dose of rhTSH, 131I (185 MBq) was administered in all subjects; WBS was acquired with a gamma-camera Orbiter 7500 (Siemens). In all but two patients, 99mTc-MIBI scintigraphy (555-740 MBq) was performed using a gamma-camera SP6HR (Elscint). Results: Baseline unfavourable Tg levels were noted in 15% of patients with recurrence disease. After rhTSH testing unfavourable Tg levels were noted in further 17%. A concordance between rhTSH testing and neck US was found in 85%. A concordance among rhTSH, neck US and 131I and 99mTc-MIBI was found in 46% of subjects. Specificity of Tg after rhTSH administration, neck US, 131I and 99mTc-MIBI was 100%, 70%, 31% and 50%, while sensitivity was 100%, 94%, 83% and 84%, respectively. Mean TSH levels at the time of radioiodine administration were significantly higher (p=0.03) after rhTSH than after LT4 withdrawal. Concordance between 131I WBS under suppressive L-T4 and overt hypothyroidism was found in 71% of patients. Pain at the injection site and mild nausea were the

  5. Liver resection: 10-year experience from a single Institution Ressecção hepática: experiência de 10 anos de uma única Instituição

    Directory of Open Access Journals (Sweden)

    Julio Cezar Uili Coelho

    2004-12-01

    Full Text Available BACKGROUND: Liver resection constitutes the main treatment of most liver primary neoplasms and selected cases of metastatic tumors. However, this procedure is associated with significant morbidity and mortality rates. AIM: To analyze our experience with liver resections over a period of 10 years to determine the morbidity, mortality and risk factors of hepatectomy. PATIENTS AND METHODS: Retrospective review of medical records of patients who underwent liver resection from January 1994 to March 2003. RESULTS: Eighty-three (41 women and 42 men patients underwent liver resection during the study period, with a mean age of 52.7 years (range 13-82 years. Metastatic colorectal carcinoma and hepatocellular carcinoma were the main indications for hepatic resection, with 36 and 19 patients, respectively. Extended and major resections were performed in 20.4% and 40.9% of the patients, respectively. Blood transfusion was needed in 38.5% of the operations. Overall morbidity was 44.5%. Life-threatening complications occurred in 22.8% of cases and the most common were pneumonia, hepatic failure, intraabdominal collection and intraabdominal bleeding. Among minor complications (30%, the most common were biliary leakage and pleural effusion. Size of the tumor and blood transfusion were associated with major complications (P = 0.0185 and P = 0.0141, respectively. Operative mortality was 8.4% and risk factors related to mortality were increased age and use of vascular exclusion (P = 0.0395 and P = 0.0404, respectively. Median hospital stay was 6.7 days. CONCLUSION: Liver resections can be performed with low mortality and acceptable morbidity rates. Blood transfusion may be reduced by employing meticulous technique and, whenever indicated, vascular exclusion.RACIONAL: A ressecção hepática constitui o principal tratamento da maioria das neoplasias primárias do fígado e de casos selecionados de tumores metastáticos. Entretanto, este procedimento está associado

  6. Neoadjuvant chemotherapy and radiation therapy in advanced stage nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. We analyzed 77 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows: AJCC stage 111-2, stage IV-75. Sixty-six patients received infusion of 5-FU (1000 mg/m2, on Day 1-5) and cisplatin (100 mg/m2, on Day 1), eleven patients received infusion of 5.FU (1000 mg/m2, on Day 1-5) and carboplatin (300 mg/m2, on Day 1) as neoadjuvant chemotherapy prior to radiation therapy. The median follow-up for surviving patients was 44 months. The overall chemotherapy response rates were 87%. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nausea/vomiting). The degree of radiation induced mucositis was not severe, and ten patients developed Grade 2 mucositis. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year freedom from distant metastasis rates were 82% and 5-year locoregional control rates were 75%. This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity

  7. Carcinoma Verrucoso Oral: Reporte de un Caso Clínico y Revisión de 20 Casos del Instituto de Referencia en Patología Oral (IREPO), Chile Oral Verrucous Carcinoma: A Case Report and Review of 20 Cases of the Oral Pathology Referral Institute (IREPO), Chile

    OpenAIRE

    D Adorno Farias; A Maturana Ramírez; M Farias Vergara; ME Franco Martínez; M Iriarte Hernández; R Sáez Salgado; J. Cortés Araya; AV Ortega Pinto

    2010-01-01

    El carcinoma verrucoso (CV) es una variante rara del carcinoma de células escamosas con características morfológicas y comportamiento específico. El presente estudio relata el caso de una paciente de género femenino, de 68 años de edad, que presenta un carcinoma verrucoso en lengua, indoloro y con 8 meses de evolución. Además, se realizó una breve revisión de casos clínicos del Instituto de Referencia en Patología Oral (IREPO) de la Facultad de Odontología de la Universidad de Chile, diagnost...

  8. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Differentiated thyroid carcinoma was studied with regard to mode of presentation, initial findings, treatment and survival. The classic signs, symptoms, physical and scan findings were found to be present in approximately 70% of the patients. Prognosis was found to be dependent on age of presentation more than any other factor. Patients with prior exposure to radiation were found to have more extensive disease and require more extensive surgery but ultimately had the same prognosis for 15-year cure. Treatment for distant metastatic disease by surgery, radioactive iodine and external radiation all resulted in long-term survival in certain cases

  9. Ultracold neutron detection with 6Li-doped glass scintillators, NANOSC: a fast ultracold neutron detector for the nEDM experiment at the Paul Scherrer Institute

    CERN Document Server

    Ban, G; Bodek, K; Chowdhuri, Z; Geltenbort, P; Griffith, W C; Hélaine, V; Henneck, R; Kasprzak, M; Kermaidic, Y; Kirch, K; Komposch, S; Koss, P A; Kozela, A; Krempel, J; Lauss, B; Lefort, T; Lemière, Y; Mtchedlishvili, A; Musgrave, M; Naviliat-Cuncic, O; Piegsa, F M; Pierre, E; Pignol, G; Quéméner, G; Rawlik, M; Ries, D; Rebreyend, D; Roccia, S; Rogel, G; Schmidt-Wellenburg, P; Severijns, N; Wursten, E; Zejma, J; Zsigmond, G

    2016-01-01

    This paper summarizes the results from measurements aiming to characterize ultracold neutron detection with 6Li-doped glass scintillators. Single GS10 or GS20 scintillators, with a thickness of 100-200 micrometer, fulfill the ultracold neutron detection requirements with an acceptable neutron-gamma discrimination. This discrimination is clearly improved with a stack of two scintillators: a 6Li-depleted glass bonded to a 6Li-enriched glass. The optical contact bonding is used between the scintillators in order to obtain a perfect optical contact. The scintillator's detection efficiency is similar to that of a 3He Strelkov gas detector. Coupled to a digital data acquisition system, counting rates up to a few 10^5 counts/s can be handled. A detector based on such a scintillator stack arrangement was built and has been used in the neutron electric dipole moment experiment at the Paul Scherrer Institute since 2010. Its response for the regular runs of the neutron electric dipole moment experiment is presented.

  10. EMPHYSEMATOUS PYELONEPHRITIS: OUR INSTITUTIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Prakasa Rao

    2015-11-01

    Full Text Available : Emphysematous pyelonephritis (EPN is a rare acute necrotizing infection of renal parenchyma. We discuss clinical details and treatment strategies of 28 patients with EPN followed at our hospital. EPN is common in persons with diabetes, often has a fulminating course and can be fatal if not recognized and treated promptly. Its overall mortality rate ranges between 19% and 43%. METHODS: We retrospectively reviewed the clinical, laboratory, radiological findings and treatment modalities of 18 patients with EPN followed at our hospital between 2012 and 2014. RESULTS: The mean patient age (Female: 12; male: 6 was 65 years (Range: 51–82. Based on computed tomographic findings, EPN was classified as class I (n=3, class II (n=6, class IIIA (n=5, class IIIB (n=3 and class 1V (n=1. All patients had fever, flank pain, nausea, and vomiting. Sixteen patients had type 2 diabetes mellitus and 4 diabetic patients also had renal stones. Escherichia coli (n=14, Klebsiella species (n=3, and mixed species (n=1 were grown in urine cultures. Seventeen patients had unilateral involvement. Increased white blood cell counts, sedimentation rate, and C-reactive protein levels were detected in all cases. In addition to medical treatment, 5 patients underwent a nephrostomy catheter placement and a total of 3 patients underwent nephrectomy upon deterioration. After achieving clinical stabilisation with medical treatment, 7 patients underwent endoscopic ureteral stone treatment. The remaining 3 cases were treated only with antibiotics. One patient died even after nephrostomy and antibiotic therapy and seventeen patients were discharged with clinical cure. CONCLUSION: Mortality rates of EPN are gradually decreasing. Preservation of renal reserve is possible due to early diagnosis, appropriate antibiotic therapy, and drainage.

  11. Carcinoma verrugoso

    Directory of Open Access Journals (Sweden)

    Esteban Quesada Jiménez

    2004-09-01

    Full Text Available Se presenta el caso de un paciente masculino de 76 años, vecino de Turrialba, agricultor, que consultó por una lesión de 3 años de evolución, localizada en la palma de la mano derecha a nivel palmar y compromiso de los dedos de la misma mano, caracterizada como una neoformación exofítica verrugosa de 5 por 11 cm. aproximadamente, con material caseoso entre sus crestas. La lesión ha estado creciendo de forma acelerada en los últimos 3 meses, causándole dolor y que le imposibilita ellaborar. Se le realizaron exámenes y se descartaron varias causas infecciosas, y concluyendo luego de varias biopsias con el diagnóstico de un carcinoma verrugoso. El paciente fue tratado mediante una amputación parcial de la mano. Este tumor es una variante del carcinoma epidermoide y presentamos su clasificación, patogénesis, histopatología, manifestaciones clínicas más frecuentes y diagnóstico diferencial.

  12. Chromophobe Renal Cell Carcinoma

    OpenAIRE

    Jyotsna Vijaykumar Wader; Sujata S Kumbhar; Huddedar AD; Wasim GM Khatib

    2013-01-01

    Renal cell carcinoma is the most common neoplasm of the kidney comprised of different histological variants. Chromophobe renal cell carcinoma (ChRCC) is a rare subtype of renal cell carcinoma (RCC) mainly diagnosed in the sixth decade of life. It is important to identify this entity because it has significantly better prognosis than the clear cell (conventional) and papillary renal cell carcinomas. The chromophobe renal cell carcinoma should be differentiated from oncocytoma and clear cell ca...

  13. Unbundling Institutions

    OpenAIRE

    Daron Acemoglu; Simon Johnson

    2003-01-01

    This paper evaluates the importance of property rights institutions', which protect citizens against expropriation by the government and powerful elites, and contracting institutions', which enable private contracts between citizens. We exploit exogenous variation in both types of institutions driven by colonial history, and document strong first-stage relationships between property rights institutions and the determinants of European colonization (settler mortality and population density bef...

  14. Institutional advantage

    NARCIS (Netherlands)

    Martin, Xavier

    2014-01-01

    Is there such a thing as institutional advantage—and what does it mean for the study of corporate competitive advantage? In this article, I develop the concept of institutional competitive advantage, as distinct from plain competitive advantage and from comparative institutional advantage. I first i

  15. Confucius Institute

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Confucius Institute(simplified Chinese:孔子学院;traditional Chinese:孔子學院;pinyin:kǒngzǐ xuéyuàn)is a non-profit public institute which aims at promoting Chinese language and culture and supporting local Chinese teaching internationally through affiliated Confucius Institutes.

  16. Ultrasound guided Core Biopsy, Fine Needle Aspiration Cytology and Surgical Excision Biopsy in the diagnosis of metastatic squamous cell carcinoma in the head and neck: An eleven year experience

    International Nuclear Information System (INIS)

    Introduction: This study aims to review our 11 year experience of diagnosing metastatic squamous cell carcinoma presenting as head and neck lumps. The techniques of Ultrasound guided Core Biopsy (USCB), Fine Needle Aspiration Cytology (FNAC) and Surgical Excision Biopsy (SEB) are compared. Materials and methods: All patients with metastatic squamous cell carcinoma (SCC) involving the lymph nodes of the head and neck or parotid gland, diagnosed at Eastbourne District General Hospital between January 1998 and November 2009 were identified. The following data items were collated: biopsy location (e.g. cervical lymph node or parotid), any history of likely primary SCC and site, type of biopsy used to establish a conclusive diagnosis (index diagnostic technique), previous biopsies, the technique and their results, subsequent histology results. Results: A total of 90 patients were diagnosed with metastatic squamous cell carcinoma. The index diagnostic technique was USCB in 48 patients, FNAC in 29 and SEB in 13. In 72 (80%) patients the index biopsy was the sole tissue sample taken prior to surgery or other treatment. The remaining 18 patients underwent a total of 22 previous biopsies prior to the index biopsy. 95% (21/22) of these previous biopsies were non-definitive FNAC and 5% (1/22) was a non-definitive USCB. FNACs also demonstrated the highest non-diagnostic rate (42%). The accuracy of USCB and FNAC in correlating with final histopathology was 97% and 85% respectively. Conclusions: USCB demonstrates excellent results in the diagnosis of metastatic SCC in the head and neck with higher accuracy and greater reliability than FNAC.

  17. A single-institution comparison of cetuximab, carboplatin, and paclitaxel induction chemotherapy followed by chemoradiation (CRT) versus CRT for locally-advanced squamous cell carcinoma of the head and neck (LA-SCCHN)

    Science.gov (United States)

    Grover, Surbhi; Mitra, Nandita; Wan, Fei; Lukens, J. Nicholas; Sharma, Sonam; Bauman, Jessica; Masroor, Farzad; Cohen, Roger B.; Desai, Arati; Algazy, Kenneth; Alonso-Basanta, Michelle; Ahn, Peter; Teo, Boon-Keng Kevin; Chalian, Ara; Weinstein, Gregory S.; O’Malley, Bert W.; Lin, Alexander

    2016-01-01

    Objectives Comparisons of induction chemotherapy (IC) against upfront chemoradiation (CRT) for locally advanced head and neck cancer (LA-HNSCC) have demonstrated no differences except greater toxicity with IC. Effective induction regimens that are less toxic are therefore warranted. To inform future efforts with IC, we present our institutional experience comparing a less toxic IC regimen to CRT. Methods We included patients with LA-HNSCC treated with organ-preservation CRT (+/− induction) between 2008–2011. Patients were age >18, ECOG performance status 0–1, and minimum 6 months follow-up. IC consisted of 8 weekly cycles of cetuximab, carboplatin, and paclitaxel followed by CRT. The CRT regimen was platinum-based, with cetuximab reserved for patients contraindicated to receive platinum. Results Of 118 patients, 24 (20%) received IC and 94 (80%) received CRT. Median follow-up was 17 (IC) and 19 (CRT) months (p=0.05). There were no differences in toxicity between the groups. IC patients were more likely male, with more advanced tumor and nodal stage. Even when controlling for these factors, IC was still associated with worse locoregional control (LRC) (HR 3.6 p=0.02), distant-metastasis free survival (HR 5.3, p=0.02), and overall survival (OS) (HR 5.1. p < 0.01). Conclusions IC patients had greater disease burden than those receiving CRT. IC was well-tolerated, but with significant rates of locoregional and systemic failures. Given the retrospective nature of the study, our findings are not meant to be definitive or conclusive, but rather suggestive in directing future efforts with IC. For now, we favor CRT as the standard option for treatment of inoperable LA-HNSCC. PMID:27441910

  18. Giant basal cell carcinoma Carcinoma basocelular gigante

    Directory of Open Access Journals (Sweden)

    Nilton Nasser

    2012-06-01

    Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

  19. Prostata carcinomas

    International Nuclear Information System (INIS)

    Pre-operative staging, using transrectal prostatic sonography and CT, was carried out in 30 patients with cytologically confirmed carcinomas of the prostate and the results compared with the clinical findings. All patients underwent radical prostatectomy and the pre-operative findings could be verified histologically. Transrectal prostatic sonography is better than CT or clinical examination for determining local tumour spread or penetration of the capsule. A high proportion of enlarged pelvic lymphnodes shown by CT had non-specific changes; failure to demonstrate enlarged nodes excludes lymph node metastases with considerable certainty. Transrectal prostatic sonography provides a higher degree of information regarding local tumour spread, whereas CT indicates the presence or absence of lymph node metastases. (orig.)

  20. Nevoid Basal Cell Carcinoma Syndrome

    Science.gov (United States)

    ... Nevoid Basal Cell Carcinoma Syndrome Request Permissions Nevoid Basal Cell Carcinoma Syndrome Approved by the Cancer.Net Editorial Board , 04/2016 What is Nevoid Basal Cell Carcinoma Syndrome? Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is ...

  1. Fractionated stereotactic radiation therapy for orbital optic nerve sheath meningioma. A single institution experience and a short review of the literature

    International Nuclear Information System (INIS)

    Optic nerve sheath meningioma (ONSM) is a rare orbital tumor that generally induces a slow progressive visual loss in affected patients. Radiotherapy (RT) has currently become the first choice to treat ONSM. In this study our experience in ONSM treatment with fractionated stereotactic radiotherapy (FSRT) is reported. Five patients with diagnosis of orbital ONSM were treated between April 2007 and December 2009 at the Radiation Oncology department of our institution. All patients underwent history and physical, and ophthalmic examinations. Orbital MRI was performed before and 6 weeks after treatment; thereafter every 6 months for the first 2 years. By previous stereotactic localization of the target, RT was delivered with 28 daily fraction of 1.8 Gy by multiple non coplanar arcs dynamically conformed by a micro multileaf-collimator. At diagnosis, in all 5 patients, visual acuity limitations of different degrees were found, while exophthalmos was present in 2, diplopy in 2, orbital pain in 1, and proptosis in 1. In all patients pre-treatment MRI showed an orbital mass involving the optic nerve. After radiotherapy, previous symptoms improved in all patients. However, after RT the MRI consistently showed a stationary status compared to the MRI before RT. At a median follow up of 26 months (range 9-37) all patients had a subjective and/or objective better visual performance than before RT without any evidence of disease progression. No late side effects were recorded. Accordingly to the current literature, our experience confirms the efficacy and the safety of FSRT in patients with orbital ONSM. (author)

  2. A hermeneutic phenomenological study of the experiences of female African American undergraduate engineering students at a predominantly White and an historically Black institution

    Science.gov (United States)

    Frillman, Sharron Ann

    2011-12-01

    This phenomenological study examined the experiences of twelve female African Americans enrolled as fulltime undergraduate engineering students at North Carolina Agricultural and Technical State University, an historically Black university, and seven female African Americans enrolled as undergraduate engineering students at Purdue University in West Lafayette, Indiana, a traditionally White institution. Interviews provided insights into the "lived" experiences of these young women and the factors they believe have contributed to their success in their respective engineering programs. Data analysis involved coding each participant's responses to interview questions using Atlas.ti, a powerful qualitative data analysis tool. This generated 181 codes that were further categorized into nine emergent themes, indicating the potential for extensive associations among the variables. The emergent themes are as follows: (1) Demographic information/special circumstances, (2) Personal attributes and characteristics, (3) Personal insights, (4) Sense of mission, (5) Sources of negative stress, (6) Success strategies, (7) Various forms of support, (8) Would/would not have made it to where she is now, and (9) Being African American and female in engineering. Analysis of these themes and their relationships led to the development of the Frillman Model of Emergent Themes in Female African American Engineering Students. Success. In addressing similarities and differences, three overriding theme categories emerged. These were: (1) Four personhood themes and dual social identity theme; (2) Environmental input and response theme; and (3) Outcome emergent theme of Would/Would not have made it to where she is now. Recommendations were made for future research to expand upon this exploratory study.

  3. Extending professional education to health workers at grass root level: An experience from All India Institute of Medical Sciences, New Delhi

    Directory of Open Access Journals (Sweden)

    K K Deepak

    2014-01-01

    Full Text Available Background: In India, the opportunities for professional education of the grass root level health workers are grossly inadequate. Capacity building of all categories of health workers is needed for enhancing health outcomes. Objectives: To plan and implement a professional development training program for all categories of allied health workers and to assess its outcomes in terms of knowledge and skills Materials and Method: We planned and organized a ′one week′(15 h training program for 10 categories of allied health workers (1260 working in our hospital. The program included nine generic skills/topics: the prestige of AIIMS, sterilization & infection control, universal precaution, biomedical waste management, public health, life style & healthy nutrition, fire safety, communication skills and office procedure besides subject specific skills. Trainers were drawn from 12 departments. Training methodology included interactive lectures, narratives, demonstrations, videos, PPT slides, and informal discussions with participants. The effectiveness of the program was judged on the basis of participants′ feedback, feedback from the supervisors, and our own observations post training. Results: Feedback from the participants and their supervisors after training was encouraging. The participants described training as a "life time experience". The supervisors reported improvement in confidence, communication skills, and awareness of workers. Conclusion: The success of the program was due to the use of interactive methods, involvement of multidisciplinary team, and commitment from leadership. We recommend that professional education should be linked with career advancement. Academic institutions can play a key role in taking such initiatives.

  4. The role of ultrasound-guided cytology of groin lymph nodes in the management of squamous cell carcinoma of the vulva: 5-year experience in 44 patients

    International Nuclear Information System (INIS)

    AIM: To assess the accuracy of ultrasound combined with fine-needle aspiration cytology (FNAC) in the detection of lymph node metastasis in patients with squamous cell carcinoma of the vulva. MATERIALS AND METHODS: The groin nodes of 44 consecutive patients with primary squamous cell carcinoma of the vulva undergoing groin node dissection were assessed with ultrasound and FNAC. The results were compared with histology from subsequent inguinofemoral lymph node dissection. Twenty-nine patients underwent bilateral groin node dissections and 15 unilateral providing comparable data for 73 groins. RESULTS: Histology demonstrated metastatic disease in 28 groins and no evidence of metastatic disease in 45. Ultrasound agreed with the histology in 67 of the 73 groins (92%), with two false-positives, four false-negatives and two indeterminate appearances. Cytology agreed with the histology in 65 of 72 FNAC samples obtained (90%), with six false-negatives, and one indeterminate result. No false-positive cytology results were seen. Ultrasound and FNAC together failed to detect metastatic disease in four groins, one with an indeterminate ultrasound appearance, another with indeterminate cytology, the two others each having a single positive inguinal node despite a negative ultrasound and FNAC. CONCLUSION: The combination of ultrasound and FNAC provides a sensitive and specific tool for pre-operative assessment and may prevent unnecessary groin dissection and the attendant morbidity in selected patients with vulval cancer

  5. The role of ultrasound-guided cytology of groin lymph nodes in the management of squamous cell carcinoma of the vulva: 5-year experience in 44 patients

    Energy Technology Data Exchange (ETDEWEB)

    Hall, T.B.; Barton, D.P.J.; Trott, P.A.; Nasiri, N.; Shepherd, J.H.; Thomas, J.M.; Moskovic, E.C. E-mail: eleanor.moskovic@rmh.nthames.nhs.uk

    2003-05-01

    AIM: To assess the accuracy of ultrasound combined with fine-needle aspiration cytology (FNAC) in the detection of lymph node metastasis in patients with squamous cell carcinoma of the vulva. MATERIALS AND METHODS: The groin nodes of 44 consecutive patients with primary squamous cell carcinoma of the vulva undergoing groin node dissection were assessed with ultrasound and FNAC. The results were compared with histology from subsequent inguinofemoral lymph node dissection. Twenty-nine patients underwent bilateral groin node dissections and 15 unilateral providing comparable data for 73 groins. RESULTS: Histology demonstrated metastatic disease in 28 groins and no evidence of metastatic disease in 45. Ultrasound agreed with the histology in 67 of the 73 groins (92%), with two false-positives, four false-negatives and two indeterminate appearances. Cytology agreed with the histology in 65 of 72 FNAC samples obtained (90%), with six false-negatives, and one indeterminate result. No false-positive cytology results were seen. Ultrasound and FNAC together failed to detect metastatic disease in four groins, one with an indeterminate ultrasound appearance, another with indeterminate cytology, the two others each having a single positive inguinal node despite a negative ultrasound and FNAC. CONCLUSION: The combination of ultrasound and FNAC provides a sensitive and specific tool for pre-operative assessment and may prevent unnecessary groin dissection and the attendant morbidity in selected patients with vulval cancer.

  6. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    International Nuclear Information System (INIS)

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy

  7. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy.

  8. Hereditary leiomyomatosis and renal cell carcinoma

    OpenAIRE

    Schmidt LS; Linehan WM

    2014-01-01

    Laura S Schmidt,1,2 W Marston Linehan11Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; 2Basic Science Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USAAbstract: Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an autosomal-dominant hereditary syndrome, which is caused by germline mutations in the FH gene that encodes the tricarboxylic ac...

  9. Radiation therapy for endometrial carcinoma

    International Nuclear Information System (INIS)

    Although pelvic irradiation has traditionally been employed as an adjunct to surgery, the role of radiation therapy as a definitive therapeutic modality continues to be controversial. One-hundred and twenty-one patients were treated for endometrial carcinoma between 1978 and 1985 at the Medical College of Virginia Hospital. These patients were divided into three groups with respect to their treatment. Group 1 consisted of 16 patients who had preoperative radiation therapy, group 2 consisted of 77 patients who had postoperative radiation therapy, and group 3 consisted of 28 patients who had radiation therapy alone. Ninety-three percent of the patients in groups 1 and 2 and 68% of patients in group 3 had stages I and II disease. In group 3, 32% of the patients had stages III and IV disease. Two-thirds of the patients in groups 1 and 2 had moderately differentiated tumor. One-third of patients in group 3 had poorly differentiated tumor. Sixty percent of the study's population in group 2 had deep myometrial invasion. The treatment doses utilized and local failures will be presented. All of the patients have been followed for a minimum period of 2 years. The observed actuarial 5-year survival was 85%, 80%, and 53%, respectively, for groups 1, 2, and 3. The overall survival of the entire patient population was 77%. There was 1 fatality secondary to small bowel complication in group 2 and another serious complication of rectovaginal fistula in group 1 requiring colostomy. Other side effects were skin reaction, diarrhea, and cystitis, which were treated symptomatically. Analysis of the authors' institution experience with adenocarcinoma of the endometrium and its management with radiation therapy is presented. Survival is correlated with stage, grade, and depth of myometrial invasion

  10. Institutional upbringing

    DEFF Research Database (Denmark)

    Gulløv, Eva

    2008-01-01

    agents, empowered with the legitimate right to define and control normality and proper ways of behaving oneself. I aim to show how institutions come to define the normal child and proper childhood in accordance with current efforts toward reinventing national culture, exemplified by legislation requiring......In the chapter, I discuss the role day care institutions play in the construction of the idea of proper childhood in Denmark. Drawing on findings from research on ethnic minority children in two Danish day care institutions, I begin with a discussion of how childcare institutions act as civilising...

  11. Giant basal cell carcinoma Carcinoma basocelular gigante

    OpenAIRE

    Nilton Nasser; Nilton Nasser Filho; Bruno Trauczynski Neto; Lissandra Melati da Silva

    2012-01-01

    The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no s...

  12. Vivencia del Embarazo en Adolescentes en una institución de protección en Colombia Teenagers pregnancy experiences in a colombian institution of protection

    Directory of Open Access Journals (Sweden)

    Dalia C. Patricia Rojas García

    2010-09-01

    pregnancy experience of adolescents helped to feed back the protection program. Qualitative Study, 17 adolescents were included; information was recollected after informed consent, by clinic histories, focal groups, and deep interviews. Data were processed using Atlas Ti, content analysis. Results: Pregnancy was not planned; 11 cases by the relationship, 1 by promiscuity, 5 by sexual abuse or incest. It was hidden for embarrass or frightened to social rejection. The partner abandoned in 9 cases; produced family crisis, social isolation, and school dropout. Psychosocial changes: denial and rejection (abortion, abandonment, adoption, risk behaviour; acceptance and establishment of mother-child bond. The institution of protection provides services during 12 months without follow-up at discharge. The state program aimed to protect pregnant teens need to: establish mechanisms to ensure the continuity of the girls in the educational system, including outpatient follow-up to mother-infant at discharge; implement participation strategies to promote the exercise of responsible sexuality in the context of sexual and reproductive rights. The institution must continue to systematize and disseminate the information and monitor periodically the findings with other institutions of protection, health and education, located in the catchment area as an input to provide feedback for the program and encourage the search for prevention strategies pregnancy or its recurrence.

  13. Institutional Economics.

    Science.gov (United States)

    Samuels, Warren J.

    1984-01-01

    Institutional economics remains a viable alternative approach to economics. It stresses power, technology, and a holistic and evolutionary approach while critiquing the neoclassical approach. General features of institutional economics are examined, and the work of institutionalists in specific areas is discussed. (RM)

  14. Liver cancer - hepatocellular carcinoma

    Science.gov (United States)

    Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma ... Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or ...

  15. Liver cancer - hepatocellular carcinoma

    Science.gov (United States)

    Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma ... Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or older. ...

  16. Undifferentiated salivary gland carcinomas

    DEFF Research Database (Denmark)

    Herbst, H.; Hamilton-Dutoit, S.; Jakel, K.T.;

    2004-01-01

    Undifferentiated salivary gland carcinomas may be divided into small cell and large cell types. Among large cell undifferentiated carcinomas, lymphoepithelial carcinomas have to be distinguished, the latter of which are endemic in the Arctic regions and southern China where virtually all cases of...... these tumors are associated with the Epstein-Barr virus (EBV). Association with EBV may also be observed in sporadic cases, and detection of EBV gene products may aid their diagnosis. Immunohistology may be employed to resolve the differential diagnosis of undifferentiated salivary gland carcinomas......, comprising malignant lymphomas, amelanotic melanomas, Merkel cell carcinomas, and adenoid cystic carcinomas, in particular in small biopsy materials. Because of the rarity of undifferentiated salivary gland carcinomas, the differential diagnosis should always include metastases of undifferentiated carcinomas...

  17. Impact of cervical disease and its definitive radiotherapeutic management on survival: Experience in 2013 patients with squamous cell carcinomas of the oropharynx and pharyngolarynx

    Energy Technology Data Exchange (ETDEWEB)

    Bataini, J.P.; Bernier, J.; Jaulerry, C.; Brunin, F.; Pontvert, D. (Institut Curie, Paris (France))

    1990-07-01

    Two thousand thirteen patients with squamous cell carcinoma of oropharynx and pharyngolarynx were reviewed with regard to neck disease presentation and disease-free survival after radical radiotherapy. All patients were staged according to both the AJCC 1976 and the UICC 1978 classifications. Causes of failure, disease-free survival, and complication rates were assessed. Sixty percent had a clinically positive neck. The 3-year disease-free survival rates were 58%, 44%, 38%, and 25% for AJCC N0, N1, N2, and N3 cases, respectively. Corresponding UICC figures were 58%, 46%, 26%, and 29%. Analyzed parameters were nodal stage, size, site and fixity, and location of primary. Complications attributed to neck disease did not exceed 3%. A critical appraisal of the nodal staging systems is derived from these sets of data.

  18. Impact of cervical disease and its definitive radiotherapeutic management on survival: Experience in 2013 patients with squamous cell carcinomas of the oropharynx and pharyngolarynx

    International Nuclear Information System (INIS)

    Two thousand thirteen patients with squamous cell carcinoma of oropharynx and pharyngolarynx were reviewed with regard to neck disease presentation and disease-free survival after radical radiotherapy. All patients were staged according to both the AJCC 1976 and the UICC 1978 classifications. Causes of failure, disease-free survival, and complication rates were assessed. Sixty percent had a clinically positive neck. The 3-year disease-free survival rates were 58%, 44%, 38%, and 25% for AJCC N0, N1, N2, and N3 cases, respectively. Corresponding UICC figures were 58%, 46%, 26%, and 29%. Analyzed parameters were nodal stage, size, site and fixity, and location of primary. Complications attributed to neck disease did not exceed 3%. A critical appraisal of the nodal staging systems is derived from these sets of data

  19. Calibration and Optimization of p53, WT1, and Napsin A Immunohistochemistry Ancillary Tests for Histotyping of Ovarian Carcinoma: Canadian Immunohistochemistry Quality Control (CIQC) Experience.

    Science.gov (United States)

    Lee, Sandra; Piskorz, Anna M; Le Page, Cécile; Mes Masson, Anne-Marie; Provencher, Diane; Huntsman, David; Chen, Wenqian; Swanson, Paul E; Gilks, C Blake; Köbel, Martin

    2016-05-01

    The Canadian Immunohistochemistry Quality Control provides proficiency testing for immunohistochemistry in Canadian laboratories. Canadian Immunohistochemistry Quality Control Run 42 assessed WT1, Napsin A, and p53; commonly used markers for histotyping ovarian carcinomas. A 42-core tissue microarray, which included the 5 major histotypes of ovarian carcinomas with a subset having known TP53 mutational status, was used for this Canadian Immunohistochemistry Quality Control challenge. Participants included 43 laboratories for p53, 29 for WT1, and 26 for Napsin A. p53 was scored as aberrant if the staining was strong and diffuse or absent. Napsin A and WT1 were scored positive if any tumor cells stained. The reference p53 expression pattern was inferred by TP53 mutation type when available. For WT1, Napsin A, and cases lacking mutational data, the reference staining pattern was based on the majority staining result. The error rate for p53 was 8.8%. Most errors (84%) were due to weak staining. The sensitivity and specificity of aberrant p53 expression for an underlying TP53 mutation was 91.6% and 87.9%, respectively. The error rate for WT1 was 0.76% with all errors occurring in laboratories using the 6F-h2 clone. The average errors for laboratories using 6F-h2 were 2.4 compared with 0 for WT-49. The error rate for Napsin A was 4%. The average errors for laboratories using polyclonal Napsin A were 3 compared with 1.1 for monoclonal Napsin A. Weak p53 staining increases interpretative errors, primarily due to absence of staining in tumors with wild-type TP53. p53 immunohistochemistry correlates strongly with TP53 mutational status. Polyclonal Napsin A and 6F-h2 may lack specificity in comparison to monoclonal Napsin A and WT-49. PMID:26598982

  20. Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: A hospital-based retrospective observational study and our experience

    Directory of Open Access Journals (Sweden)

    AND Dwivedi

    2012-01-01

    Full Text Available Purpose: The aim of this diagnostic observational study was to assess the spread and biological behavior of gallbladder cancer using 64-slice computerized tomography (CT scanner in this particular geographic belt (eastern Uttar Pradesh, western Bihar, and northern Madhya Pradesh provinces of North India. Indians are ethnically and culturally different from their Western counterparts among whom the incidence of this disease is comparatively low. Subjects and Methods: After systemic examination, all patients (87 were subjected to ultrasonographic examination. All cases were histopathologically proven. Confirmed cases were subjected to volumetric CT examination of abdomen and pelvis, plain, post contrast and delayed phase. Results: Majority of the cases were adenocarcinoma. There was female preponderance with majority belonging to fifth and sixth decades. Commonest presentation was diffuse, irregular, enhancing wall thickening in 49.4%. Majority had invasion of liver parenchyma (74.7%. Cholelithiasis was seen in 48.3% cases. Invasion of biliary radicals was high (13.8-18.4%. Eleven cases had invasion of portal vein and tumor thrombus, with hepatic artery invasion in one case. In two cases, both hepatic artery and portal vein invasion was seen. Portal and peripancreatic nodal metastasis was seen in 58.5%. Distant metastasis was reported. Conclusion: Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder.

  1. Recent Nigerian experience illustrates the importance of ensuring that the institutional, financial, and operational powers of election management bodies are safeguarded

    OpenAIRE

    Sani, Ibrahim

    2014-01-01

    How should countries organise their systems of electoral administration? Recent election cycles in Nigeria illustrate the importance of ensuring that electoral management bodies are not just institutionally independent, but that steps are also taken to ensure that sufficient emphasis is placed on the institutional, financial, and operational powers and functions of these organisations, argues Ibrahim Sani.

  2. Experience of psycho-pedagogical monitoring Psychological-medical-pedagogical counseling (PMPC) of teachers in educational institutions in the process of introducing and implementing inclusive education in the Republic of Sakha (Yakutia)

    OpenAIRE

    Yu. Kobazova; Kozina, G

    2013-01-01

    The paper describes the experience of psycho-pedagogical support of teachers in educational institutions, their psychological readiness for the introduction of inclusive education in Neryungri district, the need of pedagogical self-consciousness transformation, teachers view on educational and training system and on social communication system. The experience of practical use and features of inclusive education introduction by PMPC specialists are being summarized. To study the readiness to ...

  3. Three-dimensional gadolinium-enhanced magnetic resonance breath-hold FLASH imaging in the diagnosis and staging of renal cell carcinoma

    International Nuclear Information System (INIS)

    Renal cell carcinoma accounts for 2% of all reported cancers. Its apparent incidence is increasing due to the more widespread use of cross-sectional imaging and as a result, tumours are being detected at an earlier stage. It is hoped that this improvement in early detection will result in a significant increase in survival rates. Radiological diagnosis and staging have a critical role in triaging patients' -treatment. Although computed tomography (CT) and ultrasound are well established in the evaluation of renal cell carcinoma, magnetic resonance (MR) techniques are still rapidly developing. In our institution breath-hold three-dimensional (3D) gadolinium-enhanced fast low-angled single shot (FLASH) spoiled gradient-echo sequence imaging has become an integral part of staging for renal cell carcinoma. In this article, we review our experience of the use of this emerging technique in the diagnosis and staging of renal cancer

  4. Surgical pathology of hypothenar hammer syndrome with new pathogenetic insights: A 25-year institutional experience with clinical and pathologic review of 67 cases.

    Science.gov (United States)

    Larsen, Brandon T; Edwards, William D; Jensen, Mark H; Johnson, Craig H; McBane, Robert D; Harmsen, William S; Maleszewski, Joseph J

    2013-11-01

    Hypothenar hammer syndrome (HHS) is characterized by digital ischemia after repetitive traumatic injury to the ulnar artery. Some hypothesize that susceptible patients have an intrinsic vasculopathy such as fibromuscular dysplasia (FMD). To investigate this hypothesis, we reviewed our institutional experience with this syndrome over 25 years. Clinical records were reviewed from all patients who underwent surgical treatment for HHS (1987 to 2011), and histologic features of excised ulnar arteries were characterized. A total of 67 patients (mean age 45 y; range, 21 to 75 y; 65 men) were treated for unilateral or bilateral disease. Common symptoms included digital pain (96% of cases), cold intolerance (79%), cyanosis (70%), numbness (54%), tingling (51%), and ulceration (40%). Angiography showed ulnar artery occlusion (89%), irregularity (56%), tortuosity (46%), and digital emboli (89%). Common pathologic features (from 75 specimens) included: luminal thrombosis (87%); intimal thickening (60%) and fibrosis (57%); internal elastic membrane disruption (95%); medial fibrosis (96%), hypertrophy (43%), neovascularization (49%), dilatation (29%), and disruption (25%); and adventitial neovascularization (53%). Specific features of dysplasia were present in 10 cases (15%), including smooth muscle disorganization and additional smooth muscle bundles outside the external elastic membrane, but typical FMD was not identified. Histologic features in HHS most often represent secondary changes consistent with repetitive trauma. Dysplastic features can be found in occasional cases, but FMD does not appear to contribute to HHS in most patients. Angiography should be interpreted with caution in superficial locations, as a string-of-beads appearance may simply reflect a posttraumatic corkscrew deformity of the ulnar artery. PMID:23887165

  5. Intensity modulated radiotherapy (IMRT) in the treatment of children and Adolescents - a single institution's experience and a review of the literature

    International Nuclear Information System (INIS)

    While IMRT is widely used in treating complex oncological cases in adults, it is not commonly used in pediatric radiation oncology for a variety of reasons. This report evaluates our 9 year experience using stereotactic-guided, inverse planned intensity-modulated radiotherapy (IMRT) in children and adolescents in the context of the current literature. Between 1999 and 2008 thirty-one children and adolescents with a mean age of 14.2 years (1.5 - 20.5) were treated with IMRT in our department. This heterogeneous group of patients consisted of 20 different tumor entities, with Ewing's sarcoma being the largest (5 patients), followed by juvenile nasopharyngeal fibroma, esthesioneuroblastoma and rhabdomyosarcoma (3 patients each). In addition a review of the available literature reporting on technology, quality, toxicity, outcome and concerns of IMRT was performed. With IMRT individualized dose distributions and excellent sparing of organs at risk were obtained in the most challenging cases. This was achieved at the cost of an increased volume of normal tissue receiving low radiation doses. Local control was achieved in 21 patients. 5 patients died due to progressive distant metastases. No severe acute or chronic toxicity was observed. IMRT in the treatment of children and adolescents is feasible and was applied safely within the last 9 years at our institution. Several reports in literature show the excellent possibilities of IMRT in selective sparing of organs at risk and achieving local control. In selected cases the quality of IMRT plans increases the therapeutic ratio and outweighs the risk of potentially increased rates of secondary malignancies by the augmented low dose exposure

  6. Concurrent Hyperfractionated Radiation Therapy and Chemotherapy in Locally Advanced (Stage III) Non-Small-Cell Lung Cancer: Single Institution Experience With 600 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Jeremic, Branislav, E-mail: nebareje@gmail.com [Department of Oncology, University Hospital, Kragujevac (Serbia); Milicic, Biljana; Milisavljevic, Slobodan [Department of Oncology, University Hospital, Kragujevac (Serbia)

    2012-03-01

    Purpose: Our institutional experience with the use of hyperfractionated radiation therapy (RT) alone or concurrently with chemotherapy (RT-CHT) in Stage III non-small-cell lung cancer was reviewed. Methods and Materials: Three phase III and two phase II studies included a total of 600 patients. Hyperfractionated RT alone was given to 127 patients, and hyperfractionated RT-CHT was given to 473 patients. RT doses were 64.8 Gy and 69.6 Gy (using 1.2 Gy twice daily) and 67.6 Gy (using 1.3 Gy twice daily). CHT consisted of concurrent administration of carboplatin and etoposide to 409 patients and concurrent administration of carboplatin and paclitaxel to 64 patients. Results: The median survival times were 19 months, 21 months, and 12 months for all, RT-CHT, and RT-only patients, respectively. The survival difference between the RT-CHT and RT group was significant (p < 0.0001). Four-year rates of local progression-free survival (LPFS) and distant metastasis-free survival (DMFS) were 29% and 35%, respectively, for the entire group. The RT-CHT group had significantly better LPFS rates than the RT group (31% for the RT-CHT group vs. 16% for the RT group; p = 0.0015) but not DMFS rates (36% for the RT-CHT group vs. 36% for the RT group, p = 0.0571). Acute high-grade esophagitis, pneumonitis, and hematological toxicities were seen most frequently and in 11%, 9%, and 12% of patients, respectively. Late high-grade esophageal and bronchopulmonary toxicity were each seen in 6% of patients. Conclusions: Compared to the majority of existing phase II and III studies, this study reconfirmed the excellent results achieved with concurrent RT-CHT, including low toxicity. Concurrent RT-CHT results in survival benefit primarily by increasing LPFS, not DMFS.

  7. Concurrent Hyperfractionated Radiation Therapy and Chemotherapy in Locally Advanced (Stage III) Non-Small-Cell Lung Cancer: Single Institution Experience With 600 Patients

    International Nuclear Information System (INIS)

    Purpose: Our institutional experience with the use of hyperfractionated radiation therapy (RT) alone or concurrently with chemotherapy (RT-CHT) in Stage III non-small-cell lung cancer was reviewed. Methods and Materials: Three phase III and two phase II studies included a total of 600 patients. Hyperfractionated RT alone was given to 127 patients, and hyperfractionated RT-CHT was given to 473 patients. RT doses were 64.8 Gy and 69.6 Gy (using 1.2 Gy twice daily) and 67.6 Gy (using 1.3 Gy twice daily). CHT consisted of concurrent administration of carboplatin and etoposide to 409 patients and concurrent administration of carboplatin and paclitaxel to 64 patients. Results: The median survival times were 19 months, 21 months, and 12 months for all, RT-CHT, and RT-only patients, respectively. The survival difference between the RT-CHT and RT group was significant (p < 0.0001). Four-year rates of local progression-free survival (LPFS) and distant metastasis-free survival (DMFS) were 29% and 35%, respectively, for the entire group. The RT-CHT group had significantly better LPFS rates than the RT group (31% for the RT-CHT group vs. 16% for the RT group; p = 0.0015) but not DMFS rates (36% for the RT-CHT group vs. 36% for the RT group, p = 0.0571). Acute high-grade esophagitis, pneumonitis, and hematological toxicities were seen most frequently and in 11%, 9%, and 12% of patients, respectively. Late high-grade esophageal and bronchopulmonary toxicity were each seen in 6% of patients. Conclusions: Compared to the majority of existing phase II and III studies, this study reconfirmed the excellent results achieved with concurrent RT-CHT, including low toxicity. Concurrent RT-CHT results in survival benefit primarily by increasing LPFS, not DMFS.

  8. Full-dose intraoperative radiotherapy with electrons in breast cancer. First report on late toxicity and cosmetic results from a single-institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Mussari, S.; Busana, L.; Vanoni, V.; Tomio, L. [Dept. of Radiation Oncology, Santa Chiara Hospital, Trento (Italy); Sala, W.S. della [Dept. of Radiology, Santa Chiara Hospital, Trento (Italy); Eccher, C.; Zani, B. [Dept. of Surgery, Santa Chiara Hospital, Trento (Italy); Menegotti, L. [Dept. of Health Physics, Santa Chiara Hospital, Trento (Italy)

    2006-10-15

    Purpose: to investigate the feasibility of applying exclusive intraoperative radiation therapy (IORT) after conservative surgery in limited-stage breast carcinoma and to evaluate late effects and cosmetic results after this new conservative treatment. Patients and methods: from October 2000 to November 2002, 47 consecutive patients with unifocal breast carcinoma up to a diameter of 2 cm received conservative surgery followed by IORT with electrons as the sole adjuvant local therapy. Three different dose levels were used: 20 Gy (seven patients), 22 Gy (20 patients), and 24 Gy (20 patients). Patients were evaluated using RTOG/EORTC scale to assess the incidence of late complications. During follow-up, a radiologic assessment with mammography and sonography was periodically performed and any breast-imaging alterations were reported. Results: after a follow-up ranging from 36 to 63 months (median, 48 months), 15 patients developed breast fibrosis (grade 2 in 14 patients, grade 3 in one patient), two patients presented with grade 3 skin changes, one patient developed a clinically relevant fat necrosis, and one patient showed breast edema and pain. Two patients developed contralateral breast cancer and one distant metastases; no local relapses occurred. Asymptomatic findings of fat necrosis were observed at mammography in twelve patients (25.5%), while an hypoechoic area was revealed by sonography in ten patients (21.5%). In four patients (8%), mammographic and sonographic findings suggested malignant lesions and required a rebiopsy to confirm the benign nature of the lesion. Conclusion: IORT in breast carcinoma is still an experimental treatment option for select patients with breast cancer and its application should be restricted to prospective trials. Although preliminary data on local control are encouraging, a longer follow-up is needed to confirm the efficacy of IORT in breast cancer and to exclude that severe late complications compromise the cosmetic results or

  9. Full-dose intraoperative radiotherapy with electrons in breast cancer. First report on late toxicity and cosmetic results from a single-institution experience

    International Nuclear Information System (INIS)

    Purpose: to investigate the feasibility of applying exclusive intraoperative radiation therapy (IORT) after conservative surgery in limited-stage breast carcinoma and to evaluate late effects and cosmetic results after this new conservative treatment. Patients and methods: from October 2000 to November 2002, 47 consecutive patients with unifocal breast carcinoma up to a diameter of 2 cm received conservative surgery followed by IORT with electrons as the sole adjuvant local therapy. Three different dose levels were used: 20 Gy (seven patients), 22 Gy (20 patients), and 24 Gy (20 patients). Patients were evaluated using RTOG/EORTC scale to assess the incidence of late complications. During follow-up, a radiologic assessment with mammography and sonography was periodically performed and any breast-imaging alterations were reported. Results: after a follow-up ranging from 36 to 63 months (median, 48 months), 15 patients developed breast fibrosis (grade 2 in 14 patients, grade 3 in one patient), two patients presented with grade 3 skin changes, one patient developed a clinically relevant fat necrosis, and one patient showed breast edema and pain. Two patients developed contralateral breast cancer and one distant metastases; no local relapses occurred. Asymptomatic findings of fat necrosis were observed at mammography in twelve patients (25.5%), while an hypoechoic area was revealed by sonography in ten patients (21.5%). In four patients (8%), mammographic and sonographic findings suggested malignant lesions and required a rebiopsy to confirm the benign nature of the lesion. Conclusion: IORT in breast carcinoma is still an experimental treatment option for select patients with breast cancer and its application should be restricted to prospective trials. Although preliminary data on local control are encouraging, a longer follow-up is needed to confirm the efficacy of IORT in breast cancer and to exclude that severe late complications compromise the cosmetic results or

  10. Validation of the model of Critical Heat Flux COBRA-TF compared experiments of Post-Dryout performed by the Royal Institute of Technology (KTH); Validacion del Modelo de Critical Heat Flux de COBRA-TF frente a los Experimentos de Post-Dryout realizados por el Royal Institute of Technology (KTH)

    Energy Technology Data Exchange (ETDEWEB)

    Abarca, A.; Miro, R.; Barrachina, T.; Verdu, G.

    2014-07-01

    In this work is a validation of the results obtained with different existing correlations for predicting the value and location of the CTF code CHF, using them for experiments of Post-Dryout conducted by the Royal Institute of Technology (KTH) in Stockholm, Sweden. (Author)

  11. Hepatocellular carcinoma.

    Science.gov (United States)

    Llovet, Josep M; Zucman-Rossi, Jessica; Pikarsky, Eli; Sangro, Bruno; Schwartz, Myron; Sherman, Morris; Gores, Gregory

    2016-01-01

    Liver cancer is the second leading cause of cancer-related deaths globally and has an incidence of approximately 850,000 new cases per year. Hepatocellular carcinoma (HCC) represents approximately 90% of all cases of primary liver cancer. The main risk factors for developing HCC are well known and include hepatitis B and C virus infection, alcohol intake and ingestion of the fungal metabolite aflatoxin B1. Additional risk factors such as non-alcoholic steatohepatitis are also emerging. Advances in the understanding of the molecular pathogenesis of HCC have led to identification of critical driver mutations; however, the most prevalent of these are not yet druggable targets. The molecular classification of HCC is not established, and the Barcelona Clinic Liver Cancer staging classification is the main clinical algorithm for the stratification of patients according to prognosis and treatment allocation. Surveillance programmes enable the detection of early-stage tumours that are amenable to curative therapies - resection, liver transplantation or local ablation. At more developed stages, only chemoembolization (for intermediate HCC) and sorafenib (for advanced HCC) have shown survival benefits. There are major unmet needs in HCC management that might be addressed through the discovery of new therapies and their combinations for use in the adjuvant setting and for intermediate- and advanced-stage disease. Moreover, biomarkers for therapy stratification, patient-tailored strategies targeting driver mutations and/or activating signalling cascades, and validated measurements of quality of life are needed. Recent failures in the testing of systemic drugs for intermediate and advanced stages have indicated a need to refine trial designs and to define novel approaches. PMID:27158749

  12. Hepatocellular carcinoma.

    Science.gov (United States)

    Edwards, J T; Macdonald, G A

    2000-05-01

    The incidence of hepatocellular carcinoma (HCC) appears to be declining in Taiwan and potentially in other high-prevalence areas as a consequence of vaccination for hepatitis B virus (HBV). However, there is evidence that the incidence of HCC is increasing in North America and Europe. This appears to be related to the increasing prevalence and duration of hepatitis C virus (HCV) infection in these countries. There is also growing evidence to support an increase in the risk of HCC in patients with HCV who are coinfected with occult HBV (patients who have lost HBV surface antigen but still have detectable HBV DNA either in blood or liver). Occult HBV infection in patients with HCV may be more common than previously thought, and HCC that occurs in this setting appears to have a worse prognosis. There is continuing interest in the effect of interferon therapy on the incidence of HCC in patients with HCV. Several studies from Japan have shown a benefit in patients without cirrhosis, although there are a number of potentially confounding variables that may partly explain these results. Prospective randomized studies are needed to investigate this important question. The molecular biology of HCC and the events of malignant transformation in the liver continue to be areas of intense study. Recently, there has been considerable interest in telomeres, the repeat units on the ends of chromosomes, and the enzyme that maintains these, telomerase. Telomeres shorten with each cell division and can be used to determine the number of divisions a cell has undergone. Eventually they reach a critical length, with further loss resulting in cellular senescence. Telomerase restores telomere length and may help malignant cells escape senescence. Nearly all HCCs have telomerase activity and assessments of telomeres and telomerase may be clinically useful. PMID:17023886

  13. CSCAPES Institute

    Energy Technology Data Exchange (ETDEWEB)

    Alex Pothen

    2008-10-26

    We report on the progress made by researchers of the CSCAPES Institute at Old Dominion University for the years 2007 and 2008 in the areas of research, software creation, education and training, and outreach activities.

  14. Institutional Ethnography

    DEFF Research Database (Denmark)

    Lund, Rebecca; Tienari, Janne

    2016-01-01

    managerial respondents. This leads to another bias in the study of M&As: an managerial one. These critiques are an important step in pinpointing some of the problematic aspects in the field, which we suggest can be part remedied by institutional ethnography developed by Dorothy Smith and her colleagues. In...... institutional ethnography the notion of objectification is applied to describe research processes like those that have been found to dominate in scholarly work on M&As. In this chapter, we offer an outline of Smiths critique of objectification, elucidate how institutional ethnography seeks to address it, and...... point to some of the problems in M&A studies identified through this lens. Finally, we argue why institutional ethnography, in comparison with other methods of inquiry, is particularly fruitful in the study of mergers and acquisitions....

  15. Institutional Investors

    DEFF Research Database (Denmark)

    Birkmose, Hanne Søndergaard; Strand, Therese

    Research Question/Issue: Institutional investors are facing increased pressure and threats of legislation from the European Union to abandon passive ownership strategies. This study investigates the prerequisites for – and potential dissimilarities in the practice of, active ownership among...... institutional investors in two Scandinavian countries with diminutive legal and cultural distance in general. Research Findings/Insights: Using data on shareholder proposals from Danish and Swedish annual general meetings from 2006 throughout 2010, we find that institutional investors are approximately a....... Practitioner/Policy Implications: Regulators should be aware of the impact by local governance mechanisms, and how shareholders react under different legal and practical prerequisites. The paper also highlights legal elements that differ between Denmark and Sweden, and which might affect institutional activism....

  16. Cryotherapy for hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Awad, Tahany; Thorlund, Kristian; Gluud, Christian

    2009-01-01

    BACKGROUND: Hepatocellular carcinoma is the most common primary malignant cancer of the liver. Evidence for the role of cryotherapy in the treatment of hepatocellular carcinoma is controversial. OBJECTIVES: The aim of this review is to evaluate the potential benefits and harms of cryotherapy for...... the treatment of hepatocellular carcinoma. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and LILACS until June 2009. We identified further studies by...... hepatocellular carcinoma. Randomised clinical trials with low-risk of bias may help in defining the role of cryotherapy in the treatment of hepatocellular carcinoma....

  17. Institutional economics

    OpenAIRE

    Rossiaud, Sylvain; Locatelli, Catherine

    2010-01-01

    The discipline of institutional economics has gained increasing prominence in recent years, because standard economic explanations can often not come to grips with major contemporary policy issues, such as economic reform in affluent, but dysfunctional economies, the transformation of the failed socialist command economies and the governance problems of the new industrial economies. Institutional economists point out that rule systems matter greatly to explaining these problems and that insti...

  18. The effectiveness of 125I seed interstitial brachytherapy for transplantation tumor of human pancreatic carcinoma in nude mice: an experiment in vivo

    International Nuclear Information System (INIS)

    Objective: To discuss the effectiveness and therapeutic mechanism of 125I interstitial brachytherapy for transplantation tumor of human pancreatic carcinoma in nude mice. Methods: The human pancreatic cell line Sw1990 was subcutaneously injected into the right lower limb partially dorsal area next to the groin of the immunodeficient BABL /c nude mice. The tumor was removed and cut into small pieces after it was formed,then the tumor pieces were inoculated in nude mice. The tumor developed to 8-10 mm in size after six weeks. A total of 16 nude mice with the suitable tumor size were used in this study. The 16 experimental mice were randomly and equally divided into two groups. The mice in study group (n = 8) were implanted with 125I seeds, while the mice in control group (n = 8) were implanted with ghost seeds. After the implantation both the long and short diameter of the tumors as well as the mouse body weight were measured every 4 days. The tumor weight was measured when the mouse was sacrificed. The paraffin-embedded samples were sent for histopathological examination. Apoptotic cells were checked with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method. Expression of proliferating cell nuclear antigen (PCNA) was detected with immuno-histochemical staining. Results: The tumor grew slowly in the study group, but rapidly in the control group. The tumor weight in the study group and the control group was (2.68 ± 0.70)g and (4.68 ± 1.45)g, respectively, the difference between two groups was statistically significant (P = 0.021). The tumor inhibition rate was about 42.66%. No significant difference in body weight of nude mice existed between two groups both before and after the treatment (P > 0.05). Marked tumor necrosis was seen in study group, but no obvious, or only a little, tumor necrosis could be observed in the control group. The apoptotic index checked with the TUENL method in the study group and control group was (23.2 ± 1.9)% and

  19. Institutions and Comparative Regional Research

    OpenAIRE

    Stallmann, Judith I.

    2010-01-01

    This is a personal view of regional science, which draws on my experiences and my training in both institutional economics and regional economics. I will start with some of those experiences and the questions they raised for me about the importance of institutions1 in regional development and some of the difficulties of doing comparative regional research. While I include regions at many levels of aggregation, my particular interest is how to incorporate institutions into the analysis of regi...

  20. Anti-drug preventive activities in a situation of a HIV outburst within a prison institution (experience and conclusions from the hiv outburst in Alytus top security prison)

    OpenAIRE

    Pečkaitis, Justinas; Justickis, Viktoras

    2006-01-01

    Abstract. Innovationsaimed to reduce any production, delivery, and consumption of drugs are the most prospective meas-ures to work out more efficientprevention of drug related offences. This is especially true for prison institutions, where drug consumption tends to be several times greater that in the general population. Therefore, prison institution has especially great need in new efficient antidrug activities. However, just here especially great problems are met designing and implementing...