WorldWideScience

Sample records for carcinoma institutional experience

  1. SPECTRUM OF RARE CARCINOMAS IN BREAST A SINGLE INSTITUTE EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Vijasree

    2015-10-01

    Full Text Available AIM : To evaluate the clinico pathological features of Metaplastic carcinomas. METHODS : Data of 11 patients with metaplastic breast carcinoma were retrospectively reviewed in a 3 years period. RESULTS : The patient’s ages ranged from 28 years to 70 years (median 49years. The tumours were 4 to 10cm (median 7cm in size. Patients underwent modified radical mastectomy and one patient underwent lumpectomy. One patient had axillary lymph node metastasis. TNM staging, tumour size and axillary nodal status were significant prognostic factors of survival. CONCLUSIO NS : All the three subtypes of Metaplstic carcinoma are known to behave aggressively and should be differentiated from the low grade fibromatosis - like Metaplastic carcinoma. Which does not metastasise

  2. Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hyung; Kim, Mi Sun; Choi, Seo Hee; Suh, Yang Gun; Koh, Yoon Woo; Kim, Se Hun; Choi, Eun Chang; Keum, Ki Chang [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-15

    We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. Adjuvant postoperative radiochemotherapy for patients with gastric carcinoma: a single institution experience

    Institute of Scientific and Technical Information of China (English)

    Manal El-Baradie; Ola Khorshid; Ahmed Touny

    2012-01-01

    Objective: The suboptimal outcome after surgery alone for gastric cancer indicated the necessity of adjuvant treatment for potentially resectable carcinoma of the stomach. In 2001, postoperative adjuvant radiochemotherapy started to be implemented in the NCI, Cairo, Egypt. However, the fear of the acute complication hindered its use as a standard treat-ment with some staff didn't follow the SWAG's adjuvant protocol. The aim of this report is to verify this issue. Methods: In the period from 1999 to 2009, 320 out of 581 patients with gastric carcinoma, underdid potentially curative surgery. Adjuvant postoperative radiochemotherapy for stage ≥ IIA started since 2001. Radiation (45 Gy, 1.8 Gy/f) was targeted to the tumor bed, anastomosis site, duodenal stump, remnant stomach and regional lymph node together with 4–5 cycles chemotherapy (SWOG protocol). Survival analysis was performed and comparison between survival curves was done to analysis different prognostic factors. Results: The patients' age ranged from 17 to 86 years [mean (54 ± 12.5) years]. About 1/3 of the patients had a diffuse lesion. Adenocarcinoma was the most common pathology (60.4%). High grade pathology constituted 59.1% of the cases. About one fifth of the patients had metastatic disease at presentation. Only 351 (75%) of the patients had potentially curative gastrectomy. The median number of lymph node (LN) dissected was 12 (ranged from 0–45) with a median number of the positive LN of 3.5 (ranged from 0–40). Postoperative mortality was 12%. The median follow up period was 21.9 months (ranged from 3–129.4 months). For the 257 patients who had curative surgery, 164 (62.8%) patients were alive at the end of follow up. During follow up period, 30 patients had loco-regional relapse, and 26 patients had metastasis, and 39 patients had both pattern of failure. The overall survival (OS), loco-regional control (LRC), and metastasis free survival (MFS) rates, at median follow up period of 22

  6. Chemoradiotherapy in squamous cell carcinoma of the anal canal: a single institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Hwan; Chang, Jee Suk; Keum, Ki Chang; Ahn, Joong Bae; Lee, Chang Geol; Koom, Woong Sub [Yonsei University College of Medicine, Yonsei University Health System, Seoul (Korea, Republic of)

    2013-01-15

    We reviewed the treatment outcomes and prognostic factors for patients with anal canal carcinoma who were treated with curative intent chemoradiotherapy (CRT) at Severance Hospital from 2005 to 2011. Data for 38 eligible patients treated during this period were reviewed. All patients were treated with curative intent using radiotherapy (RT) with (n = 35) or without concomitant chemotherapy (n = 3). Among 35 patients who received CRT, most of the chemotherapeutic regimens were either 5-fluorouracil (5-FU) plus mitomycin C (23 patients) or 5-FU plus cisplatin (10 patients). Recurrence-free survival (RFS), colostomy-free survival (CFS), overall survival (OS), and locoregional control (LRC) rates were calculated using the Kaplan-Meier method and survival between subgroups were compared using the log-rank test. Cox's proportional hazard model was used for multivariate analysis. Over a median follow-up period of 44 months (range, 11 to 96 months), 3-year RF S, Cfs, OS, and LRC were 80%, 79%, 85%, and 92%, respectively. In multivariate analysis, tumor size >4 cm was an independent predicting factor for poorer RFS (hazard ratio [HR], 6.35; 95% confidence interval [CI], 1.42 to 28.5; p = 0.006) and CFS (HR, 6.25; 95% CI, 1.39-28.0; p = 0.017), while the presence of external iliac lymph node metastasis was an independent prognosticator for poorer OS (HR, 9.32; 95% CI, 1.24 to 70.3; p 0.030). No treatment-related colostomies or deaths occurred during or after treatment. Curative intent CRT resulted in excellent outcomes that were comparable to outcomes in previous randomized trials. No severe treatment-related toxicities were observed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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…

  11. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  12. Surgical experience in children with differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Haveman, JW; van Tol, KM; Rouwe, CW; Piers, DA; Plukker, JTA

    2003-01-01

    Background: The optimal surgical treatment in children with well-differentiated thyroid carcinoma remains an important point of discussion. In this study, we evaluated our surgical experience and reviewed the literature accordingly to identify the most adequate treatment. Methods: We retrospectively

  13. Temporal bone squamous cell carcinoma - Penang experience.

    Science.gov (United States)

    Ng, S Y; Pua, K C; Zahirrudin, Z

    2015-12-01

    Temporal bone squamous cell carcinoma (TBSCC) is rare and poses difficulties in diagnosing, staging and management. We describe a case series with six patients who were diagnosed TBSCC, from January 2009 to June 2014, with median age of 62 years old. All patients presented with blood-stain discharge and external auditory canal mass, showing that these findings should highly alert the diagnosis of TBSCC. Three patients staged T3 and another three with T4 disease. High-resolution CT (HRCT) temporal findings were noted to be different from intraoperative findings and therefore we conclude that MRI should be done to look for middle ear involvement or other soft tissue invasion for more accurate staging. Lateral temporal bone resection (LTBR) and parotidectomy was done for four patients with or without neck dissection. Patients with positive margin, perineural invasion or parotid and glenoid involvement carry poorer prognosis and postoperative radiotherapy may improve the survival rate. One patient had successful tumor resection via piecemeal removal approach in contrast with the recommended en bloc resection shows that with negative margin achieved, piecemeal removal approach can be a good option for patients with T2-3 disease. In general, T4 tumor has dismal outcome regardless of surgery or radiotherapy given.

  14. Is Hashimoto's thyroiditis a risk factor for medullary thyroid carcinoma? Our experience and a literature review.

    Science.gov (United States)

    Zayed, Ayman A; Ali, Moaath K Mustafa; Jaber, Omar I; Suleiman, Moh'd J; Ashhab, Ashraf A; Al Shweiat, Wajdi Mohammed; Momani, Munther Suliaman; Shomaf, Maha; AbuRuz, Salah Mohammed

    2015-03-01

    The etiology of medullary thyroid carcinoma remains unknown. The aim of this study was to determine whether there is a significant association between medullary thyroid carcinoma and Hashimoto's thyroiditis in the histopathologic material of thyroidectomized patients. Retrospective cross-sectional study. In this study, we reviewed the medical records of all patients who underwent total thyroidectomy for different thyroid-related complaints between January 2000 and January 2012 at Jordan University Hospital-Amman, Jordan. To highlight relevant previously published studies addressing this topic, a literature search was conducted for English language studies reporting "medullary thyroid carcinoma" or "C-cell hyperplasia" in patients with Hashimoto's thyroiditis. Of the 863 patients with a mean age of 47.2 ± 12.3 years who underwent total thyroidectomy during the study period, 78 (9.04 %) were diagnosed with Hashimoto's thyroiditis, and 15 (1.74 %) had medullary thyroid carcinoma, 3 (20 %) of whom had coexistent Hashimoto's thyroiditis. A total of 683 (79.1 %) patients had benign thyroid disease, 67 (9.8 %) of whom had Hashimoto's thyroiditis. The difference between these rates was not statistically significant (p = 0.19). When examined by gender, 9 females had medullary thyroid carcinoma, 3 (33.3 %) of whom had coexistent Hashimoto's thyroiditis; by contrast, of 560 females with benign thyroid disease, 62 (11.1 %) had Hashimoto's thyroiditis (p = 0.04). Although this study population represents a small and single-institution experience, our results suggest that there might be an association between Hashimoto's thyroiditis and medullary thyroid carcinoma only in female patients who undergo total thyroidectomy.

  15. BENIGN BREAST DISEASE: OUR INSTITUTIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Harish Kumar

    2014-11-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this modern era of change in dietary habits, life style and increased awareness about the self-breast examination, the rate of detection of breast lump is on increasing trend. Due to its enormous anatomical and physiological changes during different phases of life, breast diseases are not uncommon. The benign conditions however are also associated with morbidity and are of great concern to the patient. This study was carried out to compare the age distribution and proportion of various benign breast tumors, taking into account the various factors associated with them. A correlation of clinical and histopathological diagnosis was drawn and thus the specificity of clinical diagnosis. METHODS: Prospective review of 50 patients from General Surgery department, who are found to have benign breast tumors on clinico-pathological examination, Bowring and Lady Curzon Hospitals, attached to Bangalore Medical College & Research Institute, Bangalore selected during the period from October 2011 to April 2014 on random basis. Post-operative follow up done to note the complications both in hospital and after discharge. RESULTS: Patients predominantly presented with lump in breast were fibroadenoma and fibrocystic disease. Ductal papilloma, phyllodes tumor and lipoma were also encountered. All patients underwent FNAC. Treatment was mostly surgical in the form of excision, simple mastectomy, microdochotomy and wide local excision. All the specimens were subjected to histopathological examination. Using clinical diagnosis, FNAC and histopathology increased the accuracy of diagnosis. Cases followed up and no recurrence was found. CONCLUSIONS: Commonest benign breast tumor found was Fibroadenoma (78%. Majority of the patients were in the active reproductive age group. Fibroadenoma was more common in 2nd decade of life, whereas fibrocystic disease found in 3rd decade. Majority of benign breast lesions presented with painless lump. FNAC

  16. Breast cancer in pregnancy: an institutional experience

    Science.gov (United States)

    Blanquisett, Abraham Hernández; Vicent, Carmen Herrero; Gregori, Joaquín Gavilá; Zotano, Ángel Guerrero; Porta, Vicente Guillem; Simón, Amparo Ruiz

    2015-01-01

    Background Breast cancer is one of the most common cancers diagnosed during pregnancy. Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy or within 12 months of delivery. Nowadays PABC can be safely diagnosed, staged, and treated during pregnancy with good outcomes for both the mother and the fetus. Recent studies suggest that prognosis of women diagnosed during postpartum seems to be worse. In order to gain a better understanding of the PABC, we reviewed our centre’s experience. Patients and methods We assessed the clinicopathological parameters, evolution, and outcome of patients treated in the Fundación Instituto Valenciano de Oncología of Valencia, Spain, from October 1990 to October 2013, and compared the results of patients diagnosed during pregnancy (group ‘A’) and patients diagnosed within one year of delivery (group ‘B’). Of 12,000 cases of breast cancer registered in our database, 35 cases of PABC were identified. We included 11 patients in group ‘A’ and 24 in group ‘B’. Results In our group the median age was 35 years (range 29–42), of which ten (28%) patients had family history (first grade) of breast cancer, four patients were BRCA 1 mutation carriers. Axillary node compromise was found in 19 patients (53.5%), 24 patients were stage II or III at diagnosis (68.5%), 22 (62.8%) were ER positive, and nine (25.7%) were HER-2 positive. In group A (n = 11), five patients diagnosed before 18th week decided that a therapeutic abortion be performed before treatment, two patients were treated during pregnancy, one with chemotherapy without treatment associated complications during delivery. Four women diagnosed after 28th week decided to delay the treatment until delivery. After a follow up of 172 months, the relapse free survival (RFS) was 69% at five years and 45% at ten years. Overall survival (OS) at five years was 90.8% and 74.2% at ten years for all patients. For group ‘A’ OS was higher

  17. 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.

  18. 76 FR 66698 - Postsecondary Educational Institutions Invited To Participate in Experiments Under the...

    Science.gov (United States)

    2011-10-27

    ... Postsecondary Educational Institutions Invited To Participate in Experiments Under the Experimental Sites..., as amended; notice inviting postsecondary educational institutions to participate in experiments.... Participating institutions will be required to describe how they will ensure that their educational...

  19. Hepatocellular carcinoma: consensus recommendations of the National Cancer Institute Clinical Trials Planning Meeting.

    Science.gov (United States)

    Thomas, Melanie B; Jaffe, Deborah; Choti, Michael M; Belghiti, Jacques; Curley, Steven; Fong, Yuman; Gores, Gregory; Kerlan, Robert; Merle, Phillipe; O'Neil, Bert; Poon, Ronnie; Schwartz, Lawrence; Tepper, Joel; Yao, Francis; Haller, Daniel; Mooney, Margaret; Venook, Alan

    2010-09-01

    Hepatocelluar carcinoma (HCC) is the most common primary malignancy of the liver in adults and the third most common cause of cancer death worldwide. The incidence of HCC in the United States is rising steadily because of the prevalence of hepatitis C viral infection and other causes of hepatic cirrhosis. The majority of patients have underlying hepatic dysfunction, which complicates patient management and the search for safe and effective therapies. The Clinical Trials Planning Meeting (CTPM) in HCC was convened by the National Cancer Institute's Gastrointestinal Cancer Steering Committee to identify the key knowledge gaps in HCC and define clinical research priorities. The CTPM structured its review according to current evidence-based treatment modalities in HCC and prioritized the recommendations on the basis of the patient populations representing the greatest unmet medical need.

  20. Experiences with Learning Management Systems in 113 European Institutions

    Directory of Open Access Journals (Sweden)

    Morten Flate Paulsen

    2003-10-01

    Full Text Available This article presents the major findings from six regional analyses conducted within the framework of the European Web-edu project (http://www.nettskolen.com/in_english/webedusite/index.html. It analyses the experiences of European institutions with the Learning Management Systems that they have purchased or developed themselves. Data was collected from in-depth interviews with 113 European experts, usually the systems managers in the institutions, in 17 countries. The analyses of the interviews revealed as many as 52 different commercial and 35 self-developed LMS systems. The article presents the data from these interviews and includes a series of important findings from the study. One conclusion is that there is a host of commercial and self-developed systems that seem to work satisfactorily in various educational institutions throughout Europe. The systems are not able to handle all the functions the institutions want, and they can be improved in many ways. But most systems encountered in the analyses seem to be good enough for handling online education successfully. Another conclusion is that the European market is not dominated by the American LMS systems. In countries that do not use English as the first language, locally developed LMS systems have successfully ousted the American products. Remarkably, a large number of the LMS systems used in Europe are commercial systems developed locally, or self-developed systems built by the institutions.

  1. 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.

  2. Radiofrequency Ablation Treatment for Renal Cell Carcinoma: Early Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seong Hoon; Yoon, Seong Kuk; Cho, Jin Han; Oh, Jong Young; Nam, Kyung Jin; Kwon, Hee Jin; Kim, Su Yeon; Kang, Myong Jin; Choi, Sun Seob; Sung, Gyung Tak [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2008-08-15

    To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43 73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow- up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1 5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17 33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.

  3. 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.)

  4. Treatment results and prognostic analysis of 1093 primary nasopharyngeal carcinoma:the experience of a single institution of Guangzhou in the beginning of the 21st century%1093例鼻咽癌疗效和预后分析:21世纪初广州单个中心的经验

    Institute of Scientific and Technical Information of China (English)

    Xiaoqing Liu; Wei Luo; Mengzhong Liu; Ling Ye; Ying Sun; Yunfei Xia

    2008-01-01

    Objective:To analyze the treatment results of primary nasopharyngeal carcinoma (NPC) treated in our institution in the beginning of the 21st century to identify key failures and late effects for refining future treatments.Methods:1093 patients with primary NPC treated during December 2001 and June 2003 were retrospectively analyzed.The distribution according to the AJCC/UICC (2002 edition) staging system was stage Ⅰ in 5.8%,stage Ⅱ 40.2%,stage Ⅲ 32.7% and stage Ⅳa-b 21.3%.Four different ERT techniques were used:fluoroscopy simulation conventionaI radiotherapy (CR) in 74.3% of patients,computer tomography simulation conventional radiotherapy (CT-sim CR) 14.2%,three-dimensional conformal radiotherapy (3D-CRT) 6.3%,intensity modulated radiotherapy (IMRT) 5.2%.In the whole series,46.7% of patients had additional treatment with chemotherapy.Results:The 4-year local failure-free rate (LFFR),nodal failure-free rate,distanl metastasis-free rate,progression-free survival and overall survivaI (OS) was 89.6%,96.1%,85.9%,73.0% and 82.4%.respectively.The stage was the most important prognostic factor.The 4-year OS and LFFR of patients treated by CR,CT-sim CR,3D-CRT and IMRT was 80.2%,89.8%,89.8%,92.4% and 87.7%,96.4%,91.0%,96.5%,respectively.The morbidity and degree of xerostomia and trismus were lower in the patients treated by 3D-CRT and IMRT than by CR and CT-sim CR.Conclusion:Treatment results of primary NPC in our institution have been substantially improved.Distant metastasis is the main failure.The CT simulation and conformal radiotherapy can enhance the OS and LFFR,and conformal radiotherapy can reduce the morbidity and degree of late effects.

  5. 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.

  6. 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.

  7. 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

  8. Carcinoma of female urethra. Manitoba experience: 1958-1987

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, P.; Krepart, G.; Malaker, K. (Manitoba Cancer Treatment and Research Foundation, Winnipeg (Canada))

    1991-02-01

    Fourteen female patients with primary urethral carcinoma were treated at the Manitoba Cancer Foundation in the last twenty-nine years. The relationship of natural history to the stage, location, and therapeutic modality has been reviewed. A higher stage and length of urethral involvement affected prognosis negatively, whereas lower stage had a positive prognostic effect and location of tumor had no prognostic influence. Two patients with Stage C, who failed to received inguinal node radiotherapy, died of disease recurring in the inguinal area. Patients who received inguinal radiation (3 patients Stages B, C, and D1) had no regional recurrence. It is suggested that, for all female urethral carcinoma, bilateral ilioinguinal nodes be included in the radiation field. For radical treatment, iridium 192 insertion in combination with external beam treatment is recommended.

  9. Diagnosis of Post-Radiotherapy Local Failures in Nasopharyngeal Carcinoma: A Prospective Institutional Study

    OpenAIRE

    2014-01-01

    Background This prospective study was conducted to evaluate and compare the efficacies of nasopharyngoscopy and CT scan in the diagnosis of local failure of external beam radiotherapy (EBRT) for nasopharyngeal carcinoma. Methods Total 52 patients of histopathologically proven nasopharyngeal carcinoma treated with external beam radiotherapy (EBRT), were included in this study. For every patient computed tomography (CT), nasopharyngoscopy and nasopharyngeal biopsies were performed 3 months afte...

  10. Retrospective analysis of 140 cases of medullary thyroid carcinoma followed-up in a single institution

    Science.gov (United States)

    SIMÕES-PEREIRA, JOANA; BUGALHO, MARIA JOÃO; LIMBERT, EDWARD; LEITE, VALERIANO

    2016-01-01

    Familial cases of medullary thyroid carcinoma (MTC) may be diagnosed by genetic screening, while in sporadic tumors the diagnosis relies mainly on fine-needle aspiration cytology. The aim of the present study was to determine the demographic, clinical and pathological characteristics of MTC patients followed-up at the Portuguese Institute of Oncology Francisco Gentil (Lisbon, Portugal). For that purpose, a retrospective analysis of 140 MTC patients diagnosed between 1990 and 2010 was performed. The results indicated that patients with hereditary MTC (11.4%) were significantly younger than patients with sporadic MTC. Of the latter, 34.3% had no clinical suspicion of MTC prior to surgery. The sensitivity of cytology and calcitonin (CT) assay in diagnosing MTC were 51.3 and 98.7%, respectively. All familial index cases and 69.0% of sporadic cases presented with advanced stage disease at the time of diagnosis, while 73.0% of familial MTC detected by genetic/pentagastrin screening were diagnosed at the early stage of the disease. Biochemical cure (BC) was achieved in 39.7% of patients and, of these, only 6.5% relapsed. The 5 and 10-year survival rates were 79.3 and 73.6%, respectively. Age >45 years (P=0.026), advanced stage at diagnosis (P<0.001) and absence of BC (P<0.001) were predictors of a worse prognosis on univariate analysis. However, when the patients detected by genetic/pentagastrin screening were excluded from the analysis, age was no longer a prognostic factor, although disease stage remained a significant prognostic factor. On multivariate analysis, BC was the only factor with a significant impact on prognosis (P=0.031). In addition, the present study confirmed that the majority of patients were diagnosed at advanced stages, and CT determination was observed to be more sensitive than cytology to diagnose MTC. Patients at early stages were more prone to achieve BC, which was a favorable prognostic factor. To the best of our knowledge, the present study

  11. Institutional change and economic development : evidence from natural and artefactual field experiments in Ethiopia

    NARCIS (Netherlands)

    Melesse, M.B.

    2015-01-01

    Thesis title: Institutional Change and Economic Development: Evidence from Natural and Artefactual Field Experiments in Ethiopia Mequanint Biset Melesse Abstract Institutions are the essential underpinning of economic development. A large volume of empirical literature has documented conclusive evid

  12. Videolaparoscopic resection of insulinomas: experience in two institutions.

    Science.gov (United States)

    Gramática, Luis; Herrera, Miguel F; Mercado-Luna, Andrés; Sierra, Mauricio; Verasay, Guillermo; Brunner, Noemí

    2002-10-01

    Laparoscopic resection of islet cell tumors has been performed in some selected cases. The aim of the study was to analyze the experience of two institutions in the laparoscopic management of insulinomas. In a 4-year period, videolaparoscopic resection of sporadic insulinomas was performed in 9 patients. All patients had hypoglycemia/hyperinsulinism and a solitary tumor demonstrated by image studies. Demographics, surgical findings, results, and complications were analyzed. Mean age of the patients was 43 years. One patient was male and eight were females. One tumor was located in the head of the pancreas, 4 in the body, and 4 in the tail. Laparoscopic resection was completed in all patients. Procedures included 4 enucleations and 5 distal pancreatectomies. Pancreatic resection with splenic preservation was achieved in 4 cases. Intraoperative ultrasound was used in 7 patients. Mean size of the tumors was 1.6 cm. All patients became normoglycemic after surgery. Complications included one pancreatic fistula, one pleural effusion, and one peripancreatic fluid collection. All resolved spontaneously. In a follow-up period between 3 and 48 months no evidence of recurrence has been observed. This series supports laparoscopic resection of preoperatively localized benign solitary insulinomas. The operation provides the advantages of minimally invasive surgery and can be safely performed in most cases.

  13. [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.

  14. The 1984 Institute of Texas Studies: The Texas Experience to 1865--An Evaluation.

    Science.gov (United States)

    Curran, Linda T.; Holahan, Carole K.

    Forty-four participants completed a questionnaire (Appendix A) designed to evaluate the Institute of Texas Studies: "The Texas Experience to 1865." Section 1 of the questionnaire consisted of a listing of 20 presentations and activities of the institute and one general institute evaluation item. The remaining sections (2-10) were…

  15. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience.

    NARCIS (Netherlands)

    Patard, J.J.; Leray, E.; Rioux-Leclercq, N.; Cindolo, L.; Ficarra, V.; Zisman, A.; Taille, A. De La; Tostain, J.; Artibani, W.; Abbou, C.C.; Lobel, B.; Guille, F.; Chopin, D.K.; Mulders, P.F.A.; Wood, C.G.; Swanson, D.A.; Figlin, R.A.; Belldegrun, A.S.; Pantuck, A.J.

    2005-01-01

    PURPOSE: To analyze to what extent histologic subtype is of prognostic importance in renal cell carcinoma based on a large, international, multicenter experience. PATIENTS AND METHODS: Four thousand sixty-three patients from eight international centers were included in this retrospective study. Hist

  16. Electrical resistance tomography experiments at the Oregon Graduate Institute

    Science.gov (United States)

    Daily, W.; Ramirez, A.; LaBrecque, D.; Barber, W.

    1995-04-01

    Three controlled experiments were conducted at the Oregon Graduate Institute (OGI) with the purpose of evaluating electrical resistance tomography for imaging underground processes associated with in-situ site assessment and remediation. The OGI facilities are unique: a double-wall tank 10 m square and 5 m deep, filled with river bottom sediments and instrumented for geophysical and hydrological studies. At this facility, liquid contaminants could be released into the confined soil at a scale sufficiently large to represent real-world physical phenomena. In the first test, images of electrical resistivity were made before and during a controlled spill of gasoline into a sandy soil. The primary purpose was to determine if electrical resistivity images could detect the hydrocarbon in either the vadose or saturated zone. Definite changes in electrical resistivity were observed in both the vadose and saturated soils. The effects were an increase in resistivity of as much as 10% above pre-release values. A single resistive anomaly was imaged, directly below the release point, principally within the vadose zone but extending below the phreatic surface. The anomaly remained identifiable in tomograms taken two days after the release ended with clear indications of lateral spreading along the water table. The second test involved electrical resistance measurements before, during, and after air sparging in a saturated soil. The primary purpose was to determine if the electrical images could be used to detect and delineate the extent of the zone influenced by sparging. The images showed an increase of about 20% in resistivity over background values within the sparged zone and the extent of the imaged zone agreed with that inferred from other information. Electrical resistivity tomography measurements were made under a simulated oil storage tank in the third test. Comparison of images taken before and during separate releases of brine and water showed effects of changes

  17. When Rubrics Collide: One Undergraduate Writing Tutor's Experience Negotiating Faculty and Institutional Assessments

    Directory of Open Access Journals (Sweden)

    Kelli Martin, BA

    2013-08-01

    Full Text Available This article recounts one undergraduate writing tutor’s experience helping a fellow peer navigate an institutional assessment rubric that seemed to contrast the assessment criteria provided by the student’s instructor. This article presents a reflection on that experience, framed by Hutchings, Huber, and Ciccone’s (2011 work on institutional assessment and the scholarship of teaching and learning.

  18. Assessing Faculty Perceptions of Free Educational Resources: One Institution's Experience

    Science.gov (United States)

    Young, Brian

    2016-01-01

    Providing financial incentives to faculty who adopt free educational resources in place of traditional textbooks is becoming more common in U.S. higher education institutions. The University of Mississippi (UM) offered liberal arts instructors the opportunity to apply for internal funding to replace one traditional textbook in their classroom with…

  19. Experience of the Eliava Institute in bacteriophage therapy

    Institute of Scientific and Technical Information of China (English)

    Mzia; Kutateladze

    2015-01-01

    <正>The rapid propagation of multidrug resistant bacterial strains is leading to renewed interest in bacteriophage therapy.With challenges in the treatment of bacterial infections,it is essential for people worldwide to understand how alternative approaches,such as bacteriophages,could be used to combat antibiotic resistant bacteria.The Eliava Institute

  20. Tumor Necrosis Adds Prognostically Significant Information to Grade in Clear Cell Renal Cell Carcinoma: A Study of 842 Consecutive Cases From a Single Institution.

    Science.gov (United States)

    Khor, Li-Yan; Dhakal, Hari P; Jia, Xuefei; Reynolds, Jordan P; McKenney, Jesse K; Rini, Brian I; Magi-Galluzzi, Cristina; Przybycin, Christopher G

    2016-09-01

    Tumor necrosis has been shown to be an independent predictor of adverse outcome in renal cell carcinoma. A modification of the International Society of Urological Pathology (ISUP) grading system for renal cell carcinomas has recently been proposed, which incorporates the presence of tumor necrosis into grade. The investigators proposing this system found that necrosis added significant prognostic information to ISUP grade. We attempted to describe our experience with the effect of tumor necrosis in relationship to nuclear grade by reviewing the slides from a large consecutive series of localized clear cell renal cell carcinomas from our institution and obtaining long-term clinical follow-up information (overall survival). Of the 842 clear cell renal cell carcinomas reviewed, 265 (31.5%) were ISUP grade 1 or 2, 437 (51.9%) were ISUP grade 3, and 140 (16.6%) were ISUP grade 4. Tumor necrosis was present in 177 (21%) cases. Five hundred and forty-seven (64.9%) cases were stage pT1, 83 (9.9%) were stage pT2, 193 (22.9%) were stage pT3a, and 19 (2.3%) were pT3b or higher. Median follow-up was 73.2 months (range 0.12 to 273.6), and 310 (36.8%) patients died. On univariable analysis, there was no significant difference in outcome for tumors of ISUP grades 1 to 3. After adjustment for age, tumor stage, and tumor size, ISUP grade 4 and necrosis were significant predictors of overall survival on multivariable analysis. When the recently proposed modified grading system incorporating tumor necrosis was applied to our data, there was no significant difference in overall survival between patients with modified grade 1 tumors and those with modified grade 2 tumors (P=0.31); however, there was a statistically significant difference between patients with modified grade 1 or 2 tumors and those with modified grade 3 tumors (P=0.04),and a substantial difference in outcome between those with modified grade 3 and modified grade 4 tumors (PISUP grade could be further prognostically

  1. Socioeconomic and Institutional Dimensions of Dam Removals: The Wisconsin Experience

    Science.gov (United States)

    Born; Genskow; Filbert; Hernandez-Mora; Keefer; White

    1998-05-01

    / There are tens of thousands of small dams in the United States; many of these aging structures are deteriorating. Governments and dam owners face decisions regarding repair or removal of these structures. Along with the many benefits society derives from dams and their impoundments, numerous recent ecological studies are revealing the extensive alteration and degradation of river ecosystems by dams. Dam removal-a principal restoration strategy-is an infrequent event. The major reasons for removal have been public safety and the high costs associated with repair; the goal of river ecosystem restoration now warrants greater attention. Substantial study is being given to the environmental aspects of dams and dam removals, but very little attention has been given to the socioeconomic and institutional dimensions associated with the removal of dams, although these factors play a significant role in the removal decision-making process. Based on a case study of dam removals in Wisconsin-where more than 30 of the state's 3600 small dams have been removed in the past few decades-legal, financial, and socioeconomic issues associated with dam removal are documented and assessed. Dam removal has been complex and contentious, with limited community-based support for removal and loss of the impounded waters. In cases examined here, the estimated costs of repairing a dam averaged more than three times the cost of removal. The availability of governmental financing has been a key determinant in removal decisions. Watershed-scale ecological considerations are not major factors for most local interests. As watershed management and restoration increasingly include dam removal options as part of an integrated strategy, more attention will need to be focused on socioeconomic factors and stakeholder perspectives-variables that strongly influence the viability of this management alternative.KEY WORDS: Dam removal; River restoration; Institutions; Stakeholders

  2. Language Anxiety: Experiences of Chinese Graduate Students at U.S. Higher Institutions

    Science.gov (United States)

    Cheng, Rui; Erben, Antony

    2012-01-01

    It is very common for Chinese graduate students to experience language anxiety in the U.S. higher institutions, yet the literature on this topic is limited. This research study focused on the influence of the length of stay in U.S. higher institutions, various programs, gender, and acculturation process on Chinese graduate students' language…

  3. 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…

  4. Complications in Neck Dissection 10 years ex-perience with 268 cases in the Cancer Institute

    Directory of Open Access Journals (Sweden)

    M.K. OSKOUI

    1973-07-01

    Full Text Available Immediate and late post operative complications or radical Neck Dissection were discussed. Preventive measures and the treatment of each were mentioned briefly. Our 10 years experience with complications or neck dissection in the Cancer Institute was presented.

  5. Aesthetic experience and institutional daily life: new maps for subjectively dealing with spaces for mental healthcare

    Directory of Open Access Journals (Sweden)

    Renata Caruso Mecca

    2008-01-01

    Full Text Available The use of artistic activities as agents for mental healthcare practices is discussed in relation to the organization of daily life and institutional spaces, in substitutive services, such as at psychosocial care centers. The importance of the porosity of this daily routine to embrace the users' creations and articulate these with the other activities that structure daily life and occupy institutional spaces is discussed. It is advocated that institutional spaces need to reflect the intrinsic characteristics and needs of people who are treated there and for the institution to function as a backdrop for semantic linkage of the subjects' experiences and their possible dialogue with culture.

  6. CARCINOMA LUNG AMONG SOUTH INDIAN FEMALE PATIENTS: A SINGLE INSTITUTE EPIDEMIOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    Sanjeeva Kumari

    2015-07-01

    Full Text Available INTRODUCTI ON: Lung cancer is the major cause of morbidity and mortality worldwide, accounting for more deaths than any other cancer cause. The data on Indian female lung cancer patients is very sparse. So the aim of our study was to analyze the epidemiology and clinical behavior of lung cancer in female patients. METHODS: A total of 244 female lung cancer patients treated at MNJIO/RCC from 2010 to 2014 were evaluated retrospectively for the epidemiology and clinical behavior. RESULTS: The median age at presentation is 56 years and majority were post - menopausal. Majority of the patients were non - smokers (75%. ECOG PS 0,1,2,3 and 4 was seen in 0.55%, 12.15%, 33.14%, 44.19% and 9.94% of the patients respectively. NSCLC was seen in about 80% of the patients. Among the NSCLC, adenocarcinoma was seen on 61%. The TNM stage at presentation was stage II, III and IV in 1%, 6% and 92% of the patients respectively. Most common site of metastasis was pleura and malignant pleural effusion (57% followed by bone metastasis (24%. Major ity of the patients were stage IV and treated with palliative intent (77%. Among patients treated with chemotherapy only 14% completed planned treatment. But among patients planned with radical CT and RT, 75% completed treatment. At the time of conclusion of the study only 13 (7.18% were alive and on follow - up. DISCUSSION & CONCLUS ION: Carcinoma lung in the female South Indian patients is similar in the mean age at presentation to other studies from North India. Majority of the patients in our study were non - smokers, much higher than other studies. NSCLC was common, with adenocarcinoma as the most common subtype. The trend of a shift from squamous cell carcinoma to adenocarcinoma mentioned in western population is confirmed in our study. Pattern of metasta ses is slightly different among Indian female lung cancer patients, with majority having metastasis to pleura or malignant pleural effusion. In our study majority had

  7. [En block hysterectomy. Institutional experience of 6 years].

    Science.gov (United States)

    Bonfante Ramírez, E; Bolaños Ancona, R; Ambas Argüelles, M; Juárez García, L; Castelazo Morales, E

    1997-06-01

    On block hysterectomy is defined as the removal of the gravid uterus with its gestational content in situ. The described indications for the realization of this procedure are neoplastic process as the most frequent cause; septic process, persistent trophoblastic diseases, and hemorrhage due to anomalous placentation. This is a retrospective, descriptive study of twelve cases of on block hysterectomy collected from January 1989 to December 1994 at Instituto Nacional de Perinatología. An average age of 33.4 years was found. The number of pregnancies for this patients in average was found to be 4.1. The gestational age was established between 9 to 29 weeks. Four patients with a 4 or more previous miscarriage background. There were two reported cases having a multiple gestation. Among the complications found, there were three cases of hipovolemic shock and one with abcess of vaginal cupula. The average days of hospitalization was 5.3 days. We found no mortality at all in this study, and the histopathologic correlation accorded in 100% of the cases. In this five year review, 12 cases of on block hysterectomy were found, being the most frequent reason for it's realization the persistent trophoblastic diseases; severe hemorrhage in second place, and serious infection process in third. The observed complications were derived from the hemodynamic compromise of each patient. Even though on block hysterectomy is one rarely seen procedure, it most be in mind as an alternative therapeutical instance it most be carried out in third level institutions, with technology and human resources capable of solving any complication derived from this kind of surgery.

  8. The incidence of postoperative meningitis in neurosurgery: An institutional experience

    Directory of Open Access Journals (Sweden)

    Dwarakanath Srinivas

    2011-01-01

    Full Text Available Introduction : Meningitis is the most dreaded cause of morbidity and mortality in neurosurgical patients. The reported incidence of postoperative meningitis is quite varied 0.5-8%. Material and Methods : The study cohort included all the patients who underwent neurosurgery at the department of neurosurgery, National Institute of Mental Health and Neurological Sciences, Bangalore, India over a period of seven years (2001 - 2007. Patients with culture positive meningitis were included for analysis. The incidence of postoperative meningitis was analyzed depending on the type of surgery performed and the microbiological profile of the organisms, and their sensitivity pattern. Results : Of the 18,092 patients who underwent neurosurgical procedures during the study period, 415 patients developed infection. The overall incidence of meningitis was 2.2%. The incidence of meningitis was high (7.7% in patients who had a pre-existing infection like post-pyogenic meningitis or tuberculosis hydrocephalus. The procedure mainly performed in this subgroup was shunt. The most common organisms causing meningitis were non-lactose fermenting Gram-negative bacillus followed by Pseudomonas and Klebsiella species. The methicillin-resistant Staphylococcus aureus strains were isolated in 2.6% of the patients. Ninety-one strains were multi-drug resistant, among which four strains were resistant to all antibiotics tested. The overall mortality in patients with meningitis was 5%. Conclusion : Meningitis remains one of the most dreaded complications of neurosurgical procedures and is common in patients with preexisting infection. Gram-negative organisms are the most common causative pathogens of postoperative meningitis.

  9. Experiences with carotid endarterectomy at Sree Chitra Tirunal Institute

    Directory of Open Access Journals (Sweden)

    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. Chemoirradiation for glioblastoma multiforme: the national cancer institute experience.

    Directory of Open Access Journals (Sweden)

    Jennifer Ho

    Full Text Available PURPOSE: Standard treatment for glioblastoma (GBM is surgery followed by radiation (RT and temozolomide (TMZ. While there is variability in survival based on several established prognostic factors, the prognostic utility of other factors such as tumor size and location are not well established. EXPERIMENTAL DESIGN: The charts of ninety two patients with GBM treated with RT at the National Cancer Institute (NCI between 1998 and 2012 were retrospectively reviewed. Most patients received RT with concurrent and adjuvant TMZ. Topographic locations were classified using preoperative imaging. Gross tumor volumes were contoured using treatment planning systems utilizing both pre-operative and post-operative MR imaging. RESULTS: At a median follow-up of 18.7 months, the median overall survival (OS and progression-free survival (PFS for all patients was 17.9 and 7.6 months. Patients with the smallest tumors had a median OS of 52.3 months compared to 16.3 months among patients with the largest tumors, P = 0.006. The patients who received bevacizumab after recurrence had a median OS of 23.3 months, compared to 16.3 months in patients who did not receive it, P = 0.0284. The median PFS and OS in patients with periventricular tumors was 5.7 and 17.5 months, versus 8.9 and 23.3 months in patients with non-periventricular tumors, P = 0.005. CONCLUSIONS: Survival in our cohort was comparable to the outcome of the defining EORTC-NCIC trial establishing the use of RT+TMZ. This study also identifies several potential prognostic factors that may be useful in stratifying patients.

  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.

  12. 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.

  13. First measurements with the Physikalisches Institut Radiometric Experiment (PHIRE)

    Science.gov (United States)

    Gunderson, K.; Thomas, N.; Whitby, J. A.

    2006-09-01

    We have constructed an experiment to perform bidirectional reflectance distribution function (BRDF) measurements of laboratory samples, and have used the experiment to characterize a sample of JSC-1 lunar regolith simulant. Characterizations relied on in-plane BRDF measurements in visible and near-infrared (NIR) bandpasses. The optical properties of the simulant sample were found to be similar to those observed for bright, lunar highland regions. Reflectance models (Hapke 1981. Bidirectional reflectance spectroscopy 1. Theory. J. Geophys. Res. 86(B4), 3,039-3,054; 1984. Bidirectional reflectance spectroscopy 3. Correction for macroscopic roughness. Icarus 59, 41-59; 1986. Bidirectional reflectance spectroscopy 4. The extinction coefficient and the opposition effect. Icarus 67, 264-280; 2002. Bidirectional reflectance spectroscopy 5. The coherent backscatter opposition effect and anisotropic scattering. Icarus 157, 523-534) made excellent fits to fixed incidence angle, variable emission angle data sets. However, the models were not found to extrapolate well to fixed, near-zero phase angle data at varying incidence angles, and no solutions were found that provided simultaneous, high quality fits to the two types of data sets. Except for the single-scattering albedo, the best-fit parameters of the fixed incidence angle data were statistically the same in the visible and NIR. Correlations between the reflectance model parameters were systematically examined, and strong correlations were found between single-scattering albedo and the two two-stream Henyey-Greenstein scattering parameters and, to a lesser extent, the small-scale mean surface roughness.

  14. 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

  15. [Ethic review on clinical experiments of medical devices in medical institutions].

    Science.gov (United States)

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  16. Cavernous sinus hemangioma: a fourteen year single institution experience.

    Science.gov (United States)

    Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

    2014-06-01

    Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ignatiev, Victor, E-mail: ignatiev@vver.kiae.ru; Surenkov, Alexandr

    2013-10-15

    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 UF{sub 4} and PuF{sub 3} + 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Zeidan, Youssef H., E-mail: youssefzaidan@gmail.com [Department of Radiation Oncology, Methodist Hospital, Indianapolis, IN (United States); Shiue, Kevin; Weed, Daniel [Department of Radiation Oncology, Methodist Hospital, Indianapolis, IN (United States); Johnstone, Peter A. [Department of Radiation Oncology, Indiana University, Indianapolis, IN (United States); Terry, Colin [Methodist Research Institute, Methodist Hospital, Indianapolis, IN (United States); Freeman, Stephen; Krowiak, Edward; Borrowdale, Robert; Huntley, Tod [CENTA Otolaryngology, Indianapolis, IN (United States); Yeh, Alex [Department of Radiation Oncology, Methodist Hospital, Indianapolis, IN (United States)

    2012-04-01

    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.

  19. Atypical presentation of Merkel cell carcinoma positive to polyomavirus DNA detection: Experience from a single center

    Directory of Open Access Journals (Sweden)

    Iovino F

    2014-07-01

    Full Text Available Merkel cell carcinoma (MCC is a rare malignant tumor of the skin with tendency to rapid local progression and frequent spread to regional lymph nodes. In this paper we retrospectively describe the atypical presentation of 5 cases of Merkel cell carcinoma observed in our surgical department in the last ten years. Four patients had buttock localization whilst one patient had primary nodal presentation. Since integration of Merkel cell polyomavirus (MCPyV DNA into the tumor genome is frequently recorded in this type of cancer, we analyzed formalin-fixed paraffin embedded MCC tissue samples from our five patients for the presence of MCPyV DNA by means of polymerase chain reaction (PCR. MCPyV DNA was present in all five carcinomas. All patients were treated with wide surgical excision of the tumor and sentinel node biopsy. One patient had stage I disease, three patients had stage II disease, and one patient had stage III disease. Adjuvant radiotherapy was administered in all cases for local control. Chemotherapy was administered to the patient with primary nodal presentation and in stage III disease. Median time of follow-up was 84 months. None of the patients relapsed. Despite the low number of patients examined, our experience suggests that surgery is a necessary step whereas implementation of adjuvant therapy, radiotherapy and chemotherapy depends on individual risk assessment. Treatment outcome was very good, probably due to early detection of MCC.

  20. Feasibility of organ preservation in muscle-invasive transitional cell carcinoma bladder: A single institutional approach

    Directory of Open Access Journals (Sweden)

    Chhaya Roy

    2015-01-01

    Full Text Available Background: Trimodality treatment initial transurethral resection of the bladder tumor [TURBT] followed by concurrent chemotherapy and radiation and organ preservation have been gradually replacing the radical cystectomy in muscle-invasive transitional cell carcinoma (TCC of bladder. Aims: The aims of this study is to determine the clinical effectiveness, safety and protocol completion rate of trimodality treatment in muscle-invasive TCC of the bladder. Settings and Design: Prospective randomized and open-labeled study. Subjects and Methods: Patients with TCC of bladder, American Joint Committee on Cancer tumor node metastasis (TNM Bladder Cancer Staging (2002 T2-3, N0, M0. Were underwent TURBT followed by three cycles of neoadjuvant chemotherapy with methotrexate, vinblastine, adriamycin, and cisplatin regimen. The patients were then randomized to receive either concurrent cisplatin 75 mg/m 2 in week 1 and 4 (arm-A or no cisplatin (arm-B along with external beam radiation therapy (EBRT 45 Gy, in 25 fractions over 5 weeks. 4 weeks after completion of the initial phase of treatment, all patients were re-evaluated with TURBT. Those with complete remission (CR received additional 15 Gy of EBRT in 8 fractions, while patients with residual disease were recommended for immediate radical cystectomy. All the patients of arm-B received boost dose of 15 Gy of EBRT. Statistical Analysis Used: The major statistical endpoints of this study were the CR rate at 8 weeks post-concurrent chemoradiotherapy (CCRT and only radiotherapy. Statistical significance was accepted at the P < 0.05 (two-sided level. Statistical analysis was performed entirely using the Statistical Package for the Social Sciences for Windows, version 17 (SPSS Inc., Chicago, IL, U.S.A.. Results: 8 weeks after completion of treatment 13/16 (81% patients were in CR in CCRT arm (arm-A compare to 6/15 (40% patients receiving radiation only (arm-B. Conclusions: Patients, after TURBT receiving CCRT

  1. Hispanic Student Experiences at a Hispanic-Serving Institution: Strong Voices, Key Message

    Science.gov (United States)

    Medina, Christina A.; Posadas, Carlos E.

    2012-01-01

    A symposium at New Mexico State University, a Hispanic-Serving Institution, revealed Hispanic students' attitudes about their experiences at the university. Discussions concerned the campus climate, mentors, the experiences of first-time students, cultural challenges, retention, and accountability. Discussion of the resulting data yields policy…

  2. When Rubrics Collide: One Undergraduate Writing Tutor's Experience Negotiating Faculty and Institutional Assessments

    Science.gov (United States)

    Martin, Kelli

    2013-01-01

    This article recounts one undergraduate writing tutor's experience helping a fellow peer navigate an institutional assessment rubric that seemed to contrast the assessment criteria provided by the student's instructor. This article presents a reflection on that experience, framed by Hutchings, Huber, and Ciccone's (2011) work on…

  3. Age at Adoption from Institutional Care as a Window into the Lasting Effects of Early Experiences

    Science.gov (United States)

    Julian, Megan M.

    2013-01-01

    One of the major questions of human development is how early experience impacts the course of development years later. Children adopted from institutional care experience varying levels of deprivation in their early life followed by qualitatively better care in an adoptive home, providing a unique opportunity to study the lasting effects of early…

  4. Does the Unemployement Benefit Institution Affect the Productivity of Workers? Evidence from a Field Experiment

    OpenAIRE

    2013-01-01

    Abstract: We investigate whether and how the type of unemployment bene t institution affects productivity. We designed a field experiment to compare workers' productivity under a welfare system, where the unemployed receive an unconditional monetary transfer, with their productivity under a workfare system, where the transfer is received conditional on the unemployed spending some time on ancillary activities. First, we fi nd that having an unemployment bene fit institution, regardless of whe...

  5. 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.

  6. Teaching Business Classes Abroad: How International Experience Benefits Faculty, Students, and Institutions

    Science.gov (United States)

    Miglietti, Cynthia

    2015-01-01

    International educational experiences can provide benefits for faculty members as well as higher education institutions and their students. The opportunity to lecture and conduct research with colleagues at universities in other countries can foster the globalization or internationalization of academic teaching, the advancement of knowledge, and…

  7. Onboarding Experiences: An Examination of Early Institutional Advancement Professionals' Decisions

    Science.gov (United States)

    Radosh, Meghan E.

    2013-01-01

    Onboarding is a new employee orientation process that is designed to formalize and socialize new hires to an organization, or in this case higher education institutions. The onboarding experience that many new employees have can shape employee views and first impressions of their new employer, and shape their early career path to stay or leave…

  8. 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…

  9. 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…

  10. 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…

  11. Institutional Power: Identity, Politics, and Lived Experiences in the Dance License via Portfolio Process

    Science.gov (United States)

    Maloney, Betsy

    2015-01-01

    In this research study, I examined how institutional power affected the experiences of two dance educators attempting to gain their K-12 dance teaching license in Minnesota. My research analyzed the ways in which candidates applying for the portfolio review process constructed, amended, or abandoned their identities as teachers/artists/individuals…

  12. A Study of Pacific Islander Scholarship Football Players and Their Institutional Experience in Higher Education

    Science.gov (United States)

    Morita, Monica K.

    2013-01-01

    This study applies the theories of social and cultural capital and introduces athletic capital in order to gain an understanding of Polynesian scholarship football players and their experiences at an institution of higher education. Additionally, theories of student identity development and student-athlete development are also utilized to gain a…

  13. 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…

  14. Does the Unemployement Benefit Institution Affect the Productivity of Workers? Evidence from a Field Experiment

    NARCIS (Netherlands)

    Blanco, M.; Dalton, P.S.; Vargas, J.F.

    2013-01-01

    Abstract: We investigate whether and how the type of unemployment bene t institution affects productivity. We designed a field experiment to compare workers' productivity under a welfare system, where the unemployed receive an unconditional monetary transfer, with their productivity under a workfare

  15. 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.…

  16. An analysis of salivary gland neoplasms: a 12-year, single-institution experience in Turkey.

    Science.gov (United States)

    Etit, Demet; Ekinci, Nese; Tan, Ayca; Altinel, Deniz; Dag, Filiz

    2012-03-01

    The epidemiology of salivary gland tumors worldwide is not very well defined. Although many studies on this subject have been undertaken, the data are generally focused on specific topics such as parotid gland neoplasms or tumors of the major salivary glands. We conducted a study to establish the prevalence and distribution of benign and malignant neoplasms of both the major and minor salivary glands at a single institution. We reviewed 244,204 cases that had come through our pathology department from January 1994 through December 2005 and found 235 cases of a salivary gland neoplasm (0.09%). The female-to-male ratio was 1.04:1, and the mean age of the patients was 47 years. Of the 235 neoplasms, 159 (67.66%) were located in the parotid gland, 34 (14.47%) in the submandibular gland, and 42 (17.87%) in the minor salivary glands. A total of 146 tumors (62.13%) were benign and 89 (37.87%) were malignant. Pleomorphic adenoma was the most common neoplasm, occurring in 98 cases (41.70%). The most common malignancy was mucoepidermoid carcinoma, with 27 cases (11.49%). Our data demonstrate that the characteristics of salivary gland tumors in a Turkish population at a single institution are similar to those reported in the literature worldwide.

  17. 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

  18. Diagnosis and surgical treatments of hepatocellular carcinoma with tumor thrombosis in bile duct:Experience of 34 patients

    Institute of Scientific and Technical Information of China (English)

    Lun-Xiu Qin; Zeng-Chen Ma; Zhi-Quan Wu; Jia Fan; Xin-Da Zhou; Hui-Chuan Sun; Qing-Hai Ye; Lu Wang; Zhao-You Tang

    2004-01-01

    AIM: Hepatocellular carcinoma (HCC) with bile duct tumor thrombosis (BDT) is a rare event. The prognosis of this type of patients is very dismal. The aim of this study was to share the experience in the diagnosis and treatment of HCC with BDT, to further improve the prognosis of these patients.METHODS: Thirty-four patients of HCC with BDT received surgical treatment in authors' institute from July 1987 to January 2003 were reviewed retrospectively. The experience in the diagnosis and treatment, and the outcome of this type of HCC patients were summarized.RESULTS: Thirty of the 34 patients (88.2%) were positive for alpha-fetoprotein (AFP) (>20 μg/L), and 12 patients (35.3%) were found having obstructive jaundice before operation, 18 cases were suspected of "obstruction of bile duct" preoperatively. The primary tumors were frequently located at the left medial (13 cases) or right anterior lobe (14 cases). Thirty-one patients received liver resections and removal of BDT, while the other 3 patients received removal of BDT combined with hepatic artery ligation and cannulation (HAL+HAI), or only removal of BDT because their liver function reservation and general condition could not tolerate the primary tumor resection. The 1-year survival rate was 71.4%(20/28). The longest disease-free survival was over 15 years. The intrahepatic tumor recurrence within 1 year after operation was found in 14 patients (14/28, 50.0%).CONCLUSION: Surgical removal of primary tumors and BDTis safe and beneficial to the HCC patients with BDT. Early detection, diagnosis, and surgical treatment are the key points to prolong the survival time of patients.

  19. Hepatocellular carcinoma surgery outcomes in the developing world: A 20-year retrospective cohort study at the National Cancer Institute of Peru

    Directory of Open Access Journals (Sweden)

    Eloy Ruiz

    2016-01-01

    Full Text Available In the developing world, most patients with hepatocellular carcinoma present with advanced-stage disease, considered to be incurable based on current therapeutic algorithms. Here, we demonstrate that curative liver resection is achievable in a portion of Peruvian patients not addressed by these treatment algorithms. We conducted a retrospective cohort study of 253 hepatocellular carcinoma patients that underwent a curative hepatectomy between 1991 and 2011 at the National Cancer Institute of Peru. The median age of the cohort was 36 years, and merely 15.4% of the patients displayed cirrhosis. The average tumor size was over 14 cm in diameter, resulting in 76.3% of major hepatectomies performed. The 5- and 10-year survival probability estimates were 37.5% and 26.2%, respectively. Age (>44 vs. ≤44 years old; P = 0.005, tumor size (>10 cm vs. ≤10 cm in diameter; P = 0.009, cirrhosis (P < 0.001, satellite lesions (P < 0.001, macroscopic vascular invasion (P < 0.001, allogeneic blood transfusion (P = 0.011, and spontaneous rupture of the tumor (P = 0.006 were independent predictive factors for prognosis. Hepatocellular carcinomas in Peru are characterized by a distinct clinical presentation with notable features compared with those typically described throughout relevant literature. Despite a large number of advanced-stage hepatocellular carcinomas, the outcomes of liver resection observed in the present study were in good standing with the results previously described in other series. It thus appears that staging systems and associated therapeutic algorithms designed for use in the developed world remain inadequate in certain populations, especially in the context of Peruvian patients. Our findings suggest that clinicians in the developing world should reconsider management guidelines pertaining to hepatocellular carcinoma. Indeed, we hypothesize that, in developing countries, a strict adherence to these therapeutic algorithms might create a

  20. Predisposing factors and histopathological variants of cutaneous squamous cell carcinoma: Experience from a North Indian teaching hospital

    Directory of Open Access Journals (Sweden)

    Geeti Khullar

    2016-01-01

    Full Text Available Background: Squamous and basal cell carcinomas together constitute the majority of non-melanoma skin cancers. These malignancies are infrequent in Indians as compared to the white skinned population. Literature on squamous cell carcinoma in dark skin is limited. Aim: To analyze the risk factors and to characterize the histopathological subtypes of cutaneous squamous cell carcinoma in Indian patients in an area, non-endemic for arsenicosis. Methods: A retrospective analysis of data from January 2003 to August 2013 was performed to evaluate the predisposing factors and histopathological types of cutaneous squamous cell carcinoma at the Postgraduate Institute of Medical Education and Research (PGIMER, Chandigarh. Demographic and disease characteristics such as age, gender and predisposing factors, particularly premalignant dermatoses were recorded and histopathology slides were reviewed. Results: Of the 13,426 skin biopsy specimens received during the 10-year period, there were 82 (0.6% cases of squamous cell carcinoma and 170 (1.7% of basal cell carcinoma. The mean age at diagnosis of cutaneous squamous cell carcinoma was 53.7 years and the male to female ratio was 2:1. The most common site of involvement was the lower limbs in 34 (41.5% patients. Marjolin's ulcer was present in 36 (43.9% cases. No predisposing factor was identified in 35 (42.7% patients. Histopathologically, the tumors were classified most commonly as squamous cell carcinoma not otherwise specified in 33 (40.2% cases. Limitations: This was a retrospective study and details of occupation and interval between the precursor lesions and development of tumor were not recorded. Immunohistochemistry for human papilloma virus and p53 tumor suppressor protein were not performed as these tests were not available. Conclusion: Cutaneous squamous cell carcinoma is uncommon in Indian patients and a high index of suspicion is necessary when a rapidly enlarging nodule, verrucous fungating plaque

  1. 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.)

  2. When the safe place does not protect: reports of victimisation and adverse experiences in psychiatric institutions.

    Science.gov (United States)

    Dos Santos Mesquita, Cristina; da Costa Maia, Ângela

    2016-12-01

    Psychiatric patients report higher levels of victimisation and are at risk for further victimisation in different contexts, such as psychiatric institutions. Studies in this field tend to focus on hospital staff as victims, experiencing classic forms of victimisation (e.g. physical assault, threats, verbal abuse), through qualitative studies. This is a quantitative retrospective study that aims to know the occurrence of psychiatric victimisation and other adverse experiences in Portuguese psychiatric patients. Ninety-five psychiatric patients, between 20 and 79 years old (M - 45.18, SD - 13.06), with a history of psychiatric hospitalisation answered the Experiences in Psychiatric Institution Inventory. Participants were recruited in four psychiatric hospitals. Inpatients were approached during their hospitalisation; outpatients were approached in scheduled appointment days. Only 23 (24.2%) participants reported no victimisation. Total Experiences of Self varied from 0 to 7 (M - 1.75, SD - 1.72), Total Witnessed Experiences varied from 0 to 7 (M - 1.17, SD - 1.64), and Total Global Experiences varied from 0 to 14 (M - 2.92, SD - 3.01). These results show that victimisation and adverse experiences in psychiatric contexts are frequent and go beyond classic forms of victimisation. A deeper knowledge of these experiences and their impact in the mental health of psychiatric patients may promote quality of care provided and lead to more effective treatments, thus reducing the number and length of hospitalisations, and the financial burden for public health services.

  3. Carcinoma of unknown primary: 35 years of a single institution's experience

    Directory of Open Access Journals (Sweden)

    Rana I Mahmood

    2016-01-01

    Conclusion: Our data confirm the heterogeneity of CUP cases and variable treatment courses. This highlights the importance of establishing a national registry for this subgroup of cancer patients. Moreover, there is a need to develop multidisciplinary specialist teams and protocols to manage this group of patients, and participation in clinical trials should be strongly encouraged.

  4. Using Laboratory Experiments to Design Efficient Market Institutions: The case of wholesale electricity markets

    OpenAIRE

    Staropoli, Carine; Jullien, Celine

    2006-01-01

    International audience; This paper assesses the contribution of laboratory experiments to the economics of design applied to the electricity industry. The analysis is dedicated to wholesale markets, and reviews the results accumulated to date concerning both the general architecture of power markets and the very details of the market rules or institution, that is the auction rule. We argue that these experimental results contribute to a better understanding of the performances properties and ...

  5. Diagnosis of atypia/follicular lesion of undetermined significance: An institutional experience

    OpenAIRE

    2014-01-01

    Background: The overall malignancy rate for the thyroid fine-needle aspiration (FNA) diagnosed as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) ranges from 5% to 30%. In this study, we present our institutional experience with thyroid nodules diagnosed as AUS/FLUS and further stratified into subcategories. In addition, we also assessed the significance of various clinicopathologic factors that may influence AUS/FLUS diagnoses and their outcomes....

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Rafael Corrêa Coelho

    Full Text Available 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.

  8. 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

  9. Experience with interstitial implantation of iodine 125 in the treatment of prostatic carcinoma.

    Science.gov (United States)

    Sogani, P C; Whitmore, W F; Hilaris, B S; Batata, M A

    1980-01-01

    Between February 1970 and April 1977 300 patients with localized prostatic carcinoma were treated with I-125 implantation and bilateral pelvic lymphadenectomy at Memorial Sloan-Kettering Cancer Center (MSKCC). 68% had clinical Stage B (T-1 and T-2) and 32% had Stage C (T-3) neoplasms. Pelvic lymph nodes were histologically positive in 38% of the patients. Five-year survival for all patients was 73%. Five-year survival for Stage B disease was 100% and Stage C 65%. Lymph node metastases implied a poor prognosis. While 92% of patients with negative nodes survived five years, only 46% of the patients with positive nodes did so. Supplemental external radiation to pelvic and periaortic region in 28 patients with positive nodes did not improve survival or disease free interval or reduce distal or local recurrence but rather increased the incidence of radiation morbidity. The complications and morbidity as a consequence of I-125 implantation are minimal. The ultimate role of I-125 implantation in the management of localized prostatic cancer is yet to be determined. The early experience with this technique, however, suggests that it may be as effective as alternative modalities for comparable stages in terms of patient survival and may prove superior in terms of the quality of survival.

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

    CERN Document Server

    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.

  11. Clinical Features of Male Breast Cancer: Experiences from Seven Institutions Over 20 Years

    Science.gov (United States)

    Hong, Ji Hyung; Ha, Kyung Sun; Jung, Yun Hwa; Won, Hye Sung; An, Ho Jung; Lee, Guk Jin; Kang, Donghoon; Park, Ji Chan; Park, Sarah; Byun, Jae Ho; Suh, Young Jin; Kim, Jeong Soo; Park, Woo Chan; Jung, Sang Seol; Park, Il Young; Chung, Su-Mi; Woo, In Sook

    2016-01-01

    Purpose Breast cancer treatment has progressed significantly over the past 20 years. However, knowledge regarding male breast cancer (MBC) is sparse because of its rarity. This study is an investigation of the clinicopathologic features, treatments, and clinical outcomes of MBC. Materials and Methods Clinical records of 59 MBC patients diagnosed during 1995-2014 from seven institutions in Korea were reviewed retrospectively. Results Over a 20-year period, MBC patients accounted for 0.98% among total breast cancer patients, and increased every 5 years. The median age of MBC patientswas 66 years (range, 24 to 87 years). Forty-three patients (73%) complained of a palpable breast mass initially. The median symptom duration was 5 months (range, 1 to 36 months). Mastectomy was performed in 96% of the patients. The most frequent histology was infiltrating ductal carcinoma (75%). Ninety-one percent of tumors (38/43) were estrogen receptor–positive, and 28% (11/40) showed epidermal growth factor receptor 2 (HER-2) overexpression. After curative surgery, 42% of patients (19/45) received adjuvant chemotherapy; 77% (27/35) received hormone therapy. Five out of ten patients with HER-2 overexpressing tumors did not receive adjuvant anti–HER-2 therapy, while two out of four patients with HER-2 overexpressing tumors received palliative trastuzumab for recurrent and metastatic disease. Letrozole was used for one patient in the palliative setting. The median overall survival durations were 7.2 years (range, 0.6 to 17.0 years) in patients with localized disease and 2.9 years (range, 0.6 to 4.3 years) in those with recurrent or metastatic disease. Conclusion Anti–HER-2 and hormonal therapy, except tamoxifen, have been underutilized in Korean MBC patients compared to female breast cancer patients. With the development of precision medicine, active treatment with targeted agents should be applied. Further investigation of the unique pathobiology of MBC is clinically warranted

  12. 77 FR 40590 - Notice of Submission for OMB Review; Institute of Education Sciences; Pell Grant Experiments Study

    Science.gov (United States)

    2012-07-10

    ... Notice of Submission for OMB Review; Institute of Education Sciences; Pell Grant Experiments Study SUMMARY: The Pell Grant Experiments evaluation is a two-part, five-year demonstration study sponsored by... notice will be considered public records. Title of Collection: Pell Grant Experiments Study. OMB...

  13. Venous obstruction of thyroid malignancy origin: the Antoine Lacassagne Institute experience

    Directory of Open Access Journals (Sweden)

    Benisvy Danielle

    2009-04-01

    Full Text Available Abstract Background and aims To show the benefits of Ultrasonography in the diagnosis of great vein involvement in the neck and mediastinum in thyroid malignancies (primary or secondary in our experience and to report patient outcomes. Methods Clinical data were collected from the thyroid unit database of the Antoine Lacassagne Institute. Results Of 1171 patients with thyroid cancer treated at our institution over the last 18 years, we retrospectively identified nine patients (0.8%, three women and six men, aged 34–81 years (median age: 70 years presenting with malignant thyroid tumor of median diameter 45 mm (range: 23–87 having venous obstruction of thyroid malignancy origin. Two patients underwent multimodal therapy. All other patients underwent external beam radiation therapy alone ± chemotherapy or palliative care. Ultrasound (US provided particularly useful information on venous involvement characteristics. Median survival was 7 months and median progression-free survival was 6 months. Survival in our series was worse than that of previously reported series despite diagnosis of vein involvement at an early stage in 2/3 cases using US. Conclusion Despite small numbers of patients, it seems that aggressive treatment modalities including surgery are required to improve survival. In our experience, US was a useful non-invasive method to describe tumor extensions to great veins of the neck (invasion versus compression, tumor thrombus versus blood clot and should be recommended to depict early venous invasion in cases of suspected thyroid malignancy.

  14. MRI-guided percutaneous laser ablation of small renal cell carcinoma: Initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kariniemi, Juho; Ojala, Risto; Hellstroem, Pekka; Sequeiros, Roberto Blanco (Dept. of Radiology, Dept. of Surgery, Oulu Univ. Hospital, Oulu (Finland)), e-mail: juho.kariniemi@oulu.fi

    2010-05-15

    Background: The number of detected small renal cell carcinomas (RCCs) has been rising, largely due to advances in imaging. Open surgical resection is the standard management of small RCCs; however, imaging-guided percutaneous ablative therapies have emerged as a minimally invasive treatment alternative, especially for patients who are poor candidates for surgery. Purpose: To evaluate the initial clinical experience of magnetic resonance imaging (MRI)-guided percutaneous laser ablation of small RCCs. Material and Methods: Eight patients with 10 tumors were treated with percutaneous MRI-guided laser ablation. All tumors (diameter range 1.5-3.8 cm, mean 2.7 cm) were biopsy-proven RCCs. By using a 0.23 T open MRI system and general anesthesia in patients, one to four (mean 2.6) laser fibers were placed and the tumors were ablated under near real-time MRI control by observing the signal void caused by the temperature change in the heated tissue. The treatment was considered successful if the tumor showed no contrast enhancement at follow-up imaging. Results: All except one tumor were successfully ablated in one session. The first patient treated showed enhancing residual tumor in post-procedural MRI; she has thus far declined retreatment. One complication, a myocardial infarction, occurred; all other patients tolerated the procedure well. No local recurrence was discovered during the follow-up (range 12-30 months, mean 20 months). Conclusion: In this small group of patients with relatively short follow-up period, MRI-guided percutaneous laser ablation proved to be a promising treatment option for small RCCs

  15. Spontaneous Rupture of Primary Hepatocellular Carcinoma: Experience of Emergency Laparotomy over a 16-Year Period

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE Spontaneous rupture is an uncommon complication of primary hepatocellular carcinoma (HCC). There is no standard method of treatment, and most often treatment depends on the condition of the patient or the assessment by the surgeon. The aim of this study was to evaluate our experience of emergency laparotomy in the management of spontaneous rupture of HCC.METHODS Retrospective analysis documented 49 rupture HCC cases who received emergency laparotomy from Oct. 1990 to Oct. 2006.RESULTS Thirty-nine cases (79.6%) had a history of hepatitis and 39 cases (79.6%) were accompanied with liver cirrhosis. The most frequent manifestation which was present in 47 cases (95.9%) was sudden right hypochondrial or epigastric pain. Shock was seen in 40 cases (81.6%), and 42 cases (85.7%) had signs of peritonitis. The methods of operation were performed in the number of cases as follows: suture in 5; packing in 2; hepatic artery ligation in 4; hepatectomy in 21; microwave coagulation in 5;microwave coagulation combined with packing in 3; microwave coagulation combined with hepatic artery ligation in 9. Morbidity occurred in 11 cases (22.4%). The overall hospital mortality rate was 10.2%. The mean survival time was 8.8 months. The main causes of death were liver failure and massive variceal bleeding.CONCLUSION Spontaneous rupture of HCC represents a life-threatening condition with an overall poor prognosis. Laparotomy should be the first choice for treating HCC rupture if the proper conditions are present. Liver failure is the vital condition influencing the prognosis.

  16. Transarterial embolisation of hepatocellular carcinoma with doxorubicin-eluting beads: single centre early experience

    Science.gov (United States)

    Nawawi, O; Hazman, MN; Abdullah, BJJ; Vijayananthan, A; Manikam, J; Mahadeva, S; Goh, KL

    2010-01-01

    Purpose: This is a retrospective study to evaluate the results of our early experience of using doxorubicin eluting beads (DEB) to treat patients with early and intermediate hepatocellular carcinoma (HCC). Material and methods: A cohort of 19 patients (84.2% male; 15.8% female; mean age 59.2 years ± 11.0; range, 32-80 years) with documented HCC of size 1.8-10cm (mean, 4.0cm ± 1.8 ) undergoing DEB transarterial chembolisation (TACE) was reviewed. All patients had at least one image examination (multiphase computed tomography or magnetic resonance imaging) after embolisation. Results: A total of 32 procedures were performed. The objective response according to the European Association for the Study of the Liver criteria was 57.9% at 1-month, 42.8% at 6-month and 50.0% at 1-year follow up. There were 4 (21.1%) treatment-related complications (1 liver abscess, 2 pancreatitis and 1 tumour rupture) which resulted in 2 deaths. One death occurred 3 weeks after second embolisation, due to ruptured pancreatic pseudocyst, giving a 5.3% 30-day mortality rate. Another patient died 2 months after embolisation caused by tumour rupture. Eight patients received radiofrequency ablation after embolisation for residual or recurrent tumours. The 1-year survival rate in the DEB TACE only group was 80% while the 1- and 2-year survival rate in the group that received radiofrequency after DEB TACE was 85.7% and 100% respectively. Conclusion: DEB TACE is safe and effective in select group of patients. Survival may be improved when combined with other treatment modality. PMID:21611067

  17. 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

  18. Oncocytic follicular nodules of the thyroid with or without chronic lymphocytic thyroiditis: An institutional experience

    Directory of Open Access Journals (Sweden)

    Sule Canberk

    2013-01-01

    Full Text Available Background : Oncocytic follicular (OF cells can be a prominent component of fine needle aspiration (FNA specimens from neoplasms (adenomas and carcinomas and nodules arising in multinodular goiter and chronic lymphocytic thyroiditis (CLT. Because OF cells can be present in non-neoplastic and neoplastic thyroid lesions it can be challenging to differentiate between these two in FNA specimens. The aims of this study were to determine the risk of malignancy in cases diagnosed as either oncocytic follicular neoplasm (OFN or hyperplastic/adenomatoid nodule with OF on FNA and to identify clinicopathologic features that may help in predicting malignancy in such cases, especially the presence or absence of CLT. Design : We retrospectively searched the computerized laboratory information system at our institution between 1998 and 2009 for thyroid US guided FNA specimens in which the term "oncocytic/oncocytes" was mentioned in the final cytopathologic diagnosis. A total of 340 cases were selected for this study. The following data points were collected: Patient demographics, site of thyroid biopsy, size of lesion, FNA diagnosis, histopathologic follow-up and presence of CLT. Surgical pathology follow-up (SPFU was available in 269 (79% cases. Results : Two hundred and sixty patients were females and 80 males (average age 53 years. The lesion size was <3.0 cm in 241 (71% and ≥ 3.0 cm in 99 (29% cases. Cytologic diagnoses included: Follicular neoplasm with oncocytic features (FNOF 321 and suggestive of FNOF 19 cases; a secondary cytologic diagnosis of CLT was made in 20 cases. SPFU was available in 269 (79% cases; it was benign in 213 (213/267 = 79% and malignant in 56 (56/269 = 21% cases. The background thyroid showed CLT in 67 (25% cases; 24% (48/196 neoplasms occurred with versus 76% (147/196 without CLT. The rate of malignancy was lower in nodules measuring less than 3.0 cm as compared to those equal or greater than 3.0 cm in size (17% vs. 28

  19. Accelerated Capacity Development in Water Resources Education: the experiences of the Ethiopian Institute of Water Resources

    Science.gov (United States)

    Alamirew, T.; Mekonnen, G.; Viglione, A.

    2012-04-01

    Ethiopia recently recognises that the water resources development is the major entry point in poverty alleviation and sustainable development. Water in Ethiopia plays a key role in the Water-Energy-Food-nexus. Over 98% of the electricity in the country is generated using hydropower and yet about 2000 MW has been developed. Out of the 3.5 Mha potentially irrigable land, only 0.25 Mha has been developed to date. Access to drinking water supply coverage is among the lowest in the world. One of the limiting factors in harnessing the resource base is the absence of water professionals to face the fast growing demand in education, research, development in the water sector. Recognising this, in collaboration with University of Connecticut of the United States, Addis Ababa University launched the Ethiopian Institute of Water Resources (EIWR) by enrolling 18 PhD and 24 MSc students. The program is unique in that much of the course instructors are coming from US and European Universities, but deliver courses together with Ethiopian collaborators. This is supposed to facilitate knowledge and experience transfer from the US/EU scientist to Ethiopian counterparts. The theses/dissertations are designed to focus on Ethiopia's immediate hydrological problems on selected basins, and will be coordinated by three advisors for each PhD - one from US/EU, one from Ethiopian Universities, and one water professional from the sector. We report here the lessons learned in setting up the EIWR institute and the education program.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Hiroshi; Inoue, Toshihiko; Yamazaki, Hideya (Osaka Univ. (Japan). Faculty of Medicine) (and others)

    1994-03-01

    Interstitial brachytherapy was conducted for mobile tongue carcinoma using a high dose rate remote afterloading machine with small [sup 192]I 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).

  1. One institution's experience in transforming the health sciences library of the future.

    Science.gov (United States)

    Allee, Nancy J; Blumenthal, Jane; Jordan, Karen; Lalla, Nadia; Lauseng, Deborah; Rana, Gurpreet; Saylor, Kate; Song, Jean

    2014-01-01

    Recognizing a need to be more relevant to its constituents, and aligned with institutional priorities, the Taubman Health Sciences Library redefined its mission, roles, and space. This transformation facilitated innovative, team-based collaborations within the health sciences community and the addition of new roles and responsibilities in academic and clinical engagement, research and informatics, enabling technologies, community outreach, and global health. Library space is being redesigned, and a branch library dedicated to interdisciplinary partnerships has been established. Information gained from this experience will be useful to other libraries faced with budget, resource, and staffing challenges and will offer practical ideas for becoming more integrated into the academic, research, and clinical work of the health sciences enterprise.

  2. Lived experiences of student nurses caring for intellectually disabled people in a public psychiatric institution

    Directory of Open Access Journals (Sweden)

    Annie Temane

    2016-02-01

    Full Text Available Background: Caring for intellectually disabled people can be demanding for student nurses who are novices in the nursing profession. To ensure that quality nursing care is provided, student nurses should have an understanding of and a positive attitude towards intellectually disabled people. Nursing intellectually disabled people can be a challenge for the student nurses. Therefore, student nurses need to be able to deal with challenges of caring for intellectually disabled people.Objective: This article aims to explore and describe experiences of student nurses caring for intellectually disabled people in a public psychiatric institution.Design and method: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected through individual in-depth phenomenological interviews, naïve sketches and field notes. Thematic analysis was utilised to analyse the collected data. Results were contextualised within the literature and measures to ensure trustworthiness were adhered to. Ethical principals were also applied throughout the research process.Results: Five themes emerged from the data. Student nurses experienced a profoundly unsettling impact on their whole being when caring for intellectually disabled people; they developed a sense of compassion and a new way of looking at life, and experienced a need for certain physical, mental and spiritual needs to be met.Conclusion: From the results, it is evident that student nurses were challenged in caring for intellectually disabled people. However, they developed a sense of awareness that intellectually disabled people have a need to be cared for like any other person.Keywords: experiences, student nurses, caring, intellectually disabled people, public psychiatric institution

  3. Differentiated thyroid carcinoma in paediatric and adolescent age group: 10-year experience in a university hospital in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulaziz Abdullah Alsaif

    2015-01-01

    Full Text Available Background and Objective: To describe the clinical presentation, surgical intervention and treatment, complications, tumour histopathology characteristics, follow-up and survival of 23 patients at or below the age of 21 at the time of diagnosis of differentiated thyroid carcinoma (DTC diagnosis. Materials and Methods: A retrospective medical chart review of 23 patients diagnosed with DTC and treated in our institute from January 2003 to December 2013 was done. Pertinent data were collected regarding clinical presentation, workups, surgical intervention and treatment, postoperative complications, histopathology, follow-up events and survival. Results: The median age at diagnosis was 17 years. 15 patients (65.2% had papillary carcinoma and 7 patients (30.4% had papillary carcinoma with follicular variant. Multifocality and extrathyroidal extension were found in 11 (47.8% and 6 (26.1% patients respectively. 21 patients underwent total thyroidectomy with neck dissection and were subjected to thyroid ablation with radioactive iodine (radioiodine and thyroid stimulation hormone (TSH-suppressant thyroxine replacement therapy. Median follow-up was 6.6 years. Recurrence occurred in 1 patient. No significant postoperative complications were observed. Conclusion: Appropriate investigations should be carried out to exclude thyroid cancer in children and adolescents presenting with a neck mass. Total thyroidectomy with appropriate cervical lymph node dissection, followed by radioiodine ablation therapy and TSH-suppressant thyroxine replacement therapy is the recommended option to manage children and adolescents with DTC. Neck examination should be part of the routine clinical examination in the paediatric and adolescent age group. A local elaborate genetic database for this disease is essential and may help compare its behaviour with that seen in other populations.

  4. 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.

  5. Neoadjuvant Chemoradiation in Squamous Cell Carcinoma of the Maxillary Sinus: A 26-Year Experience

    Directory of Open Access Journals (Sweden)

    Matthias Kreppel

    2012-01-01

    Full Text Available Background. The aim of our study was to evaluate the effects of neoadjuvant platinum-based radiochemotherapy (RCT in patients with maxillary sinus squamous cell carcinoma and to compare the results with other multimodality treatment concepts for advanced-stage maxillary sinus carcinoma in the literature. Methods. In total, 53 patients with squamous cell carcinoma of the maxillary sinus were reviewed retrospectively. All patients received a neoadjuvant RCT containing either cisplatin or carboplatin followed by radical surgery. Overall survival and locoregional control were plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. Results. Five-year overall survival for all patients was 35%. Eleven patients achieved a complete response after radiochemotherapy. The complete response rate was significantly higher for patients treated with cisplatin (P=0.028; however the 5-year overall survival rates did not differ significantly (P=0.673 for patients treated with cisplatin (37% and carboplatin (32%. Orbital invasion (P=0.005 and complete response to radiochemotherapy (P=0.021 had a significant impact on overall survival in univariate analysis. Conclusions. Neoadjuvant radiochemotherapy followed by radical surgery is an effective treatment for patients with advanced maxillary sinus squamous cell carcinoma. In terms of treatment response cisplatin seems to be more effective than carboplatin.

  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. 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.

  9. 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)

  10. [Experience with rIL2 in the treatment of metastatic renal carcinoma].

    Science.gov (United States)

    Cardellini, P; Vicini, D; Ruggieri, M; Franceschetti, G P; Nicrosini, S

    1993-04-01

    Eight patients with metastatic renal cell carcinoma, all nephrectomized, were treated with rIL2 continuous i.v. infusion or subcutaneous administering (+/- INF). Six patients alive. Continuous infusion is possible event out of Intensive Care Unity. Adverse effects, sometimes serious, rapidly decrease with suspension. Subcutaneous infusion is more easy and with lower adverse effects. We don't know methodic of which can give more security.

  11. 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

  12. Photodynamic Therapy in Gynecologic Malignancies: A Review of the Roswell Park Cancer Institute Experience

    Directory of Open Access Journals (Sweden)

    Paul C. Mayor

    2016-09-01

    Full Text Available Photodynamic therapy (PDT is a treatment modality used in the management of solid tumor malignancies that employs the use of a photosensitizing agent, a light source and oxygen in order to illicit a direct cytotoxic effect. Its use in gynecologic malignancies is somewhat novel and has been used for palliative and curative intent. At the Roswell Park Cancer Institute, the use of PDT in the management of gynecologic cancers began in the mid 1980s and since that time 35 patients have received PDT as a treatment for recurrent or metastatic cutaneous and vulvar, vaginal, anal, and cervical recurrences. In our experience, 85% patients with metastatic cutaneous lesions had a complete response. Twenty-seven percent of patients with metastatic vaginal, cervical or anal recurrences had a complete response to therapy with a median response time of 28 months. Side effects from the treatment included moderate to severe burning sensation, pain and edema at the treatment site requiring narcotic pain medication for symptom management in patients who underwent treatment to cutaneous lesions as well as lower genital tract recurrences. PDT should be considered an option in patients who are too frail to undergo the standard of care or decline the standard of care in lieu of a less invasive treatment modality.

  13. Photodynamic Therapy in Gynecologic Malignancies: A Review of the Roswell Park Cancer Institute Experience

    Science.gov (United States)

    Mayor, Paul C.; Lele, Shashikant

    2016-01-01

    Photodynamic therapy (PDT) is a treatment modality used in the management of solid tumor malignancies that employs the use of a photosensitizing agent, a light source and oxygen in order to illicit a direct cytotoxic effect. Its use in gynecologic malignancies is somewhat novel and has been used for palliative and curative intent. At the Roswell Park Cancer Institute, the use of PDT in the management of gynecologic cancers began in the mid 1980s and since that time 35 patients have received PDT as a treatment for recurrent or metastatic cutaneous and vulvar, vaginal, anal, and cervical recurrences. In our experience, 85% patients with metastatic cutaneous lesions had a complete response. Twenty-seven percent of patients with metastatic vaginal, cervical or anal recurrences had a complete response to therapy with a median response time of 28 months. Side effects from the treatment included moderate to severe burning sensation, pain and edema at the treatment site requiring narcotic pain medication for symptom management in patients who underwent treatment to cutaneous lesions as well as lower genital tract recurrences. PDT should be considered an option in patients who are too frail to undergo the standard of care or decline the standard of care in lieu of a less invasive treatment modality. PMID:27669307

  14. 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

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

    Science.gov (United States)

    Salvador, Israel I.; Kenoyer, David; Myrabo, Leik N.; Notaro, Samuel

    2010-10-01

    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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

    assurance manual including an evaluation of the legal aspects and implications to the European Union (EU). Through the network of excellence, TACADAR will strengthen the competitive position of European institutions involved in fish ageing through institutional synergy and international co-operation. (c......) 2005 Elsevier B.V. All rights reserved...

  20. 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…

  1. Institutional Silence: Experiences of Australian Lesbian Teachers Working in Catholic High Schools

    Science.gov (United States)

    Ferfolja, Tania

    2005-01-01

    This article, based on the author's doctoral research, examines the ways in which some religious schools in New South Wales (NSW), via institutional practices, maintain and perpetuate discrimination in relation to lesbian teachers and lesbian sexualities. These institutional practices, which included threats of dismissal, forced resignations,…

  2. Cultural Diplomacy and Internationalization of Higher Education: The Experience of Three Confucius Institutes in Canada

    Science.gov (United States)

    Kwan, Covina Y. W.

    2014-01-01

    This paper is based on a study of three Confucius Institutes in Canada. The research aims to explore the nature of operations at Confucius Institutes, ranging from the selection of partnering Chinese universities, to the program planning at each individual site. Specifically, it focuses on the perceived impacts of the Confucius Institute…

  3. Overview of local flaps of the face for reconstruction of cutaneous malignancies: Single institutional experience of seventy cases

    Directory of Open Access Journals (Sweden)

    Jagdeep K Rao

    2016-01-01

    Full Text Available Context: The most common malignant tumours of the face are basal cell carcinoma, squamous cell carcinoma and melanoma. While the results of skin graft are less than satisfactory for large areas to cover, distant flaps are bulky with a poor colour match. Local fasciocutaneous flaps provide reasonable option for reconstruction of facial defects with good colour and texture match and good success rate. Aims: This study aimed to analyse the various modalities of reconstruction after resection of facial malignancies and their advantages and disadvantages. Settings and Design: This was a retrospective study. Materials and Methods: Of 70 patients, 34 were managed with V-Y advancement flap, 24 with nasolabial flap, 8 with median forehead flap and 4 with standard forehead flap cover. The duration of follow-up ranged from 6 months to 2 years. Statistical Analysis Used: Nil. Results: Of 34 V-Y advancement flaps, 2 showed suture dehiscence at the apex of triangle which was allowed to heal secondarily with regular dressings. All the 24 nasolabial flaps were healthy without any complication. All patients had satisfactory functional and cosmetic outcomes. Conclusions: In our experience, local flaps give the best results and are the first choice for reconstruction of the face. Most defects can be best closed by nasolabial, V-Y advancement and forehead flap. Outstanding functional and cosmetic results can be achieved. Proper execution requires considerable technical skill and experience.

  4. Comparison between peritoneal tuberculosis and primary peritoneal carcinoma: a 16-year, single-center experience

    Institute of Scientific and Technical Information of China (English)

    WANG Dan; ZHANG Jun-ji; HUANG Hui-fang; SHEN Keng; CUI Quan-cai; XIANG Yang

    2012-01-01

    Background Peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125.The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis,compare them with features of primary peritoneal carcinoma,and establish definitive diagnostic procedures.Methods We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital.During this time,the data of 38 patients with primary peritoneal carcinoma were reviewed.Results The median age was 34 years (range,19-80 years).The most common symptoms were abdominal distension (16/30,53.3%) and an abdominal mass (12/30,40.0%).The serum CA125 level was elevated in 25 patients (83.3%).The median level of cancer antigen CA125 was 392.5 U/ml (range,0.64-850.0 U/ml).Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients.Diagnostic laparoscopy was performed in 15 patients (50.0%) and exploratory laparotomy was performed in 12 patients (40.0%),and 3 patients (10.0%) who underwent laparoscopy converted to laparotomy because of severe adhesions.The intraoperative findings were adhesions,multiple white tubercles,and ascites.Frozen tissue sections were obtained in 17 patients,and 14 of whom showed chronic granulomatous reactions.Final pathological examinations confirmed the diagnosis.Conclusions Peritoneal tuberculosis should be considered as a differential diagnosis,especially for young women with an abdominal mass,ascites,and elevated serum CA125 levels.Laparoscopy is a useful diagnostic method for peritoneal tuberculosis,and intraoperative frozen sections are recommended when the diagnosis is in doubt.

  5. 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

  6. Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience

    Science.gov (United States)

    Kilius, Alfredas; Petrulis, Kestutis; Samalavicius, Narimantas E.

    2017-01-01

    Purpose The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM). Methods Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences. Results The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days. Conclusion TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.

  7. Minimal invasive surgical correction of pectus excavatum deformities in adolescents: Our institutional experience

    Directory of Open Access Journals (Sweden)

    Jokić Radoica

    2013-01-01

    Full Text Available Introduction. Nuss procedure is a minimal invasive surgical technique based on retrosternal placement of a metal plate to correct pectus excavatum chest deformity. We are presenting our five­year (2006­2011 institutional experience of 21 patients. Objective. The aim of this study was to determine characteristics and advantages of minimal invasive surgical approach in correcting deformities of the chest. Methods. Surgical procedure, named after its author Nuss, involves the surgical placement of a molded metal plate, the so­called pectus bar, behind the sternum under thoracoscopic view whereby immediate controlled intraoperative corrections and stabilizations of the depression can be made. The great advantage of this method is reflected in a significant shortening of operative time, usually without indications for compensation in blood volume, and with a significantly shortened postoperative recovery that allows patients to quickly return to their normal activities. Results. In the period 2006­2011, 21 patients were operated by the Nuss procedure. The pectus bar was set in front or behind the muscles of the chest. Among the complications listed were inflammation of wounds in three patients, dislocation (shifting of the bar requiring a reoperation in two patients, an occurrence of a pericardial effusion in one patient, and allergic response to foreign body in one patient. Five patients required extraction of the bar two years later, and three patients after three years, all with excellent results. Conclusion. Minimally invasive Nuss procedure is safe and effective. It currently represents the primary method of choice for solving the chest deformity pectus excavatum for patients of all ages. Modification of thoracoscopic control allows a safe field of operation. Postoperative results are excellent with very few complications that can be attributed to the learning curve.

  8. Experience of Future Economists’ Self-Study Organization in Foreign Higher Education Institutions

    Directory of Open Access Journals (Sweden)

    Aliyev Oktay

    2016-06-01

    Full Text Available The article consolidates information sources on the issues of future economists’ self-study organization at foreign universities. There has been carried out the study of approaches to the interpretation of the term “self-study process” in the contemporary scientific thought abroad. There have been specified the productive ideas of foreign experience which are to be understood and implemented into practice of domestic higher education institutions in terms of professional training of future specialists in the field of social and behavioural sciences majoring in Economics, including the following: 1 student self-study is supposed to be a mandatory part of the educational process, with the amount of time dedicated to being less than 65 percent. At the same time a student-personalized approach to each student should be implemented and the course of study, specifics of the subject being learnt should be taken into account; the teachers are expected to offer verbal consulting and ICT support (including university web resources of student self-study; 2 while organizing the educational process (syllabi, curricula for students of different educational levels it should be taken into account that there is a link between self-education of future economists with his/her practical activities along with development prospects of the sector; 3 organization of future economists’ self-study should be based on the student’s conscious attitude to learning, recognition of its role in meeting the challenges and solving the urgent problems of economic education (motivational component; on knowledge forming the basis for the individual’s self-study and determining his/her readiness for self-education in their future careers (cognitive component; on combination of skills and abilities of the individual, determining his/her functional readiness for professional self-education on challenging issues of economic sphere (operational and pragmatist component.

  9. 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

  10. 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.)

  11. [The influence of leadership experience on the style of resolving management decisions by executives of healthcare institutions].

    Science.gov (United States)

    Vezhnovets', T A

    2013-12-01

    The aim of our study was to examine the influence of age and management experience of executives in healthcare institutions at the style of decision-making. The psychological study of 144 executives was conducted. We found out that the age of executives in healthcare institutions does not affect the style of managerial decision making, while experience in leadership position does. Also it was established that the more experienced leader is, the more often he will make decision in authoritative, autonomous, marginal style and the less management experience is, the more likely is the usage of indulgent and situational style. Moreover, the authoritarian style is typical for younger executives, marginal and autonomous is typical for elder executives.

  12. A CLINICAL STUDY ON INCIDENCE, PATHOLOGICAL PATTERN AND MANAGEMENT OF GASTRIC CARCINOMA IN RURAL SETUP (ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES, MANDYA

    Directory of Open Access Journals (Sweden)

    Abinash

    2016-05-01

    Full Text Available BACKGROUND Stomach cancer or gastric cancer is when cancer develops from the lining of stomach. Early symptoms may include heartburn, upper abdominal pain, nausea and loss of appetite. Later symptoms may include weight loss, yellow skin, vomiting, difficulty swallowing and blood in the stool among others. The cancer may spread from the stomach to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen and lymph nodes. The most common cause is infection by the bacteria Helicobacter pylori, which accounts for more than 60% of cases. About 10% of cases run in families and between 1% and 3% of cases are due to genetic syndromes inherited from a person’s parents such as hereditary diffuse gastric cancer. AIMS AND OBJECTIVES 1 To study the prevalence of carcinoma stomach as occurring in Adichunchanagiri Institute of Medical Sciences and Research Centre, Mandya. 2 To study the clinical presentation including the anatomic site of occurrence and histological type. 3 To study the association of risk factors. 4 To study the surgical modalities of treatment. METHODS The tissue for diagnosis was obtained by endoscopy or following surgical resection. Patients presenting to Adichunchanagiri Hospital, Mandya, during the study period and those found eligible were included in the study. Sample Size Minimum of 50 cases meeting criteria of the present study. RESULTS Gastric carcinoma is more common in males with 56% of the cases being males in this study. The prevalence is more among the low socio-economic group, which is 80% of the population. Smoked foods is a risk factor in 15 (30% of the patients and 40 (80% in high spicy diet in everyday food. Tobacco smoking (44%, alcohol consumption (44% are also risk factors. Blood Group A is associated with gastric cancer, 23 (46% patients. Anorexia was the most common symptoms reported in 42 (84% of the patients. Anaemia was the most common sign in 35 (70% of the cases. The most common

  13. 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.

  14. 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)

  15. Adjuvant Radiation Therapy and Survival for Pure Tubular Breast Carcinoma-Experience From the SEER Database

    Energy Technology Data Exchange (ETDEWEB)

    Li Baoqing, E-mail: bal9018@med.cornell.edu [Department of Radiation Oncology, Weill Cornell Medical College, New York, New York (United States); Chen, Margaret [Department of Surgery, Weill Cornell Medical College, New York, New York (United States); Nori, Dattatreyudu; Chao, K.S. Clifford [Department of Radiation Oncology, Weill Cornell Medical College, New York, New York (United States); Chen, Allen M. [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, California (United States); Chen, Steven L. [Department of Surgery, University of California Davis Cancer Center, Sacramento, California (United States)

    2012-09-01

    Purpose: Pure tubular carcinoma of the breast (PTCB) represents a distinct subtype of invasive ductal carcinoma (IDC) that is generally thought to be associated with better prognosis than even low-grade IDC. There has been controversy as to the role of adjuvant radiation therapy (RT) in this population. We hypothesized that adjuvant RT would demonstrate a survival improvement. Methods and Materials: We queried the Surveillance, Epidemiology and End Results database for the years 1992-2007 to identify patients with pure tubular carcinomas of the breast. Patient demographics, tumor characteristics, and surgical and RT treatments were collected. Survival analysis was performed using the Kaplan-Meier method for univariate comparisons and Cox proportional hazards modeling for multivariate comparisons, stratifying on the basis of age with a cutoff age of 65. Results: A total of 6465 patients were identified: 3624 (56.1%) patients underwent lumpectomy with RT (LUMP+RT), 1525 (23.6%) patients underwent lumpectomy alone (LUMP), 1266 (19.6%) patients received mastectomy alone (MAST), and 50 (0.8%) patients underwent mastectomy with RT (MAST+RT). When we compared the LUMP+RT and LUMP groups directly, those receiving adjuvant RT tended to be younger and were less likely to be hormone receptor-positive. Overall survival was 95% for LUMP+RT and 90% for LUMP patients at 5 years. For those 65 or younger, the absolute overall survival benefit of LUMP+RT over LUMP was 1% at 5 years and 3% at 10 years. On stratified multivariate analysis, adjuvant RT remained a significant predictor in both age groups (P=.003 in age {<=}65 and P=.04 in age >65 patients). Other significant unfavorable factors were older age and higher T stage (age >65 only). Conclusions: Since sufficiently powered large scale clinical trials are unlikely, we would recommend that adjuvant radiation be considered in PTCB patients age 65 or younger, although consideration of the small absolute survival benefit is

  16. Central Asia: Kyrgyzstan and the learning experience in the design of pastoral institutions.

    Science.gov (United States)

    Kasymov, U; Undeland, A; Dörre, A; Mackinnon, A

    2016-11-01

    The authors analyse the nature of policy development to understand the reasons for institutional change in pasture management in Kyrgyzstan. They use the concept of intentional institutional change, emphasising its incremental nature and the important relationship between belief systems and institutions. The paper explores the relationship between the perceptions and beliefs of policy-makers, the policy interventions they undertake, and the consequences for pastoral migration and practices. The study reveals the gap between the intentions behind such policies and their outcomes, the persistence and importance of pastoral migration, and the learning process that policy-makers undergo. This close look at the development and institutionalisation of new dominant societal beliefs highlights the possible direction of the future development of formal pastoral institutions in Central Asia. Policy-makers should respond better to changes in pastoral mobility and the unsustainable increase in intensified use of natural pastures. Policy-makers must also respond to the growth in conflict over pasture use by becoming more aware of the need for inter-sectoral cooperation. The authors argue that a crucial test for the new formal institutions still lies ahead. The key questions are: whether policy-makers and pasture users can eventually come to hold the same beliefs about what is needed in their society, and what new effective institutions will emerge to define the future of pastoralism in Central Asia.

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

    Energy Technology Data Exchange (ETDEWEB)

    Spirtos, N.M.; Doshi, B.P.; Kapp, D.S.; Teng, N. (Stanford Univ. Medical Center, CA (USA))

    1989-10-01

    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.

  18. 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.

  19. Clinical experience with temsirolimus in the treatment of advanced renal cell carcinoma.

    Science.gov (United States)

    Zanardi, Elisa; Verzoni, Elena; Grassi, Paolo; Necchi, Andrea; Giannatempo, Patrizia; Raggi, Daniele; De Braud, Filippo; Procopio, Giuseppe

    2015-06-01

    Temsirolimus is an inhibitor of the mammalian target of rapamycin (mTOR) kinase, a protein that has been shown to be particularly active in metastatic renal cell carcinoma (mRCC) with poor prognosis. Therefore, temsirolimus should be considered as the first-line treatment indicated in mRCC patients classified as poor risk. The benefits of temsirolimus are not limited to an increased survival but are also related to a better quality of life, which is certainly one of the most important aspects in the clinical management of these frail patients. Temsirolimus is a well-tolerated treatment, and the most frequent adverse events are manageable with supportive care. To this end, the identification of predictive factors of response to temsirolimus could help us to better select patients and obtain a more tailored clinical management of mRCC.

  20. Prevalence trends of oral squamous cell carcinoma. Mexico City’s General Hospital experience

    Science.gov (United States)

    Hernández-Guerrero, Juan C.; Jacinto-Alemán, Luís F.; Jiménez-Farfán, María D.; Macario-Hernández, Alejandro; Hernández-Flores, Florentino

    2013-01-01

    Objective: Recent reports suggest an increase in oral squamous cell carcinoma (OSCC) frequency. To improve programs in public health, it is necessary to understand the epidemiological conditions. The aim of this study was to analyze the trend in gender, age, anatomic zone and OSCC stage from Mexico City’s General Hospital patients from 1990 to 2008. Study design: A retrospective review of all OSCC cases diagnosed by the Pathology Department of the Mexico City General Hospital was performed. Demographic data, in addition to anatomic zone and histological degree of differentiation were obtained. Central tendency, dispersion and prevalence rate per 100,000 individuals were determined. Results: A total of 531 patients were diagnosed with OSCC; 58.4% were men, giving a male:female ratio of 1.4:1, and the mean age was 62.5 ± 14.9 years. The predominant anatomic zone was the tongue (44.7%), followed by the lips (21.2%) and gums (20.5%). The most frequent histological degree was moderately differentiated in 325 cases (61.2%). The rates of OSCC prevalence showed similar patterns in terms across time. A significant correlation (P = 0.007) between anatomic zone and age was observed. Conclusion: According to our results, the prevalence of OSCC does not show important variations; however, a relationship between age and anatomic zone was observed. These data could be used as parameters for the diagnosis of OSCC as well as for the development and dissemination of preventive programs for the early detection of oral cancer. Key words:Oral squamous cell carcinoma, prevalence, histology degree and anatomic zone. PMID:23385493

  1. Clinical experience and critical evaluation of the role of everolimus in advanced renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Sun M

    2011-04-01

    Full Text Available Maxine Sun1, Firas Abdollah2, Jan Schmitges1, Claudio Jeldres1, Shahrokh F Shariat3, Paul Perrotte4, Pierre I Karakiewicz1,4 1Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; 2Department of Urology, Vita Salute San Raffaele University, Milan, Italy; 3Department of Urology, Weill Medical College of Cornell University, New York, NY, USA; 4Department of Urology, University of Montreal Health Center, Montreal, CanadaAbstract: The efficacy of sequential everolimus, an orally administered inhibitor of mammalian target of rapamycin (mTOR, was proven in a placebo-controlled phase III study, where median progression-free survival was 4.9 vs 1.9 months for placebo (hazard ratio: 0.33, P < 0.001. Placebo crossovers (80% contaminated overall survival data. Adverse event discontinuation rate was of only 10% and health-adjusted quality-of-life was sustained. These data represent the first placebo-controlled evidence of efficacy for a seque ntially used targeted agent. Everolimus resulted in the strongest hazard ratio ever recorded for progression-free survival, despite it being tested in a population with the most aggressive natural history ever recorded in all available phase III metastatic renal cell carcinoma trials. Everolimus use after exclusively one prior antivascular endothelial growth factor f ailure resulted in an even longer progression-free survival time (5.4 months than in the entire population (4.9 months. These benefits should also be considered in the light of sustained and unimpaired health-related quality of life. Use in first line other than second or subsequent lines remains to be validated.Keywords: everolimus, metastatic renal cell carcinoma, targeted therapy, sequential therapy, mTOR

  2. 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

  3. Regadenoson in Myocardial Perfusion Study - First Institutional Experiences in Bosnia and Herzegovina

    Science.gov (United States)

    Beslic, Nermina; Milardovic, Renata; Sadija, Amera; Ceric, Sejla; Raic, Zeljka

    2016-01-01

    diastolic. ST segment depression of up to 1 mm occurred in 4 cases (8%), and T-wave changes in 3 cases (6%). No conduction abnormalities, significant hypotension, symptomatic bradycardia or cardiac arrest ocurred. Conclusion: Our first institutional experiences proved regadenoson as A2A selective adenosine agonist as a pharmacologic stressor to be safe, tolerable and easily used. Its safety profile enabled the study to be performed in patients with respiratory disease also. PMID:28077904

  4. Building Comprehensive and Sustainable Health Informatics Institutions in Developing Countries: Moi University Experience.

    Science.gov (United States)

    Were, Martin C; Siika, Abraham; Ayuo, Paul O; Atwoli, Lukoye; Esamai, Fabian

    2015-01-01

    Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving 3 million people. Moi University has formed strategic HI partnerships with Regenstrief Institute, Inc. (USA), University of Bergen (Norway), and Makerere University (Uganda), among others. The University has also created an Institute of Biomedical Informatics to serve as an HI Center of Excellence in the region. This Institute has divisions in Training, Research, Service and Administration. The HI capacity-building approach by Moi provides a model for adoption by other institutions in resource-limited settings.

  5. [Human brain resource--experience at the Brain Research Institute,University of Niigata].

    Science.gov (United States)

    Kakita, Akiyoshi; Takahashi, Hitoshi

    2010-10-01

    Through 40 years of neuropathological practice,the Brain Research Institute, University of Niigata (BRI-Niigata), Japan has accumulated extensive human brain resource,including fresh-frozen brain slices,for scientific research. Over 30,000 slices obtained from consecutive autopsies have been systematically stored in 25 deep freezers. Establishment of effective networks between brain banks and institutional collections in Japan is essential for promoting scientific activities that require human brain resource. We at the BRI-Niigata are eager to contribute to the establishment of such networks.

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

    OpenAIRE

    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

    2016-01-01

    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 unde...

  7. 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…

  8. 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–

  9. The neutron Electric Dipole Moment experiment at the Paul Scherrer Institute

    Directory of Open Access Journals (Sweden)

    Hélaine V.

    2014-06-01

    Full Text Available The neutron Electric Dipole Moment (nEDM is a probe for physics beyond the Standard Model. A report on the nEDM measurement performed at the Paul Scherrer Institute (Switzerland is given. A neutron spin analyzer designed to simultaneously detect both neutron spin states is presented.

  10. 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…

  11. 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.

  12. 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…

  13. 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…

  14. Prior Experience as a Predictor for Institutional Performance: An Emerging Dynamic for the Community College Presidency

    Science.gov (United States)

    King, Matteel Deneen

    2010-01-01

    For the past several years, community college presidents have retired at alarming rates. At the same time, institutional needs have shifted and new skill sets are often desired. These changes, coupled with a lack of leader succession plans, budget cuts, and an increased emphasis on accountability, created opportunities for candidates with…

  15. Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska Univ. Hospital experience

    Energy Technology Data Exchange (ETDEWEB)

    Taheri-Kadkhoda, Zahra; Bjoerk-Eriksson, Thomas; Mercke, Claes [Dept. of Oncology, Sahlgrenska Univ. Hospital, Goeteborg (Sweden); Johansson, Karl-Axel [Dept. of Radiophysics, Sahlgrenska Univ. Hospital, Goeteborg (Sweden)

    2007-08-15

    Nasopharyngeal carcinoma (Nc) is a rare disease in Sweden. For evaluation of the treatment outcomes in our NPC patients, 52 new cases that were referred to our department between 1991 and 2002 were retrospectively analysed. Tumor stage, according to the 1997 AJCC staging system, was I in five, II in ten, III in 12 and IV in 25 patients. Majority of the patients (87%) had World Health Organization type II-III tumors. Neoadjuvant chemotherapy was delivered in 33 patients. Thirty-two patients received hyperfractionated accelerated radiation therapy with a median dose of 64.6Gy (1.7Gy/fr bid). Conventional external irradiation with a median dose of 66Gy (2Gy/fr) was delivered to 18 patients. An intracavitary brachy-boost of 4.5-12Gy was delivered to 40 patients. Two patients were excluded from the analysis due to treatment refusal. For the patients with tumor stages I-IVB, the 5-year disease-free and overall survival rates were 61% and 55%, respectively. The 5-year local, regional, and distant relapse-free survival rates were 70%, 92% and 77%, respectively. The most frequent late side effects were xerostomia (98%), otitis (70%) and hearing deterioration (64%). Our data suggest that optimization of the treatment outcomes in NPC patients requires implementation of new therapeutic strategies.

  16. Extrapulmonary small cell carcinoma. An indication for prophylactic cranial irradiation? A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Frueh, Martin; Cerny, Thomas [Kantonsspital St. Gallen (Switzerland). Dept. of Oncology/Hematology; Kacsir, Bela; Plasswilm, Ludwig [Kantonsspital St. Gallen (Switzerland). Dept. of Radiation Oncology; Ess, Silvia [Cancer Registry, Canton of St. Gallen, Appenzell (Switzerland); Rodriguez, Regulo [Kantonsspital St. Gallen (Switzerland). Dept. of Pathology

    2011-09-15

    Information about extrapulmonary small cell carcinoma (EPSCC) is limited and the role of prophylactic cranial irradiation (PCI) is unknown. Disease presentation and outcome of all EPSCC at our hospital between 1990 and 2009 were retrospectively analyzed. Of 30 EPSCC, the male:female ratio was 58%:42%; 83% had a performance status of 0-2. Median age was 71 years (32-80). Seventeen (57%) had limited stage (LS), 13 (43%) extensive stage (ES). The location of the primary tumor was gastrointestinal (n = 8), unknown (6), gynecological (6), urogenital (5), and ear nose throat (5). Four (13%) developed brain metastases (2 ES, 2 LS). In ES, first line chemotherapy (CT) was given in 85%, mostly platinum-etoposide (64%). Response rate was 90%. In LS, CT and radiotherapy (RT) {+-} resection resulted in persistent remissions in 67% of patients. Median survival was 16 months (1-107 months), 18 months (1-107 months), and 9 months (0.4-25 months) for LS + ES, LS, and ES, respectively. Weight loss {>=}5 % and ECOG performance status 3 + 4 were associated with poorer survival (p < 0.001 and p < 0.01, respectively). The incidence of brain metastases was relatively low (13%). More studies are necessary, before routinely offering PCI to patients with EPSCC. Best survival outcomes in LS were achieved with multimodality treatment including CT and RT. Prognosis was poor in patients with ES. (orig.)

  17. 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 

  18. The Sun Health Research Institute Brain Donation Program: description and experience, 1987-2007.

    Science.gov (United States)

    Beach, Thomas G; Sue, Lucia I; Walker, Douglas G; Roher, Alex E; Lue, LihFen; Vedders, Linda; Connor, Donald J; Sabbagh, Marwan N; Rogers, Joseph

    2008-09-01

    The Brain Donation Program at Sun Health Research Institute has been in continual operation since 1987, with over 1000 brains banked. The population studied primarily resides in the retirement communities of northwest metropolitan Phoenix, Arizona. The Institute is affiliated with Sun Health, a nonprofit community-owned and operated health care provider. Subjects are enrolled prospectively to allow standardized clinical assessments during life. Funding comes primarily from competitive grants. The Program has made short postmortem brain retrieval a priority, with a 2.75-h median postmortem interval for the entire collection. This maximizes the utility of the resource for molecular studies; frozen tissue from approximately 82% of all cases is suitable for RNA studies. Studies performed in-house have shown that, even with very short postmortem intervals, increasing delays in brain retrieval adversely affect RNA integrity and that cerebrospinal fluid pH increases with postmortem interval but does not predict tissue viability.

  19. An Institutional Analysis of Groundwater Quality Control: Experiences in Hadano, Kanagawa Prefecture, Japan

    Directory of Open Access Journals (Sweden)

    Takahiro Endo

    2016-05-01

    Full Text Available A considerable number of studies have been made of institutional arrangements that can prevent excessive groundwater pumping based on Hardin’s seminal work, the “tragedy of the commons.” In contrast, this paper is concerned with groundwater quality control for which policy studies are very limited. This paper not only clarifies institutional challenges specific to groundwater contamination, but also demonstrates how government and industry could solve them using a case study of Hadano, Kanagawa Prefecture, Japan, which has pioneered countermeasures for groundwater pollution in Japan. Hadano solved the challenges by enacting an innovative local ordinance with three pillars: Proxy purification by the city government, fundraising for purification activities and a retroactive system. Lessons learnt from the Hadano case will be very useful to policy makers because these problems already occur in other urban areas, or are likely to occur in the near future.

  20. 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.

  1. Surgical management of renal cell carcinoma with inferior vena caval thrombus: A teaching hospital experience

    Directory of Open Access Journals (Sweden)

    Kulkarni Jagdeesh

    2007-01-01

    Full Text Available Purpose: To evaluate the outcome of patients of renal cell carcinoma (RCC with inferior vena caval (IVC thrombus treated by radical nephrectomy and IVC thrombectomy in terms of clinical and pathological factors and prognosis. Materials and Methods: Sixty-three consecutive patients of RCC with IVC thrombus who underwent radical nephrectomy with IVC thrombectomy between June 1993 and May 2003 were included in this retrospective analysis. Data was analyzed in terms of clinical factors, such as level of thrombus, and pathological factors, such as grade, local invasion and N status. Results: Tumor thrombus level was infrahepatic in 35 patients, retrohepatic in 20 and suprahepatic in 8, including 5 with right atrial thrombus. The immediate post-operative mortality was 3%, and the incidence of major post-operative complications was 34%, but most of them improved after conservative management except one who needed surgery for burst abdomen. The disease free survival (DFS was 48.5%, 50.6%, 66.6% and 40% for infrahepatic, retrohepatic, suprahepatic and intra-atrial tumors, respectively. Of the histological types, patients with clear cell tumors had the best prognosis; those with granular cell had the worst prognosis (DFS of 53.5% vs 33.3%, though statistically not significant. Grade-2 tumors had better prognosis than grade-4 tumors (DFS 66.6% vs 0%, P < 0.001. Sixty-eight percent of patients without perinephric fat invasion were free of disease as compared to 31% of those with perinephric fat invasion (P < 0.01. Further, N status showed DFS of 60.9% in patients with negative nodes and 30% in patients with positive nodes (P < 0.05. Conclusion: Though surgery for RCC with IVC thrombus has high morbidity, it can give good results in terms of prolonged DFS in expert hands. Regarding long-term survival, pathological factors, such as local stage and grade, are more important than clinical factors, such as level of thrombus.

  2. 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.

  3. 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.

  4. [Conservative surgical treatment of renal carcinoma. Personal experience with 29 surgical excisions of tumors].

    Science.gov (United States)

    Villani, U; Pastorello, M

    1991-03-01

    From 1980 to 1988, elective conservative surgery (tumorectomy by enucleo-resection) was performed for renal cell carcinoma at stage I in 29 patients. An accurate preoperative renal investigation was carried out to identify the exact extension of the tumor and to study all the parenchimal situation, through IVP, ultrasound, CT scanning and, particularly, conventional selective angiography. The operative technique employed was: lymphadenectomy, peri-pararenal fat extirpation, in situ tumor enucleation by circular incision of the renal capsule and blunt dissection of the renal parenchyma with 2 cm safety margin to the tumor; multiple biopsies in the "bed" of resection for histopathologic peroperative evaluation; careful examination of the pseudocapsule and surrounding renal tissue; hemostasis. Follow-up was 10-113 months (mean 40,34 months). 2 of 29 patients died for progression of disease (at 52nd and 16yh month from surgery, 2/29 died for non-neoplastic reasons; 25/29 pts are living without local recurrences or distant metastases. In the same period (1980-1988), radical nephrectomy was performed for renal tumors at stage I in 34 patients. In an average observation period of 49,67 months, 2/34 patients died for progression of disease; 3/34 pts died for non-neoplastic reasons. 1/34 patient is living with pulmonar metastases and 28/34 are living without evidence of cancer. From this study we have got the conclusion that elective renal-sparing excision of the tumor (with macro-micro examination of the abscission surfaces) should be considered as a curative treatment in the case of low stage single tumors smaller than 7 cm, peripherally located in renal cortex, with unbroken pseudocapsule.

  5. Hepatitis C virus genotype 3a infection and hepatocellular carcinoma: Pakistan experience

    Institute of Scientific and Technical Information of China (English)

    Muhammad Idrees; Shazia Rafique; Irshad-ur Rehman; Haji Akbar; Muhammad Zubair Yousaf; Sadia Butt; Zunaira Awan; Sobia Manzoor; Madiha Akram; Mahwish Aftab; Bushra Khubaib; Sheikh Riazuddin

    2009-01-01

    AIM: To assess the association between chronic hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) in Pakistan, and the genotype distribution among these HCC patients.METHODS: One hundred and sixty-one subjects with HCC were included in this study. Liver biopsy was performed on 145 of the patients; sixteen were excluded because they failed to fulfill the inclusion criteria. Qualitative polymerase chain reaction (PCR) was performed for hepatitis B virus and HCV. Samples positive for HCV RNA were genotyped using genotypespecific PCR and confirmed by HCV 5' noncoding region sequencing analysis.RESULTS: Chronic HCV infection was identified a major risk factor (63.44% of tested HCC patients) for the development of HCC. The time from HCV infection to appearance of cancer was 10-50 years. In the HCC patient population, broader distributions of genotypes were present with genotype 3a as the predominant genotype. Using the type-specific genotyping method,we found HCV genotype 3a in 40.96%, 3b in 15.66%, 1a in 9.63%, and 1b in 2.40% of HCC tissue samples. About 28% of cases were found with mixed genotypes. Two cases were unable to be genotyped because of low viral load. Sixty-six percent of treated patients with cirrhosis had an end of treatment response, but unfortunately they relapsed quickly when the treatment was discontinued,and HCC developed during a median 3.8 years.CONCLUSION: There was a strong association between chronic HCV infection and HCC in Pakistan,and between HCV genotype 3a and HCC.

  6. Treatment outcome of patients with carcinoma of vulva: Experience from a tertiary cancer center of India

    Directory of Open Access Journals (Sweden)

    Sharma Daya

    2010-01-01

    Full Text Available Purpose: The aim of our retrospective study was to analyze and report the clinical outcome of patients with vulvar carcinoma (VC treated at our center. Materials and Methods: We retrieved the information regarding patients′ clinical details, treatment given, survival and complications from the case records of all VC patients who were treated at our center during the year 1998-2005. Overall survival (OS was determined with respect to age, histopathological grade, stage of disease, treatment group, pathological lymph node status, etc. Results: A total of 60 case records were retrieved for this retrospective analysis. Age ranged from 24 to 92 years (median 63 years. International Federation of Gynecology and Obstetrics (FIGO stage distribution was as follows: stage I: 2 patients; stage II: 17 patients; stage III: 31 patients; stage IV: 9 patients; and unknown stage: 1 patient. Thirty-three patients underwent surgery (wide local excision 3, radical vulvectomy 30. Eleven patients received postoperative radiation therapy (PORT, 12 received palliative radiation therapy (RT and 15 underwent definitive RT (5 of them received concurrent chemotherapy. Median follow-up period was 23 months (range 2-144 months. The 5-year OS for all stages was 41%. FIGO stage and pathological node positivity were found to be statistically significant prognostic factors for survival. Conclusion: Despite the majority of patients presenting in advanced stage, the 5-year OS of 41% in our series reflects a decent therapeutic outcome. The results have shown FIGO stage and pathological node positivity to be significant prognostic factors for survival. The use of preoperative chemotherapy/RT needs to be studied in our setup.

  7. 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.

  8. 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.

  9. [Medullary carcinoma experience in breast oncology unit of Hospital Juarez Mexico].

    Science.gov (United States)

    Jiménez-Villanueva, Xicoténcatl; Hernández-Rubio, Angela; García-Rodríguez, Francisco Mario; García, Rebeca Gil; Moreno-Eutimio, Mario; Herrera-Torre, Analy

    2014-01-01

    Antecedentes: el carcinoma de mama, variante medular, es poco frecuente y de buen pronóstico. Objetivo: conocer las características epidemiológicas y clínicas de la población atendida en el Hosital Juárez de México, saber si se asemejan a las descritas a nivel mundial y si los tratamientos propuestos internacionalmente son aplicables para este centro hospitalario. Material y métodos: estudio retrospectivo y descriptivo de 41 expedientes de pacientes con cáncer de mama tipo medular atendidas entre febrero de 1993 y febrero 2011. Resultados: se encontró que la incidencia de cáncer de mama de tipo medular fue de 3.04% en pacientes originarias de 11 estados mexicanos, con edad promedio de 50 años, nivel socioeconómico medio bajo para 39.02%, sin antecedentes familiares pero sí personales patológicos para: diabetes mellitus tipo 2, hipertensión arterial sistémica y cáncer de mama previo. Eran postmenopáusicas 63.41%. El promedio del tamaño clínico del tumor fue 58 mm, localizado en 63% de los casos en la mama izquierda. Los estadios clínicos fueron: 53.1% en I y II, 46.3% en III y 9.6% no etapificable. El 47% de las pacientes tenía ganglios linfáticos axilares positivos al momento del diagnóstico. La inmunohistoquímica sólo se reportó en 14 de las 41 pacientes; de acuerdo con la clasificación molecular para cáncer de mama: 8 fueron triple negativo, 2 luminal A, 1 luminal B y 3 Her2Neu. Conclusión: la población mexicana tiene características epidemiológicas y clínicas similares a las de las pacientes descritas en estudios internacionales.

  10. 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.

  11. 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.

  12. Prognostic Factors and Recurrence in Breast Cancer: Experience at the National Cancer Institute of Mexico

    OpenAIRE

    Stankov, A.; J. E. Bargallo-Rocha; A. Ñamendys-Silva Silvio; Ramirez, M. T.; Stankova-Ninova, K.; Meneses-Garcia, A.

    2012-01-01

    The purpose of this study was to analyze the prognostic and predictive factors that relate to locoregional or distant recurrences in breast cancer patients who have been treated at the National Cancer Institute of Mexico. Multivariate, time-dependent Cox regression analyses indicate that the pN status (positive versus negative lymph node; P = 0.003; HR (hazard ratio), 3.47; CI (confidence interval), 1.52–7.91) and the pathological complete response of the patient to neoadjuvant chemotherapy (...

  13. Experience of radioactive needle implants in the Institute of Radiotherapy Hospital Kuala Lumpur.

    Science.gov (United States)

    Lim, G C; Azhar, M T

    1997-03-01

    This retrospective study of radioactive needle implants at the Institute of Radiotherapy and Oncology, Kuala Lumpur Hospital serves as an audit of our practice as well as a demonstration of the usefulness of this technique of brachytherapy. A variety of tumour sites were implanted, of which over two-thirds involved the tongue and buccal mucosa. Although most of the implants were carried out with radical intent, one-tenth of these implants were performed for palliation. Radiotherapy techniques employed are described. The crude survival ranged from 1 month to 109 months while the disease free interval ranged from 0 months to 102 months.

  14. Which factors influence students' selection of advanced graduate programs? One institution's experience.

    Science.gov (United States)

    Saeed, Sophia; Jimenez, Monik; Howell, Howard; Karimbux, Nadeem; Sukotjo, Cortino

    2008-06-01

    The reasons that students choose certain specialties may be integral to the quality of specialty programs and the future of those specialties. The Harvard School of Dental Medicine (HSDM) has a high percentage (87.6 percent) of students who enroll in postgraduate programs. The goals of this study were to establish a baseline of factors that affect postgraduate program selection at HSDM and to determine if there was a significant difference in factor selection by gender, relationship status, graduation year, or choice to specialize versus choice to pursue advanced training in general dentistry. As a pilot study, we asked HSDM graduates from the classes of 2005 to 2007 to rank the importance of forty-two factors in selecting a field of dentistry and a particular program or institution within a specialty. Overall, students felt that intellectual content, challenging diagnostic problems, and possessing a special skill or talent unique to a specialty were the most important factors in choosing a field of dentistry. Influence of family members in dentistry was ranked as least important. In choice of a certain program or institution within a given field, clinical training and philosophy of training were ranked most highly. Students felt that the opportunity to moonlight was least important. Significant differences (p<0.05) were found regarding gender, relationship status, and students who chose to specialize versus those pursuing advanced general dentistry training. No significant differences were found among the students in different graduating classes.

  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. Toward Data-Driven Radiology Education-Early Experience Building Multi-Institutional Academic Trainee Interpretation Log Database (MATILDA).

    Science.gov (United States)

    Chen, Po-Hao; Loehfelm, Thomas W; Kamer, Aaron P; Lemmon, Andrew B; Cook, Tessa S; Kohli, Marc D

    2016-12-01

    The residency review committee of the Accreditation Council of Graduate Medical Education (ACGME) collects data on resident exam volume and sets minimum requirements. However, this data is not made readily available, and the ACGME does not share their tools or methodology. It is therefore difficult to assess the integrity of the data and determine if it truly reflects relevant aspects of the resident experience. This manuscript describes our experience creating a multi-institutional case log, incorporating data from three American diagnostic radiology residency programs. Each of the three sites independently established automated query pipelines from the various radiology information systems in their respective hospital groups, thereby creating a resident-specific database. Then, the three institutional resident case log databases were aggregated into a single centralized database schema. Three hundred thirty residents and 2,905,923 radiologic examinations over a 4-year span were catalogued using 11 ACGME categories. Our experience highlights big data challenges including internal data heterogeneity and external data discrepancies faced by informatics researchers.

  18. 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.

  19. POOR HEMOPOIETIC STEM CELL MOBILIZERS IN MULTIPLE MYELOMA : A SINGLE INSTITUTION EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Guillermo Jose Ruiz-Delgado

    2010-06-01

    Full Text Available In a single institution, in a group of 28 myeloma patients deemed eligible for autologous transplant, stem cell mobilization was attempted using filgrastim: 26 individuals were given 31 autografts employing 1-4 (median three apheresis sessions, to obtain a target stem cell dose of 1 x 106 CD34 viable cells / Kg of the recipient. The median number of grafted CD34 cells was 7.56 x 106  / Kg of the recipient; the range being 0.92 to 14.8.  By defining as poor mobilizers individuals in which a cell collection of 1 x 106 CD34 viable cells / Kg was better (80% at 80 months than those grafted with < 1 x 106 CD34 viable cells / Kg (67% at 76 months. Methods to improve stem cell mobilization are needed and may result in obtaining better results when autografting multiple myeloma patients.

  20. 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

  1. 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.

  2. [On the problems of getting an opinion, finding a decision when working in psychiatrie institutions. - Experiences with counselling a psychiatrie institution (author's transl)].

    Science.gov (United States)

    Veltin, A

    1981-08-01

    Exemplifying an occurrence within an every day's situation of a clinic makes obvious, how conflicts between claims of treatment and therapeutic reality can be present and painfully discussed. This can appear within that space of tension which is immanent to a institution of that kind. Emphasis is laid on the importance of institutional Counseling for the solving of these problems.

  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. 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…

  5. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  7. [Pulmonary carcinoid: analysis of a single institutional experience and prognostic factors].

    Science.gov (United States)

    Correia, Silvia da Silva; Pinto, Carlos; Bernardo, João

    2014-01-01

    IntroduçÉo: Os tumores carcinóides pulmonares sÉo tumores raros com origem nas células neuro-endócrinas do pulmÉo. Classificam-se de acordo com os critérios da OMS em carcinóides típicos ou atípicos. Quando comparados com outros tipos de neoplasia pulmonar, os tumores carcinóides apresentam melhor prognóstico.Objetivos: CaracterizaçÉo dos doentes com diagnóstico histológico de tumor carcinóide observados numa instituiçÉo. Análise dos fatores que influenciaram o prognóstico.Material e Métodos: Análise retrospetiva incluindo todos os doentes com diagnóstico histológico de tumor carcinóide pulmonar durante um período de 11 anos numa instituiçÉo. Os tumores foram classificados em típicos e atípicos de acordo com a classificaçÉo da OrganizaçÉo Mundial de Saúde de 2004. O estadiamento foi feito com base na classificaçÉo TNM de 2009 para o carcinoma do pulmÉo de nÉo pequenas células: T (Tumor); N (Ganglionar); M (Metástase).Resultados: Foram incluídos 59 doentes: 53 carcinóides típicos e seis carcinóides atípicos. Destes, 90% foram submetidos a cirurgia. O follow-up médio foi de 57 meses. A mortalidade operatória foi de 2% (n = 1) tratando-se de cirurgia paliativa para um doente em estádio IV. Em 49 doentes nÉo se verificou envolvimento ganglionar (N0), um doente apresentava doença N1, oito doença N2 e um doente doença N3. A sobrevivência global aos cinco anos foi de 79,2%: 80,2% nos carcinóides típicos e 66,7% nos carcinóides atípicos (p dados obtidos em estudos anteriores.Conclusões: Os tumores carcinóides pulmonares sÉo na maioria carcinóides típicos com uma excelente sobrevivência a longoprazo. A cirurgia de ressecçÉo é o tratamento de eleiçÉo nestes doentes. Os fatores relacionados com um pior prognóstico foram o subtipo histológico (carcinóides típicos versus carcinóides atípicos), o tamanho do tumor, o envolvimento ganglionar e a presença de metástases.

  8. Gorham-stout disease: the experience of the Rizzoli Institute and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Ruggieri, Pietro; Montalti, Maurizio; Angelini, Andrea; Mercuri, Mario [University of Bologna, Istituto Ortopedico Rizzoli, Department of Orthopedics, Bologna (Italy); Alberghini, Marco [Istituto Ortopedico Rizzoli, Anatomy and Pathological Histology Unit, Bologna (Italy)

    2011-11-15

    Gorham-Stout disease (also known as ''disappearing bone disease'') was first described by Jackson in 1838, but was properly defined by Gorham and Stout in a series of 24 patients in 1954-1955. It is a rare disease of unknown etiology (about 200 cases reported in the literature) characterized by spontaneous progressive resorption of bone without malignant proliferation of vascular structures. The diagnosis is one of exclusion and it is based on combined histological, radiological, and clinical features. Benign vascular proliferation with fatty bone marrow and thinning of bony trabeculae is a typical histological feature. Standard radiographs of disappearing bone disease show progressive bony resorption with adjacent soft tissue involvement. Most cases of Gorham-Stout disease resolve spontaneously, but prognosis remains unpredictable. This study reports 13 cases of Gorham-Stout disease treated in our institution from 1968 to 2008. The aim of the work was to review our series and the literature on this rare disease, as well as to evaluate whether or not an optimal treatment can be identified and recommended. (orig.)

  9. Radiological assessment of bone segments for transplantation: Experience at Rizzoli Orthopedic Institute

    Energy Technology Data Exchange (ETDEWEB)

    Tetta, Cecilia [Servizio di Radiologia e Diagnostica per Immagini, Dipartimento di Oncologia Muscolo-scheletrica I.F. Goidanich, Istituti Ortopedici Rizzoli, via G.C. Pupilli-1, 40136 Bologna (Italy)]. E-mail: ceciliatetta@katamail.com; Taddia, Nicoletta [Servizio di Radiologia e Diagnostica per Immagini, Dipartimento di Oncologia Muscolo-scheletrica I.F. Goidanich, Istituti Ortopedici Rizzoli, via G.C. Pupilli-1, 40136 Bologna (Italy); Poli, Tiziana [Servizio di Radiologia e Diagnostica per Immagini, Dipartimento di Oncologia Muscolo-scheletrica I.F. Goidanich, Istituti Ortopedici Rizzoli, via G.C. Pupilli-1, 40136 Bologna (Italy); Quinto, Carmelo [Servizio di Immunoematologia e Medicina Trasfusionale, Banca del Tessuto Muscolo-scheletrico, Istituti Ortopedici Rizzoli, Bologna (Italy); Fornasari, Pier Maria [Servizio di Immunoematologia e Medicina Trasfusionale, Banca del Tessuto Muscolo-scheletrico, Istituti Ortopedici Rizzoli, Bologna (Italy); Albisinni, Ugo [Servizio di Radiologia e Diagnostica per Immagini, Dipartimento di Oncologia Muscolo-scheletrica I.F. Goidanich, Istituti Ortopedici Rizzoli, via G.C. Pupilli-1, 40136 Bologna (Italy)

    2006-01-15

    Aim: To analyse results obtained from radiological assessment of skeletal segments stored in the musculoskeletal tissue bank (MTB) at Rizzoli Orthopaedic Institute. Materials and methods: Between January 1997 and June 2003, 891 bone segments underwent radiographic examination in two views. Two hundred and thirteen of these segments were examined by a radiologist between July 2002 and June 2003. Diagnostic evaluation was aimed at recognising relevant degenerative, traumatic and focal lesions. Focal lesions underwent histological tests. Results: Twenty-two lytic lesions were found in 12 segments. Ten of these were studied between July 2002 and June 2003 and two in the period before specialist radiological assessment. In the latter cases the lesions were identified by the orthopedic specialist who had examined the X-rays before planning surgery. Histological tests showed that the bone tissue was normal or involved by degenerative phenomena. Conclusions: We think donor screening should include radiological assessment of bone segments, performed according to standard parameters by a radiologist to identify bone lesions that may jeopardise the successful outcome of surgery.

  10. An institutional experience of 26 patients with Moyamoya disease: A study from Northwest India

    Directory of Open Access Journals (Sweden)

    Trilochan Srivastava

    2014-01-01

    Full Text Available Aim: Moyamoya disease (MMD is a slowly progressive bilateral stenocclusive process of the distal internal carotid and proximal portions of the anterior and middle cerebral arteries and the formation of an abnormal vascular network at the base of the brain. The purpose of this retrospective study was to identify clinical features, salient features, radiological features and yield of diagnostic cerebral angiography in MMD. Materials and Methods: We analyzed the records of 26 patients with MMD evaluated and treated at our institute from August 2010 until March 2013. Diagnosis of MMD was made on the basis of features of angiographic findings. Cerebral angiography showed typically fine network of vessels at the base of the brain with puff of smoke appearance suggestive of MMD. CT angiography (CTA was done in 25 (96.15% patients where as Digital substraction angiography (DSA was done in 18 (69.23% patients. Results: Out of the 26 patients 13 were in the pediatric age group and 13 were adults. At presentation 14 patients had infarcts and 10 patients had hemorrhages. Among the hemorrhagic group 20% had isolated intracerebral hemorrhage (ICH, 50% patients had ICH with intraventricular extension (IVE and 30% patients had primary intraventricular hemorrhage (PIVH. 50 % of the patients had involvement of the posterior circulation. Conclusion: Posterior circulation involvement is frequent in MMD. Though parenchymal bleed with/without intraventricular extension is the usual presentation of hemorrhagic MMD, isolated intraventricular hemorrhage could also be the mode of presentation.

  11. The prognostic value of pretreatment CA-125 levels and CA-125 normalization in ovarian clear cell carcinoma: a two-academic-institute study

    Science.gov (United States)

    Bai, Huimin; Sha, Guisha; Xiao, Meizhu; Gao, Huiqiao; Cao, Dongyan; Yang, Jiaxin; Chen, Jie; Wang, Yue; Zhang, Zhenyu; Shen, Keng

    2016-01-01

    Objectives The present study investigated the clinical implications of pretreatment carbohydrate antigen 125 (CA-125) levels and CA-125 normalization in patients with ovarian clear cell carcinoma (CCC), and it provides useful information for the improvement of monitoring strategies for this lethal disease. Methods The medical records of patients with ovarian CCC who had undergone primary staging surgery or cytoreductive surgery followed by systemic chemotherapy were retrospectively reviewed. A range of clinico-pathological parameters were collected and examined. Results A total of 375 women were included in the analysis. FIGO stage (p < 0.001) was identified as the only significant prognostic factor for relapse. Residual tumor and advanced stage (p = 0.001 and p < 0.001, respectively) were identified as independent adverse factors for survival. The potential risk factors associated with elevated pretreatment CA-125 levels included advanced-stage disease, positive residual tumors and negative endometriosis (p < 0.001, p = 0.001 and p <0.001, respectively). Pretreatment CA-125 levels were not associated with relapse-free survival (RFS) or overall survival (OS) (p = 0.060 and p = 0.176, respectively). CA-125 normalization after chemotherapy exhibited a positive linear correlation with advanced stage (r = 0.97, p = 0.001) and residual tumor (r = 0.81, p = 0.027) and a negative relationship with 5-year RFS (r = −0.97, p = 0.002) and 5-year OS (r = −0.97, p= 0.001). Patients with CA-125 levels that normalized before cycle 2 of chemotherapy had a similar prognosis as patients whose CA-125 levels normalized prior to chemotherapy (RFS: p = 0.327; OS: p = 0.654). By contrast, patients with CA-125 levels that normalized after cycle 2 of chemotherapy or never normalized were significantly more likely to experience disease progression. Conclusions Pretreatment CA-125 levels are not very useful for predicting clinical outcome. CA-125 levels following treatment are a valid

  12. 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. .

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Cosset, J.M.; Perdereau, B.; Dubray, B.; Helfre, S.; Brixy, F.; Gongora, R.; Fourquet, A. [Institut Curie, 26 rue d' Ulm, 75005 Paris (France)

    1999-12-01

    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)

  16. Ganglioglioma: Single-institutional experience of 24 cases with review of literature

    Science.gov (United States)

    Tandon, Vivek; Bansal, Sumit; Chandra, P. Sarat; Suri, Ashish; Tripathi, Manjari; Sharma, Mehar C.; Sarkari, Avijit; Mahapatra, Ashok K.

    2016-01-01

    Background: Ganglioglioma is a common seizure associated tumor. The goal of this study was to observe the postoperative outcome in patients with gangliogliomas. Material and Methods: A total 24 patients with gangliogliomas who underwent surgery at our institute from 2008 to 2011 were included. There were 13 males (54%) in our study. A retrospective analysis for the demographic profile, surgery and outcome was performed using STATA software. Literature on this subject was also reviewed, MEDLINE and PUBMED databases were searched. Observations: Sixteen patients presented with signs and symptoms of raised intracranial pressure and 12 patients had seizure disorder. Average age at surgery was 20 years (range 7-50 years). Twelve each were located in the temporal lobe and extra-temporal location. Intra-operative electrocorticography (ECoG) alone in three and image guidance alone were used in two patients, respectively. Both ECoG and image guidance were used in one patient and none of them was used in 18 patients. Gross total resection was achieved in 17 patients. After a mean follow-up of 1.6 years (range 3 months to 2.5 years), out of 12 patients with preoperative seizures, 10 (83.3%) were seizure free (Engel class-I) and 2 (16.6%) belonged to Engel class-II. None of the factors, including age at surgery, seizure duration prior to surgery, type of seizures, use of intra-operative ECoG and image guidance, extent of tumor resection, and surgical strategy proved to have significant correlation with postoperative seizure outcome. Conclusions: Surgical treatment is effective and safe for patients with gangliogliomas. Neither intra-operative ECoG nor image guidance necessarily leads to better seizure control, although they are useful adjunct for achieving safe and complete tumor resection. PMID:27695546

  17. [Cancer in Madagascar. Experience of the Institut Pasteur de Madagascar from September 1992 to June 1996].

    Science.gov (United States)

    Raharisolo Vololonantenaina, C; Pécarrère, J L; Roux, J F

    1998-01-01

    The Unit of the anatomo-pathology in the "Institut Pasteur de Madagascar" (IPM) examined in the period from September 1992 to June 1996 tissue specimens from 10,275 patients. Tumorous pathology presented 40% of the tissues and half of which were of malign etiology. 64% of the cancer diagnosed were in females. Cervical cancer was most frequently observed (17%), followed by breast cancer (16%). Cancer in the gastro-intestinal tract (15%) was most often located in the colon without sex difference. Stomach cancer occurring predominantly in males presented 25% of the total cases of cancer in the gastro-intestinal tract. Cancer of liver is rarely diagnosed despite the high prevalence of infection with hepatitis B virus. Skin cancer constituted 9% of the malign diagnosis and was mainly found in males. Children under 15 years old presented 7.4% of the total cases of malignancy with the haematopoietic tissues (30%) and the eyes (17%) as the most frequent topic locations. Due to a very low seroprevalence of the HIV in Madagascar, malign tumours associated to AIDS were only seen in a few rare cases. The review of cancer cases in the IPM may not be representative for the cancer epidemiology of Madagascar because of a general very low level of health care coverage, especially in the rural areas. Furthermore, a major part of the specimens originates from easily accessible organsystems, whereas other organs seem less investigated due to lack of appropriate available technique. Therefore, it is not feasible for the moment to establish a cancer register in Madagascar, although the Unit of Pathology in the IPM can offer a valid cancer diagnostical service.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Surgical management of Wilms tumor with intravascular extension: a single-institution experience.

    Science.gov (United States)

    Aspiazu, Diego; Fernandez-Pineda, Israel; Cabello, Rosa; Ramirez, Gema; Alvarez-Madrid, Antonio; De Agustin, Juan Carlos

    2012-02-01

    The purpose of this study was to retrospectively analyze the clinical presentation, treatment, and outcomes of children with Wilms tumor (WT) and intravascular extension who were treated at a single institution. A retrospective review was conducted of medical records of all children with Wilms tumor and intravascular extension treated at Virgen del Rocio Children's Hospital between 1992 and 2010. Seven patients (median age 3.4 years, range 2-8.1 years) were identified. At diagnosis, 6 of the 7 patients (85.7%) presented with tumor thrombus that reached the right atrium (RA) and 1 patient with infrahepatic inferior vena cava (IVC) thrombus. All patients received neoadjuvant chemotherapy (SIOP 2001 protocol) with vincristine, doxorubicin, and actinomycin D. Regression of the intravascular extension of the tumor was documented in all patients. Postchemotherapy level of extension was suprahepatic IVC in 1 patient, infrahepatic IVC in 2 patients, renal vein (RV) in 1 patient, and RA in 3 patients. Nephrectomy and thrombectomy were performed in all cases, requiring cardiopulmonary bypass for the 4 patients who presented with suprahepatic IVC and RA thrombus. The other 3 patients with infrahepatic IVC and RV involvement underwent cavotomy and thrombus extraction. Computed tomography, ultrasonography, and echocardiography were used for diagnosis and follow-up. All patients remain disease-free with a median follow-up of 6.3 years (range, 2-19 years). Neoadjuvant chemotherapy for WT with intravascular extension may facilitate the resection by decreasing the extent of the tumor thrombus. Cardiopulmonary bypass is indicated for suprahepatic IVC and RA involvement. Accurate diagnostic imaging is necessary.

  20. Single-incision laparoscopic cholecystectomy:Single institution experience and literature review

    Institute of Scientific and Technical Information of China (English)

    Yasumitsu; Hirano; Toru; Watanabe; Tsuneyuki; Uchida; Shuhei; Yoshida; Kanae; Tawaraya; Hideaki; Kato; Osamu; Hosokawa

    2010-01-01

    Single-incision laparoscopic surgery is a rapidly evolving field as a bridge between traditional laparoscopic surgery and natural orifice transluminal endoscopic surgery.We report one of the initial clinical experiences in Japan with this new technique.Four cases of gallbladder diseases were selected for this new technique.A single curved intra-umbilical 25-mm incision was made by pulling out the umbilicus.A 12-mm trocar was placed through an open approach,and the abdominal cavity was explored with a 10-mm ...

  1. Intra-arterial treatment with {sup 90}Y microspheres for hepatocellular carcinoma: 4 years experience at the Ghent University Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lambert, Bieke; Mertens, Jeroen; Oltenfreiter, Ruth [Ghent University Hospital, Department of Nuclear Medicine, Ghent (Belgium); Sturm, Emiel; Defreyne, Luc [Ghent University Hospital, Department of Vascular and Interventional Radiology, Ghent (Belgium); Smeets, Peter [Ghent University Hospital, Department of Radiology, Ghent (Belgium); Troisi, Roberto [Ghent University Hospital, Department of Hepatobiliary Surgery and Liver Transplantation, Ghent (Belgium); Vlierberghe, Hans van [Ghent University Hospital, Department of Gastroenterology and Hepatology, Ghent (Belgium)

    2011-12-15

    We report on our experience in terms of eligibility, safety, response and survival for treatment of hepatocellular carcinoma (HCC) with {sup 90}Y microspheres. Secondly, we investigated the urinary excretion of {sup 90}Y following treatment. We retrospectively reviewed all HCC patients referred to our department for {sup 90}Y microsphere treatment. We recorded reasons for not proceeding to actual treatment. In case treatment was performed, we assessed the tolerance (Common Terminology Criteria for Adverse Events v3.0, CTCAE v3.0), the response [modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria] and long-term survival (Kaplan-Meier). The urinary excretion was estimated by 12-h urine collections post-injection for analysis in a gamma counter. Forty-three HCC patients were referred for radioembolization. Fourteen patients were excluded, mainly due to unfavourable {sup 99m}Tc-macroaggregated albumin (MAA) distribution. Twenty-nine patients were treated with {sup 90}Y microspheres (TheraSphere, mean activity 2.17 GBq). In four patients severe clinical adverse events were encountered, however only in one case clearly related to the therapy. Twenty patients were assessable by mRECIST: complete response in 15%, partial response in 35%, stable disease in 30% and progression in 20% were observed. A median survival of 12.3 months (95% confidence interval 9.4-15.2) was estimated. Concerning the substudy on urinary excretion, only 0.0025% of the administered activity was excreted in the urine within the first 12 h following TheraSphere. Following a strict workup before admitting patients to radioembolization with TheraSphere, we found good clinical tolerance in the vast majority of patients. Radiological response assessment yielded an overall response rate of 50%, when evaluated early following treatment. Urine analysis showed consistently only low activities of {sup 90}Y excreted in the urine. (orig.)

  2. POOR HEMOPOIETIC STEM CELL MOBILIZERS IN MULTIPLE MYELOMA : A SINGLE INSTITUTION EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Aura Ramirez-Medina

    2010-05-01

    Full Text Available

                      In a single institution, in a group of 28 myeloma patients deemed eligible for autologous transplant, stem cell mobilization was attempted using filgrastim: 26 individuals were given 31 autografts employing 1-4 (median three apheresis sessions, to obtain a target stem cell dose of 1 x 106 CD34 viable cells / Kg of the recipient. The median number of grafted CD34 cells was 7.56 x 106  / Kg of the recipient; the range being 0.92 to 14.8.  By defining as poor mobilizers individuals in which a cell collection of < 1 x 106 CD34 viable cells / Kg was obtained, a subset of eight poor mobilizers was identified; in two patients the autograft was aborted because of an extremely poor CD34 cell yield (< 0.2 x 106 CD34 viable cells / Kg of the recipient after four apheresis sessions. The long-term overall survival of the patients grafted with > 1 x 106 CD34 viable cells / Kg was better (80% at 80 months than those grafted with < 1 x 106 CD34 viable cells / Kg (67% at 76 months. Methods to improve stem cell mobilization are needed and may result in obtaining better results when autografting multiple myeloma patients.

  3. Tumor surgery within cerebral eloquent areas: A two-institutions experience

    Directory of Open Access Journals (Sweden)

    Signorelli Francesco

    2014-07-01

    Full Text Available Introduction: Tumor surgery within eloquent areas represents a formidable challenge and the use of electrical cortico-subcortical stimulation mapping (ESM, allows to localize sensorimotor and language areas and pathways. Our aim is to point out methodological issues of ESM and its impact on outcome at the light of a prospective analysis of a two-institution series of 159 patients with lesions involving eloquent areas with a lengthy follow up. Material and Methods: All patients operated on for lesions involving eloquent areas between May 2000 and May 2010 at the Neurosurgical Department of the Neurological and Neurosurgical Hospital 'P. Wertheimer' in Lyon (France and at the Neurosurgical Department of the University Hospital in Catanzaro (Italy, were enrolled prospectively in our study. Results: Of 159 consecutive patients, 141 of them underwent surgical removal of the lesion with the aid of electrical cortico-subcortical stimulation mapping integrated in a setting of intraoperative localization of anatomic landmarks for eloquent areas. For the remaining 18 patients ESM was not deemed useful or feasible: 15 patients received a biopsy and 3 patients received tumor debulking under general anesthesia. For patients operated with ESM, it was possible to achieve a gross total removal of the lesion in 67,4% of cases (95 patients. One patient died in the immediate postoperative period for a pulmonary embolism. At a total mean follow-up of 62.8 months 78 patients were alive, 62 of which were recurrence free and had a KPS of 70% or more, while the other 80 patients had a mean survival time of 23.9 months, with a mean high quality survival period (KPS ≥ 70 of21.6 months. Discussion and Conclusion: Intraoperative electrical language and motor mapping, when feasible and indicated, consistently localizes eloquent cortical areas and subcortical pathways and allows to set the tumor resection boundaries according to functional limits, with a favorable impact

  4. Hepatobilio-pancreatic robotic surgery: initial experience from a single center institute.

    Science.gov (United States)

    Quijano, Yolanda; Vicente, Emilio; Ielpo, Benedetto; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Malave, Luis; Ferri, Valentina; Plaza, Carlos; Lindemann, Jan Lammel; D'Andrea, Vito; Caruso, Riccardo

    2016-12-30

    The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy. There were two left hepatectomies, one right hepatectomy, one associated liver partition and portal vein ligation staged procedure (both steps by robotic approach), three bisegmentectomies and three segmentectomies, eight wedge resections, and three pericystectomies. The mean operating time was 282 min. The overall conversion rate and postoperative complication rate were 4.7 and 19%, respectively. The mean length of hospital stay was 13.4 days (range 4-64 days). Of the 45 patients subjected to pancreatic resection, 22 were male and 23 female. The average age of all patients was 62 years (range 31-82 years). The mean operating room (OR) time was 370 min (120-780 min). Among the procedures performed were 15 pancreatico-duodenectomies, 19 distal pancreatectomies, and 11 enucleations. All procedures in the HBP area were R0. Our early experience shows that robotic surgery is a safe and feasible procedure in the HBP area. The complication and mortality rates are comparable to those of open surgery, but with the advantages of minimally invasive surgery.

  5. 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

    2016-01-01

    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.

  6. 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.

  7. 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.

  8. The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment.

    Science.gov (United States)

    McEwen, Jean E; Boyer, Joy T; Sun, Kathie Y; Rothenberg, Karen H; Lockhart, Nicole C; Guyer, Mark S

    2014-01-01

    For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

  9. Radiotherapy as an effective treatment modality for follicular lymphoma: a single institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seo Hee; Cho, Jae Ho; Kim, Jin Seok; Cheong, June Won; Suh, Chang Ok [Dept. of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.

  10. 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

  11. Spectrum of Childhood and Adolescent Ovarian Tumors in India: 25 Years Experience at a Single Institution

    Directory of Open Access Journals (Sweden)

    Ruchi Rathore

    2016-09-01

    Full Text Available BACKGROUND: Ovarian tumour in children and adolescent girls form an uncommon but important part of gynaecological malignancies. They account for 1% of all the childhood malignancies and 8% of all abdominal tumours in children. Since the ovarian cysts are thought to arise from mature follicles, these tumours were considered to be infrequent in the paediatric population. AIM: The rarity of this condition prompted us to conduct this study and share our experience on the incidence and clinicopathological features of different ovarian tumours in girls up to 20 years of age observed in last 25 years at a single tertiary care hospital. MATERIAL AND METHODS: This was a retrospective study conducted in the Department of Pathology at a tertiary hospital, Delhi. All ovarian tumours up to the age of 20 years in the past 25 years (1990-2014 were included for the purpose of studying the clinicopathological aspects of ovarian tumours in this age group. Descriptive statistics for prevalence and age-wise prevalence was done. Chi-square test, to find an association between the age, laterality and size with malignancy was performed. RESULTS: We received a total of 1102 cases of ovarian tumours over the period of 25 years  (1990 to 2014, of which 112 (10% cases were seen in girls up to 20 years of age. The mean age of the patients was 15.3 ± 4 years. The most common presenting complaint was pain abdomen (46.4 % There was a statistically significant correlation found between size and malignancy status of tumours in our study (p = 0.00. Of 112 cases of ovarian tumours, 39/112 (34.8% were malignant and 73/112 (65.2% were benign. Mature  cystic teratoma (27.6% was the most common type of benign tumour in this age group and immature teratomas were the most common type of malignant ovarian neoplasms. CONCLUSION: Premenarchal girls with ovarian masses may have varied presentations. Abdominal pain is the most common presenting complaint of young adolescent girls with

  12. Sociological Support for the Job Placement of Students and Graduates of Higher Educational Institutions: The Experience of the Moscow Institute of Aviation and Technology (MATI)

    Science.gov (United States)

    Bolotin, I. S.; Basalai, S. I.; Pugach, V. F.; Mikhailov, A. A.

    2013-01-01

    The weak connection between Russia's system of higher education and the labor market in Russia requires that greater attention be paid to preparing students for successful, employment. This will require more careful research into best practices, and the development of more effective links between employers and educational institutions.

  13. Pazopanib in metastatic renal cancer: a “real-world” experience at National Cancer Institute “Fondazione G. Pascale”

    Directory of Open Access Journals (Sweden)

    Sabrina Chiara Cecere

    2016-08-01

    Full Text Available Pazopanib is an oral angiogenesis inhibitor, currently approved for treatment of metastatic renal cell carcinoma (mRCC and soft tissue sarcoma. The present study analyzed the outcomes of pazopanib in first-line treatment of mRCC, in a single Italian cancer center. In the light of the retrospective, observational nature and the unselected population, our experience can be defined a real-world study. The medical records of 38 mRCC patients treated with front-line pazopanib were retrospectively reviewed and analyzed. The progression free survival (PFS and the overall survival (OS were the primary endpoints, while secondary objectives included Objective Response Rate (ORR, Disease Control Rate (DCR, and treatment tolerability. Pazopanib achieved a median PFS (mPFS of 12.7 months (95% CI, 6.9-18.5 months. The median OS (mOS was 26.2 months (95% CI, 12.6-39.9 months; the observed ORR and DCR were 30.3% and 72.7%, respectively, with a median duration of response of 11 weeks. mPFS appeared not to be influenced by number of co-morbidities (3, gender, Fuhrman grade and age. Conversely, the ORR and the DCR positively affect the mPFS (HR=0.05 [95% CI, 0.05-055], p=0.01; HR=0.10 [95% CI, 0.02-0.43], p=0.002 respectively. A worse outcome was associated with a lower mPFS in patients with liver metastases (p= 0.2 and with a high tumor burden (number of metastatic sites 6 (p= 0.08. Worst OS was observed in patients age >70 years old (HR=6.91 [95% CI, 1.49-31.91], p=0.01. The treatment was well tolerated: no grade 4 adverse events, nor discontinuation due to toxicities was reported. Grade 3 hypertension affected positively the OS reaching the statistical significance (HR=0.22 [95% CI, 0.05-0.8], p=0.03 and thyroid dysfunction (hypo and hyperthyroidism seems to correlate with better outcome in terms of a longer mPFS (HR=0.12 [95% CI, 0.02-0.78], p=0.02. Our results are consistent with those reported in prospective phase III trials and the published retrospective

  14. 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.

  15. Spray cryotherapy (SCT): institutional evolution of techniques and clinical practice from early experience in the treatment of malignant airway disease

    Science.gov (United States)

    Turner, J. Francis; Parrish, Scott

    2015-01-01

    Background Spray cryotherapy (SCT) was initially developed for gastroenterology (GI) endoscopic use in the esophagus. In some institutions where a device has been utilized by GI, transition to use in the airways by pulmonologists and thoracic surgeons occurred. Significant differences exist, however, in the techniques for safely using SCT in the airways. Methods We describe the early experience at Walter Reed National Military Medical Center from 2011 to 2013 using SCT in patients with malignant airway disease and the evolution of our current techniques and clinical practice patterns for SCT use in patients. In November 2013 enrollment began in a multi-institutional prospective SCT registry in which we are still enrolling and will be reported on separately. Results Twenty-seven patients that underwent 80 procedures (2.96 procedures/patient). The average age was 63 years with a range of 20 to 87 years old. The average Eastern Cooperative Oncology Group (ECOG) status was 1.26. All malignancies were advanced stage disease. All procedures were performed in the central airways. Other modalities were used in combination with SCT in 31 (39%) of procedures. Additionally 45 of the 80 (56%) procedures were performed in proximity to a silicone, hybrid, or metal stent. Three complications occurred out of the 80 procedures. All three were transient hypoxia that limited continued SCT treatments. These patients were all discharged from the bronchoscopy recovery room to their pre-surgical state. Conclusions SCT can be safely used for treatment of malignant airway tumor (MAT) in the airways. Understanding passive venting of the nitrogen gas produced as the liquid nitrogen changes to gas is important for safe use of the device. Complications can be minimized by adopting strict protocols to maximize passive venting and to allow for adequate oxygenation in between sprays. PMID:26807288

  16. [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.

  17. 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.

  18. 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.

  19. 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.

  20. League academic of clinical biochemistry: implementation of experience and participation in first on academic in higher education institution of Juazeiro do Norte – Ceará

    Directory of Open Access Journals (Sweden)

    Vanderlan Nogueira Holanda

    2015-12-01

    Full Text Available The creation of Academic Leagues in private institutions is usual today. The Academic League of Clinical Biochemistry (LABiC from the Faculdade Leão Sampaio was designed by students of Biomedicine course in 2014 and is the first Academic League of this institution. The research outlined here presents exploratory, descriptive, qualitative approach. It was carried out in a higher education institution of Juazeiro do Norte - CE during June of 2015. As a tool for data collection, we used a questionnaire that was applied to members of LABiC in order to investigate their experiences in relation to the participation in the Academic League. The creation of the first Academic League in a higher education institution of the Cariri region was extremely positive and accepted by the academic community. One year after the creation of LABiC other leagues were created reaffirming the important result of this relevant outreach activity.

  1. Pazopanib in Metastatic Renal Cancer: A “Real-World” Experience at National Cancer Institute “Fondazione G. Pascale”

    Science.gov (United States)

    Cecere, Sabrina C.; Rossetti, Sabrina; Cavaliere, Carla; Della Pepa, Chiara; Di Napoli, Marilena; Crispo, Anna; Iovane, Gelsomina; Piscitelli, Raffaele; Sorrentino, Domenico; Ciliberto, Gennaro; Maiolino, Piera; Muto, Paolo; Perdonà, Sisto; Berretta, Massimiliano; Pignata, Sandro; Facchini, Gaetano; D'Aniello, Carmine

    2016-01-01

    Pazopanib is an oral angiogenesis inhibitor, currently approved for treatment of metastatic renal cell carcinoma (mRCC) and soft tissue sarcoma. The present study analyzed the outcomes of pazopanib in first-line treatment of mRCC, in a single Italian cancer center. In the light of the retrospective, observational nature and the unselected population, our experience can be defined a “real-world” study. The medical records of 38 mRCC patients treated with front-line pazopanib were retrospectively reviewed and analyzed. The progression free survival (PFS) and the overall survival (OS) were the primary endpoints, while secondary objectives included objective response rate (ORR), disease control rate (DCR), and treatment tolerability. Pazopanib achieved a median PFS (mPFS) of 12.7 months (95% CI, 6.9–18.5 months). The median OS (mOS) was 26.2 months (95% CI, 12.6–39.9 months); the observed ORR and DCR were 30.3 and 72.7%, respectively, with a median duration of response of 11 weeks. mPFS appeared not to be influenced by number of co-morbidities (< 3 vs. ≥3), gender, Fuhrman grade and age. Conversely, the ORR and the DCR positively affect the mPFS (HR = 0.05 [95% CI, 0.05–0.55], p = 0.01; HR = 0.10 [95% CI, 0.02–0.43], p = 0.002, respectively). A worse outcome was associated with a lower mPFS in patients with liver metastases (p = 0.2) and with a high tumor burden (number of metastatic sites < 6 vs. ≥6) (p = 0.08). Worst OS was observed in patients aged ≥70 years old (HR = 6.91 [95% CI, 1.49–31.91], p = 0.01). The treatment was well-tolerated: no grade 4 adverse events, nor discontinuation due to toxicities was reported. Grade 3 hypertension affected positively the OS reaching the statistical significance (HR = 0.22 [95% CI, 0.05–0.8], p = 0.03). Thyroid dysfunction (hypo and hyperthyroidism) seems to correlate with better outcome in terms of a longer mPFS (HR = 0.12 [95% CI, 0.02–0.78], p = 0.02). Our results are consistent with those reported in

  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. 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

  4. My Experience as a Student Participant in the Institute for Geophysics/Huston-Tillotson University Geodiversity Project

    Science.gov (United States)

    Putman, N.; Ellins, K.; Holt, J.; Olson, H. C.

    2006-12-01

    As a senior pre-service teacher at Huston-Tillotson University, a minority-serving institution in Texas, I found myself in need of a science course and reluctantly enrolled in "Special Topics in the Geosciences," a survey course taught by visiting scientists from The University of Texas at Austin's Institute for Geophysics (UTIG). I had no idea what the geosciences were about. On the first day of class we took a test and I began to feel a sense of foreboding, but after speaking with the instructors, I left filled with excitement. With my limited background in science, I knew that the class was going to be challenging and require a lot of studying. I took every opportunity offered in the class to learn more about the geosciences. If there was a field trip, I went. If there was an opportunity for me to speak to children about what I learned, I did. For example, I participated in the Explore UT open house event where, rather than being an observer as I had expected, I found myself explaining earthquake seismology to students, parents and visitors. The experience was pivotal. As I explained to a small group of 3rd graders how they could use computer applications to observe and understand seismic waves, I realized I wanted to be a science teacher and not an elementary level-teacher as I had planned. Since completing "Special Topics in the Geosciences," I've been an undergraduate research assistant at UTIG. Over the summer, I adapted approximately ten existing UTIG Earth Science learning activities into the 5-E instructional model for the fall 2006 professional development Earth Science Revolution Workshops for in- service teachers, and I developed a new lesson on tides for these workshops. I also participated in presenting both a workshop for minority-serving elementary teachers and a class for alternative certification teachers at HTU. In early September, I joined a group of scientists, engineers, and space-suited "astronauts" in the Arizona desert near Meteor Crater

  5. Language Anxiety: A Case Study of the Perceptions and Experiences of Students of English as a Foreign Language in a Higher Education Institution in the United Arab Emirates

    Science.gov (United States)

    Lababidi, Rola Ahmed

    2016-01-01

    This case study explores and investigates the perceptions and experiences of foreign language anxiety (FLA) among students of English as a Foreign Language in a Higher Education Institution in the United Arab Emirates. The first phase explored the scope and severity of language anxiety among all Foundation level male students at a college in the…

  6. A Day in the Life of African American and European American College Students: Daily Affective Experience and Perceptions of Climate at a Predominantly White Institution

    Science.gov (United States)

    Birk, Nancy Adair

    2009-01-01

    In the context of the under-representation of African Americans in higher education and the lawsuits targeting affirmative action policies in college admissions, the purpose of this study was to examine the daily affective experiences of African American and European American students at a predominantly White institution, exploring the activities…

  7. [Hepatic fine needle aspiration biopsy. Experience in the study of hepatic masses at the Salvador Zubiran National Institute of Nutrition].

    Science.gov (United States)

    Angeles-Angeles, A; Gamboa-Domínguez, A; Velázquez Fernández, D; Muñoz-Fernández, L

    1994-01-01

    The results of 114 fine-needle aspiration biopsies (FNAB) of the liver performed during six years (1987-1992) at the Departament of Pathology of the Instituto Nacional de la Nutrición Salvador Zubirán are presented. All were done by radiologists under ultrasonographic (three cases) or computerized tomographic guidance (111 cases). In order to determine the diagnostic accuracy, diagnoses made by FNAB were compared with those made by histological examination (coarse biopsies or surgical specimens) and/or by other diagnostic procedures including the clinical follow-up. Six cases were excluded because clinical information was not available. In 92 cases (85.2%) a correct diagnosis was made, in six (5.5%) the sample was inadequate and in 10 (9.3%) the diagnosis made by FNAB was incorrect. The diagnoses made were as follows: hepatocarcinoma 44, metastatic carcinoma 27, inflammatory lesions 12, regeneration 10, normal eight, unclassified carcinoma five, and lymphoma two. The sensitivity was 96.2, specificity 93.1, positive predictive value 97.4, negative predictive value 90.0, accuracy 95.3 and prevalence 73.1. There were three false negative and two false positive for carcinoma. These figures are similar to those found by other authors. No relevant complications were observed. It is concluded that FNAB of the liver is a safe, inexpensive and reliable method in the diagnoses of liver masses.

  8. TEACHERS' EXPERIENCES IN EDUCATIONAL MULTI-MEDIA CONTENT DEVELOPMENT The case of Tanzania’s Institute of Adult Education

    Directory of Open Access Journals (Sweden)

    Belingtone Eliringia MARIKI

    2014-10-01

    Full Text Available This paper is an academic observation of an Educational Multimedia Content development-training programme funded by the Commonwealth of Learning (COL in Tanzania. This project focused on skills development in script writing and in radio and video programme development, aimed at transforming selected subjects from text to multimedia content. The ultimate objective was to enable better and easy understanding of the lessons, for Open and Distance Learning learners. A group of 25 teachers from the Tanzania’s Institute of Adult Education participated in the training and development of the programmes. In this paper the author shares the new and exciting experiences of teachers on adding such skills to their professional career, as the development of these programmes. Author’s own participation and interviews with peers in the project were employed as methods of data collection. A total number of 13 videos and 12 radio programmes were developed over the span of six months. Five school subjects were covered, namely: English, Mathematics, Biology, History and Geography. Some of the challenges encountered in developing the programmes included: difficulties in developing a video idea from the textbooks; working as a group online in collaboration with the training consultant in another country especially in script development; memorizing words (as actors playing in the productions and saying it on camera; and time constraints (working under pressure. The author recommends to African nations and educators in other parts of the world to access these multimedia-learning programmes online since they are OER, and to use them in their context. The video and radio programmes reflect the Tanzanian context to some extent, but most of the lessons are general for use by any country. The paper concludes that skills development on technological innovations among ODL teachers in both formal and non-formal education system is essential towards attaining EFA goals.

  9. 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.

  10. 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

  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. 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.

  13. 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.

  14. 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

    OpenAIRE

    Maurilio Toscano de Lucena; Adauto Barros; Antônio Booz; Carlos Loyo; Carlos Uchôa; Ernesto Roesler; Fernando Monteiro; Francisco Sarmento; Joaquim Herbênio; José Edson dos Santos; Marcelo Padilha; Maurício Matos; Paula Gomes Lobo; Roberto Regis; Roberta Torreão

    2010-01-01

    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,...

  15. Radiation treatment of early vocal cord carcinoma. Eighteen years experience at "Instituto de Oncologia y Radioterapia de Mar del Plata".

    Science.gov (United States)

    Castro Vita, H

    1990-01-01

    A detailed retrospective analysis of 260 patients with T 1 NO MO vocal cord carcinoma treated at "Instituto de Oncologia y Radioterapia de Mar del Plata" from 1967 to 1985 was performed. The majority of the patients were in the age range of 50 to 79 years, and 79% were males. The overall observed three year tumor free survival was 85.3%. When survival rate was adjusted for intercurrent disease and second primary tumor death, the 3 year tumor free survival was 92%. Sixty two percent of the patients (17/27) undergoing surgical salvage for recurrence, were controlled. Second primary tumors were seen in 18 patients (6.9%). It is emphasized the importance of close follow up to diagnose as early as possible both the vocal cord recurrence and the second primary tumors.

  16. Results of radiation therapy in stage 1B cervical carcinoma at King Chulalongkorn Memorial Hospital: fifteen-year experience.

    Science.gov (United States)

    Lertbutsayanukul, C; Lertsanguansinchai, P; Shotelersuk, K; Khorprasert, C; Rojpornpradit, P; Asavametha, N; Pataramontree, J; Suriyapee, S; Tresukosol, D; Termrungruanglert, W

    2001-06-01

    A retrospective study was performed on 131 patients with stage 1B cervical carcinoma who were referred and treated with external beam radiation and intracavitary brachytherapy at the Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between February 1985 and February 2000. Primary outcomes were overall survival rate, progression free survival rate, recurrence, and treatment-related complications. The treatment results from different sources of intracavitary radiation therapy were secondary endpoints. The number of patients treated with Ra-226, Cs-137, and Ir-192 intracavitary irradiation were 12, 84, and 35 patients respectively. The median follow-up times were 69, 59, and 21 months for Ra-226, Cs-137, and Ir-192, respectively. Actuarial 5-year overall survival rate was 89 per cent. The 5-year progression free survival rate was 80 per cent. Actuarial 5-year survival and progression free survival rate were comparable among different sources of intracavitary brachytherapy (p = 0.553 and p=0.793, respectively). The overall recurrent rate was 16.8 per cent. Of the recurrence; 40.9 per cent was locoregional, 54.6 per cent was distant failure, and 4.5 per cent was combined locoregional and distant failure. The overall complication rate was 25.95 per cent. The severe complication rates (Grade III-V) from treatment occurred in the urinary bladder (0.76%) and in the small bowel (0.76%.) These results suggest that radiation therapy alone is an effective treatment for stage 1B cervical carcinoma. Additionally, all types of intracavitary brachytherapy provide comparable clinical results.

  17. Core binding factor acute myeloid leukemia (CBF-AML) in México: a single institution experience.

    Science.gov (United States)

    Ruiz-Delgado, Guillermo J; Macías-Gallardo, Julio; Lutz-Presno, Julia; Garcés-Eisele, Javier; Hernández-Arizpe, Ana; Montes-Montiel, Maryel; Ruiz-Argüelles, Guillermo J

    2011-01-01

    Twenty one patients with CBF-AML presented prospectively in the Centro de Hematología y Medicina Interna de Puebla (Puebla, México) between February 1995 and March 2010, 14 with the t(8;21)(q22;q22) and 7 with the inv(16)(p13;q22)/t(16;16)(p13;q22); they represent 13% of all cases of AML. The median age of the patients was 24 years (range 1 to 61). Seven of 14 patients with t(8;21)(q22;q22) had an M2 morphology whereas 3/7 with the inv(16) had an M4 morphology; in addition to the myeloid markers identified by flow-cytometry (surface CD13, surface CD33, and cytoplasmic myeloperoxidase) lymphoid markers were identified in the blast cells of 8/14 cases of the t(8;21) patients, but in no patient with the inv(16). Nineteen patients were treated with combined chemotherapy and 16 (84%) achieved a complete molecular remission. Seven patients were auto or allografted. Relapses presented in 10/16 patients. The median probability of overall survival (OS) has not been reached being above 165 months, whereas the 165-month probability of OS and leukemia-free survival was 52%; despite a tendency for a better outcome of patients with the t(8;21), there were no significant differences in survival of patients with either the t(8;21) or the inv(16). In this single institution experience in México, we found that the CBF variants of AML have a similar prevalence as compared with Caucasian populations, that the co-expression of lymphoid markers in the blast cells was frequent in the t(8;21) and that these two AML subtypes were associated with a relatively good long-term prognosis. Further studies are needed to describe with more detail the precise biological features of these molecular subtypes of acute leukemia.

  18. Squamous Cell Carcinoma

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Squamous cell carcinoma Overview Squamous cell carcinoma: This man's skin ... a squamous cell carcinoma on his face. Squamous cell carcinoma: Overview Squamous cell carcinoma (SCC) is a ...

  19. 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.

  20. 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.

  1. Validation of the histologic grading for ovarian clear cell adenocarcinoma: a retrospective multi-institutional study by the Japan Clear Cell Carcinoma Study Group.

    Science.gov (United States)

    Yamamoto, Sohei; Kasajima, Atsuko; Takano, Masashi; Yaegashi, Nobuo; Fujiwara, Hiroyuki; Kuzuya, Kazuo; Kigawa, Junzo; Tsuda, Hiroshi; Kurachi, Hirohisa; Kikuchi, Yoshihiro; Sugiyama, Toru; Tsuda, Hitoshi; Moriya, Takuya

    2011-03-01

    Pathologic slides from 150 patients with clear cell adenocarcinoma from the collaborating institutions were reviewed independently by 2 pathologists, and each tumor was graded histologically using the Shimizu-Silverberg and International Federation of Gynecology and Obstetrics (FIGO) grading systems. For the Shimizu-Silverberg grading system, 3 parameters-architectural pattern, nuclear pleomorphism, and mitotic activity-were assessed and scored as 1 to 3. When the summed scores of these parameters were 3 to 5, 6 to 7, and 8 to 9, grades 1, 2, and 3 were assigned, respectively. The FIGO grade was based on the ratio of glandular/papillary growth versus solid growth: grade 1, less than 5% solid tumor; grade 2, 5% to 50% solid tumor; grade 3, greater than 50% solid tumor. Interobserver agreement levels for assignment of both gradings were fair (κ=0.32 and 0.24, respectively). After consensus had been acquired, 82 (55%), 56 (37%), and 12 (8%) tumors were classified as grades 1, 2, and 3 by the Shimizu-Silverberg grading system, and 88 (59%), 38 (25%), and 24 (16%) were classified as grades 1, 2, and 3 by the FIGO grading system, respectively. Survival analyses indicated that patients with grade 3 tumors, as defined by both the grading systems, tended to have a poor outcome, but any differences between them were not statistically significant. Multivariate analysis showed that only the presence of residual tumor after initial surgery was an independent prognostic factor for overall survival. These results suggest that the 2 tested grading systems have limited value for the prognostication of patients with clear cell adenocarcinoma, and that a more effective grading system for this tumor may be required.

  2. A somatostatin-secreting cell line established from a human pancreatic islet cell carcinoma (somatostatinoma): release experiment and immunohistochemical study.

    Science.gov (United States)

    Iguchi, H; Hayashi, I; Kono, A

    1990-06-15

    Production and secretion of somatostatin (SRIF) were studied using a carcinoembryonic antigen (CEA)-producing cell line (QGP-1) established from a human pancreatic islet cell carcinoma. High concentrations of SRIF (274 +/- 51 ng/mg of protein, mean +/- SD, n = 5) and CEA (3083 +/- 347 ng/mg of protein, mean +/- SD, n = 5) were present in QGP-1 cells, and the basal secretion rates of SRIF and CEA by the cells (n = 5) were 46.4 +/- 4.8 and 1690 +/- 78 pg/10(5) cells/h, respectively. Immunohistochemical studies revealed the presence of SRIF in xenografts of QGP-1 cells and colocalization of SRIF and CEA. Secretion of SRIF by QGP-1 cells was stimulated in the presence of high K+ (50 mmol) and theophylline (10 mmol), but arginine (10 mmol) and glucose (300 mg/dl) had no effect on the SRIF secretion. The QGP-1 cell line may be useful for studying the regulation mechanism of SRIF secretion.

  3. The management of carcinoma of the anal canal by external beam radiotherapy, experience in Vancouver 1971-1988

    Energy Technology Data Exchange (ETDEWEB)

    Newman, G. (Bristol Oncology Centre (United Kingdom)); Calverley, D.C.; Acker, B.D.; Manji, M.; Hay, J.; Flores, A.D. (British Columbia Cancer Inst., Vancouver, BC (Canada))

    1992-11-01

    From 1971 to 1988 72 cases of carcinoma of the anal canal were treated by external beam radiotherapy, most commonly by 5000 cGy in 20 fractions given over 4 weeks. The actuarial survival at 5 years was 66% and the disease specific survival 78%. Nine patients had inguinal node metastases at diagnosis; their 5-year disease specific survival was 75%. 63 Patients were inguinal node negative at presentation; their 5-year specific survival was 78%, by UICC 1987 staging: T[sub 1] 71%, T[sub 2] 88%, T[sub 3] 41%, T[sub 4] 42%. 17 Patients developed local recurrence; 10 were suitable for abdominoperineal resection which was successful in 7. The probability of local control was related to T stage. 13 patients were left with a colostomy because of recurrence, 2 had a colostomy for radiation damage and 4 had their local recurrence managed palliatively, without a colostomy. As a result, 53 of the 72 patients (74%) were left with a functional anus. Severe late complications occurred in 6 (8%). (author). 13 refs., 3 figs., 7 tabs.

  4. Sebaceous Carcinoma

    Science.gov (United States)

    ... Hill Medical; 2008. p. 240-9. Nelson BR, Hamlet KR, Gillard M et al. “Sebaceous carcinoma.” J ... Acad Dermatol . 2003 48:401-8. Nelson BR, Hamlet KR, Gillard M et al . “Sebaceous carcinoma.” J ...

  5. From clinical trials to the front line: Vinflunine for Treatment of UrothelialCell Carcinoma at the National Cancer Institute of Naples

    Directory of Open Access Journals (Sweden)

    GAETANO eFACCHINI

    2016-05-01

    Full Text Available 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. Management of malignant phyllode tumors of the breast: the experience of the Institut Curie; Prise en charge des tumeurs phyllodes malignes du sein: l'experience de l'Institut Curie

    Energy Technology Data Exchange (ETDEWEB)

    Haberer, S.; Kirova, Y.M.; Dendale, R.; Campana, F.; Miranda, O.; Fourquet, A.; Bollet, M.A. [Institut Curie, Dept. de Radiotherapie Oncologique, 75 - Paris (France); Lae, M. [Institut Curie, Dept. de Biologie des Tumeurs, 75 - Paris (France); Seegers, V. [Institut Curie, Dept. de Biostatistiques, 75 - Paris (France); Pierga, J.Y. [Institut Curie, Dept. d' Oncologie Medicale, 75 - Paris (France); Salmon, R.; Reyal, F. [Institut Curie, Dept. de Chirurgie, 75 - Paris (France)

    2009-07-15

    Purpose Given the scarcity of malignant phyllode tumours of the breast and the absence of consensus regarding their management justify the need for institutional retrospective evaluations of clinical practices. Patients and methods Retrospective study with central pathology review of the 25 consecutive patients treated at the Institut Curie (Paris, France) between 1969 and 2006 for non metastatic malignant phyllodes tumors of the breast. The median follow-up was 65 months (7-257 months). Results Median age at diagnosis was 52 years (20-64 years). Breast surgery was conservative in five patients (20%). Surgical margins were wide (> 10 mm), narrow, involved or unknown in respectively 17 (68%), three (12%), three (12%) and two (8%) patients. Median tumour size was 65 mm (12-250 mm). Adjuvant radiotherapy was delivered in seven (28%) patients (two patients, post tumor-ectomy; five patients, post mastectomy) and 13 patients (52%) received anthracycline-based adjuvant chemotherapy. Five-year overall survival rate was 91% (95% CI, 80-100%). Five patients (20%) developed distant metastases (one after chemotherapy) and three (12%) locoregional relapse (one after tumor-ectomy and unknown margin without radiotherapy, two after mastectomy and involved margins with radiotherapy). Conclusion Wide breast surgery (that can be conservative in selected patients) is the mainstay of the treatment of non metastatic malignant phyllodes tumors of the breast. To better determine the respective roles of adjuvant systemic treatment and radiotherapy, further clinical studies and the search for new prognostic and predictive factors remain necessary. (authors)

  12. 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.

  13. 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.

  14. ORIENTATION ON STAKEHOLDERS’ OBJECTIVES AS A KEY COMPETENCE OF IMAGE FORMATION OF THE EDUCATIONAL INSTITUTIONS OF HIGHER EDUCATION (GERMAN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    E. N. Kovaleva

    2015-01-01

    Full Text Available Summary. Creating relevant targets activities of marketing model of image formation of the educational organization of higher education is not possible without a systematic approach to understanding the purpose of the key stakeholder organizations that are not only state controls system (one of the stakeholders, but also a number of other, no less important: applicants, students, alumni, members of the business community. In Russia, the opinion of stakeholders in the organization of the learning process is not widely used in the practice of evaluation of educational institutions of higher education, with the exception of the activities implemented in some universities of quality management systems. The article explains the need to reorient the objectives and criteria for measuring the efficiency of the educational institutions of higher education in the target key stakeholder groups. The author has made a comparative analysis of the basic regulations of Russia and Germany in the field of higher education to establish the objectives of the universities and their orientation to target stakeholders. It revealed a possible mechanism for measuring the satisfaction of the stakeholders of the educational activities of the organization on the basis of benchmarking analysis of multi-dimensional ranking higher education programs in Germany. The activities of the state and the public in Germany shows that the estimate legitimate stakeholder groups can be used to assess the activity of educational institutions, the formation of a rational demand for educational services, improve the activities of universities and the formation of objective information field of competitive relations of universities. Focusing on the needs of the stakeholders may not be manifested hypothetical task of universities and law enshrined in the form of goals and objectives of universities imperative to correlate with national interests, the interests of the professional community as

  15. Epstein-Barr virus (EBV) association and latency profile in pediatric Burkitt's lymphoma: experience of a single institution in Argentina.

    Science.gov (United States)

    Lara, Julia; Cohen, Melina; De Matteo, Elena; Aversa, Luis; Preciado, Maria Victoria; Chabay, Paola

    2014-05-01

    The aim of this study is to characterize EBV expression and latency pattern in pediatric Burkitt's lymphoma in a single institution in Argentina. EBV-encoded RNA or protein was analyzed in 27 patients. EBERs was expressed in 37% of patients (29% of immunocompetent and 100% of immunosuppressed patients). EBV-positive cases were observed exclusively in patients younger than 5 years old. EBV association with immunocompetent patients exhibits the sporadic pattern in region under study, while its presence in patients infected with HIV was higher than described previously. EBV latency I profile was present in most of the patients, except for two immunosuppressed patients who displayed LMP1 expression.

  16. The Role of Liquid Based Cytology and Ancillary Techniques in the Peritoneal Washing Analysis: Our Institutional Experience

    Science.gov (United States)

    Rossi, Esther; Bizzarro, Tommaso; Martini, Maurizio; Longatto-Filho, Adhemar; Schmitt, Fernando; Fagotti, Anna; Scambia, Giovanni; Zannoni, Gian Franco

    2017-01-01

    Background The cytological analysis of peritoneal effusions serves as a diagnostic and prognostic aid for either primary or metastatic diseases. Among the different cytological preparations, liquid based cytology (LBC) represents a feasible and reliable method ensuring also the application of ancillary techniques (i.e immunocytochemistry-ICC and molecular testing). Methods We recorded 10348 LBC peritoneal effusions between January 2000 and December 2014. They were classified as non-diagnostic (ND), negative for malignancy-NM, atypical-suspicious for malignancy-SM and positive for malignancy-PM. Results The cytological diagnosis included 218 ND, 9.035 NM, 213 SM and 882 PM. A total of 8048 (7228 NM, 115SM, 705 PM) cases with histological follow-up were included. Our NM included 21 malignant and 7207 benign histological diagnoses. Our 820 SMs+PMs were diagnosed as 107 unknown malignancies (30SM and 77PM), 691 metastatic lesions (81SM and 610PM), 9 lymphomas (2SM and 7PM), 9 mesotheliomas (1SM and 8SM), 4 sarcomas (1SM and 3PM). Primary gynecological cancers contributed with 64% of the cases. We documented 97.4% sensitivity, 99.9% specificity, 98% diagnostic accuracy, 99.7% negative predictive value (NPV) and 99.7% positive predictive value (PPV). Furthermore, the morphological diagnoses were supported by either 173 conclusive ICC results or 50 molecular analyses. Specifically the molecular testing was performed for the EGFR and KRAS mutational analysis based on the previous or contemporary diagnoses of Non Small Cell Lung Cancer (NSCLC) and colon carcinomas. We identified 10 EGFR in NSCCL and 7 KRAS mutations on LBC stored material. Conclusions Peritoneal cytology is an adjunctive tool in the surgical management of tumors mostly gynecological cancers. LBC maximizes the application of ancillary techniques such as ICC and molecular analysis with feasible diagnostic and predictive yields also in controversial cases. PMID:28099523

  17. [Anatomical Vitamin C-Research during National Socialism and the Post-war Period: Max Clara's Human Experiments at the Munich Anatomical Institute].

    Science.gov (United States)

    Schûtz, Mathias; Schochow, Maximilian; Waschke, Jens; Marckmann, Georg; Steger, Florian

    2014-01-01

    In autumn of 1942, Max Clara (1899-1966) became chairman of the anatomical institute Munich. There, he intensified his research concerning the proof of vitamin C with the bodies of executed prisoners which were delivered by the Munich-Stadelheim prison. This research on human organs was pursued by applying ascorbic acid (Cebion) to prisoners before their execution. The paper investigates this intensified and radicalized anatomical research through human experiments, which Max Clara conducted in Munich and published from Istanbul during the postwar years, as well as its scientific references from the Nazi period.

  18. Basal Cell Carcinoma

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Basal cell carcinoma Overview Basal cell carcinoma: This skin cancer ... that has received years of sun exposure. Basal cell carcinoma: Overview Basal cell carcinoma (BCC) is the ...

  19. Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience.

    Science.gov (United States)

    Walker, R; Kessar, P; Blanchard, R; Dimasi, M; Harper, K; DeCarvalho, V; Yucel, E K; Patriquin, L; Eustace, S

    2000-04-01

    This study was undertaken to assess the utility of whole-body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) to detect metastases to liver, brain, and bone as a single examination in women with breast cancer. Seventeen patients with biopsy-proven breast cancer and suspected metastatic disease attending over a 12-month period referred for both conventional imaging and whole-body MRI were included in the study. Three patients were found to be free of metastases at both conventional and MR imaging. Appendicular or axial skeletal metastases were identified in 11 of 17 patients, with correlation between findings at whole-body MRI and scintigraphy in 15 of the 17 patients. Five patients had evidence of hepatic metastases on whole-body MRI, of which metastases were identified in only three patients at CT despite contrast enhancement. Four patients had brain abnormalities (metastases in three patients, meningioma in one patient) detected on both whole-body and dedicated brain MRI. Preliminary clinical experience suggests that turbo STIR whole-body MRI may represent a convenient and cost-effective method of total body screening for metastases in patients with breast carcinoma.

  20. Transjugular Intrahepatic Portosystemic Shunt for Treatment of Cirrhosis-related Chylothorax and Chylous Ascites: Single-institution Retrospective Experience

    Energy Technology Data Exchange (ETDEWEB)

    Kikolski, Steven G., E-mail: skikolski@ucsd.edu; Aryafar, Hamed, E-mail: haryafar@ucsd.edu; Rose, Steven C., E-mail: scrose@ucsd.edu [University of California San Diego Health Sciences, Department of Radiology (United States); Roberts, Anne C., E-mail: acroberts@ucsd.edu [University of California San Diego Health Sciences, Department of Vascular and Interventional Radiology (United States); Kinney, Thomas B., E-mail: tbkinney@ucsd.edu [University of California San Diego Health Sciences, Department of Radiology (United States)

    2013-08-01

    PurposeTo investigate the efficacy and safety of the use of transjugular intrahepatic portosystemic shunt (TIPS) creation to treat cirrhosis-related chylous collections (chylothorax and chylous ascites).MethodsWe retrospectively reviewed data from four patients treated for refractory cirrhosis-related chylous collections with TIPS at our institution over an 8 year period.ResultsOne patient had chylothorax, and three patients had concomitant chylothorax and chylous ascites. There were no major complications, and the only procedure-related complications occurred in two patients who had mild, treatable hepatic encephalopathy. All patients had improvement as defined by decreased need for thoracentesis or paracentesis, with postprocedure follow-up ranging from 19 to 491 days.ConclusionTIPS is a safe procedure that is effective in the treatment of cirrhosis-related chylous collections.

  1. Accreditation of medical laboratories in Croatia--experiences of the Institute of Clinical Chemistry, University Hospital "Merkur", Zagreb.

    Science.gov (United States)

    Flegar-Mestrić, Zlata; Nazor, Aida; Perkov, Sonja; Surina, Branka; Kardum-Paro, Mirjana Mariana; Siftar, Zoran; Sikirica, Mirjana; Sokolić, Ivica; Ozvald, Ivan; Vidas, Zeljko

    2010-03-01

    Since 2003 when the international norm for implementation of quality management in medical laboratories (EN ISO 15189, Medical laboratories--Particular requirements for quality and competence) was established and accepted, accreditation has become practical, generally accepted method of quality management and confirmation of technical competence of medical laboratories in the whole world. This norm has been translated into Croatian and accepted by the Croatian Institute for Norms as Croatian norm. Accreditation is carried out on voluntary basis by the Croatian Accreditation Agency that has up to now accredited two clinical medical biochemical laboratories in the Republic of Croatia. Advantages of accredited laboratory lie in its documented management system, constant improvement and training, reliability of test results, establishing users' trust in laboratory services, test results comparability and interlaboratory (international) test results acceptance by adopting the concept of metrological traceability in laboratory medicine.

  2. Pharyngocutaneous fistula after total laryngectomy: A single-institution experience, 2001–2012☆,☆☆

    Science.gov (United States)

    Benson, Eleni M.; Hirata, Richard M.; Thompson, Carol B.; Ha, Patrick K.; Fakhry, Carole; Saunders, John R.; Califano, Joseph A.; Arnaoutakis, Demetri; Levine, Marshall; Tang, Mei; Neuner, Geoffrey; Messing, Barbara P.; Blanco, Ray G.F.

    2015-01-01

    Purpose The purpose of this study was to determine the incidence of and risk factors for pharyngocutaneous fistula in patients undergoing total laryngectomy at a single institution. Materials and methods The records of 59 patients undergoing primary or salvage total laryngectomy at our institution from 2001 to 2012 were retrospectively reviewed. Data collected included patient, tumor and treatment characteristics, and surgical technique. Risk factors were analyzed for association with pharyngocutaneous fistula formation. Results Twenty patients (34%) developed fistulas. Preoperative tracheostomy (OR 4.1; 95% CI 1.3–13 [p = 0.02]) and low postoperative hemoglobin (OR 9.1; 95% CI 1.1–78 [p = 0.04]) were associated with fistula development. Regarding surgical technique, primary sutured closure of the total laryngectomy defect had the lowest fistula rate (11%). In comparison, primary stapled closure and pectoralis onlay flap over primary closure had nonsignificantly increased fistula rates (43%, OR 6.0; 95% CI 1.0–37.3 [p = 0.06] and 25%, OR 2.7; 95% CI 0.4–23.9 [p = 0.38], respectively). Pectoralis flap incorporated into the suture line had a significantly increased fistula rate (50%, OR 7.1; 95% CI 1.4–46 [p = 0.02]). After stratification for salvage status, patient comorbidities were associated with fistula in non-salvage cases whereas disease-related characteristics were associated with fistula in salvage cases. Fistula development was associated with increased length of hospital stay (p < 0.001) and increased time before oral diet initiation (p < 0.001). Conclusions Pharyngocutaneous fistula is a common complication of total laryngectomy. Preoperative tracheostomy, postoperative hemoglobin, and surgical technique are important in determining the risk of fistula. PMID:25245411

  3. Primary intracranial soft tissue sarcomas in children, adolescents, and young adults: single institution experience and review of the literature.

    Science.gov (United States)

    Maher, Ossama M; Khatua, Soumen; Mukherjee, Devashis; Olar, Adriana; Lazar, Alexander; Luthra, Raja; Liu, Diane; Wu, Jimin; Ketonen, Leena; Zaky, Wafik

    2016-03-01

    There is a paucity of literature reporting the outcome of intracranial sarcomas (IS) in children, adolescents, and young adults (CAYA). A multimodal therapeutic approach is commonly used, with no well-established treatment consensus. We conducted a retrospective review of CAYA with IS, treated at our institution, to determine their clinical findings, treatments, and outcomes. Immunohistochemistry (PDGFRA and EGFR) and DNA sequencing were performed on 5 tumor samples. A literature review of IS was also conducted. We reviewed 13 patients (median age, 7 years) with a primary diagnosis of IS between 1990 and 2015. Diagnoses included unclassified sarcoma (n = 9), chondrosarcoma (n = 2), and rhabdomyosarcoma (n = 2). Five patients underwent upfront gross total resection (GTR) of the tumor. The 5-drug regimen (vincristine, doxorubicin, cyclophosphamide, etoposide, and ifosfamide) was the most common treatment used. Nine patients died due to progression or recurrence (n = 8) or secondary malignancy (n = 1). The median follow-up period of the 4 surviving patients was 1.69 years (range 1.44-5.17 years). The 5-year progression-free survival and overall survival rates were 21 and 44 %, respectively. BRAF, TP53, KRAS, KIT, ERBB2, MET, RET, ATM, and EGFR mutations were detected in 4 of the 5 tissue samples. All 5 samples were immunopositive for PDGFRA, and only 2 were positive for EGFR. IS remain a therapeutic challenge due to high progression and recurrence rates. Collaborative multi-institutional studies are warranted to delineate a treatment consensus and investigate tumor biology to improve the disease outcome.

  4. 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

  5. A contemporary, single-institutional experience of surgical versus expectant management of congenital heart disease in trisomy 13 and 18 patients.

    Science.gov (United States)

    Costello, John P; Weiderhold, Allison; Louis, Clauden; Shaughnessy, Conner; Peer, Syed M; Zurakowski, David; Jonas, Richard A; Nath, Dilip S

    2015-06-01

    The objective of this study was to examine a large institutional experience of patients with trisomy 13 and trisomy 18 in the setting of comorbid congenital heart disease and present the outcomes of surgical versus expectant management. It is a retrospective single-institution cohort study. Institutional review board approved this study. Thirteen consecutive trisomy 18 patients and three consecutive trisomy 13 patients (sixteen patients in total) with comorbid congenital heart disease who were evaluated by our institution's Division of Cardiovascular Surgery between January 2008 and December 2013 were included in the study. The primary outcome measures evaluated were operative mortality (for patients who received surgical management), overall mortality (for patients who received expectant management), and total length of survival during follow-up. Of the thirteen trisomy 18 patients, seven underwent surgical management and six received expectant management. With surgical management, operative mortality was 29 %, and 80 % of patients were alive after a median follow-up of 116 days. With expectant management, 50 % of patients died before hospital discharge. Of the three patients with trisomy 13, one patient underwent surgical management and two received expectant management. The patient who received surgical management with complete repair was alive at last follow-up over 2 years after surgery; both patients managed expectantly died before hospital discharge. Trisomy 13 and trisomy 18 patients with comorbid congenital heart disease can undergo successful cardiac surgical intervention. In this population, we advocate that nearly all patients with cardiovascular indications for operative congenital heart disease intervention should be offered complete surgical repair over palliative approaches for moderately complex congenital cardiac anomalies.

  6. 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)

  7. [The value of the triad: clinical examination, mammography and needle aspiration cytology in the diagnosis of breast carcinoma. Our experience].

    Science.gov (United States)

    Cipolla, C; Amato, C; Di Lisi, G; Graceffa, G; Cassano, T; Salanitro, L; Bajardi, G; De Simone, G F; Barberi, G; Tomasino, R M

    1990-11-01

    Based on the authors' personal experience of the use of the triad, clinical examination, mammography and needle-aspiration cytology, in the strategic diagnosis of breast cancer, the paper emphasizes the importance of early diagnosis as the sole means of obtaining an improved outcome. Using this integrated methodology the authors have obtained a specificity of 99%, sensitivity of 97.8%, and a diagnostic accuracy and prognostic value for positive tests of 98%. In conclusion, the authors affirm that the comparative interpretation of clinical examination, mammography and cytology appears to be an extremely efficacious and reliable method for the diagnosis of the nature of breast nodules.

  8. 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...

  9. DEVELOPING CURRICULUM MATERIALS FOR COOPERATIVE EXPERIENCE PROGRAMS IN AGRICULTURE, AGRICULTURAL OCCUPATIONS INSTITUTE 1966 WORKSHOP REPORT (JUNE 6-JULY 15, 1966).

    Science.gov (United States)

    Oklahoma State Univ., Stillwater. Research Foundation.

    THIRTY VOCATIONAL AGRICULTURE TEACHERS FROM 11 STATES DEVELOPED THESE CURRICULUM MATERIALS FOR A 2-YEAR HIGH SCHOOL COOPERATIVE EXPERIENCE PROGRAM FOR OCCUPATIONS IN AGRICULTURAL SALES AND SERVICE, AGRICULTURAL MACHINERY, AND HORTICULTURE. A RATIONALE FOR CURRICULUM DEVELOPMENT, AN EXPLANATION OF THE CURRICULUM, AND AN EXPLANATION OF THE…

  10. [Management of medulloblastoma in children: the experience of a single institution in Liege from 1991 to 2005].

    Science.gov (United States)

    Fransolet, A C; Born, J D; Misson, J P; Dresse, M F; Forget, P; Rausin, L; Otto, B; Weerts, E; Rutten, I; Closon, M T; Bolle, S; Lebrethon, M C; Mouchamps, M; Hoyoux, C

    2007-04-01

    We present the experience of the Citadelle Hospital (Liege, B) in the diagnosis, treatment and follow-up of medulloblastoma in children. A retrospective study of 10 cases of medulloblastoma was performed. Five years after diagnosis, the event-free survival was 77%.

  11. 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.

  12. Scientific Fellow of Max Planck Institute of Plasma Physics (IPP) and European Physical Society President Elect F. Wagner at ATLAS experiment with Collaboration Spokesperson P. Jenni on 22 September 2006.

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    Scientific Fellow of Max Planck Institute of Plasma Physics (IPP) and European Physical Society President Elect F. Wagner at ATLAS experiment with Collaboration Spokesperson P. Jenni on 22 September 2006.

  13. 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

  14. Overview of the Focused Isoprene eXperiment at the California Institute of Technology (FIXCIT): mechanistic chamber studies on the oxidation of biogenic compounds

    Science.gov (United States)

    Nguyen, T. B.; Crounse, J. D.; Schwantes, R. H.; Teng, A. P.; Bates, K. H.; Zhang, X.; St. Clair, J. M.; Brune, W. H.; Tyndall, G. S.; Keutsch, F. N.; Seinfeld, J. H.; Wennberg, P. O.

    2014-12-01

    The Focused Isoprene eXperiment at the California Institute of Technology (FIXCIT) was a collaborative atmospheric chamber campaign that occurred during January 2014. FIXCIT is the laboratory component of a synergistic field and laboratory effort aimed toward (1) better understanding the chemical details behind ambient observations relevant to the southeastern United States, (2) advancing the knowledge of atmospheric oxidation mechanisms of important biogenic hydrocarbons, and (3) characterizing the behavior of field instrumentation using authentic standards. Approximately 20 principal scientists from 14 academic and government institutions performed parallel measurements at a forested site in Alabama and at the atmospheric chambers at Caltech. During the 4 week campaign period, a series of chamber experiments was conducted to investigate the dark- and photo-induced oxidation of isoprene, α-pinene, methacrolein, pinonaldehyde, acylperoxy nitrates, isoprene hydroxy nitrates (ISOPN), isoprene hydroxy hydroperoxides (ISOPOOH), and isoprene epoxydiols (IEPOX) in a highly controlled and atmospherically relevant manner. Pinonaldehyde and isomer-specific standards of ISOPN, ISOPOOH, and IEPOX were synthesized and contributed by campaign participants, which enabled explicit exploration into the oxidation mechanisms and instrument responses for these important atmospheric compounds. The present overview describes the goals, experimental design, instrumental techniques, and preliminary observations from the campaign. This work provides context for forthcoming publications affiliated with the FIXCIT campaign. Insights from FIXCIT are anticipated to aid significantly in interpretation of field data and the revision of mechanisms currently implemented in regional and global atmospheric models.

  15. Implementation of an Accelerated Rehabilitation Protocol for Total Joint Arthroplasty in the Managed Care Setting: The Experience of One Institution

    Directory of Open Access Journals (Sweden)

    Nicholas B. Robertson

    2015-01-01

    Full Text Available Accelerated rehabilitation following total joint replacement (TJR surgery has become more common in contemporary orthopaedic practice. Increased utilization demands improvements in resource allocation with continued improvement in patient outcomes. We describe an accelerated rehab protocol (AR instituted at a community based hospital. All patients undergoing total knee arthroplasty (TKA and total hip arthroplasty (THA were included. The AR consisted of preoperative patient education, standardization of perioperative pain management, therapy, and next day in-home services consultation following discharge. Outcomes of interest include average length of stay (ALOS, discharge disposition, 42-day return to Urgent Care (UC, Emergency Department (ED, or readmission. A total of 4 surgeons performed TJR procedures on 1,268 patients in the study period (696 TKA, 572 THA. ALOS was reduced from 3.5 days at the start of the observation period to 2.4 days at the end. Discharge to skilled nursing reduced from 25% to 14%. A multifaceted and evidence based approach to standardization of care delivery has resulted in improved patient outcomes and a reduction in resource utilization. Adoption of an accelerated rehab protocol has proven to be effective as well as safe without increased utilization of UC, ER, or readmissions.

  16. 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.

  17. [Treatment of chronic refractory idiopathic thrombocytopenia purpura. 10 years experience at the Salvador Zubiran National Institute of Nutrition].

    Science.gov (United States)

    Pita-Ramírez, L; Hurtado-Monroy, R; Labardini-Méndez, J

    1992-01-01

    A total of 126 patients with chronic idiopathic thrombocytopenic purpura were diagnosed from January 1980 to January 1990 in our institute. In this group of patients, 21 were refractory to prednisone therapy, splenectomy or both, or had had a relapse after a good response with these treatments. They were given other therapies. There was enough information for evaluation in 16 of the 21 patients. The treatment responses were classified according to the post-therapy platelet counts: complete response (CR) = > 150 x 10(9)/L for more than three months; partial response (PR) = 50-150 x 10(9)/L for more than three months; any response (AR) = CR + PR; no response (NR) = < 50 x 10(9)/L. There were 15 women and one male. The median age was 41 years (range 11 to 65). 6-mercaptopurine was given in all patients with CR = 31.2%, PR = 18.8%, AR = 50% and NR = 50%. Seven patients received cyclophosphamide with CR = 28.6%, PR = 14.3%, AR = 42.9% and NR = 57%. Vincristine was given in four patients with only one PR. Interferon alpha 2B was given in four patients with two transitory PR. One patient received colchicine and vitamin C without response. It is concluded that 6-mercaptopurine and cyclophosphamide are useful drugs in refractory thrombocytopenic purpura.

  18. Do iatrogenic factors bias the placement of external ventricular catheters?--a single institute experience and review of the literature.

    Science.gov (United States)

    Woernle, Christoph M; Burkhardt, Jan-Karl; Bellut, David; Krayenbuehl, Niklaus; Bertalanffy, Helmut

    2011-01-01

    Placement of external ventricular drainage (EVD) catheters is the gold standard for managing acute hydrocephalus, but the range of complications varies in different studies. The objective of this present single institute study is to analyze iatrogenic factors, which may influence the EVD device placement and the patient's outcome. A total of 137 EVD placements in 120 patients at the University Hospital Zurich were analyzed retrospectively. Discriminative findings between the pre- and postoperative imaging were obtained and evaluated in detail with regards to the postoperative course, ventriculostomy-related infection, and acute neurological deterioration directly related to the EVD placement. These findings were correlated to iatrogenic factors including education level of the neurosurgeon and surgical setting. Overall EVD-related complication rate was 16.1%, including infection rate of 10.2%, catheter malplacement rate of 2.2%, and hemorrhage rate of 3.6%. Although not statistically significant, catheter-associated hemorrhages and malplacements were found mostly in primary EVD surgery, with a higher complication rate associated with junior residents as the performing surgeon. In contrast, ventriculostomy-related infection was most likely present in patients with more than one EVD placement and in patients treated by more experienced physicians. Complications related to EVD are common. The rate and character of the complication depends on the education level of the surgeon.

  19. Outcome of MRI-guided vacuum-assisted breast biopsy – initial experience at Institute of Oncology Ljubljana, Slovenia

    OpenAIRE

    Zebic-Sinkovec, Marta; Hertl, Kristijana; Kadivec, Maksimiljan; Cavlek, Mihael; Podobnik, Gasper; Snoj, Marko

    2012-01-01

    Background. Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to sur...

  20. Can Robotic Gastrectomy Surpass Laparoscopic Gastrectomy by Acquiring Long-Term Experience? A Propensity Score Analysis of a 7-Year Experience at a Single Institution

    Science.gov (United States)

    Hong, Sung-Soo; Shin, Ho-Jung; Cui, Long-Hai; Hur, Hoon; Han, Sang-Uk

    2016-01-01

    Purpose It is hypothesized that robotic gastrectomy may surpass laparoscopic gastrectomy after the operators acquire long-term experience and skills in the manipulation of robotic arms. This study aimed to evaluate the long-term learning curve of robotic distal gastrectomy (RDG) for gastric cancer compared with laparoscopic distal gastrectomy (LDG). Materials and Methods From October 2008 to December 2015, patients who underwent LDG (n=809) were matched to patients who underwent RDG (n=232) at a 1:1 ratio, by using a propensity score matching method after stratification for the operative year. The surgical outcomes, such as trends of operative time, blood loss, and complication rate, were compared between the two groups. Results The RDG group showed a longer operative time (171.3 minutes vs. 147.6 minutes, P<0.001) but less estimated blood loss (77.6 ml vs. 116.6 ml, P<0.001). The complication rate and postoperative recovery did not differ between the two groups. The RDG group showed a longer operative time and similar estimated blood loss compared with the LDG group after 5 years of experience (operative time: 159.2 minutes vs. 136.0 minutes in 2015, P=0.003; estimated blood loss: 72.9 ml vs. 78.1 ml in 2015, P=0.793). Conclusions In terms of short-term surgical outcomes, RDG may not surpass LDG after a long-term experience with the technique. PMID:28053810

  1. Integrated model of primary and secondary eye care for underserved rural areas: the L V Prasad Eye Institute experience.

    Science.gov (United States)

    Rao, Gullapalli N; Khanna, Rohit C; Athota, Sashi Mohan; Rajshekar, Varda; Rani, Padmaja Kumari

    2012-01-01

    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.

  2. 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.

  3. 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.

  4. 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

  5. Effect of Metformin Use on Survival in Resectable Pancreatic Cancer: A Single-Institution Experience and Review of the Literature.

    Science.gov (United States)

    Ambe, Chenwi M; Mahipal, Amit; Fulp, Jimmy; Chen, Lu; Malafa, Mokenge P

    2016-01-01

    Observational studies have demonstrated that metformin use in diabetic patients is associated with reduced cancer incidence and mortality. Here, we aimed to determine whether metformin use was associated with improved survival in patients with resected pancreatic cancer. All patients with diabetes who underwent resection for pancreatic adenocarcinoma between 12/1/1986 and 4/30/2013 at our institution were categorized by metformin use. Survival analysis was done using the Kaplan-Meier method, with log-rank test and Cox proportional hazards multivariable regression models. For analyses of our data and the only other published study, we used Meta-Analysis version 2.2. We identified 44 pancreatic cancer patients with diabetes who underwent resection of the primary tumor (19 with ongoing metformin use, 25 never used metformin). There were no significant differences in major clinical and demographic characteristics between metformin and non-metformin users. Metformin users had a better median survival than nonusers, but the difference was not statistically significant (35.3 versus 20.2 months; P = 0.3875). The estimated 2-, 3-, and 5-year survival rates for non-metformin users were 42%, 28%, and 14%, respectively. Metformin users fared better with corresponding rates of 68%, 34%, and 34%, respectively. In our literature review, which included 111 patients from the two studies (46 metformin users and 65 non-users), overall hazard ratio was 0.668 (95% CI 0.397-1.125), with P = 0.129. Metformin use was associated with improved survival outcomes in patients with resected pancreatic cancer, but the difference was not statistically significant. The potential benefit of metformin should be investigated in adequately powered prospective studies.

  6. Stent placement for chronic iliac arterial occlusive disease: the results of 10 years experience in a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kwang Bo; Do, Young Soo; Kim, Dong Ik; Kim, Duk Kyung; Kim, Young Wook; Shin, Sung Wook; Cho, Sung Ki; Choo, Sung Wook; Choe, Yeon Heyon; Choo, In Wook [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jae Hyung; Han, Yoon Hee [Inje Univ., Kimhae (Korea, Republic of)

    2005-12-15

    We wanted to retrospectively evaluate the long-term therapeutic results of iliac arterial stent placement that was done in a single institution for 10 years. From May 1994 to April 2004, 206 patients who underwent iliac arterial stent placement (mean age; 64 {+-} 8.8) were followed up for evaluating the long term stent patency. Combined or subsequent bypass surgery was performed in 72 patients. The follow up period ranged from one month to 120 months (mean; 31 {+-} 25.2 months). The factors that were analyzed for their effect on the patency of stents were age, the stent type and diameter, the lesion site, lesion shape, lesion length, the Society of Cardiovascular and Interventinal Radiology criteria, the total run off scores, the Fontaine stage and the cardiovascular risk factors (diabetes mellitus, hypertension and smoking). Follow-up included angiography and/or CT angiography, color Doppler sonography and clinical evaluation with the ankle-brachial index. Two hundred and eighty-four stents were placed in 249 limbs of 203 patients. The technical success rate was 98% (203/206). The primary patency rates of the stents at 3, 5, 7 and 10 year were 87%, 83%, 61% and 49%, respectively. One hundred seventy-seven patients maintained the primary stent patency until the final follow up and 26 patients showed stenosis or obstruction during the follow up. Secondary intervention was performed in thirteen patients. Lesions in the external iliac artery (EIA) or lesions in both the common iliac artery (CIA) and EIA were a poor prognostic factor for stent patency. The run off score and stent diameter also showed statistically significant influence on stent patency. The overall complication rate was 6%. Iliac arterial stent placement is a safe treatment with favorable long term patency. Lesions in the EIA or lesions in both the EIA and CIA, poor run off vessels and a stent having the same or a larger diameter than 10 mm were the poor prognostic factors for long term stent patency.

  7. 3. Early outcomes of minimally invasive versus conventional mitral valve surgery in mitral valve diseases. A single institutional experience

    Directory of Open Access Journals (Sweden)

    E. Nourelden

    2016-07-01

    Full Text Available Minimally invasive techniques in cardiac surgery gained popularity due to many advantages like less postoperative pain, minimal blood loss, less hospital stay, less cost. Minimally invasive mitral valve surgery through right anterolateral mini thoracotomy became safe technique. In our study we compared mini-MV surgery with conventional technique regarding cross clamp time, bypass time, total blood loss, reopening for bleeding, and hospital and ICU length of stay. In our institution between 2010 and 2015, 147patients underwent minimally invasive mitral surgery through right lateral minithoracotomy 8 cm incision and 118 patient underwent conventional mitral valve surgery through median sternotomy in minimally invasive technique: mean age was 38 ± 20 vs 59 ± 21, 70.7% were female (n = 104 vs 39.8% (n = 47, 23.8% were associated with tricuspid valve regurgitation (n = 33 vs 55% in conventional technique (n = 65, 0.08% were able to use endovascular clamp (n = 12, mean Euroscore predected risk of mortality 14.7 ± 13.6% vs 8.7 ± 10.9%. Minimally invasive mitral valve repair surgery was accomplished in 77.5% (n = 114 vs 46.15% (n = 55 and replacement of mitral valve in 22.4% (n = 30 vs 53.8% (n = 64 , concomitant procedures consists of tricuspid valve surgery in 23.8% (n = 35 vs 55% (n = 65, primary mitral valve repair included implantation of rigid annuloplasty ring in 79.6% vs 38.9% (n = 46, duration of cardiopulmonary bypass in minimally invasive surgery was 123 ± 64 min vs 116 ± 62 min, cross clamp time was 64 ± 27 min vs 59 ± 23 min, postoperative mechanical ventilation time 4 ± 1.5 h vs 6.5 ± 2 h, ICU lenght of stay (LOS was 48 ± 12 h vs 3 ± 1 days. Minimally invasive mitral surgery can be performed very safely with excellent early results. mini-MV surgery can be performed with a reasonable operative time, good perioperative course with decrease in postoperative ICU and hospital

  8. 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.

  9. A systematic review of the efficacy and safety experience reported for sorafenib in advanced renal cell carcinoma (RCC in the post-approval setting.

    Directory of Open Access Journals (Sweden)

    Mayer N Fishman

    Full Text Available Sorafenib was FDA approved in 2005 for treatment of renal cell carcinoma (RCC based on the results of the pivotal phase 3 clinical trial, TARGET (Treatment Approaches in Renal Cancer Global Evaluation Trial. Since that time, numerous clinical studies have been undertaken that substantially broaden our knowledge of the use of sorafenib for this indication.We systematically reviewed PubMed, Web of Science, Embase, Cochrane Library, and www.clinicaltrials.gov for prospective clinical studies using single agent sorafenib in RCC and published since 2005. Primary endpoints of interest were progression-free survival (PFS and safety. PROSPERO International prospective register of systematic reviews #CRD42014010765.We identified 30 studies in which 2182 patients were treated with sorafenib, including 1575 patients who participated in randomized controlled phase 3 trials. In these trials, sorafenib was administered as first-, second- or third-line treatment. Heterogeneity among trial designs and reporting of data precluded statistical comparisons among trials or with TARGET. The PFS appeared shorter in second- vs. first-line treatment, consistent with the more advanced tumor status in the second-line setting. In some trials, incidences of grade 3/4 hypertension or hand-foot skin reaction (HFSR were more than double that seen in TARGET (4% and 6%, respectively. These variances may be attributable to increased recognition of HFSR, or potentially differences in dose adjustments, that could be consequences of increased familiarity with sorafenib usage. Several small studies enrolled exclusively Asian patients. These studies reported notably longer PFS than was observed in TARGET. However, no obvious corresponding differences in disease control rate and overall survival were seen.Collectively, more recent experiences using sorafenib in RCC are consistent with results reported for TARGET with no marked changes of response endpoints or new safety signals

  10. Correlation of HER2 overexpression with gene amplification and its relation to chromosome 17 aneuploidy: a 5-year experience with invasive ductal and lobular carcinomas.

    Science.gov (United States)

    Nassar, Aziza; Khoor, Andras; Radhakrishnan, Reshmitha; Radhakrishnan, Anu; Cohen, Cynthia

    2014-01-01

    The HER2 oncogene shows expression or amplification, or both, in approximately 15% to 20% of breast cancers and has been associated with poor prognosis and a response to trastuzumab therapy. HER2 gene status determines the eligibility of breast cancer patients for trastuzumab therapy and a large fraction (41-56%) of these patients respond to targeted therapy. Several studies have related the increased expression of HER2 to an increased copy number of chromosome 17, rather than amplification of the HER2 gene. We compared the results of immunohistochemistry and fluorescence in situ hybridization in both invasive ductal and invasive lobular carcinomas, to determine the frequency of chromosome 17 aneuploidy associated with discordant results. In total, 390 invasive ductal carcinomas and 180 invasive lobular carcinomas diagnosed from January 2000 to December 2005 were included in the study only if results were available for immunohistochemistry (HercepTest; DAKO, Carpinteria, California) and fluorescence in situ hybridization (PathVysion HER2 DNA Probe Kit; Abbott Laboratories, Des Plaines, Illinois). Tumors classified as invasive ductal carcinomas were graded according to the Bloom-Richardson grading system. Correlation between the results of immunohistochemistry and fluorescence in situ hybridization was performed for all categories. Among invasive ductal carcinomas, 29% (115/390) showed chromosome 17 aneuploidy, mostly associated with grade 3/HER2 2+ (45%) or grade 2/HER2 3+ (55%) that were not amplified. Also, 34% (12/35) of invasive lobular carcinomas showed chromosome 17 aneuploidy; approximately one-third of these cases were HER2 2+ (33%) and HER2 3+ (37%) that were not amplified. Discordance between the results of immunohistochemistry and fluorescence in situ hybridization in both ductal and lobular carcinomas is largely associated with chromosome 17 aneuploidy.

  11. 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

  12. Institutional experience with a rotational total skin electron irradiation (RTSEI) technique—A three decade review (1981–2012)

    Science.gov (United States)

    Evans, Michael D.C.; Hudon, Christine; Podgorsak, Ervin B.; Freeman, Carolyn R.

    2013-01-01

    Total skin electron irradiation (TSEI) for patients with cutaneous lymphomas is technically challenging, and numerous approaches have been developed to overcome the many field matching problems associated with such a large and complex treatment volume. Since 1981 we have delivered TSEI using a rotational total skin electron irradiation (RTSEI) technique in conjunction with patch, treat and boost fields in order to provide complete skin and dose coverage. Initially we used a 6 MeV electron beam at an extended source-skin distance (SSD) on a modified linear accelerator. More recently we began using a high dose rate electron mode on a commercially available linear accelerator. The RTSEI technique allows the delivery of a seamless surface dose to the majority of the patient's skin surface in a single treatment. In this review paper we present our three-decade experience with the technical development, dosimetry, treatment delivery and clinical outcomes of our RTSEI technique. PMID:24936331

  13. Institutional experience with a rotational total skin electron irradiation (RTSEI) technique-A three decade review (1981-2012).

    Science.gov (United States)

    Evans, Michael D C; Hudon, Christine; Podgorsak, Ervin B; Freeman, Carolyn R

    2014-03-01

    Total skin electron irradiation (TSEI) for patients with cutaneous lymphomas is technically challenging, and numerous approaches have been developed to overcome the many field matching problems associated with such a large and complex treatment volume. Since 1981 we have delivered TSEI using a rotational total skin electron irradiation (RTSEI) technique in conjunction with patch, treat and boost fields in order to provide complete skin and dose coverage. Initially we used a 6 MeV electron beam at an extended source-skin distance (SSD) on a modified linear accelerator. More recently we began using a high dose rate electron mode on a commercially available linear accelerator. The RTSEI technique allows the delivery of a seamless surface dose to the majority of the patient's skin surface in a single treatment. In this review paper we present our three-decade experience with the technical development, dosimetry, treatment delivery and clinical outcomes of our RTSEI technique.

  14. 民营医院药物临床试验机构建设%Experience on construction of drug clinical trials institution

    Institute of Scientific and Technical Information of China (English)

    周巧霞; 鲁继光; 王之敏; 刘峰

    2014-01-01

    The drug clinical trials are benefit in increasing the level of scientific research and medical quality for hospital. But private hospitals are lack of experiences in application of drug clinical trials institution. In the paper, we made ??a detailed introduction about the construction of drug clinical trial institution in our hospital.It is noted that the support of local government and hospital, building of institution office, construction of the Ethics Committee, establishment of quality control system, development of human resource, construction of clinical professional departments, preparation of material, notices on-site inspection.%药物临床试验机构的申请设立对于医疗机构科研和医疗质量的提高均具有深远的意义,民营医院也应积极加入到申请设立的行列中。但是民营医院申请药物临床试验机构资格认定的案例比较少,缺乏可借鉴的经验。本文从当地政府和医院的政策支持、机构办公室建设、伦理委员会建设、质控体系建立、人才建设、各专业科室的内部建设、材料的准备、现场检查时的注意事项等8个方面对苏州九龙医院药物临床试验机构申请工作做了详细的介绍。

  15. Fibroelastoma papilífero: experiência de uma instituição Cardiac papillary fibroelastoma: experience of an institution

    Directory of Open Access Journals (Sweden)

    Suzelle F. de M Oliveira

    2005-09-01

    sporadic². With the improvement of echocardiography techniques, PFE has been more frequently diagnosed. They are usually described as a movable, pedunculate, well-delimited mass and with predilection for valve endocardium. Therapeutic proposal, when they are pedunculate, is surgical resection, preventing cerebral, pulmonary, coronary or peripheral embolic phenomena1,3. Five cases diagnosed in our institution, in the period from August 1995 to June 2004, will be presented

  16. Improvement of Advanced Parkinson’s Disease Manifestations with Deep Brain Stimulation of the Subthalamic Nucleus: A Single Institution Experience

    Directory of Open Access Journals (Sweden)

    Ahmed Rabie

    2016-12-01

    Full Text Available We present our experience at the University of Illinois at Chicago (UIC in deep brain stimulation (DBS of the subthalamic nucleus (STN, describing our surgical technique, and reporting our clinical results, and morbidities. Twenty patients with advanced Parkinson’s disease (PD who underwent bilateral STN-DBS were studied. Patients were assessed preoperatively and followed up for one year using the Unified Parkinson’s Disease Rating Scale (UPDRS in “on” and “off” medication and “on” and “off” stimulation conditions. At one-year follow-up, we calculated significant improvement in all the motor aspects of PD (UPDRS III and in activities of daily living (UPDRS II in the “off” medication state. The “off” medication UPDRS improved by 49.3%, tremors improved by 81.6%, rigidity improved by 50.0%, and bradykinesia improved by 39.3%. The “off” medication UPDRS II scores improved by 73.8%. The Levodopa equivalent daily dose was reduced by 54.1%. The UPDRS IVa score (dyskinesia was reduced by 65.1%. The UPDRS IVb score (motor fluctuation was reduced by 48.6%. Deep brain stimulation of the STN improves the cardinal motor manifestations of the idiopathic PD. It also improves activities of daily living, and reduces medication-induced complications.

  17. Improvement of Advanced Parkinson’s Disease Manifestations with Deep Brain Stimulation of the Subthalamic Nucleus: A Single Institution Experience

    Science.gov (United States)

    Rabie, Ahmed; Verhagen Metman, Leo; Fakhry, Mazen; Eassa, Ayman Youssef Ezeldin; Fouad, Wael; Shakal, Ahmed; Slavin, Konstantin V.

    2016-01-01

    We present our experience at the University of Illinois at Chicago (UIC) in deep brain stimulation (DBS) of the subthalamic nucleus (STN), describing our surgical technique, and reporting our clinical results, and morbidities. Twenty patients with advanced Parkinson’s disease (PD) who underwent bilateral STN-DBS were studied. Patients were assessed preoperatively and followed up for one year using the Unified Parkinson’s Disease Rating Scale (UPDRS) in “on” and “off” medication and “on” and “off” stimulation conditions. At one-year follow-up, we calculated significant improvement in all the motor aspects of PD (UPDRS III) and in activities of daily living (UPDRS II) in the “off” medication state. The “off” medication UPDRS improved by 49.3%, tremors improved by 81.6%, rigidity improved by 50.0%, and bradykinesia improved by 39.3%. The “off” medication UPDRS II scores improved by 73.8%. The Levodopa equivalent daily dose was reduced by 54.1%. The UPDRS IVa score (dyskinesia) was reduced by 65.1%. The UPDRS IVb score (motor fluctuation) was reduced by 48.6%. Deep brain stimulation of the STN improves the cardinal motor manifestations of the idiopathic PD. It also improves activities of daily living, and reduces medication-induced complications. PMID:27983589

  18. Improvement of Advanced Parkinson's Disease Manifestations with Deep Brain Stimulation of the Subthalamic Nucleus: A Single Institution Experience.

    Science.gov (United States)

    Rabie, Ahmed; Verhagen Metman, Leo; Fakhry, Mazen; Eassa, Ayman Youssef Ezeldin; Fouad, Wael; Shakal, Ahmed; Slavin, Konstantin V

    2016-12-13

    We present our experience at the University of Illinois at Chicago (UIC) in deep brain stimulation (DBS) of the subthalamic nucleus (STN), describing our surgical technique, and reporting our clinical results, and morbidities. Twenty patients with advanced Parkinson's disease (PD) who underwent bilateral STN-DBS were studied. Patients were assessed preoperatively and followed up for one year using the Unified Parkinson's Disease Rating Scale (UPDRS) in "on" and "off" medication and "on" and "off" stimulation conditions. At one-year follow-up, we calculated significant improvement in all the motor aspects of PD (UPDRS III) and in activities of daily living (UPDRS II) in the "off" medication state. The "off" medication UPDRS improved by 49.3%, tremors improved by 81.6%, rigidity improved by 50.0%, and bradykinesia improved by 39.3%. The "off" medication UPDRS II scores improved by 73.8%. The Levodopa equivalent daily dose was reduced by 54.1%. The UPDRS IVa score (dyskinesia) was reduced by 65.1%. The UPDRS IVb score (motor fluctuation) was reduced by 48.6%. Deep brain stimulation of the STN improves the cardinal motor manifestations of the idiopathic PD. It also improves activities of daily living, and reduces medication-induced complications.

  19. Treatment of choledochal cyst in a pediatric population. A single institution experience of 15-years. Case series

    Science.gov (United States)

    Silva-Baez, Hector; Coello-Ramírez, Pedro; Ixtabalán-Escalante, Eddy Mizraím; Sotelo-Anaya, Eduardo; Gallo-Morales, Mariana; Cordero-Estrada, Eduardo; Sainz-Escarrega, Victor Hugo; Ploneda-Valencia, César Felipe

    2015-01-01

    Background Choledochal cyst (CC) is a rare congenital anomaly of the bile duct that approximately 75% of the patients are diagnosed in childhood. Without a standardized surgical procedure for the biliary reconstruction, we present our experience over the last 15 years and show the differences between the biliary reconstructions techniques in our population. Methods We did a retrospective hospital archive search for patients admitted to the pediatric surgery department with the diagnosis of a choledochal cyst from January 2000 to June 2015. Results We found 15 patients, of which, 1 was excluded because of missing data from the hospital record. Of the remaining 14, eight had hepaticojejunal (HY) anastomosis in Roux-en-Y, with a 25% rate of complications; six had hepatoduodenal (HD) anastomosis with a rate of complications of 16.6%. The average hospital length of stay in the group of HD vs. HY was 14 ± 1.6-days vs. 19 ± 8.2-days respectively. Discussion There are no standardized surgical reconstruction techniques of the biliary tract after the CC excision, there is literature that supports the biliary reconstruction with an HY and an HD without a distinct advantage over one or the other. Conclusion: In our series HD anastomosis represents a safe procedure with fewer complications than HY. PMID:26900456

  20. 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.

  1. Assessment of learning preferences among dental students using Visual, Aural, Read-Write, Kinesthetic questionnaire: An institutional experience

    Directory of Open Access Journals (Sweden)

    Runki Saran

    2015-01-01

    Full Text Available Background and Objectives: Every individual has different learning style. As dental educators, it is necessary to recognize the fact that each dental student may have a preference of acquiring information and skill in one style over another. The objective of this study was to determine the learning style preferences of dental students using the Visual, Aural, Read-Write, Kinesthetic (VARK questionnaire. Materials and Methods: The VARK questionnaire was administered to 20 1 st year and 40 2 nd year dental students of Melaka Manipal Medical College, Manipal University to determine their preferred mode of learning. Completed questionnaires were scored and tabulated to determine the distribution of VARK preferences. Results: Nearly 50% of 1 st year students were quadmodal whereas 55% of 2 nd year students were unimodal in which kinesthetic preference was dominant. Mean V and A scores were significantly higher for 1 st year than 2 nd year students. No significant gender difference was seen. Conclusion: The dental students in this study had varied learning preferences. As dental educators, we need to adopt different methods of teaching in order to reach most of the students and make the educational experience more productive.

  2. 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).

  3. 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

  4. 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...

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. Data acquisition in a high-speed rotating frame for New Mexico Institute of Mining and Technology liquid sodium αω dynamo experiment.

    Science.gov (United States)

    Si, Jiahe; Colgate, Stirling A; Li, Hui; Martinic, Joe; Westpfahl, David

    2013-10-01

    New Mexico Institute of Mining and Technology liquid sodium αω-dynamo experiment models the magnetic field generation in the universe as discussed in detail by Colgate, Li, and Pariev [Phys. Plasmas 8, 2425 (2001)]. To obtain a quasi-laminar flow with magnetic Reynolds number R(m) ~ 120, the dynamo experiment consists of two co-axial cylinders of 30.5 cm and 61 cm in diameter spinning up to 70 Hz and 17.5 Hz, respectively. During the experiment, the temperature of the cylinders must be maintained to 110 °C to ensure that the sodium remains fluid. This presents a challenge to implement a data acquisition (DAQ) system in such high temperature, high-speed rotating frame, in which the sensors (including 18 Hall sensors, 5 pressure sensors, and 5 temperature sensors, etc.) are under the centrifugal acceleration up to 376g. In addition, the data must be transmitted and stored in a computer 100 ft away for safety. The analog signals are digitized, converted to serial signals by an analog-to-digital converter and a field-programmable gate array. Power is provided through brush/ring sets. The serial signals are sent through ring/shoe sets capacitively, then reshaped with cross-talk noises removed. A microcontroller-based interface circuit is used to decode the serial signals and communicate with the data acquisition computer. The DAQ accommodates pressure up to 1000 psi, temperature up to more than 130 °C, and magnetic field up to 1000 G. First physics results have been analyzed and published. The next stage of the αω-dynamo experiment includes the DAQ system upgrade.

  11. Data acquisition in a high-speed rotating frame for New Mexico Institute of Mining and Technology liquid sodium αω dynamo experiment

    Science.gov (United States)

    Si, Jiahe; Colgate, Stirling A.; Li, Hui; Martinic, Joe; Westpfahl, David

    2013-10-01

    New Mexico Institute of Mining and Technology liquid sodium αω-dynamo experiment models the magnetic field generation in the universe as discussed in detail by Colgate, Li, and Pariev [Phys. Plasmas 8, 2425 (2001)]. To obtain a quasi-laminar flow with magnetic Reynolds number Rm ˜ 120, the dynamo experiment consists of two co-axial cylinders of 30.5 cm and 61 cm in diameter spinning up to 70 Hz and 17.5 Hz, respectively. During the experiment, the temperature of the cylinders must be maintained to 110 °C to ensure that the sodium remains fluid. This presents a challenge to implement a data acquisition (DAQ) system in such high temperature, high-speed rotating frame, in which the sensors (including 18 Hall sensors, 5 pressure sensors, and 5 temperature sensors, etc.) are under the centrifugal acceleration up to 376g. In addition, the data must be transmitted and stored in a computer 100 ft away for safety. The analog signals are digitized, converted to serial signals by an analog-to-digital converter and a field-programmable gate array. Power is provided through brush/ring sets. The serial signals are sent through ring/shoe sets capacitively, then reshaped with cross-talk noises removed. A microcontroller-based interface circuit is used to decode the serial signals and communicate with the data acquisition computer. The DAQ accommodates pressure up to 1000 psi, temperature up to more than 130 °C, and magnetic field up to 1000 G. First physics results have been analyzed and published. The next stage of the αω-dynamo experiment includes the DAQ system upgrade.

  12. 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.

  13. 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

  14. [Factors affecting the adoption of ICT tools in experiments with bioinformatics in biopharmaceutical organizations: a case study in the Brazilian Cancer Institute].

    Science.gov (United States)

    Pitassi, Claudio; Gonçalves, Antonio Augusto; Moreno Júnior, Valter de Assis

    2014-01-01

    The scope of this article is to identify and analyze the factors that influence the adoption of ICT tools in experiments with bioinformatics at the Brazilian Cancer Institute (INCA). It involves a descriptive and exploratory qualitative field study. Evidence was collected mainly based on in-depth interviews with the management team at the Research Center and the IT Division. The answers were analyzed using the categorical content method. The categories were selected from the scientific literature and consolidated in the Technology-Organization-Environment (TOE) framework created for this study. The model proposed made it possible to demonstrate how the factors selected impacted INCA´s adoption of bioinformatics systems and tools, contributing to the investigation of two critical areas for the development of the health industry in Brazil, namely technological innovation and bioinformatics. Based on the evidence collected, a research question was posed: to what extent can the alignment of the factors related to the adoption of ICT tools in experiments with bioinformatics increase the innovation capacity of a Brazilian biopharmaceutical organization?

  15. Ultracold neutron detection with {sup 6}Li-doped glass scintillators. NANOSC: A fast ultracold neutron detector for the nEDM experiment at the Paul Scherrer Institute

    Energy Technology Data Exchange (ETDEWEB)

    Ban, G.; Lefort, T.; Lemiere, Y.; Naviliat-Cuncic, O.; Pierre, E.; Quemener, G.; Rogel, G. [Normandie Univ, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, Caen (France); Bison, G.; Chowdhuri, Z.; Henneck, R.; Lauss, B.; Mtchedlishvili, A.; Schmidt-Wellenburg, P.; Zsigmond, G. [Paul Scherrer Institute, Villigen-PSI (Switzerland); Bodek, K.; Zejma, J. [Jagiellonian University, Marian Smoluchowski Institute of Physics, Cracow (Poland); Geltenbort, P. [Institut Laue-Langevin, Grenoble (France); Griffith, W.C.; Musgrave, M. [University of Sussex, Falmer, Department of Physics and Astronomy, Brighton (United Kingdom); Helaine, V. [Normandie Univ, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, Caen (France); Paul Scherrer Institute, Villigen-PSI (Switzerland); Kasprzak, M.; Koss, P.A.; Severijns, N.; Wursten, E. [Katholieke Universiteit Leuven, Instituut voor Kernen Stralingsfysica, Leuven (Belgium); Kermaidic, Y.; Pignol, G.; Rebreyend, D. [LPSC, Universite Grenoble Alpes, CNRS/IN2P3, Grenoble (France); Kirch, K.; Komposch, S.; Krempel, J.; Ries, D. [Paul Scherrer Institute, Villigen-PSI (Switzerland); Institute for Particle Physics, ETH Zuerich, Zuerich (Switzerland); Kozela, A. [Henryk Niedwodniczanski Institute for Nuclear Physics, Cracow (Poland); Piegsa, F.M.; Rawlik, M. [Institute for Particle Physics, ETH Zuerich, Zuerich (Switzerland); Roccia, S. [CSNSM, Universite Paris Sud, CNRS/IN2P3, Orsay (France)

    2016-10-15

    This paper summarizes the results from measurements aiming to characterize ultracold neutron detection with {sup 6}Li-doped glass scintillators. Single GS10 or GS20 scintillators, with a thickness of 100-200μm, fulfill the ultracold neutron detection requirements with an acceptable neutron-gamma discrimination. This discrimination is clearly improved with a stack of two scintillators: a {sup 6}Li-depleted glass bonded to a {sup 6}Li-enriched glass. The technique of optical contact bonding is used between the two glasses in order to eliminate the need for optical glue or grease between them. Relative to a {sup 3}He Strelkov gas detector, the scintillator's detection efficiency is lower for UCN energies close to the scintillator's Fermi potential (85-100 neV), but becomes larger at higher UCN energies. Coupled to a digital data acquisition system, counting rates up to a few 10{sup 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 routine runs of the neutron electric dipole moment experiment is presented. (orig.)

  16. 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.

  17. Ultracold neutron detection with 6Li-doped glass scintillators. NANOSC: A fast ultracold neutron detector for the nEDM experiment at the Paul Scherrer Institute

    Science.gov (United States)

    Ban, G.; Bison, 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.

    2016-10-01

    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 100-200μm, 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 technique of optical contact bonding is used between the two glasses in order to eliminate the need for optical glue or grease between them. Relative to a 3He Strelkov gas detector, the scintillator's detection efficiency is lower for UCN energies close to the scintillator's Fermi potential (85-100 neV), but becomes larger at higher UCN energies. Coupled to a digital data acquisition system, counting rates up to a few 105 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 routine runs of the neutron electric dipole moment experiment is presented.

  18. Patterns of fisheries institutional failure and success: experience from the Southern Gulf of St. Lawrence snow crab fishery in Nova Scotia, Canada

    NARCIS (Netherlands)

    Loucks, L.

    2007-01-01

    This paper examines why market and government institutions failed to prevent over fishing in the Southern Gulf snow crab fishery, whereas non-market institutions succeeded. A general conclusion is that the institutional environment in which economic behaviour must be coordinated for successful fishe

  19. 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

  20. 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.A 76 year old farmer from Turrialba (Cartago, presented with a 3 year old lesion of his right pal and proximal fingers. It was exophitic, wart like, and it measured 5x11 cm, draining caseous material from its crests. The lesion had grows quickly for the last 3 months and it became tender to the point of making impossible for him to work. A series of tests were done to rule out other possible infections causes, after several biopsies the diagnosis of verrocous carcinoma was made. The patient underwent a partial amputation of his hand. This tumor is considered a from of squamous cell carcinoma, we present here its classification, pathogenesis, histopathology, clinical manifestations and diferential diagnosis.

  1. 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.

  2. [Shock in obstetrics. Institutional experience].

    Science.gov (United States)

    Bonfante Ramírez, E; Ahued Ahued, R; García-Benítez, C Q; Bolaños Ancona, R; Callejos, T; Juárez García, L

    1997-04-01

    Shock is one of the most difficult problems an obstetrician can face. Hemorrhage is the main reason of shock. A descriptive and retrospective research was conducted at Instituto Nacional de Perinatología, from January 1992 to May 1996, including all patients admitted to the intensive care unit with diagnosis of shock. There were found 90 cases with diagnosis of shock, 82 were hipovolemic, and 8 cases had the septic kind of shock. The average of age was 32.2 years, with a gestational age between 6.2 to 41.4 weeks . There were 71 healthy patients, hypertension was associated to pregnancy in 9 cases, infertility in two, myomatosis in 2, and diabetes in 2 more patients. Other 5 cases reported different pathologies. The most frequent cause for hipovolemic shock resulted to be placenta acreta (40 cases), followed by uterine tone alterations in 37 patients, ectopic pregnancy in 7, uterine rupture or perforation in 4, and vaginal or cervical lacerations in 2. The estimated blood loss varied from 2200 cc to 6500 cc, and the minimal arterial pressure registered during shock was between 40/20 mmHg to 90/60 mmHg. Medical initial assistance consisted in volume reposition with crystalloids, globular packages, and plasma expansors in 73 patients (81.1%). The rest of the patients received in addition coloids, platelets and cryoprecipitates. A total of 76 patients required surgical intervention consisting in total abdominal hysterectomy. In 5 cases the previous surgical procedure was done and ligation of hypogastric vessels was needed. Salpingectomy was performed in 5 patients, and rupture or perforation repair in 3. The average surgery time was 2 hours and 33 minutes. The observed complications were 7 cases with abscess of the cupula, consumption coagulopathy in 2, 1 vesical quirurgical injury, 1 intestinal occlusion, and 11 vesico-vaginal fistula. The average days of hospitalization resulted to be 5. The most frequent kind of shock seen by obstetricians is the hipovolemic type, followed by septic shock, Volume reposition and restoration of adequate tissue oxygenation is the main goal in treatment, and so the rapid and opportune decision for surgery shall prevent the patients decriment and maternal mortality.

  3. Molecular pathology of breast apocrine carcinomas

    DEFF Research Database (Denmark)

    Celis, J.E.; Gromova, I.; Gromov, P.;

    2006-01-01

    Breast cancer is a heterogeneous disease that encompasses a wide range of histopathological types including: invasive ductal carcinoma, lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, and apocrine carcinoma among others. Pure apocrine carcinomas represent about 0.5%...

  4. 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.

  5. Intraoperative endoscopy in obstructive hypopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Predrag Pesko; Djordjije Saranovic; Vera Todorovic; Milos Bjelovic; Predrag Sabljak; Dejan Stojakov; Ebrahimi Keramatollah; Dejan Velickovic; Bratislav Spica; Branka Nenadic; Aleksandra Djuric-Stefanovic

    2006-01-01

    AIM: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma.METHODS: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7(22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach.RESULTS: We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present.CONCLUSION: It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.

  6. Institutional ethnography

    DEFF Research Database (Denmark)

    Lund, Rebecca; Tienari, Janne

    2016-01-01

    . 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...

  7. Institutional upbringing

    DEFF Research Database (Denmark)

    Gulløv, Eva

    2008-01-01

    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...... 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...... current testing of Danish language fluency levels among pre-school minority children. Testing language skills marks and defines distinctions that reinforce images of deviance that, in turn, legitimize initiatives to enrol children, specifically minority children, in child care institutions....

  8. 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.

  9. 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.

  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. Student Discipline Intervention Strategies: A Case Study of Two Institutions' Processes Utilized to Resolve Misconduct of Students Who Concomitantly Experience a Mental Health Crisis

    Science.gov (United States)

    Dickstein, Gary G.

    2011-01-01

    This study contributes to the research regarding processes and procedures utilized by two institutions of higher education to respond to students who participate in inappropriate behavior and who are concomitantly experiencing a mental health crisis. A case study analysis of two institutions of higher education was used to examine this issue. The…

  12. Transparent Institutions

    Directory of Open Access Journals (Sweden)

    Javier Fombona

    2011-04-01

    Full Text Available The objective of this project is to create sets of media-based imagery that illustrate the internal workings of public institutions to the common citizen. This is an important need in countries that are seeking to open up their public and private institutions and bring them closer to their users. Method: There is a clear need to carry out proposals that tackle organizational lack of transparency; to this end, through an interdisciplinary approach, we propose the creation of a freeaccess Web-based portal that shows the interior of the institutions at hand, learning institutions to start with, this scope will be broadened later to institutions of health and public safety. The project chooses and shows a core selection of features capable of becoming international models for each kind of institutions, elementary schools in this phase. These features are shown in short videos, depicting every core element found: installations, governing bodies, documentation, samples of learning and teaching methodologies in use, etc. Results: the propossed project succeeds in getting institutions closer to their users. It has been developed in Spain, and translated to other Latin-American countries and the United States.

  13. Autoradiographic studies and experiments on partial synchronization of human tumors, especially mammary carcinomas, in vitro and in vivo following xenotransplantation to NU/NU mice

    Energy Technology Data Exchange (ETDEWEB)

    Nord, D.

    1980-08-20

    Human mammary carcinomas were evaluated radiographically in vitro in the native state. Penetration depths up to 552 ..mu..m into the tissue were reached by the incubating medium. The labelling indices for the 3H-thymidine autoradiography lay between 1.5 and 19.3 percent. A correlation of the autoradiographic labelling indices with the findings of a simultaneously performed in vitro sensitivity test against cytostatics could not be proved. There seems to be a relation between the histomorphological tumour image and the proliferation behaviour expressed by the autoradiographic labelling index. Human mammary carcinomas were cultivated as xeno-transplant on thymus-aplastic NU/NU mice in parallel to this investigation. These heterotransplants show a remarkable correlation to the proliferation behaviour of the directly examined human tumours, after an autoradiographic in-vivo-labelling, with index values between 1.5 and 23.8 percent. This parallelism in the biological behaviour represents a further proof for the usefulness of the oncological test model of the NU/NU mouse as a carrier for human carcinomas. The application of this pre-therapeutical test model followed by determination of the synchronization behaviour of three human malignomas after xeno-transplantation onto NU/NU mice. For all three tumous an individual synchronization behaviour could be determined. Therapy attempts followed with cyclophosphomide or ionizing radiation by using the optimal cell-cycle therapy. Therefore an improvement of the therapeutical success by means of pre-therapeutical synchronization of human tumours can be reached in particular cases.

  14. Treatment of Advanced or Recurrent Endometrial Carcinoma with Doxorubicin in Patients Progressing after Paclitaxel/Carboplatin: Memorial Sloan-Kettering Cancer Center (MSKCC) Experience from 1995-2009

    Science.gov (United States)

    Makker, Vicky; Hensley, Martee L.; Zhou, Qin; Iasonos, Alexia; Aghajanian, Carol. A.

    2013-01-01

    Objective Long-term survival for patients with advanced endometrial carcinoma is poor, and limited options exist for the management of recurrent disease. Our goal was to investigate the activity of doxorubicin in the second-line setting in patients who progressed after paclitaxel/carboplatin adjuvant treatment. Methods We conducted a retrospective analysis of patients with recurrent endometrial carcinoma who were treated at Memorial Sloan-Kettering Cancer Center from 1995-2009, and who received paclitaxel/carboplatin adjuvant chemotherapy followed by second-line doxorubicin therapy at time of recurrence. The median PFS and OS times following paclitaxel/carboplatin and following second-line doxorubicin therapy were estimated using the Kaplan-Meier method. Toxicity was assessed by the treating physician at each visit and graded using version 4.0 of Common Terminology Criteria for Adverse Events (CTCAE). Patient presentation, treatment, patterns of recurrence, and patient outcomes were summarized. Results Seventeen patients were included in study analyses. The median PFS from completion of paclitaxel/carboplatin was 8.0 months (95% CI: 4.5-13.6 months). At the time of recurrence, all 17 patients were treated with doxorubicin as second-line therapy. No patient achieved objective response of stable disease. The median PFS of this cohort following doxorubicin treatment was 2.1 months (95% CI: 0.95-2.7) months. Median OS was 5.8 months (95% CI: 1.0-15.0 months). There is only one patient still alive; her median follow-up time is 49.4 months. Predominant doxorubicin-related grade 2 toxicities included nausea/vomiting (18.8%), fatigue (18.8%), and neutropenia (12.5%). No grade 3 or 4 toxicities occurred. Conclusions Among patients with advanced endometrial carcinoma who had received adjuvant paclitaxel/carboplatin, treatment with doxorubicin at time of disease recurrence failed to achieve any objective responses and was associated with a very short (2 months) time to

  15. Intensity modulated radiotherapy (IMRT in the treatment of children and Adolescents - a single institution's experience and a review of the literature

    Directory of Open Access Journals (Sweden)

    Huber Peter

    2009-09-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion 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.

  16. The link between industry and social interests in health in Brazil's National Health Innovation System: the experience of the Brazilian National Institute of Traumatology and Orthopedics (INTO).

    Science.gov (United States)

    Vianna, Cid Manso de Mello; Fermam, Marcelo Kropf Santos; Rodrigues, Marcus Paulo da Silva; Mosegui, Gabriela Bittencourt Gonzalez

    2016-11-03

    This article has two parts. The first discusses the relationship between industry and health interests based on three different but non-mutually exclusive "logics": (a) independent; (b) divergent; and (c) convergent. The second part describes the experience at the Brazilian National Institute of Traumatology and Orthopedics (INTO) with a technology management model. The accumulated expertise in orthopedics at INTO can favor Brazil's domestic medical equipment industry without jeopardizing the country's social health needs. This means directing the production of feasible technologies adapted to the national reality, with a focus on safety and quality, without burdening the public coffers and by overcoming the country's dependency on imported products. The proposal is to promote socioeconomic development through a virtuous circle by attracting reserves and fomenting national competitiveness in domestic and foreign markets while improving social conditions and access to health. Resumo: Este artigo está dividido em duas partes. Na primeira, discute-se como se relacionam os interesses produtivos e a saúde a partir de três "lógicas" ou perspectivas diferentes que não são mutuamente excludentes: (a) independente; (b) divergente e (c) convergente. Na segunda, descreve-se a experiência do Instituto Nacional de Traumatologia e Ortopedia (INTO) na montagem de um modelo de gestão de tecnologia. O conhecimento internalizado em ortopedia do INTO pode favorecer a indústria nacional de equipamentos médicos sem abandonar as necessidades sociais brasileiras de saúde. Isto é, direcionar a produção de tecnologias viáveis e adaptadas à realidade nacional, com foco em segurança e qualidade, sem onerar os cofres públicos e abandonando a dependência de produtos importados. A proposta é a de promover um desenvolvimento socioeconômico que construa um ciclo virtuoso, por atrair divisas e fomentar a competitividade nacional em mercados internos e externos, melhorando as

  17. 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...

  18. Institutional Controls

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset consists of institutional control data from multiple Superfund sites in U.S. EPA Region 8. These data were acquired from multiple sources at different...

  19. Burn Institute

    Science.gov (United States)

    ... Now Help keep local seniors safe from fire! Burn Survivor Support If you are reading this, chances ... year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute provides fire ...

  20. 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.

  1. Incidence, histopathology, and surgical outcome of tumors of spinal cord, nerve roots, meninges, and vertebral column - Data based on single institutional (Sher-i-Kashmir Institute of Medical Sciences) experience

    OpenAIRE

    2016-01-01

    Context: In the absence of a community-based study on the spinal tumors in the Valley, medical records of the only Regional Neurosurgical Center are available. Aim: The aim of this study is to establish a hospital-based regional epidemiology of spinal tumors in the Valley since the data are derived from a single institution. Materials and Methods: A retrospective analysis of 531 malignant and nonmalignant tumors of spinal cord, its coverings and vertebrae, which were managed in a Regional Neu...

  2. 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.

  3. STUDY EXPERIENCE AND ESTABLISHMENT OF METASTATIC RABBIT MODEL WITH VX-2 CARCINOMA IN LIVER%兔肝VX2移植癌模型的建立

    Institute of Scientific and Technical Information of China (English)

    陈利平; 文天夫

    2011-01-01

    [目的]制作VX-2兔肝移植癌模型.[方法]新西兰白兔10只,采用VX-2瘤株动物自身接种传代.采用瘤组织块包埋法,均接种于肝左叶.[结果]2周后均顺利成瘤,该瘤在肝组织中呈浸润式生长.[结论]成功建立了兔VX-2移植性肝癌模型,为肝癌治疗的基础及临床研究提供了成熟的大型实验动物肝癌模型.%[Objective]To establish a metastatic rabbit VX-2 liver tumor model.[Methods]10 New-Zealand white rabbits were inoculated with VX-2 carcinoma in the left lobe of the liver by implantation.[Results]The tumor was successfully established two weeks later.The tumor grew in the liver tissue and infiltrated into the normal liver tissue.[Conclusion]It is successful to establish a modified metastatic rabbit VX-2 liver carcinma model, and it makes it possible to gain a reliable mature large animal model of tumor for the basic and clinical study of therapy of liver carcinoma.

  4. Recurrence rates and survival in a Danish cohort with renal cell carcinoma

    DEFF Research Database (Denmark)

    Azawi, Nessn H; Tesfalem, Helen; Mosholt, Karina Sif Søndergaard;

    2016-01-01

    INTRODUCTION: Patients with localised and locally advanced renal cancer experience about 20% recurrence during a five-year follow-up period. The aim of the present study was to report recurrence rates and survival in a Danish population with renal cancer. METHODS: Data on patients diagnosed...... with renal cell carcinoma (RCC) at our institute from January 2005 to December 2013 were collected retrospectively. RESULTS: Overall, 367 patients were diagnosed with RCC during the period, and 78 patients (21%) presented with metastasis. The mean follow-up period for all patients was 41 months (standard...

  5. 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

  6. Unimagined Institutions

    DEFF Research Database (Denmark)

    Zangenberg, Mikkel Bruun

    2007-01-01

    In this paper it is argued that war contains inherent and thus necessary aesthetic traits (ranging from sensory data to narrative features), but that existing research institutions throughout the West have failed to address this issue adequately, in terms of research policy, recruitment and metho......In this paper it is argued that war contains inherent and thus necessary aesthetic traits (ranging from sensory data to narrative features), but that existing research institutions throughout the West have failed to address this issue adequately, in terms of research policy, recruitment...... and methodology. Accordingly, it is suggested that scholars from the humanities in particular aggressively seek to develop new types of research institutions and methods in order to deal with the manifold forms of overlap between warfare and aesthetics. In empirical terms, focus is limited to the current...

  7. Thyroid cancer - medullary carcinoma

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... in children and adults. Unlike other types of thyroid cancer, MTC is less likely to be caused by ...

  8. Stages of Adrenocortical Carcinoma

    Science.gov (United States)

    ... Symptoms of adrenocortical carcinoma include pain in the abdomen. These and other signs and symptoms may be caused by adrenocortical carcinoma: A lump in the abdomen . Pain the abdomen or back. A feeling of ...

  9. 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 arising...

  10. 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 ...

  11. Improving outcomes for patients receiving transarterial chemoembolization for hepatocellular carcinoma.

    Science.gov (United States)

    McCurdy, Heather M

    2013-01-01

    Hepatocellular carcinoma is a cancer with increasing incidence in the veteran population. This type of cancer can be treated with transarterial chemoembolization, an invasive procedure performed by specially trained interventional radiologists. The most common serious complications are liver failure, sepsis secondary to ischemic cholecystitis or liver abscess, gastrointestinal bleeding, and death. However, nursing staff and physicians often have little or no experience in caring for patients in the hospital who have had this procedure. Patient safety can be threatened by this lack of knowledge. Sources of threat to patient safety are described by the Institute of Medicine as falling into 4 categories: management, workforce, work processes, and organizational culture. To promote patient safety, defenses need to be deployed to address each category. In this article, the author provides a case example, describes threats to the patient's safety, and describes a plan to improve the care of all patients undergoing this procedure.

  12. European Institutions?

    NARCIS (Netherlands)

    Meacham, Darian

    2016-01-01

    The aim of this article is to sketch a phenomenological theory of political institutions and to apply it to some objections and questions raised by Pierre Manent about the project of the European Union and more specifically the question of “European Construction”, i.e. what is the aim of the Europea

  13. Institutional Paralysis

    Science.gov (United States)

    Yarmolinsky, Adam

    1975-01-01

    Institutional paralysis of higher education is the result of the disjunction between faculty and administration; the disjunction between substantive planning and bugetary decision-making; the disjunction between departmental structures and functional areas of university concern; and the disjunction between the theory of direct democracy and its…

  14. Institution Morphisms

    Science.gov (United States)

    Goguen, Joseph; Rosu, Grigore; Norvig, Peter (Technical Monitor)

    2001-01-01

    Institutions formalize the intuitive notion of logical system, including both syntax and semantics. A surprising number of different notions of morphisim have been suggested for forming categories with institutions as objects, and a surprising variety of names have been proposed for them. One goal of this paper is to suggest a terminology that is both uniform and informative to replace the current rather chaotic nomenclature. Another goal is to investigate the properties and interrelations of these notions. Following brief expositions of indexed categories, twisted relations, and Kan extensions, we demonstrate and then exploit the duality between institution morphisms in the original sense of Goguen and Burstall, and the 'plain maps' of Meseguer, obtaining simple uniform proofs of completeness and cocompleteness for both resulting categories; because of this duality, we prefer the name 'comorphism' over 'plain map.' We next consider 'theoroidal' morphisms and comorphisims, which generalize signatures to theories, finding that the 'maps' of Meseguer are theoroidal comorphisms, while theoroidal morphisms are a new concept. We then introduce 'forward' and 'semi-natural' morphisms, and appendices discuss institutions for hidden algebra, universal algebra, partial equational logic, and a variant of order sorted algebra supporting partiality.

  15. Experience on diagnosis and treatment of cystic renal cell carcinoma%囊性肾癌临床特点及诊治分析

    Institute of Scientific and Technical Information of China (English)

    王启飞; 郑伟; 王丽娜

    2014-01-01

    目的:分析囊性肾癌的临床特点,探讨囊性肾癌的诊断及治疗方法。方法回顾性分析12例囊性肾癌患者的临床表现、影像学特征、手术方法、病理特征及随访结果,并结合相关文献就其临床特点进行讨论。结果12例患者术后病理结果透明细胞癌10例,嫌色细胞癌2例。肿瘤直径1.5~8.5cm,平均4.4cm。TNM分期:T1N0M010例,T2N0M02例,其中多房囊性肾癌7例,单房囊性肾癌5例。随访13~78个月,平均39个月,均无复发和转移。结论囊性肾癌早期诊断较为困难,应结合影像学检查、术中冰冻切片及术后病理结果确诊。囊性肾癌恶性度低,预后较好。囊性肾癌同肾癌一样采用肾癌根治术或保留肾单位的手术,保留肾单位的手术为治疗的最佳选择。%Objective To analyze clinical features of cystic renal cell carciuoma ( CRCC) and to investigate the diagnosis and treatment of CRCC .Methods The clinical data of 12 cases with CRCC was analyzed retrospectively .The clinical presen-tation,radiologic features ,surgical procedures ,pathologic features as well as follow -up outcomes of the CRCC were stud-ied.Clinical characteristics were discussed combining references .Results The diagnoses of CRCC were confirmed by post-operative pathology .Histological examination showed that 10 cases of clear cell carcinoma and 2 cases of chromophobe car-cinoma.The size of the tumors ranged from 1.5 cm to 8.5 cm with an average of 4.4 cm.Ten cases were classified as T1N0 M0 and two cases as T2N0M0 for TNM staging.Histopathologic examination demonstrated multilocular cystic renal cell car-cinoma in 7 cases and unilocular cystic renal cell carcinoma in 5 cases.All of the patients remained tumor -free with no ev-idence of neoplastic recurrence or metastasis during a 13 to 78 months (39 months in average ) follow-up.Conclusion Early diagnosis of CRCC is difficult and should be combined with preoperative

  16. A REGIONAL INSTITUTE TO AID IMPROVEMENT OF INSTRUCTIONAL PRACTICES, MATERIALS AND STUDENT EXPERIENCES FOR COORDINATORS AND INSTRUCTORS OF VOCATIONAL ORIENTATION PROGRAMS. FINAL REPORT.

    Science.gov (United States)

    BLAIR, MARGARET; AND OTHERS

    APPROXIMATELY 100 EDUCATORS FROM FIVE STATES AND THE VIRGIN ISLANDS PARTICIPATED IN AN INSTITUTE TO HELP INSTRUCTIONAL AND GUIDANCE PERSONNEL IMPROVE THE VOCATIONAL ORIENTATION OF HIGH SCHOOL STUDENTS WHO ARE PREPARING TO ENTER THE WORLD OF WORK. THE AGENDA CONSISTED OF SPEECHES ON VOCATIONS, GROUP SESSIONS TO DISCUSS VOCATIONAL PROGRAM…

  17. Portraits of Success: A Mixed-Method Study of the Enrollment, Persistence, and Success Experiences of Female Graduate Engineering Students at a Hispanic Serving Institution

    Science.gov (United States)

    Aguirre-Covarrubias, Sandra

    2013-01-01

    The current study addresses the underrepresentation of female graduate engineering students. Specifically, its purpose was to gain insight on how enrollment, persistence, and success factors are experienced by female graduate engineering students at a Hispanic Serving Institution located on the U.S.-Mexico border. The topic of underrepresentation…

  18. Towards the Education Nation: Revisiting the Impact of Financial Aid, College Experience, and Institutional Context on Baccalaureate Degree Attainment Using a Propensity Score Matching, Multilevel Modeling Approach

    Science.gov (United States)

    Franke, Ray

    2012-01-01

    To compete in the global marketplace, the U.S. economy heavily relies on higher education institutions to educate the college graduates and knowledge workers needed to create the innovative products and services of tomorrow. And yet, where once America led the world in educational attainment, recent data from the Organization for Economic…

  19. [Hygiene and Infection Prevention in Medical Institutions, Kindergartens and Schools - Statutory Basis, Infection Control Practice and Experiences of the Public Health Services].

    Science.gov (United States)

    Heudorf, U

    2015-07-01

    Infection prevention is one of the main tasks of the public health services. The "Protection against infection act" places all medical institutions and facilities for children (kindergartens and schools) under the obligation to assume responsibility and to cooperate. Duties of the institutions are described, and public health services are obliged to perform hygiene control visits.Regarding medical institutions, the guidelines of the German Commission on Hospital Hygiene and Infection Control have to be observed, and the counties were obliged to publish hygiene enactments. Subsequently, good improvements in hygiene management in medical institutions were achieved. In schools, however, severe hygienic problems (i.e. sanitary hygiene, indoor air hygiene) are detected, without any improvement - obviously due to a missing sense of responsibility in the school community. Causes for poor behaviour prevention (hand hygiene, ventilation) and missing situational prevention (i.e. cleaning) are discussed. Without reversion to the obviously needed but nearly forgotten subject school hygiene, obligatory guidelines and the assuming of responsibility, permanent improvements cannot be achieved.

  20. Latino College Students at Highly Selective Institutions: A Comparison of Their College Experiences and Outcomes to Other Racial/Ethnic Groups

    Science.gov (United States)

    Kim, Young K.; Rennick, Liz A.; Franco, Marla A.

    2014-01-01

    This study examines unique patterns of college engagement and outcomes among Latino undergraduate students attending highly selective institutions in comparison with those from other racial/ethnic groups. The study also identifies predictors of select college outcomes--that is, cognitive, affective, and civic outcomes--for this population.…

  1. Institutional analysis of marine reserves and fisheries governance policy experiments : a case study of Nassau grouper conservation in the Turks and Caicos Islands

    NARCIS (Netherlands)

    Rudd, M.A.

    2003-01-01

    Keywords: Ecosystem-based fisheries management; marine reserves; marine protected areas; social capital; institutional analysis; Turks and Caicos Islands; Nassau grouper Many tropical fisheries around the world are in crisis because of the depletion of valuable reef species and the destruction of ha

  2. iUTAH Summer Research Institutes: Supporting the STEM Pipeline Through Engagement of High School, Undergraduate and Graduate Students, Secondary Teachers, and University Faculty in Authentic, Joint Research Experiences

    Science.gov (United States)

    Stark, L. A.; Malone, M.

    2015-12-01

    Multiple types of programs are needed to support the STEM workforce pipeline from pre-college through graduate school and beyond. Short-term, intensive programs provide opportunities to participate in authentic scientific research for students who may not be sure of their interest in science and for teachers who may be unable to devote an entire summer to a research experience. The iUTAH (innovative Urban Transitions and Aridregion Hydro-Systainability) Summer Research Institute utilizes an innovative approach for a 5-day program that engages high school and undergraduate students as well as middle and high school teachers in conducting research projects led by graduate students and faculty members. Each Institute involves 3-4 half to full-day research projects. Participants collect (usually in the field) and analyze data for use in on-going research or that is related to a current research project. The participants work in groups with the graduate students to create a poster about each research project. They present their posters on the last day of the Institute at the state-wide meeting of all researchers and involved in this EPSCoR-funded program. In addition to introducing participants to research, one of the Institute's goals is to provide opportunities for meaningful near-peer interactions with students along the STEM pipeline from high school to undergraduate to graduate school. On the end-of-Institute evaluations, almost all students have reported that their discussions with other participants and with graduate students and faculty were a "Highly effective" or "Effective" part of the Institute. In response to a question about how the Institute will impact their course choices or their plans to pursue a career in science, many high school and undergraduate students have noted that they plan to take more science courses. Each year several undergraduates who were previously unsure about a career in science have indicated that they now intend to pursue a

  3. Combined external irradiation and interstitial implantation for T1 and T2 epidermoid carcinomas of base of tongue: the Creteil experience (1971-1981)

    Energy Technology Data Exchange (ETDEWEB)

    Crook, J.; Mazeron, J.J.; Marinello, G.; Martin, M.; Raynal, M.; Calitchi, E.; Faraldi, M.; Ganem, G.; Le Bourgeois, J.P.; Pierquin, B.

    1988-07-01

    Forty-eight patients with T1 or T2 epidermoid carcinomas of the base of tongue were treated at the Henri Mondor Hospital between 1971 and 1981. Forty-one patients received moderate dose /sup 60/Co external beam irradiation (mean: 48.6 Gy) to the primary tumor and regional nodes, followed by an interstitial iridium-192 implant to the primary tumor (mean: 32 Gy). This completed the treatment for the 30 node negative patients, but those with clinically positive nodes were managed by either an additional electron beam boost to the involved nodes or a neck dissection. Seven tumors were treated exclusively by implantation to the base of tongue (mean: 63 Gy). Five-year crude disease-free survival is 50% with 35% of patients dying of recurrent disease. Definitive local control for T1 lesions is 85% (11/13) and for T2 is 71% (25/35). A dose response effect was observed with local control of 79% (26/33) obtained with a combined dose greater than or equal to 75 Gy, but only 50% (4/8) for less than or equal to 70 Gy. For N0 patients definitive regional control is 97% and for N1-3 is 89%. Minor or moderate soft tissue ulceration was observed in 12 patients, including 3 cases that progressed to osteonecrosis. None required surgical intervention. No correlation exists between necrosis and tumor size or total dose.

  4. A score model for predicting post-liver trans-plantation survival in HBV cirrhosis-related hepatocellular carcinoma recipients:a single center 5-year experience

    Institute of Scientific and Technical Information of China (English)

    Li-Ying Wang; Xin-Hua Chen; Tian-An Jiang; Fen Chen; Shu-Sen Zheng; Xiao Xu; Wei-Lin Wang; Jian Wu; Min Zhang; Yan Shen; Sheng Yan; Hai-Yang Xie

    2015-01-01

    BACKGROUND: The prognostic prediction of liver transplan-tation (LT) guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients' outcome, especially for the patients with HBV cirrhosis-re-lated hepatocellular carcinoma (HCC). The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC patients. METHODS: Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox regression. RESULTS: The score model was as follows: 0.114×(Child-Pugh score)-0.002×(positive HBV DNA detection time)+0.647× (number of tumor nodules)+0.055×(max diameter of tumor nodules)+0.231×lnAFP+0.437×(tumor differentiation grade). The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predict-ing the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a speci-ficity of 90.7%, respectively. CONCLUSION: The quantitative score model for predicting post-LT survival proved to be sensitive and specific.

  5. The Preference for Anterior Approach Major Hepatectomy: Experience Over 3 Decades and a Propensity Score-Matching Analysis in Right Hepatectomy for Hepatocellular Carcinoma.

    Science.gov (United States)

    Chan, Kun-Ming; Wang, Yu-Chao; Wu, Tsung-Han; Lee, Chen-Fang; Wu, Ting-Jung; Chou, Hong-Shiue; Yu, Ming-Chin; Lee, Wei-Chen

    2015-08-01

    Surgical treatment for primary hepatocellular carcinoma (HCC) has progressed enormously over time. The aim of this study was to analyze the evolution of surgical techniques and outcomes of patients undergoing major right hepatectomy (RH) over the last few decades.A retrospective review of 557 consecutive patients who had undergone RH for HCC between January 1982 and December 2011 was performed. Patients were categorized into subgroups and analyzed according to period and surgical approach to hepatectomy. Based on a propensity score-matching model, the surgical approach in patients in the second period was also analyzed in terms of anterior approach (AA) and conventional approach (CA)-RH.Tumor factors remained the most important prognostic factors related to postoperative HCC recurrence throughout the 2 periods examined in this study. Comparison of patients selected by a propensity score-matching model showed that AA-RH led to significantly better outcomes including recurrence-free survival (RFS) (P = 0.011) and overall survival (OS) (P = 0.012) in patients with HCC as compared with CA-RH. The 5-year RFS and OS were 33.4% and 52.2% after AA-RH, and 21.0% and 36.5% after CA-RH.Major hepatectomy has evolved into a safe procedure that can be performed with confidence. RH by an AA has shown several advantages over CA-RH, and can thus be recommended as the standard procedure for liver resection in patients who require right hepatectomy.

  6. Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MRI versus Gadobenate Dimeglumine (Gd-BOPTA)-Enhanced MRI for Preoperatively Detecting Hepatocellular Carcinoma: an Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yu Lri; Kim, Seong Hyun; Kim, Seung Hoon; Choi, Dong Il; Lee, Won Jae; Kim, Hee Jung; Koo, Ji Hyun; Lim, Hyo Keun [Samsung Medical Center, Seoul (Korea, Republic of); Jeon, Yong Hwan [Kangwon National University Hospital, Chuncheon (Korea, Republic of); Lee, Jong Mee; Kim, Min Ju [Korea University College of Medicine, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2010-08-15

    This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC). Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated. The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05). The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar

  7. Verrucoid Variant of Invasive Squamous Cell Carcinoma in Oral Submucous Fibrosis: A Clinicopathological Challenge

    Science.gov (United States)

    Ramani, Priya; Krithika, C.; Ananthalakshmi, R.; Jagdish, Praveena; Janardhanan, Sunitha; Jeevakarunyam, Sathiyajeeva

    2016-01-01

    Verrucous carcinoma (VC) is an exophytic, low-grade, well-differentiated variant of squamous cell carcinoma. It is described as a lesion appearing in the sixth or seventh decade of life that has minimal aggressive potential and, in long-standing cases, has been shown to transform into squamous cell carcinoma. Oral submucous fibrosis (OSMF) is a potentially malignant disorder, and about one-third of the affected population develop oral squamous cell carcinoma. The histopathological diagnosis of verrucous carcinoma is challenging, and the interpretation of early squamous cell carcinoma requires immense experience. Here we present a rare case of a 24-year-old male with OSMF transforming to verrucous carcinoma with invasive squamous cell carcinoma. Even though the case had a straightforward clinical diagnosis, the serial sectioning done for pathological diagnosis disclosed the squamous cell carcinoma.

  8. Squamoid eccrine ductal carcinoma*

    Science.gov (United States)

    Saraiva, Maria Isabel Ramos; Vieira, Marcella Amaral Horta Barbosa; Portocarrero, Larissa Karine Leite; Fraga, Rafael Cavanellas; Kakizaki, Priscila; Valente, Neusa Yuriko Sakai

    2016-01-01

    Squamoid eccrine ductal carcinoma is an eccrine carcinoma subtype, and only twelve cases have been reported until now. It is a rare tumor and its histopathological diagnosis is difficult. Almost half of patients are misdiagnosed as squamous cell carcinoma by the incisional biopsy. We report the thirteenth case of squamoid eccrine ductal carcinoma. Female patient, 72 years old, in the last 6 months presenting erythematous, keratotic and ulcerated papules on the nose. The incisional biopsy diagnosed squamoid eccrine ductal carcinoma. After excision, histopathology revealed positive margins. A wideningmargins surgery and grafting were performed, which again resulted in positive margins. The patient was then referred for radiotherapy. After 25 sessions, the injury reappeared. After another surgery, although the intraoperative biopsy showed free surgical margins, the product of resection revealed persistent lesion. Distinction between squamoid eccrine ductal carcinoma and squamous cell carcinoma is important because of the more aggressive nature of the first, which requires wider margins surgery to avoid recurrence. PMID:28099603

  9. Squamoid eccrine ductal carcinoma.

    Science.gov (United States)

    Saraiva, Maria Isabel Ramos; Vieira, Marcella Amaral Horta Barbosa; Portocarrero, Larissa Karine Leite; Fraga, Rafael Cavanellas; Kakizaki, Priscila; Valente, Neusa Yuriko Sakai

    2016-01-01

    Squamoid eccrine ductal carcinoma is an eccrine carcinoma subtype, and only twelve cases have been reported until now. It is a rare tumor and its histopathological diagnosis is difficult. Almost half of patients are misdiagnosed as squamous cell carcinoma by the incisional biopsy. We report the thirteenth case of squamoid eccrine ductal carcinoma. Female patient, 72 years old, in the last 6 months presenting erythematous, keratotic and ulcerated papules on the nose. The incisional biopsy diagnosed squamoid eccrine ductal carcinoma. After excision, histopathology revealed positive margins. A wideningmargins surgery and grafting were performed, which again resulted in positive margins. The patient was then referred for radiotherapy. After 25 sessions, the injury reappeared. After another surgery, although the intraoperative biopsy showed free surgical margins, the product of resection revealed persistent lesion. Distinction between squamoid eccrine ductal carcinoma and squamous cell carcinoma is important because of the more aggressive nature of the first, which requires wider margins surgery to avoid recurrence.

  10. A perspective on 10-years HTS experience at the Walter and Eliza Hall Institute of Medical Research - eighteen million assays and counting.

    Science.gov (United States)

    Lackovic, Kurt; Lessene, Guillaume; Falk, Hendrik; Leuchowius, Karl-Johan; Baell, Jonathan; Street, Ian

    2014-03-01

    The Walter and Eliza Hall Institute of Medical Research (WEHI) is Australia's longest serving medical research institute. WEHI's High Throughput Screening (HTS) Facility was established in 2003 with $5 million of infrastructure funds invested by WEHI, and the Victorian State Government's Strategic Technology Initiative through Bio21 Australia Ltd. The Facility was Australia's first truly academic HTS facility and was one of only a handful operating in publicly funded institutions worldwide at that time. The objectives were to provide access to enabling HTS technologies, such as assay design, liquid handling automation, compound libraries and expertise to promote translation of basic research in a national setting that has a relatively young biotech sector and does not have a big Pharma research presence. Ten years on and the WEHI HTS Facility has participated in over 92 collaborative projects, generated over 18 million data points, and most importantly, projects that began in the Facility have been commercialized successfully (due to strong ties with Business Development and emphasis on intellectual property management) and now have molecules progressing in clinical trials.

  11. Incidence, histopathology, and surgical outcome of tumors of spinal cord, nerve roots, meninges, and vertebral column - Data based on single institutional (Sher-i-Kashmir Institute of Medical Sciences) experience

    Science.gov (United States)

    Bhat, Abdul Rashid; Kirmani, Altaf Rehman; Wani, Muhammed Afzal; Bhat, Mohammed Haneef

    2016-01-01

    Context: In the absence of a community-based study on the spinal tumors in the Valley, medical records of the only Regional Neurosurgical Center are available. Aim: The aim of this study is to establish a hospital-based regional epidemiology of spinal tumors in the Valley since the data are derived from a single institution. Materials and Methods: A retrospective analysis of 531 malignant and nonmalignant tumors of spinal cord, its coverings and vertebrae, which were managed in a Regional Neurosurgical Center under a standard and uniform medical-protocol over 30-year period from 1983 to 2014. Results: The hospital-based incidence for all spinal tumors was 0.24/100,000 persons per year. The malignant spinal cord and vertebral tumors comprised 32.58% (173/531) of all tumors, and benign spinal cord and vertebral tumors comprised 67.42% (358/531). The extradural–intradural tumors such as metastatic lesions and primary malignant vertebral tumors were on rise with 16.38% (87/531) cases. The children below 18 years were 5.46% (29/531), of which 55.17% (16/29) were below 9 years. The most common primary bone malignancy was multiple myeloma (54.54% =12/22). Histopathologically, the most common metastatic deposit in the spinal canal was non-Hodgkin's lymphoma (24.61% =16/65). A mortality of 3.20% (17/531) was noted. Recurrences were noted in 4.90% (26/531), and adjuvant therapies were given to 16.38% (87/531) patients. Conclusion: The malignant spinal cord and vertebral tumors, especially metastatic deposits, are on rise in elderly population. The surgical outcome, in terms of recovery and spinal stability, of benign tumors, is comparatively better than malignant ones. The study reveals a low regional incidence (hospital-based) of spinal tumors. PMID:27365955

  12. Incidence, histopathology, and surgical outcome of tumors of spinal cord, nerve roots, meninges, and vertebral column - Data based on single institutional (Sher-i-Kashmir Institute of Medical Sciences experience

    Directory of Open Access Journals (Sweden)

    Abdul Rashid Bhat

    2016-01-01

    Full Text Available Context: In the absence of a community-based study on the spinal tumors in the Valley, medical records of the only Regional Neurosurgical Center are available. Aim: The aim of this study is to establish a hospital-based regional epidemiology of spinal tumors in the Valley since the data are derived from a single institution. Materials and Methods: A retrospective analysis of 531 malignant and nonmalignant tumors of spinal cord, its coverings and vertebrae, which were managed in a Regional Neurosurgical Center under a standard and uniform medical-protocol over 30-year period from 1983 to 2014. Results: The hospital-based incidence for all spinal tumors was 0.24/100,000 persons per year. The malignant spinal cord and vertebral tumors comprised 32.58% (173/531 of all tumors, and benign spinal cord and vertebral tumors comprised 67.42% (358/531. The extradural–intradural tumors such as metastatic lesions and primary malignant vertebral tumors were on rise with 16.38% (87/531 cases. The children below 18 years were 5.46% (29/531, of which 55.17% (16/29 were below 9 years. The most common primary bone malignancy was multiple myeloma (54.54% =12/22. Histopathologically, the most common metastatic deposit in the spinal canal was non-Hodgkin's lymphoma (24.61% =16/65. A mortality of 3.20% (17/531 was noted. Recurrences were noted in 4.90% (26/531, and adjuvant therapies were given to 16.38% (87/531 patients. Conclusion: The malignant spinal cord and vertebral tumors, especially metastatic deposits, are on rise in elderly population. The surgical outcome, in terms of recovery and spinal stability, of benign tumors, is comparatively better than malignant ones. The study reveals a low regional incidence (hospital-based of spinal tumors.

  13. Experiencia en reconstrucción auricular en cáncer de piel con colgajo en "quesadilla" Experience in auricle reconstruction after skin carcinoma with "quesadilla" flap

    Directory of Open Access Journals (Sweden)

    C. Gutiérrez Gómez

    2008-06-01

    Full Text Available La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y no con un simple injerto. Frente a esta dificultad técnica, diseñamos un colgajo ricamente vascularizado que preserva el cartílago no afectado con una buena cubierta y al mismo tiempo respeta la anatomía de la oreja. Para la cobertura del cartílago auricular anterior usamos un colgajo fasciocutáneo posterior que se asemeja a un plato típico de la cocina mexicana que llamamos "quesadilla", donde el cartílago por su color blanco recuerda el queso y el gran colgajo fasciocutaneo recuerda la tortilla que cubre al queso. Este colgajo incluye la piel enrollada del hélix, que en un segundo tiempo retornará a su lugar de origen anatómico mediante una z-plastía asimétrica. Presentamos, de entre una serie de 13 pacientes con carcinoma de pabellón auricular, 2 casos resueltos mediante esta técnica.Auricle reconstruction is one of the most difficult techniques because of the sophisticated and delicates forms of the ear. When we need to remove the auricular skin, preserving the cartilage is very important to keep the shape of the auricle. If treating an auricular skin cancer we find an unaffected cartilage, we can use a skin grafting, but in such delicates forms and curves many times it results inappropriate or the lack of pericondrium difficult skin graft integration. When pericondrium is affected, we will need a skin flap to cover de defect. We designed a rich vascularized flap that preserves the unaffected cartilage with an adequate coverage

  14. Hepatic resection for hepatocellular carcinoma in end-stage renal disease patients: Two decades of experience at Chang Gung Memorial Hospital

    Institute of Scientific and Technical Information of China (English)

    Chun-Nan Yeh; Wei-Chen Lee; Miin-Fu Chen

    2005-01-01

    AIM: Hepatocellular carcinoma (HCC) is a common disease in Taiwan. The prevalence of viral hepatitis infection and the subsequent development of HCC are well known to be higher in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) or peritoneal dialysis (PD) than among the general population. However, information on hepatic resection for ESRD-HCC patients is limited. METHODS: The clinical features of 26 ESRD-HCC patients who underwent hepatic resection from 1982 to 2001 were retrospectively reviewed. Meanwhile, the clinicopathological features and the outcome of 1 198 HCC patients without ESRD undergoing hepatic resection were used for comparison. RESULTS: Of 1 224 surgically resected HCC patients, 26 (4.2%) were ESRD-HCC. Univariate analysis revealed more associated disease, more physical signs of anemia and postoperative complications, lower hemoglobin, platelet, α-fetoprotein, elevated blood urea nitrogen (BUN) and creatinine levels, smaller tumors, lower HBsAg positivity, higher HCV positivity, and longer hospital stays in the ESRDHCC group compared with the HCC group. Furthermore, multivariate stepwise logistic regression analysis revealed that elevated BUN and creatinine levels were the only two independently significant factors in the patients in the ESRD-HCC group. Overall and disease-free survival rates were similar between the ESRD-HCC and HCC groups.CONCLUSION: Elevated BUN and creatinine were the only two main independent factors differentiating ESRD-HCC from HCC patients. ESRD should not be a contraindication of hepatic resection in HCC patients; however, careful operative techniques and perioperative care are crucial to achieving lower morbidity and mortality. Comparable overall survival and disease-free survival can be achieved in selected ESRD-HCC patients undergoing hepatic resection when compared with conventional HCC patients.

  15. Hepatocellular carcinoma in Budd-Chiari syndrome: A single center experience with long-term follow-up in South Korea

    Institute of Scientific and Technical Information of China (English)

    Hana Park; Jin Young Yoon; Kyeong Hye Park; Do Young Kim; Sang Hoon Ahn; Kwang-Hyub Han; Chae Yoon Chon; Jun Yong Park

    2012-01-01

    AIM:To evaluate long-term clinical course of BuddChiari syndrome (BCS) and predictive factors associated with the development of hepatocellular carcinoma (HCC)and survival.METHODS:We analyzed 67 patients with BCS between June 1988 and May 2008.The diagnosis of BCS was confirmed by hepatic venous outflow obstruction shown on abdominal ultrasound sonography,computed tomography,magnetic resonance imaging,or venography.The median follow-up period was 103 ± 156 [interquartile range (IQR)] mo.RESULTS:The median age of the patients was 47 ±16 (IQR) years.At diagnosis,54 patients had cirrhosis,25 (37.3%) Child-Pugh class A,23 (34.3%) Child-Pugh class B,and six (9.0%) patients Child-Pugh class C.During the follow-up period,HCC was developed in 17 patients,and the annual incidence of HCC in patients with BCS was 2.8%.Patients in HCC group (n =17)had higher hepatic venous pressure gradient (HVPG)than those in non-HCC group (n =50) (21 ± 12 mmHg vs 14 ± 7 mmHg,P =0.019).The survival rate of BCS patients was 86.2% for 5 years,73.8% for 10 years,and 61.2% for 15 years.In patients with BCS and HCC,survival was 79% for 5 years,43.1% for 10 years,and 21.5% for 15 years.CONCLUSION:The incidence of HCC in patients with BCS was similar to that in patients with other etiologic cirrhosis in South Korea.The HVPG is expected to provide additional information for predicting HCC development in BCS patients.

  16. Carcinomas não-palpáveis da mama: avaliação e experiência com protocolo específico para estudo anatomopatológico Non-palpable breast cancer: evaluation and experience with a specific protocol for histopathologic study

    Directory of Open Access Journals (Sweden)

    Rair Geraldo Richard Xavier

    2005-02-01

    Full Text Available INTRODUÇÃO: Nós desenvolvemos um protocolo de estudo para exame de carcinomas não-palpáveis da mama detectados por mamografia com ênfase na avaliação das margens cirúrgicas. METODOLOGIA: Revimos nossa experiência na aplicação do protocolo em 52 espécimes examinados por seis residentes e orientados por um patologista especialista em mama. Todos os espécimes foram submetidos a mamografia, a qual orientou o exame macroscópico. Os espécimes foram pintados e seccionados obedecendo-se às referências anatômicas e de acordo com seu tamanho. Espécimes 3cm foram seccionados radialmente, sendo processado um mínimo de seis fragmentos, com registro no mapa de clivagem. RESULTADOS: A maioria das cirurgias (40 casos; 76,6% foi realizada para diagnóstico e 12 (23,4% com finalidade terapêutica. Foram obtidos em média 7,4 blocos por espécime. Carcinoma ductal in situ (CDIS, isolado ou em associação com carcinoma ductal invasor, foi o tipo histológico mais freqüente (35/52 casos; 67,3%. Os tumores variaram de 0,1 a 4cm (média de 1,14cm. As margens foram positivas em 22 casos (42,2%. O tipo histológico mais comum nas margens foi o CDIS (12/22 casos. Foram reexcisados 33 casos, dos quais 17 tinham tumor residual (48,5%, a maioria de espécimes com fins diagnósticos. CONCLUSÃO: Nosso protocolo foi considerado de fácil uso pelos residentes. Embora não seja de baixo custo, devido ao tempo de exame, ao grande número de secções realizadas e por poder resultar em procedimento cirúrgico em dois tempos, ele é seguro para o diagnóstico e eficiente para a detecção de margens comprometidas.INTRODUCTION: We developed a study protocol for the examination of non-palpable breast carcinomas detected by mammography with emphasis on evaluation of surgical margins. METHODOLOGY: We reviewed our experience applying the protocol to 52 specimens evaluated by six residents oriented by a breast pathologist. All specimens were submitted to

  17. Surveillance of HCC Patients after Liver RFA: Role of MRI with Hepatospecific Contrast versus Three-Phase CT Scan—Experience of High Volume Oncologic Institute

    Directory of Open Access Journals (Sweden)

    Vincenza Granata

    2013-01-01

    Full Text Available Purpose. To compare the diagnostic accuracy of hepatospecific contrast-enhanced MRI versus triple-phase CT scan after radiofrequency ablation (RFA in hepatocellular carcinoma (HCC patients. Methods. Thirty-four consecutive HCC patients (42 hepatic nodules were treated with percutaneous RFA and underwent MR and CT scans. All patients were enrolled in a research protocol that included CT with iodized contrast medium injection and MR with hepatospecific contrast medium injection. All patients were restaged within four weeks and at 3 months from ablation. The images were reviewed by four different radiologists to evaluate tumor necrosis, residual or recurrence disease, and evidence of new foci. Results. Thirty-two nodules were necrotic after treatment; 10 showed residual disease. Six new HCCs were identified. At first month followup CT has identified 34 necrotic lesions and 8 residual diseases; no new foci were recognized. At MRI instead, 32 complete necrotic lesions were identified, 10 lesions showed residual disease, and 2 new HCCs were found. At three months, CT demonstrated 33 completely necrotic lesions, 9 residual diseases, and 2 new HCCs. MR showed 31 complete necrotic lesions, 11 cases of residual disease, and 6 new HCCs. Conclusions. Hepatospecific contrast-enhanced MRI is more effective than multiphase CT in assessment of HCC treated with RFA.

  18. Surgical outcome of adenosquamous carcinoma of the pancreas

    Institute of Scientific and Technical Information of China (English)

    Takehiro Okabayashi; Kazuhiro Hanazaki

    2008-01-01

    Adenosquamous carcinoma is rare, accounting for 3%-4% of all pancreatic carcinoma cases. These tumors are characterized by the presence of variable proportions of mucin-producing glandular elements and squamous components, the latter of which should account for at least 30% of the tumor tissue. Recently, several reports have described cases of adenosquamous carcinoma of the pancreas. However, as the number of patients who undergo resection at a single institute is limited, large studies describing the clinicopathological features, therapeutic management, and surgical outcome for adenosquamous carcinoma of the pancreas are lacking. We performed a literature review of English articles retrieved from Medline using the keywords 'pancreas' and 'adenosquamous carcinoma'. Additional articles were obtained from references within the papers identified by the Medline search. Our subsequent review of the literature revealed that optimal adjuvant chemotherapy and/or radiotherapy regimens for adenosquamous carcinoma of the pancreas have not been established, and that curative surgical resection offers the only chance for long-term survival. Unfortunately, the prognosis of the 39 patients who underwent pancreatic resection for adenosquamous carcinoma was very poor, with a 3-year overall survival rate of 14.0% and a median survival time of 6.8 mo. Since the postoperative prognosis of adenosquamous carcinoma of the pancreas is currently worse than that of pancreatic adenocarcinoma, new adjuvant chemotherapies and/or radiation techniques should be investigated as they may prove indispensible to the improvement of surgical outcomes.

  19. Synchronous gastric neuroendocrine carcinoma and hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Ewertsen, Caroline; Henriksen, Birthe Merete; Hansen, Carsten Palnæs

    2009-01-01

    UNLABELLED: Gastric neuroendocrine carcinomas (NECs) are rare tumours that are divided into four subtypes depending on tumour characteristics. Patients with NECs are known to have an increased risk of synchronous and metachronous cancers mainly located in the gastrointestinal tract. A case...... of synchronous gastric NEC and hepatocellular carcinoma in a patient with several other precancerous lesions is presented. The patient had anaemia, and a gastric tumour and two duodenal polyps were identified on upper endoscopy. A CT scan of the abdomen revealed several lesions in the liver. The lesions were...... invisible on B-mode sonography and real-time sonography fused with CT was used to identify and biopsy one of the lesions. Histology showed hepatocellular carcinoma. A literature search showed that only one case of a hepatocellular carcinoma synchronous with a gastric NEC has been reported previously. TRIAL...

  20. Clinical experience and institutional in a Department of Mental Health: The multifamily groups for parents and children with psychiatric illness in the time of post-modernity

    Directory of Open Access Journals (Sweden)

    Luisella Ferraris

    2014-09-01

    Full Text Available The following work shows the beginning and development of a multifamily group, involving mental health professionals, parents and psychiatric patients, in a mental health center. The group goals and the main functions of this setting, will be described, observing also the social and community changes, occurring in recent years. Finally, starting from the analysis of the major psychoanalysis research findings, the concepts of inter-subjectivity, therapeutic alliance and institution's role regarding the psychiatric patients’ treatment, will be deepened. Keywords: Department of Mental Health; Multifamily group; Community changes; Therapeutic alliance; Psychiatric patients

  1. Improvement of Professional Training of Maritime Fleet Specialists: Experience of Interactive Technologies Introduction in the Danube Institute of National University «Odessa Maritime Academy»

    Directory of Open Access Journals (Sweden)

    Olga Demchenko

    2016-08-01

    Full Text Available The article focuses on the coverage of the most effective methods and technologies on improving communicative skills during the professional training of maritime fleet specialists. A complex study of skills formation process for communication in a foreign language in the Danube Institute of National University «Odessa Maritime Academy» has identified its the most problematic areas. In the result of using interactive technologies («brainstorming», project techniques, etc. was established positive dynamics in formation of skills of professional communication.

  2. Concurrent chemo- and radiotherapy in patients with locally advanced carcinoma of the cervix

    NARCIS (Netherlands)

    Pras, E; Willemse, PHB; Hollema, H; Heesters, MAAM; Szabo, BG; deBruijn, HWA; Aalders, JG; deVries, EGE; Boonstra, J.

    1996-01-01

    Background: The feasibility of concurrent chemotherapy and radiotherapy for advanced primary carcinoma of the cervix was evaluated and the results were compared to historical controls. Patients and methods: In a single institution study, patients (n = 74) with primary cervical carcinoma received 3 c

  3. Concurrent chemo- and radiotherapy in patients with locally advanced carcinoma of the cervix

    NARCIS (Netherlands)

    Pras, E; Willemse, P H; Boonstra, H; Hollema, H; Heesters, M A; Szabó, B G; de Bruijn, H W; Aalders, J G; de Vries, E G

    1996-01-01

    BACKGROUND: The feasibility of concurrent chemotherapy and radiotherapy for advanced primary carcinoma of the cervix was evaluated and the results were compared to historical controls. PATIENTS AND METHODS: In a single institution study, patients (n = 74) with primary cervical carcinoma received 3 c

  4. Hedgehog pathway inhibitor in combination with radiation therapy for basal cell carcinomas of the head and neck. First clinical experience with vismodegib for locally advanced disease

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, Bjoern; Roedel, Claus; Balermpas, Panagiotis [University Hospital Johann Wolfgang Goethe University, Department of Radiation Oncology, Frankfurt (Germany); Meissner, Markus [University Hospital Johann Wolfgang Goethe University, Department of Dermatology, Frankfurt (Germany); Ghanaati, Shahram [University Hospital Johann Wolfgang Goethe University, Department of Craniofacial and Plastic Surgery, Frankfurt (Germany); Burck, Iris [University Hospital Johann Wolfgang Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany)

    2016-01-15

    Definitive radiotherapy and vismodegib, an oral inhibitor of the hedgehog pathway, are both established treatment options for locally advanced basal cell carcinomas (BCC). Both have shown good results in local tumor control; however, the effects concerning advanced tumors are often not of a lasting nature and to date no systematic data about the combination of the two modalities are available. We retrospectively analyzed four patients who received vismodegib and radiotherapy in combination. Radiation doses varied between 50.4 Gy and 66.0 Gy. Three patients had recurrent BCC. One patient had locoregional lymph node involvement. Vismodegib was taken once a day (150 mg) during the entire time of irradiation and beyond upon instructions of the attending dermatologist. In three cases a persistent complete response was observed, in one case the tumor remained stable for approximately 6 months until further tumor progression was documented. The combined therapy was well tolerated in all cases. No exceptional side effects pointing at a drug-radiation interaction were observed. The combination of vismodegib and radiation seems feasible and the initial results are promising. In our cohort, there was no increase in unexpected side effects. Further research is needed to evaluate the significance of this combined therapy. (orig.) [German] Sowohl definitive Radiotherapie als auch Vismodegib, ein oraler Inhibitor der Hedgehog-Signalkaskade, sind etablierte Behandlungsoptionen fuer lokal fortgeschrittene Basalzellkarzinome (BCC). Beide Therapien zeigen fuer sich gute Ansprechraten, aber die lokale Tumorkontrolle ist oft nicht dauerhaft und bis heute existieren kaum Daten ueber eine Kombination der beiden Modalitaeten. Wir analysierten retrospektiv vier Patientenfaelle nach simultaner Applikation von Vismodegib und Bestrahlung. Die Bestrahlungsdosis variierte zwischen 50,4 Gy und 66,0 Gy. Drei der Patienten hatten ein rezidiviertes BCC. Ein Patient hatte einen befallenen regionalen

  5. Institute news

    Science.gov (United States)

    1999-11-01

    Joining the team A new member of staff has recently joined the Institute of Physics Education Department (Schools and Colleges) team. (Dr) Steven Chapman will have managerial responsibility for physics education issues in the 11 - 16 age range, particularly on the policy side. He will work closely with Mary Wood, who spends much of her time out and about doing the practical things to support physics education pre-16. Catherine Wilson will be spending more of her time working to support the Post-16 Physics Initiative but retains overall responsibility for the department. Steven graduated in Physics and Astronomy and then went on to do his doctorate at Sussex University. He stayed in the research field for a while, including a period at NPL. Then, having decided to train as a teacher, he taught for the last five years, most recently at a brand new school in Sutton where he was Head of Physics. Physics update Dates for `Physics Update' courses in 2000, intended for practising science teachers, are as follows: 1 - 3 April: Malvern College 9 - 10 June: Stirling University 8 - 10 July: York University 8 - 10 December: Oxford University The deadline for applications for the course to be held on 11 - 13 December 1999 at the School of Physics, Exeter University, is 12 November, so any late enquiries should be sent to Leila Solomon at The Institute of Physics, 76 Portland Place, London W1N 3DH (tel: 020 7470 4821) right away. Name that teacher! Late nominations are still welcome for the Teachers of Physics/Teachers of Primary Science awards for the year 2000. Closing date for nominations is `the last week in November'. Further details can be obtained from Catherine Wilson or Barbara Hill in the Institute's Education Department. Forward and back! The Education Group's one-day meeting on 13 November is accepting bookings until almost the last minute, so don't delay your application! The day is entitled `Post-16 physics: Looking forward, learning from the past' and it aims to

  6. Carcinomas neuroendocrinos de colon y recto: Experiencia de una unidad en seis años Neuroendocrine carcinomas of the colon and rectum: A unit's experience over six years

    Directory of Open Access Journals (Sweden)

    R. Vilallonga

    2008-01-01

    Full Text Available Introducción: los tumores neuroendocrinos de colon y recto son poco frecuentes. Suelen ser tumores poco diferenciados, diagnosticados por el patólogo y de especial agresividad en su comportamiento clínico. El pronóstico suele ser malo, con tendencia a la rápida metastatización. Material y métodos: se ha revisado la experiencia de una Unidad de Coloproctología durante un periodo de seis años. Se han revisado de manera retrospectiva los pacientes con un tumor de estirpe neuroendocrina. Se han excluido los tumores carcinoides. Resultados: durante este periodo, se han intervenido 2.155 pacientes por cáncer de colon y recto y se han hallado cinco pacientes con tumores neuroendocrinos. La edad media fue de 66 años, tres varones y dos hembras. Se localizaron uno en ciego, dos en recto y dos en sigma. Dos pacientes presentaban diseminación del tumor a distancia. Se realizó cirugía en todos los pacientes con quimioterapia posterior en dos de ellos. Un paciente falleció por insuficiencia hepática postoperatoria, otro a los dos meses y otro al año. Dos pacientes siguen vivos con un seguimiento medio de ocho meses. Conclusiones: los tumores neuroendocrinos son unos tumores de aparición rara en el colon y recto. La clínica de presentación no difiere de la que podrían tener los adenocarcinomas. En el momento del diagnóstico estos tumores suelen presentar enfermedad a distancia, como en dos de los cinco casos presentados, relacionándose con un mal pronóstico para el enfermo. El tratamiento quirúrgico y quimioterápico combinado es el que puede alargar más la supervivencia de los pacientes.Introduction: neuroendocrine tumours of the colon and rectum are infrequent. They are usually undifferentiated, easy to diagnose for the pathologist and are especially aggressive in their clinical behaviour. Prognosis is usually poor and they have a high tendency to metastase early. Material and methods: we have reviewed our experience in a

  7. Metachronous colorectal carcinoma

    DEFF Research Database (Denmark)

    Bülow, Steffen; Svendsen, L B; Mellemgaard, A

    1990-01-01

    During the period 1943-67, 903 Danish patients aged less than 40 years had colorectal carcinoma. The patients were followed up for up to 41 years and during this period 44 of 501 (9 per cent) operated on for cure developed a metachronous colorectal carcinoma. The cumulative risk of a metachronous...... colorectal carcinoma was 30 per cent after up to 41 years of observation. The occurrence of a metachronous colorectal carcinoma was evenly distributed in the observation period. The cumulative survival rate after operation for a metachronous colorectal carcinoma was 41 per cent after 20 years of observation....... We propose a lifelong follow-up programme after resection of colorectal carcinoma for cure in this age group, including annual Hemoccult test and colonoscopy at 3-year intervals....

  8. URACHAL CARCINOMA IN BLADDER

    Institute of Scientific and Technical Information of China (English)

    薛丽燕; 吕宁; 何祖根; 林冬梅; 刘秀云

    2004-01-01

    Objective: To investigate the clinicopathologic features and diagnostic criteria of urachal carcinoma in the bladder.Methods: Seven cases of urachal carcinoma in the bladder were analyzed retrospectively. Results: All the tumors were found locating in the dome of bladder. Of them, 4 were mucinous adenocarcinoma, one was well differentiated papillary enteric adenocarcinoma, one was well differentiated squamous carcinoma, and one was neuroendocrine carcinoma. Cystomorphous urachal remnants were found in 4 cases. The main complaint was hematuria and all patients underwent partial excision of bladder and urachus. Conclusion: Mucinous adenocarcinoma is the main histo-pathological type, and cystomorphous urachal remnants are often accompanied with urachal carcinoma in the bladder. The key diagnostic criteria of urachal carcinoma in bladder are site and histopathology. And to examine the specimens carefully to find the urachal remnants is important.

  9. Between biomedical and psychological experiments: The unexpected connections between the Pasteur Institutes and the study of animal mind in the second quarter of twentieth-century France.

    Science.gov (United States)

    Thomas, Marion

    2016-02-01

    This article explores the unexpected connections between the Pasteur Institute in French Guinea and the study of animal mind in early twentieth century France. At a time when the study of animal intelligence was thriving in France and elsewhere, apes were appealing research subjects both in psychological and biomedical studies. Drawing on two case studies (Guillaume/Meyerson and Urbain), and then, on someone responding negatively to those connections, Thétard, this article shows how the long reach of biomedicine (linked to the prestige of Bernard and Pasteur) impinged on French biology and played a role in the tortuous, if not unsuccessful fate of animal psychology in France in the second quarter of the twentieth century. It shows how attempts to use apes (and other zoo animals) to yield new insights on animal psychology faced heavy restrictions or experienced false starts, and examines the reasons why animal psychology could not properly thrive at that time in France. Beyond the supremacy of biomedical interests over psychological ones, this article additionally explains that some individuals used animal behaviour studies as steppingstones in careers in which they proceeded on to other topics. Finally, it illustrates the tension between non-academic and academic people at a time when animal psychology was trying to acquire scientific legitimacy, and also highlights the difficulties attached to the scientific study of animals in a multipurpose and hybrid environment such as the early twentieth century Parisian zoo and also the Pasteur Institute of French Guinea.

  10. [Institutional support as a method of analysis-intervention in the context of public health policies: the experience in a general hospital].

    Science.gov (United States)

    Barros, Maria Elizabeth Barros de; Guedes, Carla Ribeiro; Roza, Monica Maria Raphael

    2011-12-01

    The article addresses the elaboration of a method for analysis/intervention in the sphere of public health policies. It describes the introduction of the National Humanization Policy of the Unified Health System (SUS) in a general hospital. It proposes institutional support expressed as a method for doing things that seeks the creation of group action, work process analysis and involves examining work management methods. It relies on promotion of health, which implies the production of subjects. The promotion of health is a networking process that involves individuals, work processes, knowledge and power. The challenge of supporting this network is to foster the exercise of the role of individuals and summon the inherent creative potential of life for the construction of new ways of work management that are not new forms of subjection. The study aims to show that by means of institutional support it is possible to bring to the fore the forces involved in the promotion of health and thereby summon the groups for an analysis of its implications. The effects produced indicate that this is a powerful strategy for the intervention of work processes within the scope of public health policies.

  11. The Medical Education Partnership Initiative (MEPI), a collaborative paradigm for institutional and human resources capacity building between high- and low- and middle-income countries: the Mozambique experience

    Science.gov (United States)

    Virgínia Noormahomed, Emília; Carrilho, Carla; Ismail, Mamudo; Noormahomed, Sérgio; Nguenha, Alcido; Benson, Constance A.; Mocumbi, Ana Olga; Schooley, Robert T.

    2017-01-01

    ABSTRACT Background: Collaborations among researchers based in lower and middle income countries (LMICs) and high income countries (HICs) have made major discoveries related to diseases disproportionately affecting LMICs and have been vital to the development of research communities in LMICs. Such collaborations have generally been scientifically and structurally driven by HICs. Objectives: In this report we outline a paradigm shift in collaboration, exemplified by the Medical Education Partnership Initiative (MEPI), in which the formulation of priorities and administrative infrastructure reside in the LMIC. Methods: This descriptive report outlines the critical features of the MEPI partnership. Results: In the MEPI, LMIC program partners translate broad program goals and define metrics into priorities that are tailored to local conditions. Program funds flow to a LMIC-based leadership group that contracts with peers from HICs to provide technical and scientific advice and consultation in a 'reverse funds flow' model. Emphasis is also placed on strengthening administrative capacity within LMIC institutions. A rigorous monitoring and evaluation process modifies program priorities on the basis of evolving opportunities to maximize program impact. Conclusions: Vesting LMIC partners with the responsibility for program leadership, and building administrative and fiscal capacity in LMIC institutions substantially enhances program relevance, impact and sustainability.

  12. Sentinel Node Mapping of VX2 Carcinoma in Rabbit Thigh with CT Lymphography Using Ethiodized Oil

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoon Jin; Kim, Young Hoon; Lee, Kyoung Ho; Park, Ji Hoon [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Lee, Hye Seung [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Jung, Seung Chai [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Joo, Seung-Moon [Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of)

    2014-07-01

    To assess the feasibility of computed tomography (CT) lymphography using ethiodized oil for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh. This experiment received approval from the institutional animal use and care administrative advisory committee. Twenty-three rabbits with VX2 carcinoma in the thigh underwent CT before and after (1 hour, 2 hour) peritumoral injection of 2 mL ethiodized oil. After the CT examination, sentinel nodes were identified by peritumoral injection of methylene blue and subsequently removed. The retrieved sentinel and non-sentinel lymph nodes were investigated with radiographic and pathologic examinations. Based on the comparison of CT findings with those of radiographic and pathologic examinations, the diagnostic performance of CT for sentinel node identification was assessed. All 23 rabbits showed 53 ethiodized oil retention nodes on post-injection CT and specimen radiography, and 52 methylene blue-stained nodes at the right femoroiliac area. Of the 52 blue-stained sentinel nodes, 50 nodes demonstrated ethiodized oil retention. Thus, the sentinel node detection rate of CT was 96% (50 of 52). On pathologic examination, 28 sentinel nodes in 17 rabbits (nodes/rabbit, mean ± standard deviation, 1.7 ± 0.6) harbored metastasis. Twenty seven of the 28 metastatic sentinel nodes were found to have ethiodized oil retention. Computed tomography lymphography using ethiodized oil may be feasible for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh.

  13. IMRT vs. 2D-radiotherapy or 3D-conformal radiotherapy of nasopharyngeal carcinoma. Survival outcome in a Korean multi-institutional retrospective study (KROG 11-06)

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Ho; Cho, Kwan Ho [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Ilsandong-gu, Goyang-si Gyeonggi-do (Korea, Republic of); Lee, Chang-Geol; Keum, Ki Chang [Yonsei University College of Medicine, Department of Radiation Oncology, Seodaemun-gu, Seoul (Korea, Republic of); Kim, Yeon-Sil [Seoul St. Mary' s Hospital, College of Medicine, the Catholic University of Korea, Department of Radiation Oncology, Seocho-gu, Seoul (Korea, Republic of); Wu, Hong-Gyun; Kim, Jin Ho [Seoul National University College of Medicine, Department of Radiation Oncology, Jongno-gu, Seoul (Korea, Republic of); Ahn, Yong Chan; Oh, Dongryul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiation Oncology, Gangnam-gu, Seoul (Korea, Republic of); Lee, Jong Hoon [The Catholic University of Korea, College of Medicine, Department of Radiation Oncology, Paldal-gu, Suwon, Gyeonggi-do (Korea, Republic of)

    2016-06-15

    We compared treatment outcomes of two-dimensional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). In total, 1237 patients with cT1-4N0-3M0 NPC were retrospectively analyzed. Of these, 350, 390, and 497 were treated with 2D-RT, 3D-CRT, and IMRT, respectively. 3D-CRT and IMRT showed better 5-year overall survival (OS) rates (73.6 and 76.7 %, respectively) than did 2D-RT (5-year OS of 59.7 %, all p < 0.001). In T3-4 subgroup, IMRT was associated with a significantly better 5-year OS than was 2D-RT (70.7 vs. 50.4 %, respectively; p ≤ 0.001) and 3D-CRT (70.7 vs. 57.8 %, respectively; p = 0.011); however, the difference between the 2D-RT and 3D-CRT groups did not reach statistical significance (p = 0.063). In multivariate analyses of all patients, IMRT was a predictive factor for OS when compared with 2D-RT or 3D-CRT, as was 3D-CRT when compared with 2D-RT. Our study showed that 3D-CRT and IMRT were associated with a better local progression-free survival and OS than was 2D-RT in NPC. IMRT was significantly superior in terms of OS for advanced primary tumors (T3-4). (orig.) [German] Wir verglichen die Behandlungsergebnisse von zweidimensionaler Strahlentherapie (2D-RT), dreidimensionaler konformer Strahlentherapie (3D-CRT) und intensitaetsmodulierter Strahlentherapie (IMRT) bei Patienten mit Nasopharynxkarzinom (NPC). Insgesamt 1237 Patienten mit NPC im Stadium cT1-4/N0-3/M0 wurden rueckwirkend analysiert. Von diesen wurden jeweils 350, 390 und 497 mit 2D-RT, 3D-CRT und IMRT behandelt. 3D-CRT und IMRT zeigten eine bessere 5-Jahres-Gesamtueberlebensrate (5y-OS; jeweils 73,6 und 76,7%) als 2D-RT (59,7%; alle p < 0,001). In der Untergruppe T3-4 war die IMRT mit einer erheblich besseren 5y-OS verbunden als 2D-RT (jeweils 70,7 vs. 50,4%; p ≤ 0,001) und 3D-CRT (jeweils 70,7 vs. 57,8%; p = 0,011); jedoch gab es keinen Unterschied zwischen den Gruppen 2D

  14. Conference Report: Functional Magnetic Resonance Imaging for Beginners – A Review of the fMRI Experience IV, 13–14 May 2002, Natcher Conference Center, National Institutes of Health, Bethesda, MD

    Directory of Open Access Journals (Sweden)

    Daniel Caggiano

    2002-01-01

    Full Text Available The fourth fMRI Experience meeting was held at the Bethesda, Maryland campus of the National Institutes of Health on May 13th and 14th, 2002. The purpose of the meeting was to provide a platform for students working with functional magnetic resonance imaging (fMRI to present their research to an international audience of peers. This year’s meeting featured special lectures from Dr. Leslie Ungerleider (“Imaging Mechanisms of Visual Attention” and Dr. Daniel Weinberger (“Genetic Variation and fMRI Response”.

  15. 香港高校财务管理的经验及对我们的启迪%Experience in the financial management of HongKong higher education institutions and its enlightenment

    Institute of Scientific and Technical Information of China (English)

    于春梅; 杨宝田

    2011-01-01

    This paper gives a detailed introduction to the status quo and features of the financial management of Hong Kong higher education institutions from six aspects such as the management structure and the sources and components of finance. Based on thorough consideration,feasible proposals were made from different angles such as government macro policies,multiple financing and purchasing management of higher education institutions,which absorb the advanced experience in financial management among higher education institutions of Hong Kong.%从香港高校的管理架构、经费来源与构成等6个方面,较为详尽地介绍了香港高校财务管理的现状及特色,并从政府宏观政策、高校多元化筹资以及采购管理等不同角度,借鉴香港高校财务管理的先进经验,提出了自身可行性的思考与建议。

  16. Transplante cardíaco: a experiência do Instituto do Coração de Pernambuco com 35 casos Heart transplant: the experience of the Heart Institute of Pernambuco with 35 cases

    Directory of Open Access Journals (Sweden)

    Fernando MORAES NETO

    2001-06-01

    Full Text Available Casuística e Métodos: Entre agosto de 1991 e fevereiro de 2000, 35 transplantes cardíacos ortotópicos foram realizados no Instituto do Coração de Pernambuco. Vinte e nove pacientes eram do sexo masculino e 6 do feminino, variando a idade de 15 a 69 anos (média 46,9. O diagnóstico dos receptores foi miocardiopatia isquêmica em 18 pacientes, miocardiopatia dilatada idiopática em 13, doença mixomatosa em 2, doença valvar reumática em 1 e doença de Chagas em 1. Todos estavam em fase final da insuficiência cardíaca (classe funcional III ou IV da classificação da New York Heart Association, e a fração de ejeção variou de 16 a 27% (média: 20,9 ± 2,9. Em todos utilizou-se a clássica técnica cirúrgica descrita por Lower e Shumway, em 1960. O tempo médio de isquemia do enxerto foi de 91 ± 21 minutos (variou de 60 a 180 min.. Resultados: Ocorreram 7 (20% óbitos no pós-operatório imediato. Treze outros pacientes apresentaram complicações não fatais, incluindo 5 episódios de rejeição. O tempo médio de seguimento dos 28 sobreviventes foi de 31,2 meses (variou de 1 a 68 meses. Houve 14 mortes tardias devido a rejeição (4, infecção (4, doença arterial coronária (2, insuficiência renal crônica (2 e morte súbita (2. A curva actuarial estima sobrevida de 70% com 1 ano e de 30% aos 5 anos. Conclusão: É possível manter um programa de transplante cardíaco em nossa comunidade, embora se deva esperar resultados piores do que os da experiência internacional devido às limitações sociais da população de receptores.Material and Methods: From August/ 1991 to February/ 2000, 35 orthotopic heart transplants were performed at the Heart Institute of Pernambuco. There were 29 male and 6 female patients ranging in age from 15 to 69 years (mean: 46.9 yr.. Recipient diagnoses included ischemic cardiomyopathy in 18, idiopatic dilated cardiomyopathy in 13, mixomatous disease in 2, rheumatic valvar disease in 1 and Chagas

  17. 机器人结直肠癌根治术的初步应用体会%Early experience of robot-assisted laparoscopic radical resection for colorectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    王首寒; 王斌; 陈佳祺; 孙小单

    2016-01-01

    Objective To investigate early experience of Da Vinci robot-assisted laparoscopic radical resection for colorectal carcinoma. Methods The clinical outcomes of 63 colorectal cancer patients undergoing robot-assisted laparoscopic radical resection from October 2014 to May 2016 were retrospectively collected and analyzed. Results All operations were completed successfully. There were no conversions to open surgery and no postoperative mortality. The robot docking time was (15.24±5.69) min. The operative time was (176.43±59.39) min. The blood loss was (28.65±22.36) ml. The number of lymph nodes harvested was (14.47±5.67). The recover time of bowel function was(51.43±12.96) hours. The postoperative hospital stay was (8.22±1.52) days. Conclusions Da Vinci robot-assisted laparoscopic radical resection for colorectal carcinoma is safe and feasible. The robotic system is suitable for clinical application.%目的:探讨达芬奇机器人手术系统应用于结直肠癌手术的初步体会。方法回顾性收集吉林省肿瘤医院腹部肿瘤科2014年10月至2016年5月的63例结直肠癌行机器人手术患者临床数据,进行整理分析。结果63例手术均顺利完成,无一例中转开腹,无术后并发症,机器人安装时间为(15.24±5.69)min,手术时间为(176.43±59.39)min,术中出血量(28.65±22.36)mL,清扫淋巴结数(14.47±5.67)枚,术后排气时间(51.43±12.96)h,术后住院日(8.22±1.52)d。结论达芬奇机器人手术系统应用于结直肠癌的手术治疗安全可行,手术效果好,术后恢复快,适合临床应用。

  18. Instituting Commoning

    Directory of Open Access Journals (Sweden)

    . STEALTH.unlimited

    2015-06-01

    Full Text Available Starting from the origins of the notion of management, this paper explores how commons governance is constituted by the earlier influential research of Elinor Ostrom, and pursues this with reference to scholars such as Saki Bailey, who emphasises that the choice of regulatory frame is ultimately a political one. We then argue that commons have to be ‘instituted’ in an open manner in order to remain accessible. This demands a set of scripts, rules or agreements that keep the process of commoning in place, and, simultaneously, keep commoning in a constant process of reproduction. We examine this tension and look at the shift in understanding about what ‘institutions of the commons’ have entailed in practice over the course of the last century and a half. Finally, we return to the political dimension to touch upon the question of whether, with the disappearance of the welfare state, a coherent concept of society can emerge from the current upsurge of commons initiatives.

  19. Exploration and Reform of Chemistry Experiment Course after Combination of Institution of Higher Learning%高校合并后化学实验课程的改革探讨

    Institute of Scientific and Technical Information of China (English)

    徐忠民; 韦须祥

    2001-01-01

    Problems in the chemistry experiment course and its teachingafter the combination of institution of higher learning were sutdied. The total reform plan about the chemistry experiment teaching adapted to the new system public basic coures teaching, imparting knowledge to students according to their varying mental make-up, improving the quality and ability was proposed.%分析了高校合并后化学实验(公共基础课)教学存在的问题,提出了"建立符合基础课教学特点、加强素质提高和能力培养、因材施教、以学生为主体的、开放式的化学实验教学新体系"为主体的总体改革方案。

  20. ‘Staging the Amateur Dispositif’ : A media archaeological experiment performed at the 9th edition of the International Orphan Film Symposium, EYE Film Institute Amsterdam

    NARCIS (Netherlands)

    Aasman, Susanna

    2014-01-01

    How did people deal with a machine like the projector? What were the social dynamics during this interaction of users with the technology? Who was allowed to handle the thing and who was not? How much experience did you need to have before employing the video recorder? Who were invited to watch the

  1. [Breast carcinoma in men].

    Science.gov (United States)

    Zigić, B; Balvanović, D; Rac, S; Bilbija, S

    1989-01-01

    The authors describe 8 cases of carcinoma of the male breast treated at the Clinic of Surgery, Clinical Medical Center Banja Luka in the period 1968-1988. In their discussion, the authors review contemporary findings concerning the genesis, evolution and treatment of this carcinoma.

  2. Circulating hematopoietic progenitors and CD34+ cells predicted successful hematopoietic stem cell harvest in myeloma and lymphoma patients: experiences from a single institution

    Directory of Open Access Journals (Sweden)

    Yu JT

    2016-02-01

    Full Text Available Jui-Ting Yu,1,2,* Shao-Bin Cheng,3,* Youngsen Yang,1 Kuang-Hsi Chang,4 Wen-Li Hwang,1 Chieh-Lin Jerry Teng,1,5,6 1Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, 2Division of Hematology/Medical Oncology, Tungs' Taichung MetroHarbor Hospital, 3Division of General Surgery, Department of Surgery, 4Department of Medical Research and Education, Taichung Veterans General Hospital, 5Department of Life Science, Tunghai University, 6School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China *These authors contributed equally to this work Background: Previous studies have shown that the numbers of both circulating hematopoietic progenitor cell (HPC and CD34+ cell are positively correlated with CD34+ cell harvest yield. However, the minimal numbers of both circulating HPCs and CD34+ cells required for performing an efficient hematopoietic stem cell (HSC harvest in lymphoma and myeloma patients have not been defined in our institution. Patients and methods: Medical records of 50 lymphoma and myeloma patients undergoing peripheral blood HSC harvest in our institution were retrospectively reviewed. The minimal and optimal HSC harvest yield required for the treatment was considered to be ≥2×106 CD34+ cells/kg and ≥5×106 CD34+ cells/kg, respectively. Results: The minimally required or optimal HSC yield obtained was not influenced by age (≥60 years, sex, underlying malignancies, disease status, multiple rounds of chemotherapy, or history of radiotherapy. The numbers of both circulating HPC and CD34+ cell were higher in patients with minimally required HSC yields (P=0.000 for HPC and P=0.000 for CD34+ cell and also in patients with optimal HSC yields (P=0.011 for HPC and P=0.006 for CD34+ cell. The cell count cutoff for obtaining minimally required HSC harvest was determined to be 20/mm3 for HPCs and 10/mm3 for CD34+ cells. Furthermore, the cell count cutoff for obtaining

  3. Summary of my experiences as an undergraduate researcher in the U.S. and as a Fulbright Student Researcher at the Institute of Immunology and Experimental Therapy in Poland

    Directory of Open Access Journals (Sweden)

    Zelasko Susan

    2016-05-01

    Full Text Available Over the course of my undergraduate studies in Molecular and Cellular Biology and the experiences following my graduation, I became increasingly interested in research that can directly improve patient care. My research experiences in the U.S. include studying cytochrome P450 enzymes in Nanodiscs at the University of Illinois Urbana-Champaign and examining immune evasion by acute lymphoblastic leukemia cells at the University of Colorado Cancer Center. Beyond work in the laboratory, I also participated in a year-long project to implement a water delivery system in Honduras, leading to my interest in infectious disease research. My interest in this field grew after learning about phage therapy, a way of treating antibiotic-resistant infections, during an honors virology seminar. Only a few research groups are dedicated to studying phage therapy, which includes the Institute of Immunology and Experimental Therapy (IIET in Poland. I was fortunate enough to receive a U.S. Fulbright research grant to study the immune response to phage therapy under the mentorship of Prof. hab. n. med. Andrzej Górski at the IIET. In this article, I will discuss my involvement at U.S. and European institutions, the insights I have gained, and how other students can similarly get involved in research.

  4. [Hepatocellular carcinoma. Part 2. Treatment].

    Science.gov (United States)

    Conte, V P

    2000-01-01

    Recent improvements on the therapeutical management of hepatocellular carcinoma are revised with special attention to evaluate the role of surgery for the disease. Considering that definitive surgical intervention is not feasible in most cases because of extreme tumor extension, multiplicity of tumor foci, and associated advanced liver cirrhosis at the time of diagnosis, others forms of treatment are listed, such as transcatheterarterial chemoembolization, percutaneous ethanol and acetic acid injections, and chemotherapy only to a small portion of patients with no indication for standard treatments. The emerging role of retinoic acid metabolism blocking agents, was examined and may offer a significant new potential treatment for cancer, inclusive the possibility of combining other anticancer drugs with exogenous retinoids or modulation of endogenous retinoids as a real opportunity to advance our ability to treat or prevent human cancer effectively Octreotide, nitrosamine and other drugs are analyzed and is concluded that improves survival and is a valuable alternative in the treatment of inoperable hepatocellular carcinoma. The potential role of intersticial laser coagulation for patients with irresectable hepatic tumors was investigated, and in terms of experience, it has now been developed sufficiently to study its effect on these patients survival. The homeostatic control of angiogenesis and its influences on the tumor growth and for migration of metastatic cells, was focused in this concise review, given that hepatocytes are the source of much of the precursor pool, regulation of angiogenesis may be regarded as a new liver function with important consequences for tissue repair and cancer. Early hepatocellular carcinoma and its recognition in routine clinical practice contributes to improved patients survival. Recombinant-Interferon-alpha therapy surely prevents, the development of cirrhosis or hepatocellular carcinoma in about one-third of patients, with

  5. Primary cutaneous myoepithelial carcinoma

    DEFF Research Database (Denmark)

    Frost, Markus Winther; Steiniche, Torben; Damsgaard, Tine Engberg;

    2013-01-01

    This study describes a case of primary myoepithelial carcinoma of the skin and reviews the available literature on this topic. Myoepitheliomas and carcinomas arise most frequently from myoepithelial cells within the salivary glands but are found in many anatomical locations. We documented a case...... of an 80-year-old man with a 2 × 2 × 1 cm tumour located on the scalp. This tumour emerged over a period of 2 months. The tumour was radically excised, and histological examination revealed a cutaneous myoepithelial carcinoma. At an 18-month follow-up, no recurrence of the tumour was found. A systematic...... literature search identified 23 papers that reported 58 cases of cutaneous myoepitheliomas and myoepithelial carcinomas. All cases are reviewed in the presented paper. This case report and literature review serves to increase awareness regarding myoepithelial carcinomas. These tumours exhibit high metastatic...

  6. Validation of the Effectiveness and Safety of Temozolomide during and after Radiotherapy for Newly Diagnosed Glioblastomas: 10-year Experience of a Single Institution.

    Science.gov (United States)

    Joo, Jin-Deok; Kim, Hansol; Kim, Young-Hoon; Han, Jung Ho; Kim, Chae-Yong

    2015-11-01

    This study was performed to validate the effectiveness and safety of concurrent chemoradiotherapy and adjuvant therapy with temozolomide for newly diagnosed glioblastoma multiforme as a standard treatment protocol. Between 2004 and 2011, patients newly diagnosed with glioblastoma who were treated with temozolomide during concurrent chemoradiotherapy and adjuvant chemotherapy were included from a single institution and analyzed retrospectively. The primary endpoint was overall survival, and the secondary endpoints were progression-free survival, response, and safety. A total of 71 patients were enrolled in this study. The response rate was 41% (29/71), and the tumor control rate was 80% (57/71). In the 67 patients who completed the concurrent chemoradiotherapy with temozolomide, the median overall survival was 19 months and the 1- and 2-yr overall survival rates were 78.3% and 41.7%, respectively. The median progression free survival was 9 months, and the 1- and 2-yr progression free survival rates were 33.8% and 14.3%, respectively. The mean duration of survival after progression of disease in salvage treatment group was 11.9 (1.3-53.2) months. Concurrent chemoradiotherapy with temozolomide resulted in grade 3 or 4 hematologic toxic effects in 2.8% of the patients. The current protocol of temozolomide during and after radiation therapy is both effective and safe and is still appropriate as the standard protocol for treatment of glioblastoma. An active salvage treatment might be required for a better prognosis.

  7. Late effects after treatment of twenty children with soft tissue sarcomas of the head and neck. Experience at a single institution with a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Fromm, M.; Littman, P.; Raney, R.B.; Nelson, L.; Handler, S.; Diamond, G.; Stanley, C.

    1986-05-15

    Twenty children with soft tissue sarcomas of the head and neck, treated at the Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania from 1972 to 1981, were evaluated for the late deleterious effects of treatment. All patients received radiation therapy and combination chemotherapy with vincristine, dactinomycin, and cyclophosphamide; certain patients also received Adriamycin (doxorubicin). All had ophthalmologic, otologic, growth, and cosmetic evaluations; 15 also had dental and maxillofacial examinations. The median age at diagnosis was 6 years (range, 7 months-13 years). Median follow-up from time of diagnosis was 5.5 years with a minimum of 3 years in all but four patients. The major problems encountered were related to the eyes (xerophthalmia and cataracts), ears (hearing loss), teeth (maleruption and caries), glandular structures (xerostomia, hypopituitarism), and development (craniofacial deformity). It is concluded that children treated for soft tissue sarcomas of the head and neck with combined modality therapy, including radiation enhancers, may show a variety of late treatment-related adversities. These children require close multidisciplinary follow-up for detection of late effects in order that appropriate prophylactic or symptomatic treatment can be instituted to minimize their consequences.

  8. Squamous cell dysplasia and carcinoma of the conjunctiva

    DEFF Research Database (Denmark)

    Ramberg, Ingvild; Heegaard, Steffen; Prause, Jan Ulrik

    2015-01-01

    %) had epithelial dysplasia, 19 (13%) had carcinoma in situ, and 29 (20%) had squamous cell carcinoma. A significantly higher proportion of men were found. The median age at diagnosis was 65 years. The risk of recurrence was 10.0% [95% confidence interval (CI): 5.0–15.0] after 1 year and 17.2% (95% CI......Purpose To investigate the epidemiology of squamous cell dysplasia and carcinoma of the conjunctiva in Denmark. Methods Review of the histopathological case reports at the Eye Pathology Institute (EPI), University of Copenhagen, and the National Danish Pathology Bank from 1980 to 2011. Information......: 10.8–23.7) after 5 years. The lesions were most often localized to the corneal limbus. In our records, one patient had a lymph node metastasis and the disease necessitated enucleation in two patients. No patients had died from squamous cell carcinoma of the conjunctiva. Conclusion Overall, our data...

  9. A decade of experience in the development and implementation of tissue banking informatics tools for intra and inter-institutional translational research

    Directory of Open Access Journals (Sweden)

    Waqas Amin

    2010-01-01

    Full Text Available Context: Tissue banking informatics deals with standardized annotation, collection and storage of biospecimens that can further be shared by researchers. Over the last decade, the Department of Biomedical Informatics (DBMI at the University of Pittsburgh has developed various tissue banking informatics tools to expedite translational medicine research. In this review, we describe the technical approach and capabilities of these models. Design: Clinical annotation of biospecimens requires data retrieval from various clinical information systems and the de-identification of the data by an honest broker. Based upon these requirements, DBMI, with its collaborators, has developed both Oracle-based organ-specific data marts and a more generic, model-driven architecture for biorepositories. The organ-specific models are developed utilizing Oracle 9.2.0.1 server tools and software applications and the model-driven architecture is implemented in a J2EE framework. Result: The organ-specific biorepositories implemented by DBMI include the Cooperative Prostate Cancer Tissue Resource (http://www.cpctr.info/ , Pennsylvania Cancer Alliance Bioinformatics Consortium (http://pcabc.upmc.edu/main.cfm , EDRN Colorectal and Pancreatic Neoplasm Database (http://edrn.nci.nih.gov/ and Specialized Programs of Research Excellence (SPORE Head and Neck Neoplasm Database (http://spores.nci.nih.gov/current/hn/index.htm. The model-based architecture is represented by the National Mesothelioma Virtual Bank (http://mesotissue.org/. These biorepositories provide thousands of well annotated biospecimens for the researchers that are searchable through query interfaces available via the Internet. Conclusion: These systems, developed and supported by our institute, serve to form a common platform for cancer research to accelerate progress in clinical and translational research. In addition, they provide a tangible infrastructure and resource for exposing research resources and

  10. Outcome of pN0 Triple-Negative Breast Cancer with or without Lymph Node Irradiation: A Single Institution Experience.

    Science.gov (United States)

    Khalifa, Jonathan; Duprez-Paumier, Raphaelle; Filleron, Thomas; Lacroix Triki, Magali; Jouve, Eva; Dalenc, Florence; Massabeau, Carole

    2016-09-01

    The optimal management of patients with pathologically node-negative triple-negative breast cancer (pN0 TNBC) remains unclear. We hypothesized that lymph node irradiation (LNI; internal mammary chain/periclavicular irradiation) had an impact on outcomes of pN0 TNBC. A cohort of 126 consecutive patients with pN0 TNBC treated between 2007 and 2010 at a single institute were included. All radiotherapy (breast/chest wall, ±LNI) was delivered adjuvantly, following completion of surgery ± chemotherapy. Tumors were reviewed and histologic features were described. Tissue microarrays were constructed and tumors were assessed by immunohistochemistry using antibodies against ER, PR, HER2, Ki-67, cytokeratins 5/6, 14, epidermal growth factor receptor and androgen receptor. Patients were divided into two groups for statistical analysis: LNI (LNI+) or no LNI (LNI-). We focused on disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS). Fifty-seven and 69 patients received or not LNI, respectively. Median age was 52 (range [25-76]) and 55 (range [29-79]) in LNI+ and LNI- group (p = 0.23). LNI was associated with larger tumors (p = 0.033), central/internal tumors (33 versus 4, p 10 mm versus ≤10 mm), histologic size (pT >10 mm versus ≤10 mm) and grade 3 (versus grade 2) were found to be significantly associated with shorter DFS. Omission of LNI in patients with pN0 TNBC does not seem to result in poorer outcome. Further studies are needed to specifically evaluate LNI in pN0 TNBC with histologic grade 3 and/or (p)T >10 mm.

  11. Trans-arterial chemo-embolization (TACE, with either lipiodol (traditional TACE or drug-eluting microspheres (precision TACE, pTACE in the treatment of hepatocellular carcinoma: efficacy and safety results from a large mono-institutional analysis

    Directory of Open Access Journals (Sweden)

    Marmorale Cristina

    2010-12-01

    Full Text Available Abstract More data about TACE and pTACE seem necessary to better define the global treatment strategy for HCC. Aim of our analysis was to evaluate the role of TACE, either with lipiodol (traditional or drug-eluting microspheres in terms of response rate (RR, time to progression (TTP, overall survival (OS and toxicity in HCC. Patients with HCC undergoing traditional TACE or pTACE (either alone or in combination with other treatment options were eligible One hundred and fifty patients were analyzed. In the global patient population median OS was 46 months for lipiodol TACE and 19 months for pTACE (p At multivariate analysis, age, the Okuda stage, type of TACE and number of TACE proved to be independent prognostic factors influencing overall survival. In our experience, lipiodol TACE showed a better OS and TTP over pTACE, without difference in toxicity profile and RR. Among the staging systems analyzed only the Okuda stage seemed able to reliably predict patients outcome.

  12. Gastric Large Cell Neuroendocrine Carcinoma

    Science.gov (United States)

    Rustagi, Tarun; Alekshun, Todd J.

    2010-01-01

    with a platinum-based regimen. Discussion: In the current WHO classification of gastric tumors, only carcinoids and small cell carcinomas are included in the neuroendocrine (NE) tumor category. However, a new pathologic entity has recently been described by Jiang et al. High-grade gastric NE carcinomas of non-small cell type have been tentatively named large cell neuroendocrine carcinomas (LCNEC). Morphologically, these tumors differ from both carcinoids and small cell carcinomas, and are confirmed immunohistochemically using NE markers, chromogranin-A and synaptophysin. Gastric LCNEC is currently defined if > 50% of tumor cells demonstrate positivity for chromogranin-A and/or synaptophysin. LCNECs account for < 1.5% of all gastric cancers. LCNECs, which had been previously diagnosed as adenocarcinomas (ACs) are highly malignant and portend a significantly worse prognosis than ACs. Reported 5-year survival rates for LCNECs and ACs have are 31.1% and 69.3%, respectively. At the time of presentation, 70–75% of LCNECs have lymph node metastases and 5–10% also have metastases to liver. Clinical management of gastric LCNECs has not been clearly defined given the rarity of the malignancy and limited experience in its management. An overall regression rate of 67% was achieved in a small series of poorly differentiated gastroenteropancreatic NE carcinomas treated with cisplatin and etoposide.

  13. Ethic Review on Clinical Experiments of Medical Devices in Medical Institutions%医疗机构中医疗器械临床试验的伦理审查

    Institute of Scientific and Technical Information of China (English)

    帅万钧; 晁勇; 王宁; 徐世宁

    2011-01-01

    医疗器械临床试验是对医疗器械的安全性和有效性按照规定进行试用或验证的过程,该过程需由具有医疗器械临床试验资格的医疗机构审核,经其医学伦理委员会评审通过后,方可进行.对医疗机构中医疗器械临床试验伦理审查的内容、流程和批准标准分别进行了分析和评述,为医疗机构保证临床试验的安全有效提供依据.%Clinical experiments are always used to evaluate the safety and validity of medical devices.The experiments have two types of clinical trying and testing.Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments.In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  14. Is there a role for mammary stem cells in inflammatory breast carcinoma?: a review of evidence from cell line, animal model, and human tissue sample experiments.

    Science.gov (United States)

    Van Laere, Steven; Limame, Ridha; Van Marck, Eric A; Vermeulen, Peter B; Dirix, Luc Y

    2010-06-01

    Stem cells are pluripotent cells, with a large replicative potential, which perform normal physiological functions such as tissue renewal and damage repair. However, because of their long lifespan and high replicative potential, stem cells are ideal targets to accumulate multiple mutations. Therefore, they can be regarded as being responsible for the initiation of tumor formation. In the past, numerous studies have shown that the presence of an elaborate stem cell compartment within a tumor is associated with aggressive tumor cell behavior, frequent formation of metastases, resistance to therapy, and poor patient survival. From this perspective, tumors from patients with inflammatory breast cancer (IBC), an aggressive breast cancer subtype with a dismal clinical course, are most likely to be associated with stem cell biology. To date, this hypothesis is corroborated by evidence resulting from in vitro and in vivo experiments. Both gene and microRNA expression profiles highlighted several stem cell-specific signal transduction pathways that are hyperactivated in IBC. Also, these stem cell-specific signal transduction pathways seem to converge in the activation of nuclear factor-kappa B, a molecular hallmark of IBC, and induction of epithelial-to-mesenchymal transition. Recently, the latter mechanism was identified as a prerequisite for the induction of stem cell characteristics in breast cancer cells.

  15. Narrating Motherhood as Experience and Institution: Experimental Life-Writing in Mary Kelly’s Post-Partum Document (1973–79

    Directory of Open Access Journals (Sweden)

    Wierzchowska Justyna

    2015-12-01

    Full Text Available This article explores American visual artist Mary Kelly’s autobiographical work Post-partum document in reference to the politics of life writing. Resorting to Lacanian psychoanalysis, a pastiche of scientific narratives and other (auto-narrative strategies, in her work Kelly documented the first five years of her son’s life from his weaning from the breast until the day when he wrote his name. By documenting her child’s development, the artist also recorded the process of her own formation as a maternal subject, a formation gradually worked out through an evolving relationship with her son. In her work, the artist made vivid the incompatibility and limitations of various narrative frameworks in retelling a fundamentally relational experience that verges on the mental and bodily, and which is necessarily mediated by the patriarchal ideology. This article analyses Kelly’s conflicting narrative strategies that fail to successfully represent the mother-child formative relationship and which demonstrate the mother’s ideological alienation. It reads Kelly’s work politically, exploring the ways in which Post-partum document’s (auto-narrative voices address questions and dilemmas of the feminine/maternal subject, the subject’s formation, and the limits of its (self- representation within patriarchy. The article argues that Kelly challenges the traditional autobiographic genre by attending to her lived experience as a mother and the culturally repressed maternal desire.

  16. Lung Transplantation and the Routine Use of Cardiopulmonary Bypass and Median Sternotomy: Experience at the Ochsner Multi-Organ Transplant Institute

    Science.gov (United States)

    Bates, Michael; Factor, Matthew; Parrino, P. Eugene; Bansal, Aditya; Rampolla, Reinaldo; Seoane, Leonardo; Mena, Jose; Gaudet, Matthew; Smith, William; McFadden, P. Michael

    2017-01-01

    Background: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups. Methods: After institutional review board approval, we conducted a retrospective review of the entire program using the Ochsner lung transplant database to identify patients in the non-CPB group from 1990-2005 and in the CPB group from 2010-2014. We calculated 1- and 3-year survival rates for each patient and reviewed medical records for evidence of stroke, the need for operative reexploration, and venous stenosis. We also performed a subgroup analysis of the first 20 consecutive patients undergoing lung transplantation on CPB with median sternotomy from February 2010 through April 2011 to examine intraoperative blood product use, the quantity of blood products administered, CPB cannulation and pump complications, ischemic time, and primary graft dysfunction. Results: Of the 208 patients in the non-CPB group, 74% had 1-year graft survival and 55% had 3-year survival following transplantation. After February 2010, 79 patients underwent lung transplantation on CPB with median sternotomy, and 90% of those patients had 1-year graft survival. Of the 46 patients available for 3-year follow-up, 59% were alive with functional grafts. The difference in 1-year survival rates between the 2 cohorts was statistically significant. Two deaths, 3 strokes, and 5 reexplorations of the chest for bleeding occurred during the perioperative time period in the CPB group, but no mortality was associated with these perioperative events. One patient who had perioperative

  17. Experience of Radiofrequency Ablation Treatment of Thyroid Papillary Micro-carcinoma Under Ultrasound Guidance%超声引导下射频消融治疗甲状腺微小乳头状癌的临床体会

    Institute of Scientific and Technical Information of China (English)

    刘晓岭; 黄靖; 孙德胜; 韦伟

    2015-01-01

    Objective To summarize the clinical experience of radiofrequency ablation ( RFA) treatment of thyroid papillary micro -carcinoma under ultrasound guidance .Methods (1)9 patients, with 11 lesions, were recruited with ultrasonography diagnosis of thyroid micro-carcinoma (less than 10 mm in diameter), who were anxious about the mass but non -acceptance of surgery.(2)Core needle his-tological biopsy was done before RFA;then the lesions were treated by RFA under ultrasound guidance .All the patients were followed up by ultrasound scan.Results (1)All patients recovered with no FRA related complications .(2)Seven lesions was pathologically diagnosed as thyroid papillary carcinoma , and in four lesions tumor cells weren′t pathologically found .( 3 ) All cases were followed up from 12 to 18 months.Post ablated lesions became smaller and smaller during follow -up, and diminished within 6 months.There was no abnormal ima-ging which was considered recurrence in both thyroid and lymph nodes .Conclusion (1)RFA could be considered as a safe and effective method in treating papillary micro -carcinoma of thyroid.(2)Due to the advantages of safety and minimally invasion of RFA , thyroid le-sions, which were highly suspected malignant, was one of the indications of RFA, even if there was no pathological confirmation.(3)Long time follow-up are needed to observe the effect and side -effect of FRA.%目的:总结超声引导下射频消融治疗甲状腺微小乳头状癌的临床经验和体会。方法(1)病例选择:超声检查疑为甲状腺微小乳头状癌(病灶最大直径小于10 mm),且患者希望首选非手术治疗者。共选取9例患者,11个病灶。(2)方法:治疗前先行病灶的组织学穿刺活检,之后在超声引导下进行甲状腺病灶的射频消融治疗,射频消融治疗后应用超声造影进行定期随访。结果(1)所有病例治疗后恢复顺利,未出现并发症;(2)11个病灶的病理诊断中,7

  18. Clinical Analysis of Diagnosis and Treatment Experiences of Gallbladder Adenosquamous Carcinoma, report of 29 cases%胆囊腺鳞癌29例临床诊治经验分析

    Institute of Scientific and Technical Information of China (English)

    史海达; 史宪杰; 周林; 马焕先; 梁雨荣; 石雍; 徐明月; 齐瑞兆

    2016-01-01

    目的:回顾性分析胆囊腺鳞癌的临床病理特点及诊治经验,初步探讨男性和女性胆囊腺鳞癌患者发病及预后的差异。方法以2000年1月至2015年12月收治的29例胆囊腺鳞癌患者的临床资料为研究对象,分男女患者组对术前的影像学、实验室指标,术后病理特征;手术方式及生存时间进行统计分析。计量资料采用x珋±s表示,采用student’ t检验(正态分布)或秩和检验(非正态分布);计数资料以百分比(%)表示,采用χ2检验或Fisher精确概率法。以SPSS统计软件18.0为分析手段,P<0.05为差异有统计学意义。结果29例患者中,26例行根治性手术,3例行姑息性手术,肿瘤标记物水平、肿瘤大小、分期、是否合并结石、局部侵犯和远处转移程度,男女组间差异均无统计学意义(P>0.05),术后病理:Her-1阳性9例(9/11),Her-2阳性5例(5/11),CK18阳性8例(8/9), CK19阳性7例(7/8),VEGF 3例(3/3),Heptocyte 阳性0例(0/5),术后总生存期为(4.56±1.67)个月,其中男患者组(3.63±1.54)个月,显著低于女患者组(5.42±1.30)个月,差异具有统计学意义(P=0.002)。结论胆囊腺鳞癌临床罕见、恶性程度高、临床表现缺乏特异性,多以局部侵犯为主,手术是目前主要的治疗手段,男女虽发病率无显著差异,但预后具有一定差异。%Objective Retrospective analysis of the clinical pathological characteristics and treatment experience of gallbladder adenosquamous carcinoma was performed , to investigate pathogenetic and prognostic differences between male and female patients with gallbladder adenosquamous carcinoma . Methods 29 patients with gallbladder adenosquamous carcinoma admitted between Jan 2000 to Dec 2015 were enrolled in the study.Statistical analysis were performed by using SPSS 18.0 statistical software

  19. Multimodality functional imaging using DW-MRI and 18F-FDG-PET/CT during radiation therapy for human papillomavirus negative head and neck squamous cell carcinoma: Meixoeiro Hospital of Vigo Experience

    Science.gov (United States)

    Aramburu Núñez, David; Lopez Medina, Antonio; Mera Iglesias, Moisés; Salvador Gomez, Francisco; Dave, Abhay; Hatzoglou, Vaios; Paudyal, Ramesh; Calzado, Alfonso; Deasy, Joseph O; Shukla-Dave, Amita; Muñoz, Victor M

    2017-01-01

    AIM To noninvasively investigate tumor cellularity measured using diffusion-weighted magnetic resonance imaging (DW-MRI) and glucose metabolism measured by 18F-labeled fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) during radiation therapy (RT) for human papillomavirus negative (HPV-) head and neck squamous cell carcinoma (HNSCC). METHODS In this prospective study, 6 HPV- HNSCC patients underwent a total of 34 multimodality imaging examinations DW-MRI at 1.5 T Philips MRI scanner [(n = 24) pre-, during- (2-3 wk), and post-treatment (Tx), and 18F-FDG PET/CT pre- and post-Tx (n = 10)]. All patients received RT. Monoexponential modeling of the DW-MRI data yielded the imaging metric apparent diffusion coefficient (ADC) and the mean of standardized uptake value (SUV) was measured from 18F-FDG PET uptake. All patients had a clinical follow-up as the standard of care and survival status was documented at 1 year. RESULTS There was a strong negative correlation between the mean of pretreatment ADC (ρ = -0.67, P = 0.01) and the pretreatment 18F-FDG PET SUV. The percentage (%) change in delta (∆) ADC for primary tumors and neck nodal metastases between pre- and Wk2-3 Tx were as follows: 75.4% and 61.6%, respectively, for the patient with no evidence of disease, 27.5% and 32.7%, respectively, for those patients who were alive with disease, and 26.9% and 7.31%, respectively, for those who were dead with disease. CONCLUSION These results are preliminary in nature and are indicative, and not definitive, trends rendered by the imaging metrics due to the small sample size of HPV- HNSCC patients in a Meixoeiro Hospital of Vigo Experience. PMID:28144403

  20. Salivary gland carcinomas

    DEFF Research Database (Denmark)

    Therkildsen, M H; Andersen, L J; Christensen, M;

    1998-01-01

    The prognosis of salivary gland carcinomas is difficult to assess. Simple mucin-type carbohydrates (T and sialosyl-T antigens, Tn and sialosyl-Tn antigens) have been shown to be of value in predicting prognosis for carcinomas in other locations. We studied the prognostic significance...... of the expression of these structures in a retrospective study of 133 patients with salivary gland carcinomas, using immunohistochemistry and a panel of well-defined monoclonal antibodies (MAbs) on formalin-fixed paraffin-embedded tissues. Sialosyl-Tn, T and sialosyl-T antigens were not correlated with prognosis...

  1. 报废汽车回收利用体系的制度演化--日本经验和启示%System for Recycling of ELVs:Institutions and Evolution---Japan's Experience and Enlightenment

    Institute of Scientific and Technical Information of China (English)

    乌力吉图; 徐静

    2013-01-01

    日本报废汽车回收利用体系经历了传统和循环型两个阶段。文章考察了传统体系的主体结构、存在的问题和制度变化的成因;探讨了循环型体系中的汽车生产商责任、回收处理成本以及汽车回收利用促进中心的经济学意义,解析生产者责任延伸制度在回收利用体系中的实践模式,指出制度的演化是日本报废汽车回收利用产业持续发展的动力所在,并在此基础上从风险管理、制度建设和监管方式等3个维度提出日本经验对我国的启示。%The end-of-life vehicles recycling system in Japan has gone through stages of traditional and recycling respectively . This article examines the main structure , the existing problems and the cause of institutional changes at the traditional stage , and explores automobile manufacturers'responsibility , recycling cost , and the economic significance of Japan Automobile Recycling Promotion Center (JARC ) in the recycle system , and also analyses the practice model of the Extended Producer Responsibility (EPR ) in the recycle sys-tem , and points out that the institutional evolution is the drive of Japan's sustainable end-of-life vehicles recycling industry . On this ba-sis , Japan's experience and enlightenment are discussed from the dimension of risk management , institutional building and supervision models .

  2. Institutional mysteries

    Directory of Open Access Journals (Sweden)

    Sidney W. Mintz

    2008-12-01

    Full Text Available [First paragraph] Africa and the Americas: Interconnections During the Slave Trade. José C. Curto & Renenée Soulodrere-La France (eds.. Trenton NJ: Africa World Press, 2005. vii + 338 pp. (Paper US$ 29.95 Slavery and African Ethnicities in the Americas. Gwenendolyn Midlo Hall. Chapel Hill: University of North Carolina Press, 2005. xxii + 225 pp. (Cloth US$ 34.95 The forced movement of enslaved Africans to the New World – before the nineteenth century, surely the largest and longest such uprooting and transfer of people in global history – resulted over time in a vast corpus of research and publication, of which these two books are a part. The first is an edited collection of twelve essays, preceded by a slightly giddy preface; the second is its author’s attempt to widen her research on African ethnic groups in the Americas, so as to demonstrate their existence. The themes of both books exemplify recent thinking among scholars of the African-American experience.

  3. ADENOSQUAMOUS LUNG CARCINOMA: CLINICAL CHARACTERISTICS,SURGICAL TREAMENT AND PROGNOSIS

    Institute of Scientific and Technical Information of China (English)

    贲勇; 于洪泉; 王振杰; 苗齐; 任华; 张志庸; 李泽坚

    2000-01-01

    Objective. The effectiveness of surgical resection of adenosquamous carcinoma of the lung remains poorly defined because of the histology' s relatively low frequency, the failure in most published series to separate adenosquamous carcinoma from the other variants of non-small cell lung carcinoma. To define the effectiveness of surgical treatment of adenosquamous carcinoma, we have retrospectively reviewed our hospital experience over a 12-year period. Methods. Retrospectively reviewed 22 cases of adenosquamous carcinoma who were surgically treated, except one patient,in the PUMCH from Jan. 1985 to Aug. 1997.This series constitutes the 1.9% of a total of 1 245 patients with all types of surgical treatment for the primary lung cancer during the same time. Results. The adenosquanous carcinoma was mostly presented in the old patients with a mean age of 60 years and mostly located in the peripheral of lung(n= 20).The overall 5-year survival was 23%.Those with stage Ⅰ tumors survival was only 18%(n= 13), stage Ⅱ 5%. The survival in stage Ⅲ tumors was not longer than 25 months and in stage Ⅳ survival was not longer than 12 months. Conclusion. Our results suggest that adenosquamous carcinoma of lung was a virulent tumor, which exhibited highly aggressive biological behavior with early lymph nodes metastasis(46% ) and its prognosis was worse than that of both squamous cell carcinoma and adenocarcinoma.

  4. [Experiences and recommendations of the German Federal Institute for Drugs and Medical Devices (BfArM) concerning clinical investigation of medical devices and the evaluation of serious adverse events (SAE)].

    Science.gov (United States)

    Renisch, B; Lauer, W

    2014-12-01

    An integral part of the conformity assessment process for medical devices is a clinical evaluation based on clinical data. Particularly in the case of implantable devices and products of risk class III clinical trials must be performed. Since March 2010 applications for the authorization of clinical trials as well as for the waiver of the authorization requirement must be submitted centrally in Germany to the appropriate federal authority, the Federal Institute for Drugs and Medical Devices (BfArM) or the Paul Ehrlich Institute (PEI). In addition to authorization, approval by the responsible ethics committee is also required under law in order to begin clinical testing of medical devices in Germany. In this paper, the legal framework for the clinical testing of medical devices as well as those involved and possible procedures including evaluation criteria for the initial application of a trial and subsequent amendments are presented in detail. In addition, the reporting requirements for serious adverse events (SAEs) are explained and possible consequences of the evaluation are presented. Finally, a summary of application and registration numbers for all areas of extensive experience of the BfArM as well as requests and guidance for applicants are presented.

  5. Institutions, Institutional Change, Language, and Searle

    NARCIS (Netherlands)

    W.A. Dolfsma (Wilfred); R. McMaster; J. Finch

    2005-01-01

    textabstractThis paper endeavours to contribute to the growing institutionalist literature on the conception of the institution. We draw from John Davis’ (2003) analysis of the individual in posing the questions: what differentiates institutions, and how can changing institutions be identified thro

  6. Minimally invasive surgery for benign intradural extramedullary spinal meningiomas: experience of a single institution in a cohort of elderly patients and review of the literature

    Directory of Open Access Journals (Sweden)

    Iacoangeli M

    2012-12-01

    Full Text Available Maurizio Iacoangeli, Maurizio Gladi, Alessandro Di Rienzo, Mauro Dobran, Lorenzo Alvaro, Niccolò Nocchi, Lucia Giovanna Maria Di Somma, Roberto Colasanti, Massimo ScerratiDepartment of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Meningiomas of the spine are the most common benign intradural extramedullary lesions and account for 25%–46% of all spinal cord tumors in adults. The goal of treatment is complete surgical resection while preserving spinal stability. Usually, these lesions occur in the thoracic region and in middle-aged women. Clinical presentation is usually nonspecific and the symptoms could precede the diagnosis by several months to years, especially in older people, in whom associated age-related diseases can mask the tumor for a long time. We report a series of 30 patients, aged 70 years or more, harboring intradural extramedullary spinal meningiomas. No subjects had major contraindications to surgery. A minimally invasive approach (hemilaminectomy and preservation of the outer dural layer was used to remove the tumor, while preserving spinal stability and improving the watertight dural closure. We retrospectively compared the outcomes in these patients with those in a control group subjected to laminectomy or laminotomy with different dural management. In our experience, the minimally invasive approach allows the same chances of complete tumor removal, while providing a better postoperative course than in a control group.Keywords: spinal meningioma, elderly, hemilaminectomy, outer dural layer, inner dural layer, minimally invasive surgery

  7. IORT and external beam irradiation (EBI) in clinical stage I-II NSCLC patients with severely compromised pulmonary function: an 52-patient single-institutional experience

    Energy Technology Data Exchange (ETDEWEB)

    Jakse, G.; Kapp, K.S.; Geyer, E.; Oechs, A. [Dept. of Therapeutic Radiology and Oncology, Dept. of Surgery, Medical Univ. of Graz (Austria); Maier, A.; Gabor, S.; Juettner, F.M. [Div. of Thoracic and Hyperbaric Surgery, Medical Univ. of Graz (Austria)

    2007-12-15

    In limited stage NSCLC surgery offers the best chance for cure. However, patients who would not tolerate a radical surgical procedure such as lobectomy on the basis of severely compromised pulmonary function or cardio respiratory impairment are also poor candidates for radical external beam irradiation. These patients may benefit from alternative procedures that allow maximum sparing of adjacent lung tissue such as brachytherapy, stereotactic radiotherapy or IORT. There is clear evidence that loco-regional control in lung cancer is dose related, but neighboring normal tissues such as ipsilateral or collateral lung, heart, spinal cord are limiting factors for delivering doses necessary to eradicate the primary or loco-regional metastases. The rational of IORT, builds on the observation that only patients in whom local control has been achieved had a prolonged survival. IORT permits to selectively deliver high single doses to the tumor or the tumor bed with maximum sparing of adjacent normal tissue and has been applied with curative and palliative intent in a variety of tumors. Experience with IORT in lung cancer is still very limited. The current study evaluates the outcome of combined IORT and EBI in a highly selected cohort of patients with clinical stage I-II NSCLC who were fit to undergo thoracotomy and lymph node sampling but unable to undergo lobectomy or conventional high dose EBI due to severely compromised pulmonary function. (orig.)

  8. Thyroid cancer - papillary carcinoma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000331.htm Thyroid cancer - papillary carcinoma To use the sharing features on ... the lower neck. Causes About 80% of all thyroid cancers diagnosed in the United States are the papillary ...

  9. MEDULLARY THYROID CARCINOMA

    Directory of Open Access Journals (Sweden)

    V. S. Medvedev

    2013-01-01

    Full Text Available Medullary thyroid carcinoma belongs to orphan diseases affecting a small part of the population. Multicenter trials are required to elaborate a diagnostic algorithm, to define treatment policy, and to predict an outcome.

  10. Parathyroid carcinoma: case report

    Science.gov (United States)

    STURNIOLO, G.; GAGLIANO, E.; TONANTE, A.; TARANTO, F.; PAPALIA, E.; CASCIO, R.; DAMIANO, C.; VERMIGLIO, F.; STURNIOLO, G.

    2013-01-01

    Summary: The authors present a case of parathyroid carcinoma in a patient with primary hyperparathyroidism. Following a literature review, the clinical and diagnostic profile, treatment and prognosis of this rare disease are discussed. PMID:23837957

  11. Breast carcinoma metastases.

    Science.gov (United States)

    Bodzin, G A; Staren, E D; Faber, L P

    1998-02-01

    With careful selection of patients, complete resection of pulmonary metastases from breast carcinoma may be a useful therapeutic option. Such a treatment appears to offer a significant survival benefit when compared with medical treatment alone, or with incomplete resection.

  12. [The experience of implementation of system of quality management in the Department of Laboratory Diagnostic of the N.V. Sklifosofskiy Research Institute of Emergency Care of Moscow Health Department: a lecture].

    Science.gov (United States)

    Zenina, L P; Godkov, M A

    2013-08-01

    The article presents the experience of implementation of system of quality management into the practice of multi-field laboratory of emergency medical care hospital. The analysis of laboratory errors is applied and the modes of their prevention are demonstrated. The ratings of department of laboratory diagnostic of the N. V. Sklifosofskiy research institute of emergency care in the program EQAS (USA) Monthly Clinical Chemistry from 2007 are presented. The implementation of the system of quality management of laboratory analysis into department of laboratory diagnostic made it possible to support physicians of clinical departments with reliable information. The confidence of clinicians to received results increased. The effectiveness of laboratory diagnostic increased due to lowering costs of analysis without negative impact to quality of curative process.

  13. Managing institutional dynamics: generalisation of modern approaches

    Directory of Open Access Journals (Sweden)

    Mazur Olena Ye.

    2013-03-01

    Full Text Available The article presents a critical analysis and systematisation of modern approaches to state management of development of institutional structures. It identifies the most popular approaches to management of institutional dynamics: implantations or shock therapy, import (transplantation and its modifications (institutional experimenting and building intermediary institutions, growing institutions and modification (elevation and cultivation and influence upon external factors of institution development. The article builds structural and logical schemes to each approach and identifies main shortcomings and restrictions of their application. It justifies prospectiveness and universality of the theory of priority of external factors in re-formation of socio-economic institutions. It offers a direction of further scientific studies on development of a specific methodology of re-formation of a specific institution on the basis of a selected and justified common strategy.

  14. Carcinoma hepatocelular: parte 2. Tratamento Hepatocelular carcinoma: part 2. Therapy

    Directory of Open Access Journals (Sweden)

    Vinício Paride CONTE

    2000-04-01

    alternative in the treatment of inoperable hepatocellular carcinoma. The potential role of intersticial laser coagulation for patients with irresectable hepatic tumors was investigated, and in terms of experience, it has now been developed sufficiently to study its effect on these patients survival. The homeostatic control of angiogenesis and its influences on the tumor growth and for migration of metastatic cells, was focused in this concise review, given that hepatocytes are the source of much of the precursor pool, regulation of angiogenesis may be regarded as a new liver function with important consequences for tissue repair and cancer. Early hepatocellular carcinoma and its recognition in routine clinical pratice contributes to improved patients survival. Recombinant-Interferon-alpha therapy surely prevents, the development of cirrhosis or hepatocellular carcinoma in about one-third of patients, with chronic hepatitis C, with sustained response. Finally, in individuals with life-threatening liver disease, such as those with cirrhosis and hepatocellular carcinoma, the liver transplantation, must be considered, besides controversial, however, with increasing experience the results of the procedure in these patients have improved, and may offer a better long-term survival than liver resection.

  15. Operation, management and service model of rehabilitation institutions -the Japanese experience%日本康复机构运营管理及服务模式对我国参考意义

    Institute of Scientific and Technical Information of China (English)

    黄秋晨; 卢迪迪; 李莹; 褚添翼; 王萌萌; 密忠祥; 程军; 崔志茹; 李蓓; 王葆华; 周小跃; 鲍雯; 刘菲

    2015-01-01

    日本康复事业起步于1945年,比中国早约43年。经过近70年发展,日本康复从无到有,建立了一个完善的康复体系,无论在运营体系、绩效评估,还是在管理方法上都取得了一套较为成熟的理念和经验。作者通过文献调查,综合分析了日本康复机构运营管理及服务模式的成功经验,并结合国内医疗机构管理现状,为康复机构的运营者和康复科室的管理者提供机构定位、人员配置和效益分析等建议。%Rehabilitation care in Japan was carried out in 1945 and by nearly 70 years of development, a comprehensive rehabilitation system has been established in Japan which involves a series of mature concepts and experiences in terms of operation/management system, outcome evaluation and administrative measures. In this article, literature analysis was carried out to dig into the success story of Japan’s operation/management and service models, in hope they can shed lights on China’s rehabilitation institution management. This article also drew experiences on function positioning, staff composition and benefit analysis of rehabilitation institution administrators and managers of rehabilitation departments.

  16. Papillary thyroid carcinoma

    DEFF Research Database (Denmark)

    Godballe, C; Asschenfeldt, P; Sørensen, J A;

    1994-01-01

    The age influence on the prognosis of papillary thyroid carcinoma was analyzed in a group of 67 patients. A marked decline in cause-specific survival was found for patients older than 60 years of age at the time of diagnosis. In order to find a tumor-biological explanation of the prognostic...... invasion and distant metastases. The results indicate that 60 years of age the time of diagnosis may be the "prognostic break-point" for papillary thyroid carcinoma....

  17. Pathobiology of ovarian carcinomas

    Institute of Scientific and Technical Information of China (English)

    Mojgan Devouassoux-Shisheboran; Catherine Genestie

    2015-01-01

    Ovarian tumors comprise a heterogeneous group of lesions, displaying distinct tumor pathology and oncogenic potentiel. These tumors are subdivided into three main categories: epithelial, germ cell, and sex-cord stromal tumors. We report herein the newly described molecular abnormalities in epithelial ovarian cancers (carcinomas). Immunohistochemistry and molecular testing help pathologists to decipher the significant heterogeneity of this disease. Our better understanding of the molecular basis of ovarian carcinomas represents the first step in the development of targeted therapies in the near future.

  18. Imaging of tongue carcinoma

    OpenAIRE

    Ong, Cheng K.; Chong, Vincent F.H.

    2006-01-01

    The tongue enables taste and plays a critical role in formation of food bolus and deglutition. The tongue is also crucial for speech and the earliest sign of tongue paresis is a change in the quality of speech. Given the importance of the tongue, tongue carcinoma should be accurately staged in order to optimise treatment options and preserve organ function. The intent of this review is to familiarise radiologists with the pertinent anatomy of the tongue and the behaviour of tongue carcinoma s...

  19. Concomitant pelvic irradiation and chemotherapy in locally advanced cervical carcinoma. A retrospective study of 92 patients treated at the Curie Institute; Chimioradiotherapie dans les cancers du col uterin localement evolues. Etude retrospective de 92 patientes traitees a l'Institut Curie de 1986 a 1998

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, D.; Rochefordiere, A. de la; Chauveinc, L.; Cosset, J.M. [Institut Curie, Dept. de Radiotherapie, 75 - Paris (France); Clough, K.B. [Institut Curie, Dept. de Chirurgie, 75 - Paris (France); Mouret-Fourme, E.; Guyonnet, M. [Institut Curie, Service de Biostatistiques, 75 - Paris (France)

    2002-06-01

    The prognosis of locally advanced cervix cancers is poor with metastatic and local recurrence risks. Recent publications reported that concurrent chemotherapy and pelvic radiation increased local control compared to radiotherapy alone. Chemotherapy could also decrease metastatic recurrences. We report 92 cases of patients with locally advanced cervix cancer treated between 1986 and 1998 at the Institut Curie. Patients and methods. - Concurrent chemo-radiation was exclusive in 51 cases and added to surgery in 41 cases. Chemotherapy with 5FU -Cisplatin-Mitomycin C-Vindesin (protocol A) was performed for 43% of patients and 57% of them received 5FU-Cisplatin alone (protocol B). Results. -Median follow-up was 64 months (6-149 months). Five-year disease-free survival rate was 47% and local control rate was 70%. Disease-free survival was correlated with therapeutic response. After exclusive chemo-radiation, the good responsive patients had a better DFS (54% vs 26%, p=0.018). In the surgery group, those patients with sterilized lymph nodes and tumours had also a higher DFS (76% vs 47%, p=0.036). Toxicity was higher with protocol A. Conclusion. - From our study, it appears that local control of advanced cervix cancers is better with combined chemoradiotherapy but disease-free survival stays low according to the metastatic evolution. Metastasis without local recurrence remained frequent in our study. 5FU-CDDP chemotherapy has a lower toxicity and is as effective as 5FU-CDDP-Mitomycin C-Vindesin protocol, in association with radiotherapy. (author)

  20. Improved outcomes after autologous bone marrow transplantation for children with relapsed or refractory Hodgkin lymphoma: twenty years experience at a single institution.

    Science.gov (United States)

    Garfin, Phillip M; Link, Michael P; Donaldson, Sarah S; Advani, Ranjana H; Luna-Fineman, Sandra; Kharbanda, Sandhya; Porteus, Matthew; Weinberg, Kenneth I; Agarwal-Hashmi, Rajni

    2015-02-01

    The purpose of this study is to evaluate the survival of pediatric patients undergoing autologous bone marrow transplantation (auBMT) for relapsed or refractory Hodgkin lymphoma (rrHL) and to identify factors that might contribute to their outcome. We reviewed the records and clinical course of 89 consecutive rrHL patients ≤ 21 years old who underwent auBMT at Stanford Hospitals and Clinics and the Lucile Packard Children's Hospital, Stanford between 1989 and 2012. We investigated, by multiple analyses, patient, disease, and treatment characteristics associated with outcome. Endpoints were 5-year overall and event-free survival. Our findings include that cyclophosphamide, carmustine, and etoposide (CBV) as a conditioning regimen for auBMT is effective for most patients ≤ 21 years old with rrHL (5-year overall survival, 71%). Transplantation after the year 2001 was associated with significantly improved overall survival compared with our earlier experience (80% compared with 65%). Patients with multiply relapsed disease or with disease not responsive to initial therapy fared less well compared with those with response to initial therapy or after first relapse. Administration of post-auBMT consolidative radiotherapy (cRT) also appears to contribute to improved survival. We are able to conclude that high-dose chemotherapy with CBV followed by auBMT is effective for the treatment of rrHL in children and adolescents. Survival for patients who undergo auBMT for rrHL has improved significantly. This improvement may be because of patient selection and improvements in utilization of radiotherapy rather than improvements in chemotherapy. Further investigation is needed to describe the role of auBMT across the entire spectrum of patients with rrHL and to identify the most appropriate preparative regimen with or without cRT therapy in the treatment of rrHL in young patients.

  1. Pharmacist-managed dose adjustment feedback using therapeutic drug monitoring of vancomycin was useful for patients with methicillin-resistant Staphylococcus aureus infections: a single institution experience

    Science.gov (United States)

    Hirano, Ryuichi; Sakamoto, Yuichi; Kitazawa, Junichi; Yamamoto, Shoji; Tachibana, Naoki

    2016-01-01

    Background Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections. Materials and methods The ASP was introduced in April 2012. We implemented a prospective audit of prescribed VCM dosages and provided feedback based on measured VCM trough concentrations. In a retrospective pre- and postcomparison study from April 2007 to December 2011 (preimplementation) and from April 2012 to December 2014 (postimplementation), 79 patients were treated for MRSA infection with VCM, and trough concentrations were monitored (pre, n=28; post, n=51). In 65 patients (pre, n=15; post, n=50), 24-hour area under the concentration–time curve (AUC 0–24 h)/minimum inhibitory concentration (MIC) ratios were calculated. Results Pharmacist feedback, which included recommendations for changing dose or using alternative anti-MRSA antibiotics, was highly accepted during postimplementation (88%, 29/33). The number of patients with serum VCM concentrations within the therapeutic range (10–20 μg/mL) was significantly higher during postimplementation (84%, 43/51) than during preimplementation (39%, 11/28) (P400) was significantly higher during postimplementation (84%, 42/50) than during preimplementation (53%, 8/15; P=0.013). There were no significant differences in nephrotoxicity or mortality rate. Conclusion Our ASP increased the percentage of patients that attained optimal VCM trough concentrations and PK/PD parameters, which contributed to the appropriate use of VCM in patients with MRSA infections. PMID:27789965

  2. OUTCOMES OF BREAST RECONSTRUCTION WITH PEDICLED TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS (TRAM FLAP AT CANCER INSTITUTE, A RETROSPECTIVE STUDY OF 10 YEARS OF EXPERIENCE

    Directory of Open Access Journals (Sweden)

    R. Omranipour

    2008-06-01

    Full Text Available Reconstruction of breast with transverse rectus abdominis myocutaneous (TRAM flap is the standard for reconstruction of breast following mastectomy. In this article, authors report their experience with pedicled TRAM flap reconstruction of the breast. Records for the patients who had undergone breast reconstruction with pedicled TRAM flap were retrieved. Records of outpatient follow-ups were also obtained. Patient satisfaction with the outcome of surgery was assessed using a detailed questionnaire including a linear visual analogue scale ranging from zero (not satisfied to ten (most satisfied. There were 61 reconstructions in 59 patients. In 42 (71.2% cases a synthetic mesh and in 14 (23.7% cases dermal graft was used for closure of the abdominal fascial defect. The mean hospital stay was 10.67 (1 - 72 days. Patients were followed up for a mean period of 621 days. The overall rates of complications were as follows: partial flap necrosis: 11 (18.6%, flap hematoma: 2 (3.4%, flap seroma: 7 (11.9%, flap wound infection: 7 (11.9%, abdominal wound hematoma: 9 (15.3%, abdominal wound seroma: 5 (8.5%, abdominal wound ischemia: 1 (1.7%, abdominal wound incisional hernia: 6 (10.2%, deep vein thrombosis: 1 (1.7%, complication requiring rehospitalization: 9 (15.3%, complication requiring reoperation: 8 (13.6%. There were no abdominal wound infection, no umbilical necrosis, and no pulmonary embolism. Aesthetic results were classified as excellent (62%, good (28%, fair (10%. The mean satisfaction score was 9.5 (range 6-10. Breast reconstruction with pedicled transverse rectus abdominis myocutaneous flap was associated with a low complication rate and a high level of patient satisfaction in our center.

  3. Long-term follow-up of pediatric moyamoya disease treated by combined direct-indirect revascularization surgery: single institute experience with surgical and perioperative management.

    Science.gov (United States)

    Rashad, Sherif; Fujimura, Miki; Niizuma, Kuniyasu; Endo, Hidenori; Tominaga, Teiji

    2016-10-01

    Moyamoya disease (MMD) is a rare occlusive cerebrovascular disease that mainly presents in children as cerebral ischemia. Prompt treatment with either a direct or indirect revascularization procedure is necessary for children with MMD in order to prevent repeated ischemic events. We herein present our experience with combined direct and indirect bypass surgery for the treatment of pediatric MMD as well as our uniquely designed perioperative protocol. Twenty-three patients with MMD, aged between 2 and 16 years old (mean 9.36), underwent 38 combined bypass procedures between 2008 and 2015. All patients underwent single superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis combined with encephalo-duro-myo-synangiosis (EDMS). The perioperative management protocol was stratified into two unique eras: the first era with normotensive care and the second era with strict blood pressure control (systolic 100-130 mmHg) and routine aspirin administration. Patients were followed after surgery for a period ranging between 3 and 131 months (mean 77 months) in yearly clinical and radiological follow-ups. Three postoperative complications were observed: two cases of cerebral hyperperfusion (2/38, 5.3 %) and one case of perioperative minor stroke (1/38, 2.6 %), two of which were in the first era. No strokes, either ischemic or hemorrhagic, were observed in the follow-up period, and the activity of daily living as shown by the modified Rankin Scale improved in 20 patients, with no deterioration being observed in any of our patients. STA-MCA bypass with EDMS is safe and effective for the management of pediatric MMD and provides long-term favorable outcomes. Perioperative care with blood pressure control combined with the administration of aspirin may reduce the potential risk of surgical complications.

  4. Pharmacist-managed dose adjustment feedback using therapeutic drug monitoring of vancomycin was useful for patients with methicillin-resistant Staphylococcus aureus infections: a single institution experience

    Directory of Open Access Journals (Sweden)

    Hirano R

    2016-10-01

    Full Text Available Ryuichi Hirano,1 Yuichi Sakamoto,2 Junichi Kitazawa,2 Shoji Yamamoto,1 Naoki Tachibana2 1Department of Pharmacy, 2Laboratory Medicine and Blood Transfusion, Aomori Prefectural Central Hospital, Aomori-shi, Japan Background: Vancomycin (VCM requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP on attaining target VCM trough concentrations and pharmacokinetics (PK/pharmacodynamics (PD parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA infections. Materials and methods: The ASP was introduced in April 2012. We implemented a prospective audit of prescribed VCM dosages and provided feedback based on measured VCM trough concentrations. In a retrospective pre- and postcomparison study from April 2007 to December 2011 (preimplementation and from April 2012 to December 2014 (postimplementation, 79 patients were treated for MRSA infection with VCM, and trough concentrations were monitored (pre, n=28; post, n=51. In 65 patients (pre, n=15; post, n=50, 24-hour area under the ­concentration–time curve (AUC 0–24 h/minimum inhibitory concentration (MIC ratios were calculated. Results: Pharmacist feedback, which included recommendations for changing dose or using alternative anti-MRSA antibiotics, was highly accepted during postimplementation (88%, 29/33. The number of patients with serum VCM concentrations within the therapeutic range (10–20 μg/mL was significantly higher during postimplementation (84%, 43/51 than during preimplementation (39%, 11/28 (P<0.01. The percentage of patients who attained target PK/PD parameters (AUC 0–24 h/MIC >400 was significantly higher during postimplementation (84%, 42/50 than during preimplementation (53%, 8/15; P=0.013. There were

  5. Management experiences of primary angiosarcoma of breast: a retrospective study from single institute in the People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Hu QC

    2015-11-01

    Full Text Available Qun-Chao Hu,1–3,* Xin Mei,1,2,* Yan Feng,1,2 Jin-Li Ma,1,2 Zhao-Zhi Yang,1,2 Zhi-Min Shao,2,4 Xiao-Li Yu,1,2 Xiao-Mao Guo1,2 1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 3Department of Radiation Oncology, Suzhou Municipal Hospital, Suzhou, 4Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Primary angiosarcoma of breast (PAOB is a rare and highly aggressive malignancy. There is no general agreement on optimal treatments or prognostic factors for this orphan disease. The objective of this study was to investigate the clinicopathologic features and management experiences of PAOB.Methods: We performed a retrospective review of medical and pathologic records of 17 consecutive patients diagnosed with PAOB between January 2000 and February 2014 at FuDan University Shanghai Cancer Center. We evaluated the clinical characteristics, multimodality treatments, and associated clinical outcomes.Results: A total of 16 patients were included in this retrospective study (median age at PAOB presentation 33.5 years, range: 19–56 years. Palpable tumor with or without breast skin ecchymosis presented as the most common initial symptom. All patients underwent surgery with curative intent. Median disease-free survival and overall survival (OS were 9 months and 13.6 months, respectively. One-year and 3-year disease-free survival rates were 43.8% and 6.3%, with OS rates of 93.8% and 78.1%, respectively. High histologic grade indicated poorer OS by univariate analysis (P=0.01. However, neither adjuvant chemotherapy nor radiotherapy contributed to clinical outcomes in our series.Conclusion: PAOB is considered as an infrequent breast neoplasm with aggressive characteristics. Histologic grade and early metastasis (within 12 months after

  6. Identity of Institution and Institutional Design

    Directory of Open Access Journals (Sweden)

    F. Bahar Ülker Kaya

    2006-05-01

    Full Text Available Corporate identity is planning and reşecting memorable, personal, characteristic pecularities of an institution and the ability that separates it from others. Corporate identity is in interaction with the corporate culture and corporate image. It is an entity formed by the philosophy of the institution, institutional communication, behavior and planning. Institutional planning formed by the planning of production and communication and architectural/ interior architectural planning, is the most significant element that constitutes the visual identity of an institution. While forming architectural and interior architectural planning of institutions, establishing places that will clearly reşect the corporate identity is gaining importance. In the perception of visual identity of institutions, planning elements such as; colour, texture, material and form are more significant than others.

  7. Carcinoma de células escamosas de cavidad bucal en un centro de tercer nivel de atención social en la ciudad de México: Experiencia de cinco años Oral cavity squamous cells carcinoma, 5 years experience in a third level social assistence center, in Mexico city

    OpenAIRE

    G. Meza García; J.J. Muñoz Ibarra; C. Páez Valencia; B. Cruz Legorreta; B. Aldape Barrios

    2009-01-01

    El carcinoma epidermoide o de células escamosas, es una neoplasia maligna que se origina de las células escamosas del epitelio que recubre la mucosa, es la más frecuente de la cavidad bucal. Objetivo: determinar si la supervivencia y muerte de los pacientes con carcinoma epidermoide de cavidad bucal, asociada a la edad, género, factores de riesgo, grado histológico y tratamiento recibido. Método: Se revisaron los archivos del servicio de Anatomía Patológica del Centro Médico Nacional "20 de N...

  8. Oesophageal carcinoma presenting with a synchronous asymptomatic colon carcinoma

    OpenAIRE

    Alok Gupta; Bharat Chauhan; V Rangarajan; Saral Desai; Vanita Noronha; Kumar Prabhash

    2013-01-01

    The advancement in diagnostic techniques has resulted in increased incidence of occult second primary in cancer patients. Here, we report a case of symptomatic oesophageal carcinoma and synchronous asymptomatic colon carcinoma diagnosed through Positron Emission Tomography-Computed Tomography imaging.

  9. Pure Lymphoepithelioma-Like Carcinoma Originating from the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Takashi Nagai

    2016-03-01

    Full Text Available Lymphoepithelioma-like carcinoma of the urinary bladder (LELCB is a rare variant of infiltrating urothelial carcinoma. We report a case of LELCB in a 43-year-old man. Ultrasonography and cystoscopy revealed two bladder tumors, one on the left side of the trigone and the other on the right side of the trigone. Transurethral resection of the bladder tumors was performed and pathological analysis revealed undifferentiated carcinoma. We therefore performed radical cystectomy and urinary diversion. Immunohistochemically the tumor cells were positive for cytokeratin, but negative for Epstein-Barr virus-encoded small RNA in situ hybridization as found for previous cases of LELCB. The final pathological diagnosis was a lymphoepithelioma-like variant of urothelial carcinoma with perivesical soft tissue invasion. For adjuvant systemic chemotherapy, three courses of cisplatin were administered. The patient subsequently became free of cancer 72 months postoperatively. Based on the literature, pure or predominant LELCB types show favorable prognoses due to their sensitivity to chemotherapy or radiotherapy. An analysis of the apparent diffusion coefficient (ADC values of bladder tumors examined in our institution revealed that the ADC value measured for this LELCB was relatively low compared to conventional urothelial carcinomas. This suggests that measuring the ADC value of a lymphoepithelioma-like carcinoma prior to operation may be helpful in predicting LELCB.

  10. Synchronous thyroid carcinoma and squamous cell carcinoma. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Seo [Chonnam National Univ. School of Dentistry, Kwangju (Korea, Republic of)

    2006-12-15

    Thyroid carcinoma occurring as a second primary associated with head and neck squamous cell carcinoma (SCC) is unusual. This report presents a synchronous thyroid carcinoma and squamous cell carcinoma in the anterior palate region of a 41-year-old man. The clinical, radiologic, and histologic features are described. At 10-month follow-up after operation, no evidence of recurrence ana metastasis was present.

  11. Early onset sebaceous carcinoma

    Directory of Open Access Journals (Sweden)

    Kaltreider Sara A

    2011-09-01

    Full Text Available Abstract Background Ocular sebaceous carcinoma can masquerade as benign lesions resulting in delay of diagnosis. Early recognition is even more difficult in young patients where the disease rarely occurs. Here, we provide a clinicopathological correlation of ocular sebaceous carcinoma in a young individual lacking history of hereditary cancer or immunosuppression. Findings A detailed histopathological study including p53 DNA sequencing was performed on an aggressive sebaceous carcinoma presenting in a healthy 32 year-old Caucasian woman. She had no history of retinoblastoma, evidence for a hereditary cancer syndrome, or radiation therapy. However, she potentially was at risk for excessive UV light exposure. A detailed review of the literature is also provided. A moderately well differentiated sebaceous carcinoma was established histopathologically arising from the meibomian gland of the upper eyelid. In most areas, the cytoplasm contained small but distinct Oil-red-O positive vacuoles. Direct sequencing of p53 identified a G:C→A:T mutation at a dipyrimidine site. The mutation results in substitution of arginine for the highly conserved glycine at residue 199 located at the p53 dimer-dimer interface. Energy minimization structural modeling predicts that G199R will neutralize negative charges contributed by nearby inter- and intramonomeric glutamate residues. Discussion This study points to the importance of recognizing that sebaceous carcinoma can occur in young patients with no evidence for hereditary cancer risk or radiation therapy. The G199R substitution is anticipated to alter the stability of the p53 tetrameric complex. The role of UV light in the etiology of sebaceous carcinoma deserves further study. Our findings, taken together with those of others, suggest that different environmental factors could lead to the development of sebaceous carcinoma in different patients.

  12. General Information about Adrenocortical Carcinoma

    Science.gov (United States)

    ... Symptoms of adrenocortical carcinoma include pain in the abdomen. These and other signs and symptoms may be caused by adrenocortical carcinoma: A lump in the abdomen . Pain the abdomen or back. A feeling of ...

  13. Treatment Option Overview (Adrenocortical Carcinoma)

    Science.gov (United States)

    ... Symptoms of adrenocortical carcinoma include pain in the abdomen. These and other signs and symptoms may be caused by adrenocortical carcinoma: A lump in the abdomen . Pain the abdomen or back. A feeling of ...

  14. Expression of lactate dehydrogenase C correlates with poor prognosis in renal cell carcinoma.

    Science.gov (United States)

    Hua, Yibo; Liang, Chao; Zhu, Jundong; Miao, Chenkui; Yu, Yajie; Xu, Aimin; Zhang, Jianzhong; Li, Pu; Li, Shuang; Bao, Meiling; Yang, Jie; Qin, Chao; Wang, Zengjun

    2017-03-01

    Lactate dehydrogenase C is an isoenzyme of lactate dehydrogenase and a member of the cancer-testis antigens family. In this study, we aimed to investigate the expression and functional role of lactate dehydrogenase C and its basic mechanisms in renal cell carcinoma. First, a total of 133 cases of renal cell carcinoma samples were analysed in a tissue microarray, and Kaplan-Meier survival curve analyses were performed to investigate the correlation between lactate dehydrogenase C expression and renal cell carcinoma progression. Lactate dehydrogenase C protein levels and messenger RNA levels were significantly upregulated in renal cell carcinoma tissues, and the patients with positive lactate dehydrogenase C expression had a shorter progression-free survival, indicating the oncogenic role of lactate dehydrogenase C in renal cell carcinoma. In addition, further cytological experiments demonstrated that lactate dehydrogenase C could prompt renal cell carcinoma cells to produce lactate, and increase metastatic and invasive potential of renal cell carcinoma cells. Furthermore, lactate dehydrogenase C could induce the epithelial-mesenchymal transition process and matrix metalloproteinase-9 expression. In summary, these findings showed lactate dehydrogenase C was associated with poor prognosis in renal cell carcinoma and played a pivotal role in the migration and invasion of renal cell carcinoma cells. Lactate dehydrogenase C may act as a novel biomarker for renal cell carcinoma progression and a potential therapeutic target for the treatment of renal cell carcinoma.

  15. What are Institutional Logics

    DEFF Research Database (Denmark)

    Berg Johansen, Christina; Waldorff, Susanne Boch

    This study presents new insights into the explanatory power of the institutional logics perspective. With outset in a discussion of seminal theory texts, we identify two fundamental topics that frame institutional logics: overarching institutional orders guides by institutional logics, as well...

  16. Agir pour l’égalité filles-garçons au collège Working for gender equality in the school: between individual experience and institutional demand, an uncertain encounter

    Directory of Open Access Journals (Sweden)

    Nicole Guenneuguès

    2011-10-01

    Full Text Available Le présent article rend compte d’une recherche conduite pour éclairer les obstacles à la prise en compte de la problématique du genre au sein de l’école, alors qu’elle fait explicitement partie de ses missions. Pour ce faire, j’ai choisi de m’intéresser à la minorité de professeur-e-s préoccupé-e-s par les questions « filles garçons » dans leurs pratiques professionnelles en collège. En appui sur la théorie de l’expérience sociale développée par F. Dubet (1994 et sa thèse d’un déclin du programme institutionnel (ibid. 2002, j’ai tenté de comprendre le sens de leur action. La dizaine d’entretiens compréhensifs réalisée ne constitue qu’une première ébauche mais il ressort de leur analyse que l’action de cette minorité doit peu aux incitations de l’institution scolaire. La place occupée par l’histoire personnelle de l’actrice et de l’acteur, tant pour légitimer son engagement que pour orienter son action, apparaît comme un puissant obstacle à l’émergence d’une dynamique collective.This article presents research conducted to clarify the obstacles to taking gender into account in the school – a theme which is actually one of its stated goals. To this aim, I chose to focus on the minority of teachers, women and men, engaged in "girls/boys" issues in their work in high school. Building on the theory of "social experience" developed by F. Dubet (1994 and his thesis of a "decline of the institutional program" (ibid, 2002, I attempted to understand the sense of their actions. The dozen comprehensive interviews conducted constitute only an initial step. But it emerges from analyzing them that the practices of this minority owe little to the promptings of the educational institution. Each individual’s personal history seems to be the principal cognitive resource to justify and guide that person’s actions. The weight of that personal history would appear to strongly block any group

  17. 高校科技创新创业典范的经验分析%Analysis on the Experience of Models of Innovation and Business of Science and Technology in Higher Learning Institutions

    Institute of Scientific and Technical Information of China (English)

    张铁山

    2011-01-01

    MIT andStanford university are the models of the western business mode of universities, they have made important contributions to the establishment and development of the business mode of university in the western countries in such aspects as adhering to the idea of the core value of the education, correctly handling the complex relationship among the university and the government and the enterprise, and creating the university park of science and technology in the world and carrying out the entrepreneurship education and practice and so on. Influenced by this, the business mode of higher learning institutions in our country has accumulated the rich experience and provided an important enlightenment for the future development of the innovation and business of science and technology in the aspects such as correctly locating higher learning institutions status as business type, actively exploring the new modes, accelerating the conversion of the acbievements of science and technology and the business education and the culture construction of science and technology in the science and technology park in higher learning institutions.%麻省理工学院和斯坦福大学是西方创业型大学的典范。它们在核心教育价值理念、正确处理大学、政府和企业复杂关系、创建世界大学科技园以及开展创业教育与实践方面为世界创业型大学的建立和发展做出了重要贡献。受此影响,我国创业型大学在正确定位创业型大学的地位、积极探索创业型大学新模式、以大学科技园为平台加速高校科技成果转换以及大学创业教育和科技文化建设等方面为我国创业型大学未来发展积累了丰富经验,对未来高校科技创新创业发展提供了重要启示。

  18. Program of institutionalism scientific research: «endogenization of institutions» and economic culture

    Directory of Open Access Journals (Sweden)

    Yu.V. Ushchapovskyy

    2015-03-01

    . Informal institutions influence significantly the steady nature of economic entities behavior in the sphere of production, exchange and consumption. They make the basis of economic culture of people. Economic culture can be understood as group experience, as it is the accumulation of experience both of a society and its certain social groups, in the adaptation of economic activity to the social and natural environment. The author arrives at the conclusion that the institution combining individual institutional restrictions of exogenous and endogenous nature can be «economic culture». Such approach allows us to consider economic culture as a formative element of institutional environment in the economy institutional structure and as a starting point for economic policy trough codification of formal rules of individuals’ behavior.

  19. Brain metastasis from esophageal carcinoma

    Directory of Open Access Journals (Sweden)

    Almasi Saeid

    2004-10-01

    Full Text Available Brain metastasis from esophageal carcinoma is rare. In our center, among 301 cases of esophageal cancer referred for radiotherapy during a 14-year period, brain metastasis from esophageal carcinoma was detected in one case. An unusual case of esophageal carcinoma that presented with brain metastasis is reported.

  20. Entrepreneurship as institutional change

    DEFF Research Database (Denmark)

    Bjerregaard, Toke; Lauring, Jakob

    2012-01-01

    between and exploit the multiple, potentially contradictory institutional logics of the different spheres in which they operate. While much research has elucidated how institutional entrepreneurs effect change, this study illustrates how effective entrepreneurs managing and exploiting institutional...... contradictions engage simultaneously in practices of maintaining and changing institutions to establish a balance between the poles on which their ventures depend. We illustrate this by two cases of small-scale entrepreneurship bridging institutional contradictions from an ethnographic study conducted under...

  1. Institutional Logics in Action

    DEFF Research Database (Denmark)

    Lounsbury, Michael; Boxenbaum, Eva

    2013-01-01

    This double volume presents state-of-the-art research and thinking on the dynamics of actors and institutional logics. In the introduction, we briefly sketch the roots and branches of institutional logics scholarship before turning to the new buds of research on the topic of how actors engage ins...... prolific stream of research on institutional logics by deepening our insight into the active use of institutional logics in organizational action and interaction, including the institutional effects of such (inter)actions....

  2. Aberrant E-cadherin staining patterns in invasive mammary carcinoma

    Directory of Open Access Journals (Sweden)

    Brogi Edi

    2005-11-01

    Full Text Available Abstract Background E-cadherin, a cell surface protein involved in cell adhesion, is present in normal breast epithelium, benign breast lesions, and in breast carcinoma. Alterations in the gene CDH1 on chromosome 16q22 are associated with changes in E-cadherin protein expression and function. Inactivation of E-cadherin in lobular carcinomas and certain diffuse gastric carcinomas may play a role in the dispersed, discohesive "single cell" growth patterns seen in these tumors. The molecular "signature" of mammary lobular carcinomas is the loss of E-cadherin protein expression as evidenced by immunohistochemistry, whereas ductal carcinomas are typically E-cadherin positive. Patients and methods We report on E-cadherin immunostaining patterns in five cases of invasive mammary carcinoma Results These were five exceptional instances in which the E-cadherin immunophenotype did not correspond to the apparent histologic classification of the lesion. These cases which are exceedingly rare in our experience are the subject of this report. Conclusion Findings such as those illustrated in this study occur in virtually all biologic phenomena and they do not invalidate the very high degree of correlation between the expression of E-cadherin and the classification of breast carcinomas as ductal or lobular type on the basis of conventional histologic criteria.

  3. Do Training Institutions Learn from Experience?

    Science.gov (United States)

    Castro, Claudio de Moura

    2011-01-01

    This essay is concerned with organisational learning and, in particular, policy learning. Sometimes, organisations learn; sometimes they do not. Sometimes they use their acquired knowledge, but this is, not always the case. Inside organisations, particular values, rules and incentive systems are developed. In addition, organisations need to…

  4. Lacunar strokes: a single institutional experience

    Directory of Open Access Journals (Sweden)

    Osama Shukir Muhammed Amin

    2013-08-01

    Full Text Available Abstract: Objective: Lacunar ischemic strokes comprise approximately 25% of all ischemic strokes. We compared the risk factors and clinical pattern of this type of stroke between males and females. Methods: This observational study involved 50 consecutive patients with their first-ever lacunar stroke and was conducted at the department of neurology of Sulaimaniya general teaching hospital, Iraq from December 1, 2010 to March 1, 2013. Patients’ risk factors, clinical presentation, and strokes’ patterns were noted and a comparison was made between males and females. Results: Males (64% outnumbered females (36% with a male to female ration of 1.7. The mean age of males was 63 years while it was 61 years in females. Although hypertension was more common in females than in males, diabetes and smoking were more common in the latter group; however, there were no statistically significant differences between the 2 genders in terms of hypertension (P-value <0.3 and diabetes (P-value < 0.07 while smoking was strongly associated with male gender (P-value<0.0001. Pure motor hemiparesis, ataxic hemiparesis, pure sensory stroke, and dysarthria-clumsy hand syndrome were more common in males; only senori-motor stroke revealed a statistically significant difference in favor males (P-value<0.0001; 95% CI -1.7 to 19.2. There was no statistically significant difference in terms of which side of the brain was infarcted between males and females (P-value<0.4. Conclusion: Males around the age of 63 years were the main target for these lacunar strokes. Cigarette smoking and sensorimotor strokes were significantly associated with male gender. [Cukurova Med J 2013; 38(4.000: 659-666

  5. Brain metastases: A single institute experience

    Directory of Open Access Journals (Sweden)

    Asifa Andleeb

    2016-01-01

    Full Text Available Background: Brain metastases represent an important cause of morbidity for cancer patients. Its incidence has increased overall overtime as a consequence of improved detection by magnetic resonance imaging (MRI. However, in Indian literature, scant data are available. At this moment, we have analyzed our data from a single tertiary care center in North India. The purpose of the study was to analyze the clinical profile of patients with brain metastases. A retrospective study from a single tertiary care center. Patients and Methods: A retrospective review of records of all patients who were registered in hospital-based cancer registry and developed brain metastases from June 2011 to June 2013 yielded 95 patients for analyses. Results: Majority of cases were seen in the 6th decade of life. Lung cancer was the most common primary followed by breast. On imaging (computed tomography or MRI, multiple lesions were more common than single. Most of the patients presented with a headache (37.9%. Supratentorial involvement was seen in 87.3% against 12.6% infratentorial involvement. Median time interval from diagnosis of primary and development of brain metastases was 13.8 months. A median survival of only 3 months was seen after development of brain metastases. Conclusion: The present study highlights that brain metastases occur mainly in elderly people with lung being the most common primary malignancy. It is a deadly event with a median survival of only 3 months.

  6. Adult onset moyamoya disease: Institutional experience

    Directory of Open Access Journals (Sweden)

    Swati Dayanand Chinchure

    2011-01-01

    Full Text Available Moyamoya disease is a progressive steno-occlusive disease of bilateral carotid forks with the formation of fine collateral vascular network and is an angiographic diagnosis. We analyzed case records of 11 patients with "adult-onset moyamoya disease." Six patients presented with intracranial hemorrhage (intracerebral and/or intraventricular and 5 with focal ischemia. Angiography revealed bilateral Internal carotid artery involvement in 8 patients and unilateral involvement in 3. Posterior cerebral artery involvement was seen in 3 patients. Saccular aneurysm involving posterior circulation was seen in only 1 patient. Although rare, adult-onset moyamoya disease should be considered as one of the causes for intracerebral and intraventricular hemorrhage in adults.

  7. Subungual squamous cell carcinoma*

    Science.gov (United States)

    Padilha, Carolina Barbosa de Sousa; Balassiano, Laila Klotz de Almeida; Pinto, Julyana Calegari; de Souza, Flávia Crespo Schueler; Kac, Bernard Kawa; Treu, Curt Mafra

    2016-01-01

    Although subungual squamous cell carcinoma is rare, it is the most common primary malignant neoplasms in this location. The higher incidence occurs in the fingernails, but involvement of the toenails is also possible. Subungual squamous cell carcinoma often looks like other more common benign lesions, such as fungal infection, onychomycosis, or viral wart. These factors, together with a general lack of awareness of this disease among physicians, often result in delayed diagnosis. Therefore, it is underdiagnosed, with few reports in the literature. The authors present a case of a man with a diagnosis of subungual squamous cell carcinoma in the hallux, without bone involvement, which was submitted to the appropriate surgical treatment. PMID:28099608

  8. Simultaneous Laryngeal Squamous Cell Carcinoma and Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Bighan Khademi

    2011-04-01

    Full Text Available The association of squamous cell carcinoma of the larynx with thyroid papillary carcinoma is an unusual finding. From 2004 to 2011, approximately 250 patients underwent laryngectomies due to squamous cell carcinoma of the larynx at the Otolaryngology Department of Khalili Hospital, affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In three patients, synchronous occurrence of squamous cell carcinoma and thyroid papillary carcinoma was found. Histopathologic study of the lymph nodes revealed metastatic papillary thyroid carcinoma in one case. We report three cases of thyroid papillary carcinoma incidentally found on histological examinations of resected thyroid lobes, as a procedure required for treatment of head and neck squamous cell carcinoma. In comparison, laryngeal squamous cell carcinoma needs more aggressive treatment than well-differentiated thyroid carcinoma. The prevalence of thyroid papillary carcinoma, as an incidental finding in our study was 0.01%. Therefore, preoperative evaluation of the thyroid gland by ultrasonography and fine needle aspiration biopsy of suspicious lesions is recommended in patients who are candidates for open laryngectomy.

  9. Radiotherapy of double primary esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ze Fen Xiao; Zong Yi Yang; Zong Mei Zhou; Wei Bo Yin; Xian Zhi Gu

    2000-01-01

    @@ INTRODUCTION Double primary esophageal carcinoma is defined as having two foci of squamous cell cancer simultaneously or consecutively developing in different sites of esophagus. This rare disease appears mostly in the literature as case reports[1-4],reports about its treatment are even more infrequent. Here we present our experiences of radiation therapy in 37 patients with this disease and focus the discussion on the optimum method of treatment and complications.

  10. Primary fallopian tube carcinoma

    Directory of Open Access Journals (Sweden)

    Mladenović-Segedi Ljiljana

    2009-01-01

    Full Text Available Introduction. Primary fallopian tube carcinoma is extremely rare, making 0.3-1.6% of all female genital tract malignancies. Although the etymology of this tumor is unknown, it is suggested to be associated with chronic tubal inflammation, infertility, tuberculous salpingitis and tubal endometriosis. High parity is considered to be protective. Cytogenetic studies show the disease to be associated with over expression of p53, HER2/neu and c-myb. There is also some evidence that BRCA1 and BRCA2 mutations have a role in umorogeneis. Clinical features. The most prevailing symptoms with fallopian tube carcinoma are abdominal pain, abnormal vaginal discharge/bleeding and the most common finding is an adnexal mass. In many patients, fallopian tube carcinoma is asymptomatic. Diagnosis. Due to its rarity, preoperative diagnosis of primary fallopian tube carcinoma is rarely made. It is usually misdiagnosed as ovarian carcinoma, tuboovarian abscess or ectopic pregnancy. Sonographic features of the tumor are non-specific and include the presence of a fluid-filled adnexal structure with a significant solid component, a sausage-shaped mass, a cystic mass with papillary projections within, a cystic mass with cog wheel appearance and an ovoid-shaped structure containing an incomplete separation and a highly vascular solid nodule. More than 80% of patients have elevated pretreatment serum CA-125 levels, which is useful in follow-up after the definite treatment. Treatment. The treatment approach is similar to that of ovarian carcinoma, and includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. Staging is followed with chemotherapy.

  11. Primary adrenal sarcomatoid carcinoma

    Directory of Open Access Journals (Sweden)

    Aftab S. Shaikh

    2014-03-01

    Full Text Available Adrenal sarcomatoid carcinomas are extremely rare tumors presenting with extensive locoregional spread at the time of diagnosis. Patients succumb to metastases within a couple of months. As a result, very few cases are reported in the literature until now. We present a case of a 62-year old female with non-functional sarcomatoid carcinoma of the right adrenal gland. There was no radiological evidence of locoregional metastases. Patient underwent right adrenalectomy. Follow up after 3 months showed para-aortic lymphadenopathy and similar left adrenal mass on computed tomography. Patient refused further treatment and succumbed to the disease. A brief case report with review of literature is presented.

  12. Urachal Carcinoma: Imaging Findings

    Directory of Open Access Journals (Sweden)

    Vanessa Monteiro

    2012-02-01

    Full Text Available Urachal carcinoma is a rare neoplasm, which accounts for only 0.5–2% of bladder malignancies, and arises from a remnant of the fetal genitourinary tract. A 46-year-old woman presented with a history of pelvic pain and frequent daytime urination. Ultrasound (US, computed tomography (CT, and magnetic resonance (MR demonstrated a supravesical heterogeneous mass with calcifications. The patient underwent a partial cystectomy with en-bloc resection of the mass and histopathological examination revealed the diagnosis of urachal adenocarcinoma. Urachal carcinomas are usually associated with poor prognosis and early diagnosis is fundamental. CT and MR are useful to correctly diagnose and preoperatively staging.

  13. Contribution to Study About Metastasis of Oral Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Fernanda Ferreira LOPES

    2006-09-01

    Full Text Available Objective: This paper is a retrospective study with aim of collecting information about neoplasm metastasis of oral squamous cell carcinoma. Method: The registry of patients with the histopathology diagnose of oral squamous cell carcinoma in Oncology Institute Aldenora Belo (IMOAB in São Luis - MA, from 1992 to 2004, was analyzed and 18 cases were selected. Results: The most common anatomical region of primary neoplasm was tongue, following by buccal floor and cheek. In related to anatomical area compromised by metastasis, the cervical ones were the most frequent, followed by tongue and buccal floor. Conclusion: It concluded that the tongue was the most common site of oral squamous cell carcinoma, where frequently, shows metastasis, and the most common loco-regional metastasis was on cervical area, especially.

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

    Directory of Open Access Journals (Sweden)

    Nabil Ismaili

    2008-01-01

    Full Text Available 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 mean age at diagnosis was 60 years (range, 45-77. All patients were male. Seventy-five per cent were smokers. All had locally advanced disease. Ten patients (71.4% were treated by cystoprostatectomy and bilateral pelvic lymph node resection, one by cystoprostatectomy alone. Two patients received neoadjuvant chemotherapy and four received adjuvant chemotherapy. One patient was treated by radiotherapy with concomitant cisplatin after transurethral resection of bladder tumor (TURBT. One patient refused surgery and was treated by chemotherapy alone. One patient was lost to follow-up after TURBT. After 49-month median follow-up, 12 patients had relapsed. Disease-free survival was 5.7 months. The most frequent sites of relapse were the retroperitoneal lymph node (seven patients and the liver (three patients. Nine patients died of metastasis. Median overall survival was 29.5 months. Survival probability at two years was 58%. Median overall survival was 34 months in the mixed small carcinoma group, as compared with 9.5 months in the pure small cell carcinoma group (P=0.01. Mean overall survival was 27.2 months for all patients and 38.6 months for patients treated with cystectomy and adjuvant chemotherapy. Conclusion: To date, the optimal treatment for locally advanced small cell bladder carcinoma is not clear. Cystectomy with neoadjuvant or adjuvant chemotherapy appears as a viable option.

  15. Pancreatic metastases from renal cell carcinoma: The state of the art

    Institute of Scientific and Technical Information of China (English)

    Roberto Ballarin; Giuseppe D'Amico; Giorgio Enrico Gerunda; Fabrizio Di Benedetto; Mario Spaggiari; Nicola Cautero; Nicola De Ruvo; Roberto Montalti; Cristina Longo; Anna Pecchi; Patrizia Giacobazzi; Giuseppina De Marco

    2011-01-01

    Pancreatic metastases are rare, with a reported inci-dence varying from 1.6% to 11% in autopsy studies of patients with advanced malignancy. In clinical series, the frequency of pancreatic metastases ranges from 2% to 5% of all pancreatic malignant tumors. Howev-er, the pancreas is an elective site for metastases from carcinoma of the kidney and this peculiarity has been reported by several studies. The epidemiology, clinical presentation, and treatment of pancreatic metastases from renal cell carcinoma are known from single-institution case reports and literature reviews. There is currently very limited experience with the surgical resection of isolated pancreatic metastasis, and the role of surgery in the management of these patients has not been clearly defined. In fact, for many years pancreatic resections were associated with high rates of morbidity and mortality, and metastatic disease to the pancreas was considered to be a terminal-stage condition. More recently, a significant reduction in the operative risk following major pancreatic surgery has been demonstrated, thus extending the indication for these operations to patients with metastatic disease.

  16. Hürthle cell carcinoma: current perspectives

    Directory of Open Access Journals (Sweden)

    Ahmadi S

    2016-11-01

    Full Text Available Sara Ahmadi,1 Michael Stang,2 Xiaoyin “Sara” Jiang,3 Julie Ann Sosa2,4,5 1Division of Endocrinology, Department of Medicine, 2Section of Endocrine Surgery, Department of Surgery, 3Department of Pathology, Duke University Medical Center, 4Duke Cancer Institute, 5Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA Abstract: Hürthle cell carcinoma (HCC can present either as a minimally invasive or as a widely invasive tumor. HCC generally has a more aggressive clinical behavior compared with the other differentiated thyroid cancers, and it is associated with a higher rate of distant metastases. Minimally invasive HCC demonstrates much less aggressive behavior; lesions <4 cm can be treated with thyroid lobectomy alone, and without radioactive iodine (RAI. HCC has been observed to be less iodine-avid compared with other differentiated thyroid cancers; however, recent data have demonstrated improved survival with RAI use in patients with HCC >2 cm and those with nodal and distant metastases. Patients with localized iodine-resistant disease who are not candidates for a wait-and-watch approach can be treated with localized therapies. Systemic therapy is reserved for patients with progressive, widely metastatic HCC. Keywords: thyroid cancer, thyroid nodule, follicular cell carcinoma, Hurthle cell lesion, minimally invasive HCC

  17. Quartz Mountain/Oklahoma Summer Arts Institute.

    Science.gov (United States)

    Frates, Mary Y.; Madeja, Stanley S.

    1982-01-01

    Describes the Quartz Mountain Oklahoma Summer Arts Institute program. It is designed to nurture artistic talent and to provide intensive arts experiences in music, dance, theater, and the visual arts for talented students aged 14-18. (AM)

  18. CAS at the Cockcroft Institute

    CERN Multimedia

    2007-01-01

    The CERN Accelerator School (CAS) and the UK’s new centre for accelerator science, the Cockcroft Institute, jointly organised a course on General Accelerator Physics, at intermediate level, at the Cockcroft Institute, Daresbury, UK, from 16 to 28 September 2007. The venue took advantage of the excellent new facilities in the Institute and the existing infrastructure of the adjacent Daresbury Laboratory. The intermediate level course followed established practice, with lectures on core topics in the mornings and specialised courses in the afternoons. The latter provided "hands-on" education and experience in the three selected topics: "RF Measurements Techniques", "Beam Instrumentation and Diagnostics" and "Optics Design and Correction". These proved to be highly successful, with participants choosing one course and following the topic throughout the school. Guided studies, tutorials, seminars and a poster session completed the prog...

  19. Clinical experience of [sup 123]I-IMP scintigraphy in detecting vertebral bone metastases of hepatocellular carcinoma. A comparison with bone scintigraphy with [sup 99m]Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Iwamiya, T. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Tanigawa, N. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Shabana, M. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Ohta, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan))

    1994-03-01

    [sup 123]I-IMP and bone scintigraphy with [sup 99m]Tc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in [sup 123]I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as ''hot'' lesions (56%) and 7 as ''cold'' lesions (44%). [sup 123]I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, [sup 123]I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings. (orig./MG).

  20. 目标管理在高校化学实验教学资源管理中的应用%Application of Management by Objective to Didactical Resource Management of Chemistry Experiment in Institution of Higher Education

    Institute of Scientific and Technical Information of China (English)

    郑思宁

    2011-01-01

    Based on quantitative management of technicians of laboratories, management by objective is introduced into didactical resource management of chemistry experiment in Institution of Higher Education to make up the shortage of current management pattern and to promote the management level. The application of management by objective is elaborated from the points of the general idea, establishing multi-level target system, process control,evaluating performance, the significance and so on.%为了克服当前高校化学实验教学资源管理模式中存在的不足,提升化学实验教学资源的管理水平,在实验技术人员定量化管理的基础上,引入了目标管理方法.从目标管理的总体思路、多层次目标体系的建立、目标实施过程中的进程控制、衡量实际绩效及实施目标管理的意义等多方面介绍目标管理的应用.

  1. Experiences in building a high performance sports team in regular institutions of higher learning in Beijing%北京市普通高校高水平运动队建设的经验

    Institute of Scientific and Technical Information of China (English)

    郝光安; 刘茂辉

    2014-01-01

    通过对北京市27所高校高水平运动队建设进行调查与分析,从6个方面总结了经验:领导重视不能成为口头空谈,而要抓紧具体落实;培养方式宜从自主培养走向合作共赢;目标定位需科学与准确;正确处理学训关系;通过研究生培养为运动员树立榜样;多渠道筹措经费。%By investigating and analyzing the building of a high performance sports team by 27 institutions of higher learning in Beijing, the authors summarized their experiences in 6 aspects: the leaders should focus on spe-cific implementation instead of empty talks about their concerns; the mode of cultivation should be changed from independent cultivation to win-win cooperation; objective setting should be scientific and accurate; the relationship between cultural learning and physical training was dealt with correctly; a role model was set up for athletes by means of postgraduate cultivation; funds were raised through multiple channels.

  2. Ghost cell odontogenic carcinoma.

    NARCIS (Netherlands)

    Nazaretian, S.P.; Schenberg, M.E.; Simpson, I.; Slootweg, P.J.

    2007-01-01

    Ghost cell odontogenic carcinoma (GCOC) is the malignant counterpart of calcifying cystic odontogenic tumour and dentinogenic ghost cell tumour. This is the case of a middle-aged male who presented with a slow-growing maxillary tumour. He was asymptomatic until pain symptoms developed prior to initi

  3. Extrapulmonary small cell carcinoma.

    NARCIS (Netherlands)

    Heijden, E. van der; Heijdra, Y.F.

    2005-01-01

    This article reviews the recent literature on extrapulmonary small cell carcinomas. Until now, only four cases have been published in the English literature, two of those in the Southern Medical Journal. Sharing the information on diagnosis and treatment of these cases is important for better unders

  4. Verrucous carcinoma of larynx

    OpenAIRE

    Varshney, Saurabh; Singh, Jasprit; Saxena, R. K.; Kaushal, Anoop; Pathak, V. P.

    2004-01-01

    A 55 years male presented with hoarsness of voice (4 months), cough (1 month), difficulty in breathing (15 days). Patient underwent an emergency tracneostomy and further workup proved it to be a case of verrucous carcinoma of larynx. Patient was treated surgically with satisfactory result.

  5. Invasive Micropapillary Carcinoma in Breast Presented as Hyperechoic Mass with Coarse Macrocalcifications: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee Sun; Seo, Bo Kyung; Song, Sung Eun; Kim, Young Sik [Dept. of Radiology, Korea University Ansan Hospital, Ansan (Korea, Republic of); Cho, Kyu Ran [Dept. of Radiology, Korea University Anam Hospital, Seoul (Korea, Republic of); Woo, Ok Hee [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Invasive micropapillary carcinoma is a rare, clinically aggressive variant of invasive ductal carcinoma. Imaging findings of invasive micropapillary carcinoma are not specific, and associated microcalcifications are frequent. Our case presented with unique radiological features: a mass with coarse macrocalcifications on mammography and breast computed tomography and a hyperechoic mass on breast ultrasound. Macrocalcifications and hyperechogenicity are not usual malignant characteristics. We report here on our experience with a 55-year-old woman who had invasive micropapillary carcinoma in the breast with unique radiological and pathological findings.

  6. Metastatic basal cell carcinoma caused by carcinoma misdiagnosed as acne - case report and literature review

    DEFF Research Database (Denmark)

    Aydin, Dogu; Hölmich, Lisbet Rosenkrantz; Jakobsen, Linda P

    2016-01-01

    Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis.......Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis....

  7. FPG Child Development Institute

    Science.gov (United States)

    ... Early Childhood Development, Teaching, and Learning The Frank Porter Graham Child Development Institute will partner with Zero ... Children with Disabilities October 12, 2016 More Frank Porter Graham Child Development Institute The University of North ...

  8. Canadian institute honours Hawking

    Science.gov (United States)

    Durrani, Matin

    2009-11-01

    The Perimeter Institute for Theoretical Physics in Waterloo, Canada, has announced that a major new extension to its campus will be known as the Stephen Hawking Centre. The extension, which is currently being built, is due to open in 2011 and will double the size of the institute. It will also provide a home for the institute's Masters students, the first of whom joined the Perimeter Institute this autumn as part of its Perimeter Scholars international programme.

  9. Furthering critical institutionalism

    NARCIS (Netherlands)

    Cleaver, Frances; Koning, De Jessica

    2015-01-01

    This special issue furthers the study of natural resource management from a critical institutional perspective. Critical institutionalism (CI) is a contemporary body of thought that explores how institutions dynamically mediate relationships between people, natural resources and society. It focus

  10. Multinationals and Institutional Competitiveness

    DEFF Research Database (Denmark)

    Hull Kristensen, Peer; Morgan, Glenn

    This article discusses how institutional competitiveness and multinationals are mutually enriching concepts. Seen from the perspective of Multinationals, institutional competitiveness becomes expressed at two levels. At the level of corporate HQs institutional competitiveness proves itself...... competitiveness of Liberal Market Economies and Coordinated Markets Economies under the current competitive regime....

  11. Leucopenia and treatment efficacy in advanced nasopharyngeal carcinoma

    OpenAIRE

    Su, Zhen; Mao, Yan-Ping; OuYang, Pu-Yun; Tang, Jie; Lan, Xiao-Wen; Xie, Fang-Yun

    2015-01-01

    Background Leucopenia or neutropenia during chemotherapy predicts better survival in several cancers. We aimed to assess whether leucopenia could be a biological measure of treatment and a marker of efficacy in advanced nasopharyngeal carcinoma (ANPC). Methods We retrospectively analyzed 3826 patients with ANPC who received chemoradiotherapy. Leucopenia was categorised on the basis of worst grade during treatment according to the National Cancer Institute Common Toxicity Criteria version 4.0:...

  12. Surgical management of parapharyngeal lymph node metastasis of thyroid carcinoma: a retrospective study of 25 patients

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-lei; XU Zhen-gang; WU Yue-huang; LIU Shao-yan; YU Yue

    2012-01-01

    Background Parapharyngeal lymph node (PPLN) metastasis from thyroid carcinoma is rare.We describe the clinical features,diagnosis,and surgical treatment of this condition.Methods Twenty-five patients with PPLN metastasis from thyroid carcinoma were treated at our institution from January 1999 to December 2010,including 22 patients with papillary carcinoma,two with medullary carcinoma,and one with follicular carcinoma.Of these,16 had a history of surgical treatment prior to PPLN metastasis.Of the nine patients without a history of surgical treatment,five had widespread cervical lymph node metastases and four had occult papillary thyroid carcinoma.PPLN metastasis was diagnosed by enhanced computed tomography in 22 cases.Results Resection of metastases was performed via a transcervical approach in 23 patients and a transmandibular approach in two patients.After a median follow-up time of 31 months (range:6-130 months),nine patients developed distant metastases,and six of these died of their disease.The 5-year survival rate was 63.8%.Conclusions PPLN metastasis from thyroid carcinoma may occur in patients:with previous neck dissection,with widespread metastases to cervical lymph nodes prior to initial treatment,and with occult thyroid carcinoma.Enhanced computed tomography is helpful for diagnosis in the first two presentations.Surgical resection remains the mainstay of treatment for this disease.PPLN metastasis has a tendency to be associated with distant metastases and a poor prognosis.

  13. A rare case report: