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Sample records for center lansce experiment

  1. The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Farrer, R.; Longshore, A. [comps.

    1995-06-01

    This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation.

  2. The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

    International Nuclear Information System (INIS)

    This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation

  3. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports, 1991 run cycle

    International Nuclear Information System (INIS)

    This report briefly discusses experiments conducted at the Lansce neutron source facility. The experiments were conducted on the following instruments: high intensity powder diffractometer; neutron powder diffractometer; single crystal diffractometer; low-q diffractometer; surface profile analysis reflectometer; filter difference spectrometer; experiment reports, and pharos

  4. The Manuel Lujan, Jr. Neutron Scattering Center, LANSCE experiment reports: 1990 Run Cycle

    Energy Technology Data Exchange (ETDEWEB)

    DiStravolo, M.A. (comp.)

    1991-10-01

    This year was the third in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each six-month LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred thirty-four proposals were submitted for unclassified research and twelve proposals for research of a programmatic nature to the Laboratory. Our definition of beam availability is when the proton current from the PSR exceeds 50% of the planned value. The PSR ran at 65{mu}A current (average) at 20 Hz for most of 1990. All of the scheduled experiments were performed and experiments in support of the LANSCE research program were accomplished during the discretionary periods.

  5. The Manuel Lujan, Jr. Neutron Scattering Center, LANSCE experiment reports: 1990 Run Cycle

    International Nuclear Information System (INIS)

    This year was the third in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each six-month LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred thirty-four proposals were submitted for unclassified research and twelve proposals for research of a programmatic nature to the Laboratory. Our definition of beam availability is when the proton current from the PSR exceeds 50% of the planned value. The PSR ran at 65μA current (average) at 20 Hz for most of 1990. All of the scheduled experiments were performed and experiments in support of the LANSCE research program were accomplished during the discretionary periods

  6. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports 1992 run cycle

    International Nuclear Information System (INIS)

    This year was the fifth in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory, examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred sixty-seven proposals were submitted for unclassified research and twelve proposals for research of a programmatic interest to the Laboratory; six experiments in support of the LANSCE research program were accomplished during the discretionary periods. Oversubscription for instrument beam time by a factor of three was evident with 839 total days requested and only 371 available for allocation

  7. The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports 1992 run cycle. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    DiStravolo, M.A. [comp.

    1993-09-01

    This year was the fifth in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory, examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and an associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred sixty-seven proposals were submitted for unclassified research and twelve proposals for research of a programmatic interest to the Laboratory; six experiments in support of the LANSCE research program were accomplished during the discretionary periods. Oversubscription for instrument beam time by a factor of three was evident with 839 total days requested and only 371 available for allocation.

  8. The Manuel Lujan, Jr. Neutron Scattering Center LANSCE experiment reports 1989 run cycle

    Energy Technology Data Exchange (ETDEWEB)

    Hyer, D.K.; DiStravolo, M.A. (comps.)

    1990-10-01

    This report contains a listing and description of experiments carried on at the LANSCE neutron scattering facility in the following areas: High Density Powder Diffraction; Neutron Powder Diffractometer, (NPD); Single Crystal Diffractometer, (SCD); Low-Q Diffractometer, (LQD); Surface Profile Analysis Reflectometer, (SPEAR); Filter Difference Spectrometer, (FDS); and Constant-Q Spectrometer.

  9. The Manuel Lujan, Jr. Neutron Scattering Center LANSCE experiment reports 1989 run cycle

    International Nuclear Information System (INIS)

    This report contains a listing and description of experiments carried on at the LANSCE neutron scattering facility in the following areas: High Density Powder Diffraction; Neutron Powder Diffractometer, (NPD); Single Crystal Diffractometer, (SCD); Low-Q Diffractometer, (LQD); Surface Profile Analysis Reflectometer, (SPEAR); Filter Difference Spectrometer, (FDS); and Constant-Q Spectrometer

  10. Design of the next generation target at Lujan center, LANSCE.

    Energy Technology Data Exchange (ETDEWEB)

    Ferres, Laurent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-27

    This is a presentation given at Los Alamos National Laboratory (LANL) on the design of the next generation target at Lujan center, LANSCE. The motivation for this design is to enable new nuclear physics experiments (defense program applications (DANCE)) that are currently limited by neutron intensity or energy resolution available at LANSCE. The target is being redesigned so that the Flight Paths in the upper tier provide a higher intensity in the epithermal and medium energy ranges.

  11. The NPDGamma Experiment at LANSCE

    CERN Document Server

    Gericke, M T; Chupp, T E; Coulter, K P; Dabaghyan, M; Dawkins, M; Desai, D; Freedman, S J; Gentile, T R; Gillis, R C; Greene, G L; Hersman, F W; Ino, T; Jones, G L; Kandes, M; Lauss, B; Leuschner, M B; Lozowski, W R; Mahurin, R; Masuda, Y; Mason, M; Mitchell, G S; Muto, S; Nann, H; Page, S A; Penttila, S I; Ramsay, W D; Santra, S B; Seo, P N; Sharapov, E I; Smith, T B; Snow, W M; Wilburn, W S; Yuan, V; Zhu, H

    2005-01-01

    The NPDGamma collaboration has constructed and commissioned an apparatus to determine the size of the pion-nucleon coupling constant in the parity non conserving pion exchange weak potential for N-N interactions. This coupling constant is directly proportional to the parity violating up-down asymmetry in the angular distribution of gamma rays with respect to the neutron spin direction in the capture of polarized cold neutrons on protons. The measurement of the weak pNN coupling will provide a test for the effective theory, describing the nucleon-nucleon interaction as mediated by the exchange of mesons, and provide results against which to compare models describing QCD at low energy. NPDGamma is located at the Los Alamos Neutron Science Center (LANSCE) and utilizes the special features of cold spallation neutrons to make it possible to measure very small gamma ray asymmetries. In this paper, we present the motivation for the experiment and report on experimental setup as well as the current status of the proj...

  12. LANSCE '90: The Manuel Lujan Jr. Neutron Scattering Center

    Energy Technology Data Exchange (ETDEWEB)

    Pynn, R.

    1990-01-01

    This paper describes progress that has been made at the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) during the past two years. Presently, LANSCE provides a higher peak neutron flux than any other pulsed spallation neutron source. There are seven spectrometers for neutron scattering experiments that are operated for a national user program sponsored by the US Department of Energy. Two more spectrometers are under construction. Plans have been made to raise the number of beam holes available for instrumentation and to improve the efficiency of the target/moderator system. 9 refs., 4 figs.

  13. Recent operational experiments at the LANSCE facility

    Energy Technology Data Exchange (ETDEWEB)

    Rybarcyk, Lawrence J [Los Alamos National Laboratory

    2010-09-15

    The Los Alamos Neutron Science Center (LANSCE) consists of a pulsed 800-MeV room-temperature linear accelerator and an 800-MeV accumulator ring. It simultaneously provides H{sup +} and H{sup -} beams to several user facilities that have their own distinctive requirements, e.g. intensity, chopping pattern, duty factor, etc.. This multibeam operation presents challenges both from the standpoint of meeting the individual requirements but also achieving good overall performance for the integrated operation. Various aspects of more recent operations including the some of these challenges will be discussed.

  14. Los Alamos Neutron Science Center (LANSCE) Nuclear Science Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Ronald Owen [Los Alamos National Laboratory; Wender, Steve [Los Alamos National Laboratory

    2015-06-19

    The Los Alamos Neutron Science Center (LANSCE) facilities for Nuclear Science consist of a high-energy "white" neutron source (Target 4) with 6 flight paths, three low-energy nuclear science flight paths at the Lujan Center, and a proton reaction area. The neutron beams produced at the Target 4 complement those produced at the Lujan Center because they are of much higher energy and have shorter pulse widths. The neutron sources are driven by the 800-MeV proton beam of the LANSCE linear accelerator. With these facilities, LANSCE is able to deliver neutrons with energies ranging from a milli-electron volt to several hundreds of MeV, as well as proton beams with a wide range of energy, time and intensity characteristics. The facilities, instruments and research programs are described briefly.

  15. Prospects for a measurement of the 237U(n,f) cross section at the LANSCE Lujan Center

    Energy Technology Data Exchange (ETDEWEB)

    Devlin, Matthew James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gavron, Victor [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Jandel, Marian [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rusev, Gencho Yordanov [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bredeweg, Todd Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-24

    A new measurement of the 237U(n, f) cross section from thermal to ≈ 100 keV is discussed, using one of the flightpaths at the LANSCE Lujan Center. Previous energy-resolved resonance-region measurements have been conducted using weapon test time-of-flight[1] and the LANSCE Lead Slowing Down Spectrometer[2], the former of which is limited in its energy range, and the latter in its energy resolution and range. We present here a proposal, based on simulations of the Lujan Center neutron flux and a hypothetical experiment, that is expected to adequately address both of these issues.

  16. The LANSCE (Los Alamos Neutron Scattering Center) target system

    International Nuclear Information System (INIS)

    During the summer of 1985, we replaced the WNR T-shaped target/moderator scheme with the LANSCE split-target/flux-trap-moderator design. The intent of this 'LANSCE upgrade' was to increase (to 12) the number of neutron beam lines serviced simultaneously, and to enhance the target area shielding and target system to accept 200 μA of 800-MeV protons. The four LANSCE moderators consist of three (chilled) water moderators, and a liquid hydrogen (20 K) moderator. The LANSCE target is machinable tungsten

  17. LANSCE (Los Alamos Neutron Scattering Center) target system performance

    International Nuclear Information System (INIS)

    The authors measured neutron beam fluxes at LANSCE using gold foil activation techniques. They did an extensive computer simulation of the as-built LANSCE Target/Moderator/Reflector/Shield geometry. They used this mockup in a Monte Carlo calculation to predict LANSCE neutronic performance for comparison with measured results. For neutron beam fluxes at 1 eV, the ratio of measured data to calculated varies from ∼0.6-0.9. The computed 1 eV neutron leakage at the moderator surface is 3.9 x 1010 n/eV-sr-s-μA for LANSCE high-intensity water moderators. The corresponding values for the LANSCE high-resolution water moderator and the liquid hydrogen moderator are 3.3 and 2.9 x 1010, respectively. LANSCE predicted moderator intensities (per proton) for a tungsten target are essentially the same as ISIS predicted moderator intensities for a depleted uranium target. The calculated LANSCE steady state unperturbed thermal (E 13 n/cm2-s. The unique LANSCE split-target/flux-trap-moderator system is performing exceedingly well. The system has operated without a target or moderator change for over three years at nominal proton currents of 25 μA of 800-MeV protons. 17 refs., 8 figs., 3 tabs

  18. LANSCE [Manuel Lujan, Jr. Neutron Scattering Center] target system performance

    International Nuclear Information System (INIS)

    We measured neutron beam fluxes at LANSCE using gold foil activation techniques. We did an extensive computer simulation of the as-built LANSCE Target/Moderator/Reflector/Shield geometry. We used this mockup in a Monte Carlo calculation to predict LANSCE neutronic performance for comparison with measured results. For neutron beam fluxes at 1 eV, the ratio of measured data to calculated varies from ∼0.6-0.9. The computed 1 eV neutron leakage at the moderator surface is 3.9 x 1010 n/eV-sr-s-μA for LANSCE high-intensity water moderators. The corresponding values for the LANSCE high-resolution water moderator and the liquid hydrogen moderator are 3.3 and 2.9 x 1010, respectively. LANSCE predicted moderator intensities (per proton) for a tungsten target are essentially the same as ISIS predicted moderator intensities for a depleted uranium target. The calculated LANSCE steady state unperturbed thermal (E 13 n/cm2-s. The unique LANSCE split-target/flux-trap-moderator system is performing exceedingly well. The system has operated without a target or moderator change for over three years at nominal proton currents of ∼25 μA of 800-MeV protons. 17 refs., 8 figs., 3 tabs

  19. LANSCE Activity Report

    Energy Technology Data Exchange (ETDEWEB)

    Amy Robinson; Audrey Archuleta; Barbara Maes; Dan Strottman; Earl Hoffman; Garth Tietjen; Gene Farnum; Geoff Greene; Joyce Roberts; Ken Johnson; Paul Lewis; Roger Pynn; Stan Schriber; Steve Sterbenz; Steve Wender; Sue Harper

    1999-02-01

    The Los Alamos Neutron Science Center Activity Report describes scientific and technological progress and achievements in LANSCE Division during the period of 1995 to 1998. This report includes a message from the Division Director, an overview of LANSCE, sponsor overviews, research highlights, advanced projects and facility upgrades achievements, experimental and user program accomplishments, news and events, and a list of publications. The research highlights cover the areas of condensed-matter science and engineering, accelerator science, nuclear science, and radiography. This report also contains a compact disk that includes an overview, the Activity Report itself, LANSCE operations progress reports for 1996 and 1997, experiment reports from LANSCE users, as well as a search capability.

  20. Lujan at Los Alamos Neutron Science Center (LANSCE)

    Data.gov (United States)

    Federal Laboratory Consortium — The Lujan Neutron Scattering Center (Lujan Center) at Los Alamos National Laboratory is an intense pulsed neutrons source operating at a power level of 80 -100 kW....

  1. LANSCE Activity Report 1995-1998

    International Nuclear Information System (INIS)

    The Los Alamos Neutron Science Center Activity Report describes scientific and technological progress and achievements in LANSCE Division during the period of 1995 to 1998. This report includes a message from the Division Director, an overview of LANSCE, sponsor overviews, research highlights, advanced projects and facility upgrades achievements, experimental and user program accomplishments, news and events, and a list of publications. The research highlights cover the areas of condensed-matter science and engineering, accelerator science, nuclear science, and radiography. This report also contains a compact disk that includes an overview, the Activity Report itself, LANSCE operations progress reports for 1996 and 1997, experiment reports from LANSCE users, as well as a search capability

  2. Design of the Next Generation Target at the Lujan Neutron Scattering Center, LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ferres, Laurent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); National Graduate School of Engineering and Research Center (ENSICAEN), Caen (France)

    2016-08-03

    Los Alamos National Laboratory (LANL) supports scientific research in many diverse fields such as biology, chemistry, and nuclear science. The Laboratory was established in 1943 during the Second World War to develop nuclear weapons. Today, LANL is one of the largest laboratories dedicated to nuclear defense and operates an 800 MeV proton linear accelerator for basic and applied research including: production of high- and low-energy neutrons beams, isotope production for medical applications and proton radiography. This accelerator is located at the Los Alamos Neutron Science Center (LANSCE). The work performed involved the redesign of the target for the low-energy neutron source at the Lujan Neutron Scattering Center, which is one of the facilities built around the accelerator. The redesign of the target involves modeling various arrangements of the moderator-reflector-shield for the next generation neutron production target. This is done using Monte Carlo N-Particle eXtended (MCNPX), and ROOT analysis framework, a C++ based-software, to analyze the results.

  3. Commissioning and initial operation of the Isotope Production Facility at the Los Alamos Neutron Science Center (LANSCE).

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, K. F. (Kenneth F.); Alvestad, H. W. (Henry W.); Barkley, W. C. (Walter C.); Barlow, D. B. (David B.); Barr, D. S. (Dean S.); Bennett, L. S. (Langdon S.); Bitteker, L. J. (Leo J.); Bjorklund, E. A. (Eric A.); Boedeker, W.; Borden, M. J. (Michael J.); Cardon, R.; Carr, G. (Gary); Casados, J. L. (Jeffrey L.); Cohen, Stanley; Cordova, J. F. (Justo J.; Faucett, John Allen,; Fresquez, M. (Matthew); Gallegos, F. R. (Floyd R.); Gilpatrick, J. D. (John Douglas); Gonzales, F. (Fermin); Gorman, F. W. (Frederick W.); Gulley, M. S. (Mark S.); Hall, M. J. (Michael J.); Hayden, D. J. (David J.); Heaton, R. C. (Richard C.); Henderson, D. B. (Dale B.); Ireland, D. B. (David B.); Jacobson, E. G. (Edward G.); Johns, G. D. (Glen D.); Kersteins, D. M. (Debora M.); Maestas, A. J. (Alfred J.); Martinez, A. M. (Alexandra M.); Martinez, D. G. (Derwin G.); Martinez, G.; Martinez, J.; Martinez, M. P. (Martin P.); Merl, R. B. (Robert B.); Merrill, J. B. (John B.); Meyer, B. J. (Bruce J.); Meyer, R., Sr.; Milder, M.; Morgan, E.; Nortier, M.; O' Hara, J. F. (James F.); Olivas, F. R. (Felix R.); Oothoudt, Michael; Pence, T. D. (Tim D.); Perets, Mikhaʾel ben Yosef; Peterson, E.; Pillai, C. (Chandra); Romero, F.; Rose, C.; Rybarcyk, L. J. (Lawrence J.); Sanchez, G. (Gary); Sandoval, J. B. (Jacob B.); Schaller, S. (Stuart); Shelley, F. E. (Fred E.); Shurter, R. B. (Robert B.); Sommer, Walter F.; Stettler, M. W. (Matthew W.); Stockton, J. L. (Jerry L.); Sturrock, J. C. (James C.); Tomei, T. L. (Tony L.); Valdez, F.; Vigil, V. P. (Victor P.); Walstrom, P. L. (Peter L.); Wanco, P. M. (Peter M.); Wilmarth, J.

    2004-01-01

    The recently completed 100-MeV H{sup +} Isotope Production Facility (IPF) at the LANSCE will provide radioisotopes for medical research and diagnosis, for basic research and for commercial use. A change to the LANSCE accelerator facility allowed for the installation of the IPF. Three components make up the LANSCE accelerator: an injector that accelerates the H{sup +} beam to 750-KeV, a drift-tube linac (DTL) that increases the beam energy to 100-MeV, and a side-coupled cavity linac (SCCL) that accelerates the beam to 800-MeV. The transition region, a space between the DTL and the SCCL, was modified to permit the insertion of a kicker magnet (23{sup o} kick angle) for the purpose of extracting a portion of the 100-MeV H{sup +} beam. A new beam line was installed to transport the extracted H{sup +} beam to the radioisotope production target chamber. This paper will describe the commissioning and initial operating experiences of IPF.

  4. Commissioning and initial operation of the Isotope Production Facility at the Los Alamos Neutron Science Center (LANSCE)

    International Nuclear Information System (INIS)

    The recently completed 100-MeV H+ Isotope Production Facility (IPF) at the LANSCE will provide radioisotopes for medical research and diagnosis, for basic research and for commercial use. A change to the LANSCE accelerator facility allowed for the installation of the IPF. Three components make up the LANSCE accelerator: an injector that accelerates the H+ beam to 750-KeV, a drift-tube linac (DTL) that increases the beam energy to 100-MeV, and a side-coupled cavity linac (SCCL) that accelerates the beam to 800-MeV. The transition region, a space between the DTL and the SCCL, was modified to permit the insertion of a kicker magnet (23o kick angle) for the purpose of extracting a portion of the 100-MeV H+ beam. A new beam line was installed to transport the extracted H+ beam to the radioisotope production target chamber. This paper will describe the commissioning and initial operating experiences of IPF.

  5. Results From Cavitation Damage Experiments With Mercury Spallation Targets At The LANSCE WNR In 2008

    International Nuclear Information System (INIS)

    Damage assessment from proton beam induced cavitation experiments on mercury spallation targets done at the LANSCE WNR facility has been completed. The experiments investigated two key questions for the Spallation Neutron Source target, namely, how damage is affected by flow velocity in the SNS coolant channel geometry, and how damage scales with proton beam intensity at a given constant charge per pulse. With regard to the former question, prior in-beam experiments indicated that the coolant channel geometry with stagnant mercury was especially vulnerable to damage which might warrant a design change. Yet other results indicated a reduction in damage with the introduction of flow. Using more prototypic to the SNS, the 2008 experiment damage results show the channel is less vulnerable than the bulk mercury side of the vessel wall. They also show no benefit from increasing channel flow velocity beyond nominal SNS speeds. The second question probed a consensus belief that damage scales with beam intensity (protons per unit area) by a power law dependence with exponent of around 4. Results from a 2005 experiment did not support this power law dependence but some observations were inconsistent and unexplained. These latest results show weaker damage dependence.

  6. LANSCE RF System Refurbishment

    CERN Document Server

    Rees, Daniel; Kwon, Sung-il; Lyles, John T M; Lynch, Michael; Prokop, Mark; Reass, William; Tallerico, Paul J

    2005-01-01

    The Los Alamos Neutron Science Center (LANSCE) is in the planning phase of a refurbishment project that will sustain reliable facility operations well into the next decade. The LANSCE accelerator was constructed in the late 1960s and early 1970s and is a national user facility that provides pulsed protons and spallation neutrons for defense and civilian research and applications. We will be replacing all the 201 MHz RF systems and a substantial fraction of the 805 MHz RF systems and high voltage systems. The current 44 LANSCE 805 MHz, 1.25 MW klystrons have an average in-service time in excess of 110,000 hours. All 44 must be in service to operate the accelerator. There are only 9 spares left. The klystrons receive their DC power from the power system originally installed in 1960. Although this power system has been extremely reliable, gas analysis of the insulating oil is indicating age related degradation that will need attention in the next few years. This paper will provide the design details of the new R...

  7. Shielding the LANSCE [Los Alamos Neutron Scattering Center] 800-MeV spallation neutron source

    International Nuclear Information System (INIS)

    Neutrons produced by medium-energy (800-MeV) proton reactions at the Los Alamos Neutron Scattering Center spallation neutron source cause a variety of difficult shield problems. We describe the general shielding questions encountered at such a spallation source, and contrast spallation and reactor source shielding issues using an infinite slab-shield composed of 100 cm of iron and 15 cm of borated polyethylene. The calculations show that (for an incident spallation spectrum characteristic of neutrons leaking at 90 degrees from a tungsten target) high-energy neutrons dominate the dose at the shield surface. Secondary low-energy neutrons (produced by high-energy neutron attenuation) and attendant gamma-rays add significantly to the dose. The primary low-energy neutrons produced directly at the tungsten source contribute negligibly to the dose, and behave similarly to neutrons with a fission spectrum distribution. 8 refs., 10 figs

  8. Neutron capture measurement on 173Lu at LANSCE with DANCE detector

    International Nuclear Information System (INIS)

    The (n,γ) cross section on the unstable 173Lu(t1/2 = 1.37y) has been measured from thermal energy up to 200 eV at Los Alamos Neutron Science Center (LANSCE) with The Detector for Advanced Neutron Capture Experiements (DANCE). The main aim of this study is to validate and optimize reaction models for unstable nucleus. A preliminary capture yield will be presented in this paper.

  9. Neutron capture measurement on {sup 173}Lu at LANSCE with DANCE detector

    Energy Technology Data Exchange (ETDEWEB)

    Theroine, C.; Ebran, A.; Meot, V.; Roig, O. [CEA DAM DIF, F-91297 Arpajon (France); Bond, E. M.; Bredeweg, T. A.; Couture, A.; Haight, R. C.; Jandel, M.; Nortier, F. M.; O' Donnell, J. M.; Rundberg, R. S.; Taylor, W. A.; Ullmann, J. L.; Viera, D. J.; Wilhelmy, J. B.; Wouters, J. M. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    2013-06-10

    The (n,{gamma}) cross section on the unstable {sup 173}Lu(t{sub 1/2} = 1.37y) has been measured from thermal energy up to 200 eV at Los Alamos Neutron Science Center (LANSCE) with The Detector for Advanced Neutron Capture Experiements (DANCE). The main aim of this study is to validate and optimize reaction models for unstable nucleus. A preliminary capture yield will be presented in this paper.

  10. LANSCE radiation security system (RSS)

    International Nuclear Information System (INIS)

    The Radiation Security System (RSS) is an engineered safety system which automatically terminates transmission of accelerated ion beams in response to pre-defined abnormal conditions. It is one of the four major mechanisms used to protect people from radiation hazards induced by accelerated pulsed ion beams at the Los Alamos Neutron Science Center (LANSCE). The others are shielding, administrative policies and procedures, and qualified, trained personnel. Prompt radiation hazards at the half-mile long LANSCE accelerator exist due to average beam intensities ranging from 1 milli-amp for H+ beam to 100 micro-amps for the high intensity H- beam. Experimental programs are supplied with variable energy (maximum 800 MeV), pulse-width (maximum 1 msec), and pulse frequency (maximum 120 Hz) ion beams. The RSS includes personnel access control systems, beam spill monitoring systems, and beam current level limiting systems. It is a stand-alone system with redundant logic chains. A fault of the RSS will cause the insertion of fusible beam plugs in the accelerator low energy beam transport. The design philosophy, description, and operation of the RSS are described in this paper

  11. Science-based stockpile stewardship at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Browne, J. [Los Alamos National Lab., NM (United States)

    1995-10-01

    Let me tell you a little about the Los Alamos Neutron Science Center (LANSCE) and how some of the examples you heard about from Sig Hecker and John Immele fit together in this view of a different world in the future where defense, basic and industrial research overlap. I am going to talk about science-based stockpile stewardship at LANSCE; the accelerator production of tritium (APT), which I think has a real bearing on the neutron road map; the world-class neutron science user facility, for which I will provide some examples so you can see the connection with defense science; and lastly, testing concepts for a high-power spallation neutron target and waste transmutation.

  12. Science-based stockpile stewardship at LANSCE

    International Nuclear Information System (INIS)

    Let me tell you a little about the Los Alamos Neutron Science Center (LANSCE) and how some of the examples you heard about from Sig Hecker and John Immele fit together in this view of a different world in the future where defense, basic and industrial research overlap. I am going to talk about science-based stockpile stewardship at LANSCE; the accelerator production of tritium (APT), which I think has a real bearing on the neutron road map; the world-class neutron science user facility, for which I will provide some examples so you can see the connection with defense science; and lastly, testing concepts for a high-power spallation neutron target and waste transmutation

  13. Physical insights and test stand results for the LANSCE H- surface converter source

    International Nuclear Information System (INIS)

    The Los Alamos Neutron Science Center (LANSCE) H- surface converter source has been under development for several years to reach 25-40 mA current with 7(πcm-mrad) lab emittance (95% beam fraction). The duty factor is 12% (120 Hz, 1 ms pulse length). Summary test stand results and interpretations for a six filament axial extraction H- source are presented. This source did produce 40-mA H- current, but with unacceptable emittance growth. More recently a fourth, modified LANSCE H- production source with radial H- extraction system has been constructed, and is presently undergoing tests. Currents up to 25mA H- have been observed with 20% emittance growth. This emittance growth may be acceptable for 800 MeV linac operations. A summary of physical principles of emittance growth mechanisms and converter physics are given. Significant upgrades to the LANSCE 800-MeV linac and Proton Storage Ring (PSR) operations can be realized by development of an if ion source with laboratory emittance of 7(πcm-mrad) at 95% beam fraction with 20-40mA H- current. The source beam energy is 80keV and the duty factor (df) is 12%. A six-filament version of the surface converter source with axial if beam extraction was developed in a collaborative effort between Lawrence Berkeley National (LBNL) and Los Alamos National Laboratories (LANL). Although this source did produce 40-mA H- current, an unexpected emittance growth factor of 2.5 made these higher current beams unacceptable for LANSCE operations. A subsequent decision was made to fabricate and develop a fourth production source to produce 25-mA H- current with an emittance growth of no greater than 20%. The source upgrade technology would be used in a 750-keV H-. injector B at LANSCE. Experiments and analysis on the six-filament axial extraction source will be reviewed in the next section. Evidence is given that at the higher discharge power characteristic of this source, two beams are formed at extraction. The two beams originate in

  14. Overview of the Neutron experimental facilities at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-06-30

    This presentation gives an overview of the neutron experimental facilities at LANSCE. The layout is mentioned in detail, with a map of the south-side experimental facilities, information on Target-4 and the Lujan Center. Then it goes into detail about neutron sources, specifically continuous versus pulsed. Target 4 is then discussed. In conclusion, we have introduced the south-side experimental facilities in operation at LANSCE. 1L target and Target 4 provide complementary neutron energy spectra. Two spallation neutron sources taken together cover more than 11 orders of magnitude in neutron energy.

  15. LANSCE Control System front-end and infrastructure hardware upgrades

    International Nuclear Information System (INIS)

    The Los Alamos Neutron Science Center (LANSCE) linear accelerator drives user facilities for isotope production, proton radiography, ultra-cold neutrons, weapons neutron research and various sciences using neutron scattering. The LANSCE Control System which is in part more than 40 years old provides control and data monitoring for most devices in the linac and for some of its associated experimental-area beam lines. In Fiscal Year 2011, the control system went through an upgrade process that affected different areas of the LANSCE Control System. We improved our network infrastructure and we converted part of our front-end control system hardware to Allen Bradley ControlsLogix 5000 and National Instruments Compact RIO programmable automation controller (PAC). In this paper, we will discuss what we have done, what we have learned about upgrading the existing control system and how this will affect our future plans. (authors)

  16. Need for an (n,α) Apparatus at the LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Koehler, Paul E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-03-05

    There is an urgent need for a new (n,α) measurement capability at the Los Alamos Neutrons Science Center (LANSCE) for several reasons. First, it has been shown that (n,α) measurements on medium- to heavy-mass nuclides can provide some of the best constraints on some of the most important reaction rates for explosive nucleosynthesis studies. A few such measurements have been made, but many more are needed. Second, there are a few (n,p) and (n,α) cross sections on lighter nuclides of importance to nuclear astrophysics that remain unmeasured. Third, it has been shown that (n,α) measurements can constrain photon strength functions (PSFs) at very low energies. This is important because recent experiments, theory, and astrophysical calculations have demonstrated that enhanced PSFs at these energies can have large impacts on nucleosynthesis occurring in explosive environments. Also, enhanced low-energy PSFs could have significant impact on (n,γ) cross sections of interest to radiochemical diagnostics of nuclear devices. However, the shape of PSFs at low energies is a subject of considerable controversy, so new data are badly needed. Fourth, previous (n,α) data have revealed a number of puzzles and hints of exotic atomic-nuclear interactions. In addition to being interesting in their own light, these interactions could be important for understanding high-energy-density environments such as in nuclear explosion and at the National Ignition Facility. Simulations indicate that the high neutron flux at the Manuel Lujan Jr. Neutron Scattering Center (MLNSC) at the LANSCE will make many more of the needed measurements feasible. Hence, a new (n,α) instrument at the MLNSC would enable a wide range of important and interesting basic and applied science.

  17. Neutron Imaging Developments at LANSCE

    Science.gov (United States)

    Nelson, Ron; Hunter, James; Schirato, Richard; Vogel, Sven; Swift, Alicia; Ickes, Tim; Ward, Bill; Losko, Adrian; Tremsin, Anton

    2015-10-01

    Neutron imaging is complementary to x-ray imaging because of its sensitivity to light elements and greater penetration of high-Z materials. Energy-resolved neutron imaging can provide contrast enhancements for elements and isotopes due to the variations with energy in scattering cross sections due to nuclear resonances. These cross section differences exist due to compound nuclear resonances that are characteristic of each element and isotope, as well as broader resonances at higher energies. In addition, multi-probe imaging, such as combined photon and neutron imaging, is a powerful tool for discerning properties and features in materials that cannot be observed with a single probe. Recently, we have demonstrated neutron imaging, both radiography and computed tomography, using the moderated (Lujan Center) and high-energy (WNR facility) neutron sources at LANSCE. Flat panel x-ray detectors with suitable scintillator-converter screens provide good sensitivity for both low and high neutron energies. Micro-Channel-Plate detectors and iCCD scintillator camera systems that provide the fast time gating needed for energy-resolved imaging have been demonstrated as well. Examples of recent work will be shown including fluid flow in plants and imaging through dense thick objects. This work is funded by the US Department of Energy, National Nuclear Security Administration, and performed by Los Alamos National Security LLC under Contract DE-AC52-06NA25396.

  18. Experience based reliability centered maintenance

    International Nuclear Information System (INIS)

    The systematic analysis and documentation of operating experiences should be included in a living NPP life management program. Failure mode and effects and maintenance effects analyses are suitable methods for analysis of the failure and corrective maintenance experiences of equipment. Combined use of the information on occurred functional failures and the decision tree logic of the reliability centered maintenance identifies applicable and effective preventive maintenance tasks of equipment in an old plant. In this study the electrical motor drives of closing and isolation valves (MOV) of TVO and Loviisa nuclear power plants were selected to serve as pilot study objects. The study was limited to valve drives having actuators manufactured by AUMA in Germany. The fault and maintenance history of MOVs from 1981 up to and including October 1991 in different safety and process systems at TVO 1 and 2 nuclear power units was at first analyzed in a systematic way. The scope of the components studied was 81 MOVs in safety-related systems and 127 other MOVs per each TVO unit. In the case of the Loviisa plant, the observation period was limited to three years, i.e. from February 1989 up to February 1992. The scope of the Loviisa 1 and 2 components studied was 44 respectively 95 MOVs. (25 refs., 22 figs., 8 tabs.)

  19. Proceedings of the workshop on neutron-induced gamma-ray physics at LANSCE/WNR

    International Nuclear Information System (INIS)

    The purpose of the workshop was to present the unique capabilities of LANSCE coupled with a large scale Compton suppressed Ge detector array and to help define a future experimental research program. This document contains the vuegraphs from the unclassified session. The vuegraphs were kindly provided by the invited speakers who came from both the university and the national laboratory communities. The talks focused on planned as well as potential experiments at LANSCE/WNR and their importance to the field

  20. GTC Exhibition and Experience Center Launched

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    On May 18, the Exhibition and Experience Center of the Beijing Global Trade Center (GTC) was inaugurated and put into service. A grand inauguration ceremony was held with participation from agent representatives in GTC, which is a complex of Grade-A office units and comprehensive commercial facilities.

  1. Neutron Imaging Developments at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Ronald Owen [Los Alamos National Laboratory; Hunter, James F. [Los Alamos National Laboratory; Schirato, Richard C. [Los Alamos National Laboratory; Vogel, Sven C. [Los Alamos National Laboratory; Swift, Alicia L. [Los Alamos National Laboratory; Ickes, Timothy Lee [Los Alamos National Laboratory; Ward, William Carl [Los Alamos National Laboratory; Losko, Adrian Simon [University of California at Berkeley; Tremsin, Anton [University of California at Berkeley; Sevanto, Sanna Annika [Los Alamos National Laboratory; Espy, Michelle A. [Los Alamos National Laboratory; Dickman, Lee Thoresen [Los Alamos National Laboratory; Malone, Michael [Los Alamos National Laboratory

    2015-10-29

    Thermal, epithermal, and high-energy neutrons are available from two spallation sources at the 800 MeV proton accelerator. Improvements in detectors and computing have enabled new capabilities that use the pulsed beam properties at LANSCE; these include amorphous Si (aSi) detectors, intensified charge-coupled device cameras, and micro-channel plates. Applications include water flow in living specimens, inclusions and fission products in uranium oxide, and high-energy neutron imaging using an aSi flat panel with ZnS(Ag) scintillator screen. images of a metal/plastic cylinder from photons, low-energy and high-energy neutrons are compared.

  2. New Pulsed Cold Neutron Beam Line for Fundamental Nuclear Physics at LANSCE

    Science.gov (United States)

    Seo, P.-N.; Bowman, J. D.; Gericke, M.; Gillis, R. C.; Greene, G. L.; Leuschner, M. B.; Long, J.; Mahurin, R.; Mitchell, G. S.; Penttila, S. I.; Peralta, G.; Sharapov, E. I.; Wilburn, W. S.

    2005-01-01

    The NPDGamma collaboration has completed the construction of a pulsed cold neutron beam line on flight path12 at the Los Alamos Neutron Science Center (LANSCE). We describe the new beam line and characteristics of the beam. We report results of the moderator brightness and the guide performance measurements. FP12 has the highest pulsed cold neutron intensity for nuclear physics in the world.

  3. Internal strain measurement using pulsed neutron diffraction at LANSCE

    International Nuclear Information System (INIS)

    The presence of residual stress in engineering components can effect their mechanical properties and structural integrity. Neutron diffraction in the only technique that can make nondestructive measurements in the interior of components. By recording the change in crystalline lattice spacings, elastic strains can be measured for individual lattice reflections. Using a pulsed neutron source, all lattice reflections are recorded in each measurement, which allows for easy examination of heterogeneous materials such as metal matrix composites. Measurements made at the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) demonstrate the potential at pulsed sources for in-situ stress measurements at ambient and elevated temperatures

  4. Characterizing and Controlling Beam Losses at the LANSCE Facility

    Energy Technology Data Exchange (ETDEWEB)

    Rybarcyk, Lawrence J. [Los Alamos National Laboratory

    2012-09-12

    The Los Alamos Neutron Science Center (LANSCE) currently provides 100-MeV H{sup +} and 800-MeV H{sup -} beams to several user facilities that have distinct beam requirements, e.g. intensity, micropulse pattern, duty factor, etc. Minimizing beam loss is critical to achieving good performance and reliable operation, but can be challenging in the context of simultaneous multi-beam delivery. This presentation will discuss various aspects related to the observation, characterization and minimization of beam loss associated with normal production beam operations in the linac.

  5. The LANSCE Low Momentum Beam Monitor

    CERN Document Server

    Merl, R

    2004-01-01

    A diagnostic has been developed at the Los Alamos Neutron Science Center (LANSCE) for the purpose of identifying low momentum beam tails in the linear accelerator. These tails must be eliminated in order to maintain the transverse and longitudinal beam size. Instead of the currently used phosphor camera system, this instrument consists of a Multi Wire Proportional Chamber (MWPC) front end coupled to an EPICS compliant VME-based electronics package. Low momentum tails are detected with a resolution of 5 mm in the MWPC at a high dispersion point near a bending magnet. While phosphor is typically not sensitive in the nano amp range, the MWPC is sensitive down to about a pico amp. The electronics package processes the signals from each of the MWPC wires to generate an array of beam currents at each of the lower energies. The electronics has an analog front end with a high-speed analog to digital converter for each wire. Data from multiple wires are processed with an embedded digital signal processor and results p...

  6. LANSCE personnel access control system (PACS)

    International Nuclear Information System (INIS)

    The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) provides personnel protection from prompt radiation due to accelerated beam. The Personnel Access Control System (PACS) is a component of the RSS that is designed to prevent personnel access to areas where prompt radiation is a hazard. PACS was designed to replace several older personnel safety systems (PSS) with a single modem unified design. Lessons learned from the operation over the last 20 years were incorporated into a redundant sensor, single-point failure safe, fault tolerant, and tamper-resistant system that prevents access to the beam areas by controlling the access keys and beam stoppers. PACS uses a layered philosophy to the physical and electronic design. The most critical assemblies are battery backed up, relay logic circuits; less critical devices use Programmable Logic Controllers (PLCs) for timing functions and communications. Outside reviewers have reviewed the operational safety of the design. The design philosophy, lessons learned, hardware design, software design, operation, and limitations of the device are described

  7. Hepatoblastoma: Experience from a single center

    OpenAIRE

    Singh, T.; C T Satheesh; Appaji, L.; Aruna Kumari BS; M Padma; Kumar, M V; Mukherjee, G.

    2010-01-01

    Background: The cornerstones of successful treatment of hepatoblastoma (HB) include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT) and surgery in HBs. Settings and Design: Our study included all ch...

  8. NASA Lewis Research Center combustion MHD experiment

    Science.gov (United States)

    Smith, J. M.

    1982-01-01

    The MHD power generation experiments were conducted in a high field strength cryomagnet which was adapted from an existing facility. In its original construction, it consisted of 12 high purity aluminum coils pool cooled in a bath of liquid neon. In this configuration, a peak field of 15 tesla was produced. For the present experiments, the center four coils were removed and a 23 cm diameter transverse warm bore tube was inserted to allow the placement of the MHD experiment between the remaining eight coils. In this configuration, a peak field of 6 tesla should be obtainable. The time duration of the experiment is limited by the neon supply which allows on the order of 1 minute of total operating time followed by an 18-hour reliquefaction period. As a result, the experiments are run in a pulsed mode. The run duration for the data presented here was 5 sec. The magnetic field profile along the MHD duct is shown. Since the working fluid is in essence superheated steam, it is easily water quenched at the exit of the diffuser and the components are designed vacuum tight so that the exhaust pipe and demister an be pumped down to simulate the vacuum of outer space.

  9. Optimizing X Center experience : case study: Company X

    OpenAIRE

    Lehtinen, Timo

    2014-01-01

    This Master’s thesis explores customer experience management and customer experience optimization. The aim is to optimize customer experience in the case company’s X Center. The thesis studies customer experience and customer experience management as a core factor in holding successful X Center events. The study is conducted in cooperation with Company X. Company X launched a new concept called X Center in Finland 2011. X Center is a place where custom-ers and company representatives can ...

  10. The Deep Impact Network Experiment Operations Center

    Science.gov (United States)

    Torgerson, J. Leigh; Clare, Loren; Wang, Shin-Ywan

    2009-01-01

    Delay/Disruption Tolerant Networking (DTN) promises solutions in solving space communications challenges arising from disconnections as orbiters lose line-of-sight with landers, long propagation delays over interplanetary links, and other phenomena. DTN has been identified as the basis for the future NASA space communications network backbone, and international standardization is progressing through both the Consultative Committee for Space Data Systems (CCSDS) and the Internet Engineering Task Force (IETF). JPL has developed an implementation of the DTN architecture, called the Interplanetary Overlay Network (ION). ION is specifically implemented for space use, including design for use in a real-time operating system environment and high processing efficiency. In order to raise the Technology Readiness Level of ION, the first deep space flight demonstration of DTN is underway, using the Deep Impact (DI) spacecraft. Called the Deep Impact Network (DINET), operations are planned for Fall 2008. An essential component of the DINET project is the Experiment Operations Center (EOC), which will generate and receive the test communications traffic as well as "out-of-DTN band" command and control of the DTN experiment, store DTN flight test information in a database, provide display systems for monitoring DTN operations status and statistics (e.g., bundle throughput), and support query and analyses of the data collected. This paper describes the DINET EOC and its value in the DTN flight experiment and potential for further DTN testing.

  11. Neutron-Induced Charged Particle Studies at LANSCE

    Science.gov (United States)

    Lee, Hye Young; Haight, Robert C.

    2014-09-01

    Direct measurements on neutron-induced charged particle reactions are of interest for nuclear astrophysics and applied nuclear energy. LANSCE (Los Alamos Neutron Science Center) produces neutrons in energy of thermal to several hundreds MeV. There has been an effort at LANSCE to upgrade neutron-induced charged particle detection technique, which follows on (n,z) measurements made previously here and will have improved capabilities including larger solid angles, higher efficiency, and better signal to background ratios. For studying cross sections of low-energy neutron induced alpha reactions, Frisch-gridded ionization chamber is designed with segmented anodes for improving signal-to-noise ratio near reaction thresholds. Since double-differential cross sections on (n,p) and (n,a) reactions up to tens of MeV provide important information on deducing nuclear level density, the ionization chamber will be coupled with silicon strip detectors (DSSD) in order to stop energetic charged particles. In this paper, we will present the status of this development including the progress on detector design, calibrations and Monte Carlo simulations. This work is funded by the US Department of Energy - Los Alamos National Security, LLC under Contract DE-AC52-06NA25396.

  12. Cross Section Measurements at LANSCE for Defense, Science and Applications

    Directory of Open Access Journals (Sweden)

    Nelson Ronald O.

    2015-01-01

    Full Text Available The Los Alamos Neutron Science Center (LANSCE has three neutron sources that are used for nuclear science measurements. These sources are driven by an 800 MeV proton linear accelerator and cover an energy range from sub-thermal to hundreds of MeV. Research at the facilities is performed under the auspices of a US DOE user program under which research proposals are rated for merit by a program advisory committee and are scheduled based on merit and availability of beam time. A wide variety of instruments is operated at the neutron flight paths at LANSCE including neutron detector arrays, gamma-ray detector arrays, fission fragment detectors, and charged particle detectors. These instruments provide nuclear data for multiple uses that range from increasing knowledge in fundamental science to satisfying data needs for diverse applications such as nuclear energy, global security, and industrial applications. Highlights of recent research related to cross sections measurements are presented, and future research initiatives are discussed.

  13. Airline experience with reliability-centered maintenance

    International Nuclear Information System (INIS)

    Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.)

  14. An overview of DANCE: a 4π BaF2 detector for neutron capture measurements at LANSCE

    International Nuclear Information System (INIS)

    The Detector for Advanced Neutron Capture experiments (DANCE) is a 162-element, 4π BaF2 array designed to make neutron capture cross-section measurements on rare or radioactive targets with masses as little as 1 mg. Accurate capture cross sections are needed in many research areas, including stellar nucleosynthesis, advanced nuclear fuel cycles, waste transmutation, and other applied programs. These cross sections are difficult to calculate accurately and must be measured. Up to now, except for a few long-lived nuclides there are essentially no differential capture measurements on radioactive nuclei. The DANCE array is located at the Lujan Neutron Scattering Center at LANSCE, which is a continuous-spectrum neutron source with useable energies from below thermal to about 100 keV. Data acquisition is done with 320 fast waveform digitizers. The design and initial performance results, including background minimization, will be discussed.

  15. An overview of DANCE: a 4II BaF[2] detector for neutron capture measurements at LANSCE.

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J. L. (John L.)

    2004-01-01

    The Detector for Advanced Neutron Capture experiments (DANCE) is a 162-element, 4{pi} BaF{sub 2} array designed to make neutron capture cross-section measurements on rare or radioactive targets with masses as little as 1 mg. Accurate capture cross sections are needed in many research areas, including stellar nucleosynthesis, advanced nuclear fuel cycles, waste transmutation, and other applied programs. These cross sections are difficult to calculate accurately and must be measured. Up to now, except for a few long-lived nuclides there are essentially no differential capture measurements on radioactive nuclei. The DANCE array is located at the Lujan Neutron Scattering Center at LANSCE, which is a continuous-spectrum neutron source with useable energies from below thermal to about 100 keV. Data acquisition is done with 320 fast waveform digitizers. The design and initial performance results, including background minimization, will be discussed.

  16. Neutron Capture Measurements on Unstable Nuclei at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, J.; Haight, R.; Wilhelmy, J.; Fowler, M.; Rundberg, R.; Miller, G.

    1998-11-04

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on {sup 169}Tm and {sup 171}Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements.

  17. Neutron Capture Measurements on Unstable Nuclei at LANSCE

    International Nuclear Information System (INIS)

    Although neutron capture by stable isotopes has been extensively measured, there are very few measurements on unstable isotopes. The intense neutron flux at the Manual Lujan Jr. Neutron Scattering Center at LANSCE enables us to measure capture on targets with masses of about 1 mg over the energy range from 1 eV to 100 keV. These measurements are important not only for understanding the basic physics, but also for calculations of stellar nucleosynthesis and Science-Based Stockpile Stewardship. Preliminary measurements on 169Tm and 171Tm have been made with deuterated benzene detectors. A new detector array at the Lujan center and a new radioactive isotope separator will combine to give Los Alamos a unique capability for making these measurements

  18. Hepatoblastoma: Experience from a single center

    Directory of Open Access Journals (Sweden)

    T Singh

    2010-01-01

    Full Text Available Background: The cornerstones of successful treatment of hepatoblastoma (HB include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. Aims: We analyzed our single center experience with neoadjuvant chemotherapy (NACT and surgery in HBs. Settings and Design: Our study included all children with HBs who received NACT and underwent surgical excision from January 1997 to July 2004. Materials and Methods: Patient characteristics, clinical features, clinical course, treatment modalities, and long-term outcome were analyzed. Results: There were 9 boys and 3 girls, aged 5-60 months (median age at tumor diagnosis was 24 months. All received NACT containing cisplatin and doxorubicin. Of the 12 children, 9 underwent hepatectomy and among them, 4 patients each had right and left hepatectomy and 1 patient underwent right extended hepatectomy. After surgery, all patients completed rest of the chemotherapy course (total 6 cycles. R0 resection was carried out in all the 9 cases with no life-threatening complications. Conclusions: Our experience of the 9 cases, although less in number, reaffirms the advantages of NACT followed by surgery. The prognosis for patients with resectable tumors is fairly good in combination with chemotherapy.

  19. Single Center Experience of Acute Disseminated Encephalomyelitis

    OpenAIRE

    J Gordon Millichap

    2013-01-01

    Investigators at Department of Pediatrics, Neurology Division, Adana Medical Research Center; and Division of Child Neurology, Ankara, Turkey, retrospectively evaluated 15 children with acute disseminated encephalomyelitis (ADEM) in children from the center in Adana.

  20. Lessons from shielding retrofits at the LAMPF/LANSCE/PSR accelerator, beam lines and target facilities

    International Nuclear Information System (INIS)

    The experience in the past 7 years to improve the shielding and radiation control systems at the Los Alamos Meson Physics Facility (LAMPF) and the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) provides important lessons for the design of radiation control systems at future, high beam power proton accelerator facilities. Major issues confronted and insight gained in developing shielding criteria and in the use of radiation interlocks are discussed. For accelerators and beam lines requiring hands-on-maintenance, our experience suggests that shielding criteria based on accident scenarios will be more demanding than criteria based on routinely encountered beam losses. Specification and analysis of the appropriate design basis accident become all important. Mitigation by active protection systems of the consequences of potential, but severe, prompt radiation accidents has been advocated as an alternate choice to shielding retrofits for risk management at both facilities. Acceptance of active protection systems has proven elusive primarily because of the difficulty in providing convincing proof that failure of active systems (to mitigate the accident) is incredible. Results from extensive shielding assessment studies are presented including data from experimental beam spill tests, comparisons with model estimates, and evidence bearing on the limitations of line-of-sight attenuation models in complex geometries. The scope and significant characteristics of major shielding retrofit projects at the LAMPF site are illustrated by the project to improve the shielding beneath a road over a multiuse, high-intensity beam line (Line D)

  1. Different approaches to modeling the LANSCE H- ion source filament performance

    Science.gov (United States)

    Draganic, I. N.; O'Hara, J. F.; Rybarcyk, L. J.

    2016-02-01

    An overview of different approaches to modeling of hot tungsten filament performance in the Los Alamos Neutron Science Center (LANSCE) H- surface converter ion source is presented. The most critical components in this negative ion source are two specially shaped wire filaments heated up to the working temperature range of 2600 K-2700 K during normal beam production. In order to prevent catastrophic filament failures (creation of hot spots, wire breaking, excessive filament deflection towards source body, etc.) and to improve understanding of the material erosion processes, we have simulated the filament performance using three different models: a semi-empirical model, a thermal finite-element analysis model, and an analytical model. Results of all three models were compared with data taken during LANSCE beam production. The models were used to support the recent successful transition from the beam pulse repetition rate of 60 Hz-120 Hz.

  2. Different approaches to modeling the LANSCE H− ion source filament performance

    International Nuclear Information System (INIS)

    An overview of different approaches to modeling of hot tungsten filament performance in the Los Alamos Neutron Science Center (LANSCE) H− surface converter ion source is presented. The most critical components in this negative ion source are two specially shaped wire filaments heated up to the working temperature range of 2600 K–2700 K during normal beam production. In order to prevent catastrophic filament failures (creation of hot spots, wire breaking, excessive filament deflection towards source body, etc.) and to improve understanding of the material erosion processes, we have simulated the filament performance using three different models: a semi-empirical model, a thermal finite-element analysis model, and an analytical model. Results of all three models were compared with data taken during LANSCE beam production. The models were used to support the recent successful transition from the beam pulse repetition rate of 60 Hz–120 Hz

  3. Overview of progress on the improvement projects for the LANSCE accelerator and target facilities

    International Nuclear Information System (INIS)

    Three projects have been initiated since 1994 to improve the performance of the accelerator and target facilities for the Los Alamos Neutron Science Center (LANSCE). The LANSCE Reliability Improvement Project (LRIP) was separated into two phases. Phase 1, completed in 1995, targeted near-term improvements to beam reliability and availability that could be completed in one-year's time. Phase 2, now underway and scheduled for completion in May 1998, consists of two projects: (a) implementation of direct H-injection for the Proton Storage Ring (PSR) and (b) an upgrade of the target/moderator system for the short pulse spallation neutron (SPSS) source. The latter will reduce the target change-out time from about 10 months to about three weeks. The third project, the SPSS Enhancement Project, is aimed at increasing the PSR output beam current to 200 microA at 30 Hz and providing up to seven new neutron scattering instruments

  4. Different approaches to modeling the LANSCE H{sup −} ion source filament performance

    Energy Technology Data Exchange (ETDEWEB)

    Draganic, I. N., E-mail: draganic@lanl.gov; O’Hara, J. F.; Rybarcyk, L. J. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    2016-02-15

    An overview of different approaches to modeling of hot tungsten filament performance in the Los Alamos Neutron Science Center (LANSCE) H{sup −} surface converter ion source is presented. The most critical components in this negative ion source are two specially shaped wire filaments heated up to the working temperature range of 2600 K–2700 K during normal beam production. In order to prevent catastrophic filament failures (creation of hot spots, wire breaking, excessive filament deflection towards source body, etc.) and to improve understanding of the material erosion processes, we have simulated the filament performance using three different models: a semi-empirical model, a thermal finite-element analysis model, and an analytical model. Results of all three models were compared with data taken during LANSCE beam production. The models were used to support the recent successful transition from the beam pulse repetition rate of 60 Hz–120 Hz.

  5. Experience-Centered Design Designers, Users, and Communities in Dialogue

    CERN Document Server

    Wright, Peter

    2010-01-01

    Experience-centered design, experience-based design, experience design, designing for experience, user experience design. All of these terms have emerged and gained acceptance in the Human-Computer Interaction (HCI) and Interaction Design relatively recently. In this book, we set out our understanding of experience-centered design as a humanistic approach to designing digital technologies and media that enhance lived experience. The book is divided into three sections. In Section 1, we outline the historical origins and basic concepts that led into and flow out from our understanding of experi

  6. The Renewal Center Time, Experience, Memory

    OpenAIRE

    Tennant, Mark

    2005-01-01

    Time, Experience, Memory Through experience we are conscious of time. Through time, our experiences become memories, influencing both conscious and unconscious thought. It is through our five senses; touch, sight, hearing, smell and taste, that these experiences are gathered. Humans are also born with inherent knowledge that our species has collected from generation to generation. This inherent knowledge, also called the collective unconscious, has a direct effect on the way we perce...

  7. Increasing Counseling Center Utilization: Yeshiva University's Experience

    Science.gov (United States)

    Schwartz, Victor; Nissel, Chaim; Eisenberg, Daniel; Kay, Jerald; Brown, Joshua T.

    2012-01-01

    Yeshiva University established a counseling center during the 2004-2005 academic year. As a religiously based institution, the administration recognized that there would likely be significant impediments to utilization of on-campus mental health services as a result of negative attitudes about mental illness and its treatment--stigma. To combat…

  8. Nuclear medicine: the Philippine Heart Center experience

    International Nuclear Information System (INIS)

    The following is a report of a three (3) months on-the-job training in Nuclear Medicine at the Nuclear Medicine Department of the Philippine Heart Center. The hospital has current generation nuclear medicine instruments with data processor and is capable of a full range of in vivo and in vitro procedures. Gamma camera is the principal instrument for imaging in nuclear medicine used in the Philippine Heart Center. Thyroid scanning procedure is being performed with these instruments. Also the cardiovascular procedures, the pulmonary, skeletal, renal and hepatobiliary procedures were being performed with the use of gamma camera. Special emphasis is on nuclear cardiology since the PHC attends primarily to cardiovascular patients. (auth.)

  9. Design of a new VHF RF power amplifier system for LANSCE

    International Nuclear Information System (INIS)

    A major upgrade is replacing much of the 40 year-old proton drift tube linac RF system with new components at the Los Alamos Neutron Science Center (LANSCE). When installed, the new system will reduce the total number of electron power tubes from twenty-four to eight in the RF powerplant. A new 200 MHz high power cavity amplifier has being developed at LANSCE. This 3.2 MW final power amplifier (FPA) uses a Thales TH628 Diacrode(regsign), a state-of-the-art tetrode that eliminates the large anode modulator of the triode-based FPA that has been in use for four decades. Drive power for the FPA is provided by a new tetrode intermediate power amplifier (and a solid-state driver stage). The new system has sufficient duty-factor capability to allow LANSCE to return to 1 MW beam operation. Prototype RF power amplifiers have been designed, fabricated, and assembled, and are being tested. High voltage DC power became available through innovative re-engineering of an installed system. Details of the electrical and mechanical design of the FPA and ancillary systems are discussed.

  10. Design of a new VHF RF power amplifier system for LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Lyles, John T M [Los Alamos National Laboratory

    2010-01-01

    A major upgrade is replacing much of the 40 year-old proton drift tube linac RF system with new components at the Los Alamos Neutron Science Center (LANSCE). When installed, the new system will reduce the total number of electron power tubes from twenty-four to eight in the RF powerplant. A new 200 MHz high power cavity amplifier has being developed at LANSCE. This 3.2 MW final power amplifier (FPA) uses a Thales TH628 Diacrode{reg_sign}, a state-of-the-art tetrode that eliminates the large anode modulator of the triode-based FPA that has been in use for four decades. Drive power for the FPA is provided by a new tetrode intermediate power amplifier (and a solid-state driver stage). The new system has sufficient duty-factor capability to allow LANSCE to return to 1 MW beam operation. Prototype RF power amplifiers have been designed, fabricated, and assembled, and are being tested. High voltage DC power became available through innovative re-engineering of an installed system. Details of the electrical and mechanical design of the FPA and ancillary systems are discussed.

  11. Low stored energy 100 kV regulator for ion sources at LANSCE

    International Nuclear Information System (INIS)

    To minimize accelerating column damage caused by uncontrolled energy release during arc-downs, it is desirable to minimize the available stored electrical energy. For the Los Alamos Neutron Science Center (LANSCE) H- ion sources, the stored energy includes, in addition to the charge in the power supply output capacitance, the charge on the electronics racks. They are supported and insulated from ground by PVC pipe and have a capacitance to ground of approximately 900 pf. In 1988 (LANSCE) personnel designed a high-voltage current source using a low-stored-energy power supply and planar triode with the goal of eliminating uncontrolled release of charge stored in the power supply. Construction and testing were performed intermittently as resources permitted until 1993. When work on the Short Pulse Spallation Source (SPSS) started on the LANSCE Ion Source Test Stand (ISTS) it was recognized that a higher current power supply would be needed and work resumed on the regulator circuitry. A 120 kV power supply having low output capacitance, and a planar triode have been used to supply 40 mA, 120 Hz, 12% duty-factor current for the ISTS beam. The triode's cathode current is controlled by circuitry operating both at power-supply voltage level and at ground level via a fiber optic link. Voltage droop is approximately 600 V during the 1 ms beam pulse. The authors present the status of the regulator and its special challenges

  12. Neutron chopper development at LANSCE

    International Nuclear Information System (INIS)

    Progress is reported on neutron chopper systems for the Los Alamos Neutron Scattering Center pulsed spallation neutron source. This includes the development of 600+ Hz active magnetic bearing neutron chopper and a high speed control system designed to operate with the Proton Storage Ring to phase the chopper to the neutron source. 5 refs., 3 figs

  13. Progress on the PSR/LANSCE upgrade

    International Nuclear Information System (INIS)

    A two-phase improvement program for the spallation neutron facilities at LANSCE is underway and scheduled to be completed early in 1998. The primary goals are a beam reliability or availability of 85% or greater, a capability for routine and sustained beam operations for eight months per year, access to the experimental room (ER-1) closest to the neutron production target with beam on, and 100 μA average beam current from PSR. Many reliability improvements are included in the project along with implementation of direct H-injection into PSR and a major upgrade of the target/moderator system. (author) 3 figs., 6 refs

  14. Body-centered cubic ion correlation experiment

    International Nuclear Information System (INIS)

    The results of an interlaboratory correlation experiment involving eight laboratory sites studying the ion irradiation of molybdenum are presented. The program was comprised of three parts. The first part compared the radiation damage produced in a reference specimen of molybdenum by ions of different masses and different energies. The second part of the program compared measurements on a common micrograph supplied to all participants in the program. The results from all the sites agreed very well. The value of standard deviation in the measurement of void volume fraction corresponded to 10 percent of the average measured value and the spread between highest and lowest reported value was 35 percent. The third part of the program compared the microstructural characteristics of a transmission electron microscope (TEM) specimen that was passed from site to site (''round robin''). The results of this part of the experiment showed greater variations from the different participants than the results from the common micrograph. One of the principal sources of discrepancy was the measurement of the foil thickness which was necessary for computation of void number density. The standard deviation in the measurements of void volume fraction (swelling) corresponded to 20 percent of the measured average value. The spread between the highest and lowest value was 70 percent. This latter value gives an idea of the conceivable differences in results due to experimental techniques between two experiments

  15. Bulgaria: INIS Center - 45 years experience

    International Nuclear Information System (INIS)

    Bulgaria is one of 35 countries in the world operating nuclear power plants. Bulgaria's nuclear program was launched in 1956 with the construction of an IRT-2000 research reactor at the Institute for Nuclear Research and Nuclear Energy (INRNE), which was commissioned in 1961. The reactor is now under reconstruction. In 1960, construction of the first Bulgarian nuclear power plant started. At the moment, there are 6 power units at the Kozloduy NPP site; 4 of them (VVER-440/B-230) under decommissioning and 2 (VVER-1000/B-320) in operation. Several storage facilities for radioactive waste, mainly from the Kozloduy NPP and from various sources of ionizing radiation in medicine and industry are also in operation. The Kozloduy NPP, INRNE, Sofia University, the Technical University, and the State Enterprise Radioactive Waste are the main generators of nuclear information in Bulgaria and the main consumers of INIS products. The Bulgarian INIS Center, therefore, maintains continuous and effective cooperation with these Institutions

  16. Pregnancy during Hemodialysis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Bahadi Abdelali

    2010-01-01

    Full Text Available Successful pregnancy outcome is an uncommon occurrence in women requiring chronic dialysis treatment. We reviewed the course and outcome of 9 pregnancies occurred in women on chronic hemodialysis in our center from 1999-2007; 5 of them ended with delivery of alive newborns, 2 with fetal deaths in-utero, and 2 with abortions. The average age of patients was 34 years. The etiology of the original kidney disease was unknown in 44.4% of the cases, and only 22.2% of the patients maintained diuresis. Dialysis started in 8 cases before the diagnosis of pregnancy. The average gestational age at diagnosis was 14 weeks. We modified the prescription of dialysis in 4 patients by increasing the frequency of the dialysis sessions to 6 per week and in 3 by increasing the duration of each session to 6 hours. Anemia was present in all the cases; 3 patients received erythropoietin and 4 patients required transfusion. The pregnancy was com-plicated in 44% of the cases by a polyhydramnios. The average time at delivery was 33 weeks and it was achieved in 80% of pregnancies through vaginal route. The average weight of newborns was to 2380 g. We conclude that pregnancy in women on hemodialysis is possible. The success of pregnancy may be influenced by the residual diuresis and early diagnosis to improve the quality of dialysis by increasing the dialysis dose.

  17. Suitability of nanodiamond NV centers for spontaneous emission control experiments

    CERN Document Server

    Mohtashami, Abbas

    2012-01-01

    NV centers in diamond are generally recognized as highly promising as indefinitely stable highly efficient single-photon sources. We report an experimental quantification of the brightness, radiative decay rate, nonradiative decay rate and quantum efficiency of single NV centers in diamond nanocrystals. Our experiments show that the commonly observed large spread in fluorescence decay rates of NV centers in nanodiamond is inconsistent with the common explanation of large nanophotonic mode-density variations in the ultra-small high-index crystals at near-unity quantum efficiency. We report that NV centers in 25 nm nanocrystals are essentially insensitive to local density of states (LDOS) variations that we induce at a dielectric interface by using liquids to vary the refractive index, and propose that quantum efficiencies in such nanocrystals are widely distributed between 0% and 20%. For single NV centers in larger 100 nm nanocrystals, we show that decay rate changes can be reversibly induced by nanomechanica...

  18. CUBED: South Dakota 2010 Research Center For Dusel Experiments

    International Nuclear Information System (INIS)

    With the selection of the Homestake Mine in western South Dakota by the National Science Foundation (NSF) as the site for a national Deep Underground Science and Engineering Laboratory (DUSEL), the state of South Dakota has sought ways to engage its faculty and students in activities planned for DUSEL. One such effort is the creation of a 2010 Research Center focused on ultra-low background experiments or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The goals of this center include to 1) bring together the current South Dakota faculty so that one may begin to develop a critical mass of expertise necessary for South Dakota's full participation in large-scale collaborations planned for DUSEL; 2) to increase the number of research faculty and other research personnel in South Dakota to complement and supplement existing expertise in nuclear physics and materials sciences; 3) to be competitive in pursuit of external funding through the creation of a center which focuses on areas of interest to experiments planned for DUSEL such as an underground crystal growth lab, a low background counting facility, a purification/depletion facility for noble liquids, and an electroforming copper facility underground; and 4) to train and educate graduate and undergraduate students as a way to develop the scientific workforce of the state. We will provide an update on the activities of the center and describe in more detail the scientific foci of the center.

  19. CUBED: South Dakota 2010 Research Center For Dusel Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Christina [University of South Dakota, Vermillion, SD 57069 (United States); Alton, Drew [Augustana College, Sioux Falls, SD 57197 (United States); Bai Xinhau [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Durben, Dan [Black Hills State University, 1200 University Street, Spearfish, SD, 57799 (United States); Heise, Jaret [Sanford Lab, Lead, SD 57754 (United States); Hong Haiping; Howard, Stan [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Jiang Chaoyang [University of South Dakota, Vermillion, SD 57069 (United States); Keeter, Kara [Black Hills State University, 1200 University Street, Spearfish, SD, 57799 (United States); McTaggart, Robert [South Dakota State University, Brookings, SD 57007 (United States); Medlin, Dana [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Mei Dongming [University of South Dakota, Vermillion, SD 57069 (United States); Petukhov, Andre [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Rauber, Joel [South Dakota State University, Brookings, SD 57007 (United States); Roggenthen, Bill [South Dakota School of Mines and Technology, Rapid City, SD 57701 (United States); Spaans, Jason; Sun Yongchen [University of South Dakota, Vermillion, SD 57069 (United States); Szczerbinska, Barbara [Department of Physical Sciences, Dakota State University, Madison, SD 57042 (United States); Thomas, Keenan [University of South Dakota, Vermillion, SD 57069 (United States); Zehfus, Michael [Black Hills State University, 1200 University Street, Spearfish, SD, 57799 (United States)

    2010-03-01

    With the selection of the Homestake Mine in western South Dakota by the National Science Foundation (NSF) as the site for a national Deep Underground Science and Engineering Laboratory (DUSEL), the state of South Dakota has sought ways to engage its faculty and students in activities planned for DUSEL. One such effort is the creation of a 2010 Research Center focused on ultra-low background experiments or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The goals of this center include to 1) bring together the current South Dakota faculty so that one may begin to develop a critical mass of expertise necessary for South Dakota's full participation in large-scale collaborations planned for DUSEL; 2) to increase the number of research faculty and other research personnel in South Dakota to complement and supplement existing expertise in nuclear physics and materials sciences; 3) to be competitive in pursuit of external funding through the creation of a center which focuses on areas of interest to experiments planned for DUSEL such as an underground crystal growth lab, a low background counting facility, a purification/depletion facility for noble liquids, and an electroforming copper facility underground; and 4) to train and educate graduate and undergraduate students as a way to develop the scientific workforce of the state. We will provide an update on the activities of the center and describe in more detail the scientific foci of the center.

  20. The LANSCE 805 MHZ RF System History and Status

    CERN Document Server

    Lynch, Michael; Tallerico, Paul J

    2005-01-01

    The Los Alamos Neutron Science Center (LANSCE) linear accelerator runs at 201.25 MHz for acceleration to 100 MeV. The remainder of the acceleration to 800 MeV is at 805 MHz. This is done with 44 accelerator cavity stages driven by 805 MHz klystrons. Each klystron has a peak power capability of 1.25 MeV. Originally, 97 klystrons were purchased, which was 70 from Varian/CPI and 27 from Litton. The 44 RF systems are laid out in sectors with either 6 or 7 klystrons per sector. The klystrons in each sector are powered from a common HV sytem. The current arrangement uses the Varian/CPI klystrons in 6 of the 7 sectors and Litton klystrons in the remaining sector. With that arrangement there are 38 CPI klystrons installed and 1 spare klystron per sector and 6 Litton klystrons installed in the final sector with 2 spares. The current average life of all of the operating and spare klystrons (52 total) is >112,000 filament hours and >93,000 HV hours. That is three times the typical klystron lifetime today f...

  1. Monte Carlo simulation of the spear reflectometer at LANSCE

    International Nuclear Information System (INIS)

    The Monte Carlo instrument simulation code, MCLIB, contains elements to represent several components found in neutron spectrometers including slits, choppers, detectors, sources and various samples. Using these elements to represent the components of a neutron scattering instrument, one can simulate, for example, an inelastic spectrometer, a small angle scattering machine, or a reflectometer. In order to benchmark the code, we chose to compare simulated data from the MCLIB code with an actual experiment performed on the SPEAR reflectometer at LANSCE. This was done by first fitting an actual SPEAR data set to obtain the model scattering-length-density profile, Β(z), for the sample and the substrate. Then these parameters were used as input values for the sample scattering function. A simplified model of SPEAR was chosen which contained all of the essential components of the instrument. A code containing the MCLIB subroutines was then written to simulate this simplified instrument. The resulting data was then fit and compared to the actual data set in terms of the statistics, resolution and accuracy

  2. LANSCE Drift Tube Linac Water Control System Refurbishment

    International Nuclear Information System (INIS)

    There are several refurbishment projects underway at the Los Alamos National Laboratory LANSCE linear accelerator. Systems involved are: RF, water cooling, networks, diagnostics, timing, controls, etc. The Drift Tube Linac (DTL) portion of the accelerator consists of four DTL tanks, each with three independent water control systems. The systems are about 40 years old, use outdated and non-replaceable equipment and NIM bin control modules, are beyond their design life and provide unstable temperature control. Insufficient instrumentation and documentation further complicate efforts at maintaining system performance. Detailed design of the replacement cooling systems is currently in progress. Previous design experience on the SNS accelerator water cooling systems will be leveraged, see the SNS DTL FDR. Plans call for replacement of water piping, manifolds, pumps, valves, mix tanks, instrumentation (flow, pressure and temperature) and control system hardware and software. This presentation will focus on the control system design with specific attention on planned use of the National Instruments Compact RIO platform with the Experimental Physics and Industrial Control system (EPICS) software toolkit.

  3. LANSCE Drift Tube Linac Water Control System Refurbishment

    Energy Technology Data Exchange (ETDEWEB)

    Marroquin, Pilar S. [Los Alamos National Laboratory

    2011-01-01

    There are several refurbishment projects underway at the Los Alamos National Laboratory LANSCE linear accelerator. Systems involved are: RF, water cooling, networks, diagnostics, timing, controls, etc. The Drift Tube Linac (DTL) portion of the accelerator consists of four DTL tanks, each with three independent water control systems. The systems are about 40 years old, use outdated and non-replaceable equipment and NIM bin control modules, are beyond their design life and provide unstable temperature control. Insufficient instrumentation and documentation further complicate efforts at maintaining system performance. Detailed design of the replacement cooling systems is currently in progress. Previous design experience on the SNS accelerator water cooling systems will be leveraged, see the SNS DTL FDR. Plans call for replacement of water piping, manifolds, pumps, valves, mix tanks, instrumentation (flow, pressure and temperature) and control system hardware and software. This presentation will focus on the control system design with specific attention on planned use of the National Instruments Compact RIO platform with the Experimental Physics and Industrial Control system (EPICS) software toolkit.

  4. AMS experiment takes off for Kennedy Space Center August 2010

    CERN Multimedia

    CERN Video Productions

    2010-01-01

    Geneva, 18 August 2010. The Alpha Magnetic Spectrometer (AMS), an experiment that will search for antimatter and dark matter in space, leaves CERN next Tuesday on the next leg of its journey to the International Space Station. The AMS detector is being transported from CERN to Geneva International Airport in preparation for its planned departure from Switzerland on 26 August, when it will be flown to the Kennedy Space Center in Florida on board a US Air Force Galaxy transport aircraft.

  5. Center for Ultra-Low Background Experiments at Dusel

    International Nuclear Information System (INIS)

    The selection of Homestake Mine in Lead South Dakota by National Science Foundation (NSF) as the site for Deep Underground Science and Engineering Laboratory (DUSEL) opened new research opportunities in the state of South Dakota. One of many efforts allowing the scientists a significant participation in the activities planned at DUSEL was the creation of a 2010 Research Center focused on the production of ultra-low background materials or a Center for Ultra-low Background Experiments at DUSEL (CUBED). The main objectives of this research center are: (1) to bring together the current South Dakota faculty to develop a critical mass of expertise necessary for the state's full participation in the large scale collaboration at DUSEL; (2) to increase the number of research faculty members in the state to complement and supplement existing expertise in nuclear physics and materials sciences; (3) to train and educate graduate and undergraduate students. The main research focus of CUBED is aimed at experiments searching for rare and difficult to detect phenomena such as neutrinoless double beta decay and dark matter. Major scientific activities proposed by CUBED include a low background counting facility, an underground crystal growth lab, a purification/depletion facility on noble gases, and an underground electroforming copper facility. We will provide detailed information of research activities at CUBED. (author)

  6. Experience with Server Self Service Center (S3C)

    CERN Multimedia

    Sucik, J

    2009-01-01

    CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

  7. Installation of center disk baffle into Madison Dynamo Experiment vessel

    Science.gov (United States)

    Clark, M. M.; Nornberg, M. D.; Taylor, N. Z.; Wallace, J. P.; Forest, C. B.

    2013-10-01

    The Madison Dynamo Experiment (MDE) comprises a 1 m diameter spherical chamber that contains a turbulent flow of liquid sodium driven by two counter rotating impellers. One of the goals of the MDE is to observe a magnetic field grow at the expense of kinetic energy in the liquid sodium flow. It has been found that turbulence in the MDE plays a significant and solely detrimental role in the generation of magnetic fields. The installation of an equatorial baffle and the three rotatable vanes in each hemisphere resulted in a reduction of large scale eddies in the flow and enhanced field generation. However, no self-excited field was observed. This Poster will present recent modifications made to the experiment consisting of installing a copper disk baffle in the center of the spherical vessel. The design and installation of the structure will be illustrated and discussed. Results from before and after the center disk baffle installation will be shown. Supported by NSF and DoE.

  8. Advanced Life Support Project: Crop Experiments at Kennedy Space Center

    Science.gov (United States)

    Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

    2004-01-01

    Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

  9. Operating experience and aging assessment of motor control centers

    International Nuclear Information System (INIS)

    As part of the NRC Nuclear Plant Aging Research Program (NPAR), an assessment was made of the characteristics of aging and service wear of motor control centers (MCCs). MCCs perform an important function in the operation and control of a large number of safety-related motors; thus, the operability and reliability of MCCs can impact the overall safety of nuclear plants. This report follows the NPAR strategy and investigates the operational performance, the design and manufacturing methods, and the current maintenance, surveillance and monitoring techniques of MCCs. A significant result described in this report concerns the identification of important MCC failure modes, causes, and mechanisms from plant operational experience. Frequencies of failure determined for the various subcomponents of MCCs also are described. In addition, recommendations are provided for functional indicators to monitor the performance of MCCs. 22 refs., 27 figs., 6 tabs

  10. Surface-loss power calculations for the LANSCE DTL

    Energy Technology Data Exchange (ETDEWEB)

    Kurennoy, Surgey S [Los Alamos National Laboratory

    2008-01-01

    The surface losses in the drift-tube linac (DTL) tanks 3 and 4 of the LANSCE linear accelerator are calculated using 3-D electromagnetic modeling with the CST MicroWave Studio (MWS). The results are used to provide more realistic power estimates for the 201.25MHz RF upgrade design within the LANSCE-R project. We compared 3-D MWS results with those from traditional 2-D Superfish computations for DTL cells and their simplified models and found differences on the level of a few percent. The differences are traced to a 3-D effect consisting in a redistribution of the surface currents on the drift tubes (DT) produced by the DT stem. The dependence of MWS results on the mesh size used in computations is also discussed.

  11. Los Alamos neutron science center nuclear weapons stewardship and unique national scientific capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Schoenberg, Kurt F [Los Alamos National Laboratory

    2010-12-15

    This presentation gives an overview of the Los Alamos Neutron Science Center (LANSCE) and its contributions to science and the nuclear weapons program. LANSCE is made of multiple experimental facilities (the Lujan Center, the Weapons Neutron Research facility (WNR), the Ultra-Cold Neutron facility (UCN), the proton Radiography facility (pRad) and the Isotope Production Facility (IPF)) served by the its kilometer long linear accelerator. Several research areas are supported, including materials and bioscience, nuclear science, materials dynamics, irradiation response and medical isotope production. LANSCE is a national user facility that supports researchers worldwide. The LANSCE Risk Mitigation program is currently in progress to update critical accelerator equipment to help extend the lifetime of LANSCE as a key user facility. The Associate Directorate of Business Sciences (ADBS) plays an important role in the continued success of LANSCE. This includes key procurement support, human resource support, technical writing support, and training support. LANSCE is also the foundation of the future signature facility MARIE (Matter-Radiation Interactions in Extremes).

  12. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  13. Single-center experience in double kidney transplantation.

    Science.gov (United States)

    Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto

    2010-05-01

    Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. PMID:20534235

  14. Preconceptual design of a Long-Pulse Spallation Source (LPSS) at the LANSCE Facility: Target system, facility, and material handling considerations

    International Nuclear Information System (INIS)

    This report provides a summary of a preconceptual design study for the proposed Long-Pulse Spallation. Source (LPSS) at the Los Alamos Neutron Science Center (LANSCE). The LPSS will use a 0.8-MW proton beam to produce neutrons from a tungsten target. This study focuses on the design of the target station and changes to the existing building that would be made to accommodate the LPSS. The LPSS will provide fifteen flight paths to neutron scattering instruments. In addition, options for generating ultracold neutrons, pions, and muons will be available. Flight-energy, forward-scattered neutrons on the downstream side of the target will also be available for autoradiography studies. A Target Test Bed (TTB) is also proposed for full-beam tests of component materials and advanced spallation neutron sources. The design allows for separation of the experiment hall from the beam line, target, and flight paths. The target and moderator systems and the systems/components to be tested in the TTB will be emplaced and removed separately by remotely operated, shielded equipment. Irradiated materials will be transported to a hot cell adjacent to the target chamber for testing by remotely operated instruments. These tests will provide information about how materials properties are affected by proton and neutron beams

  15. Endovascular Treatment of Dural Arteriovenous Fistulas: Single Center Experience

    Science.gov (United States)

    Oh, Jae-Sang; Oh, Hyuk-Jin; Shim, Jai-Joon; Bae, Hack-Gun; Lee, Kyeong-Seok

    2016-01-01

    Objective Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ≥2 times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route. PMID:26885282

  16. Ghana's experience in the establishment of a national data center

    Science.gov (United States)

    Ekua, Amponsah Paulina; Yaw, Serfor-Armah

    2012-08-01

    The government of Ghana in a bilateral agreement with the Preparatory Commission for the Comprehensive Nuclear Test-Ban Treaty Organization (CTBTO) has established a National Data Center in Ghana with the aim of monitoring the testing of nuclear explosions. Seismic, hydroacoustic, radionuclide and infrasound methods are used for the monitoring. The data center was commissioned on 3 February, 2010 at the Ghana Atomic Energy Commission. At present Ghana does not have any operational, centralised data (seismic, hydroacoustic, radionuclide and infrasound) acquisition system with the capability of accessing data from other international stations. Hence, the need of setting up the National Data Center which would enable us constantly monitor, manage and coordinate both natural and man-made seismic activities in the country and around the globe, upload data to the International Data Center (IDC) as well as receive and use International Monitoring System (IMS) data and IDC products for treaty verification and compliance. Apart from these, the center also accesses and analyzes seismic waveforms relevant to its needs from the International Data Center; makes data available to its stakeholder institutions for earthquake disaster mitigation; reports on all aspects of disasters related to earthquake to the relevant government agencies that deal with disasters; makes recommendations to the government of Ghana on earthquake safety measures; provides information to assist government institutions to develop appropriate land and building policies. The center in collaboration with stakeholder agencies periodically organises public lectures on earthquake disaster risk mitigation.

  17. Encapsulating peritoneal sclerosis: experience of a tertiary referral center.

    LENUS (Irish Health Repository)

    Phelan, P J

    2010-05-01

    Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.

  18. National Spherical Torus Experiment (NSTX) Center Stack Upgrade

    Energy Technology Data Exchange (ETDEWEB)

    Neumeyer, C; Chrzanowski, J; Dudek, L; Fan, H; Hatcher, R; Heitzenroeder, P; Menard, J; Ono, M; Ramakrishnan, S; Titus, P; Woolley, R

    2009-09-24

    The purpose of the NSTX Center Stack Upgrade project is to expand the NSTX operational space and thereby the physics basis for next-step ST facilities. The plasma aspect ratio (ratio of plasma major to minor radius) of the upgrade is increased to 1.5 from the original value of 1.26, which increases the cross sectional area of the center stack by a factor of ~ 3 and makes possible higher levels of performance and pulse duration.

  19. First results from PHAROS, the new chopper spectrometer at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Olivier, B.J.; Sandoval, J.P.; Lysaght, P.; Nutter, M.; Robinson, R.A.

    1993-06-01

    In this article we present the first experimental measurements obtained on PHAROS during the 1992 run cycle at LANSCE. These are data on the phasing of the choppers relative to the accelerator system along with the consequent neutronic resolution, data on the real-space position resolution of the main detectors, a white-beam nickel powder calibration, and our first inelastic scattering measurement made on TiH{sub 2} with an incident energy of 300 MeV. The characteristic features of the new chopper spectrometer PHAROS, designed for low-angle inelastic neutron scattering and neutron Brillouin scattering, are described elsewhere in these proceedings.

  20. First results from PHAROS, the new chopper spectrometer at LANSCE

    International Nuclear Information System (INIS)

    In this article we present the first experimental measurements obtained on PHAROS during the 1992 run cycle at LANSCE. These are data on the phasing of the choppers relative to the accelerator system along with the consequent neutronic resolution, data on the real-space position resolution of the main detectors, a white-beam nickel powder calibration, and our first inelastic scattering measurement made on TiH2 with an incident energy of 300 MeV. The characteristic features of the new chopper spectrometer PHAROS, designed for low-angle inelastic neutron scattering and neutron Brillouin scattering, are described elsewhere in these proceedings

  1. HELIOS: A high intensity chopper spectrometer at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Mason, T.E. [Oak Ridge National Lab., TN (United States); Broholm, C. [Johns Hopkins Univ., Baltimore, MD (United States). Dept. of Physics and Astronomy; Fultz, B. [California Inst. of Tech., Pasadena, CA (United States). Dept. of Materials Science] [and others

    1998-12-31

    A proposal to construct a high intensity chopper spectrometer at LANSCE as part of the SPSS upgrade project is discussed. HELIOS will be optimized for science requiring high sensitivity neutron spectroscopy. This includes studies of phonon density of states in small polycrystalline samples, magnetic excitations in quantum magnets and highly correlated electron systems, as well as parametric studies (as a function of pressure, temperature, or magnetic field) of S(Q,{omega}). By employing a compact design together with the use of supermirror guide in the incident flight path the neutron flux at HELIOS will be significantly higher than any other comparable instrument now operating.

  2. HELIOS: A high intensity chopper spectrometer at LANSCE

    International Nuclear Information System (INIS)

    A proposal to construct a high intensity chopper spectrometer at LANSCE as part of the SPSS upgrade project is discussed. HELIOS will be optimized for science requiring high sensitivity neutron spectroscopy. This includes studies of phonon density of states in small polycrystalline samples, magnetic excitations in quantum magnets and highly correlated electron systems, as well as parametric studies (as a function of pressure, temperature, or magnetic field) of S(Q,ω). By employing a compact design together with the use of supermirror guide in the incident flight path the neutron flux at HELIOS will be significantly higher than any other comparable instrument now operating

  3. User-Centered Design in Practice: The Brown University Experience

    Science.gov (United States)

    Bordac, Sarah; Rainwater, Jean

    2008-01-01

    This article presents a case study in user-centered design that explores the needs and preferences of undergraduate users. An analysis of LibQual+ and other user surveys, interviews with public service staff, and a formal American with Disabilities Act accessibility review served as the basis for planning a redesign of the Brown University…

  4. A center's experience: pulmonary function in spinal cord injury.

    Science.gov (United States)

    Schilero, Gregory J; Radulovic, Miroslav; Wecht, Jill M; Spungen, Ann M; Bauman, William A; Lesser, Marvin

    2014-06-01

    Traumatic spinal cord injury (SCI) is associated with significant psychological and physical challenges. A multidisciplinary approach to management is essential to ensure recovery during the acute phase, and comprehensive rehabilitative strategies are necessary to foster independence and quality of life throughout the chronic phase of injury. Complications that beset these individuals are often a unique consequence of SCI, and knowledge of the effects of SCI upon organ systems is essential for appropriate management. According to the National SCI Statistical Center (NSCISC), as of 2010 there were an estimated 265,000 persons living with SCI in the United States, with approximately 12,000 incidence cases annually. Although life expectancy for newly injured individuals with SCI is markedly reduced, persons with chronic SCI are expected to live about as long as individuals without SCI; however, longevity varies inversely with level of injury. Since 2005, 56 % of persons with SCI are tetraplegic, and due to paralysis of respiratory muscles, these individuals may be especially prone to pulmonary complications, which remain a major cause of mortality among persons with chronic SCI. We at the VA Rehabilitation Research and Development Center of Excellence for the Medical Consequences of SCI at the James J. Peters VA Medical Center have devoted more than 25 years to the study of secondary medical conditions that complicate SCI. Herein, we review pulmonary research at the Center, both our past and future endeavors, which form an integral part of our multidisciplinary approach toward achieving a greater understanding of and improving care for veterans with SCI. PMID:24723067

  5. Thrombolytics in VAD management — A single-center experience

    OpenAIRE

    Nair, N.; Schmitt, A A; E.M. Rau; Anders, S.; Sandler, D.; T.B. Icenogle

    2016-01-01

    Background: With continued increase in the use of mechanical circulatory support, the incidence of device thrombus remains a challenge. This study is a retrospective analysis of data at a single center to assess the safety and efficacy of thrombolytic use in durable mechanical assist devices. Methods: Data was analyzed retrospectively from 154 patients who underwent left ventricular assist device (LVAD) implantation from 1/1/2005 to 6/30/2014. The HMII device was implanted in 131 patients ...

  6. Systems engineering aspects to installation of the phased multi-year LANSCE-refurbishment project

    Energy Technology Data Exchange (ETDEWEB)

    Pieck, Martin [Los Alamos National Laboratory; Erickson, John E [Los Alamos National Laboratory; Gulley, Mark S [Los Alamos National Laboratory; Jones, Kevin W [Los Alamos National Laboratory; Rybarcyk, Larry J [Los Alamos National Laboratory

    2009-01-01

    The LANSCE Refurbishment Project (LANSCE-R) is a phased, multiyear project. The project is scheduled to start refurbishment in the 2nd quarter of fiscal year 2011. Closeout will occur during the 4th quarter of FY2016. During the LANSCE-R project, installation of project components must be scheduled during six annual 6-month maintenance-outages and not conflict with annual LANSCE operational commitments to its user facilities. The project and operations schedules must be synchronized carefully. Therefore, the scheduled maintenance outages, functional testing (with beam off, by primarily project personnel) and commissioning (with beam on, by primarily Accelerator Operation Technology (AOT) personnel) must be managed to accommodate operation. Active and effective coordination and communication between the project and AOT personnel must be encouraged to identify, as early as possible, any operational issues. This paper will report on the systems engineering approach to the integration and control of engineering activities.

  7. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  8. Acute renal transplant rejections: A single center experience

    Directory of Open Access Journals (Sweden)

    Jabur Wael

    2008-01-01

    Full Text Available We undertook this observational study to assess the incidence of acute rejections (AR in the first six months after transplantation at Al-Karama Hospital, Iraq. Sixty eight patients (49 males and 19 females underwent renal transplantation in 2006 and were followed up weekly. Forty six received kidneys from related donors and 22 from unrelated donors. During the first six months after transplantation AR occurred in 16 patients (23%; 11 (23% related and 5 (23% unrelated donor transplantation. We conclude that the incidence of acute rejection was similar in related and unrelated donor transplantation and the general incidence was comparable to that reported from most centers.

  9. High pressure neutron powder diffraction at LANSCE

    International Nuclear Information System (INIS)

    By making use of the recently developed ''Paris-Edinburgh'' high pressure cell, the author has successfully performed neutron powder experiments to 10GPa at ambient temperature. Results for the structural compression of the high Tc 1223-Hg superconductor to 9.2 GPa, the compression and possible hydrogen bond formation in brucite, Mg(OD)2, to 9.3 GPa, and the molecular reorientation in nitromethane to 5.5 GPa will be presented

  10. Docker experience at INFN-Pisa Grid Data Center

    Science.gov (United States)

    Mazzoni, E.; Arezzini, S.; Boccali, T.; Ciampa, A.; Coscetti, S.; Bonacorsi, D.

    2015-12-01

    Clouds and virtualization offer typical answers to the needs of large-scale computing centers to satisfy diverse sets of user communities in terms of architecture, OS, etc. On the other hand, solutions like Docker seems to emerge as a way to rely on Linux kernel capabilities to package only the applications and the development environment needed by the users, thus solving several resource management issues related to cloud-like solutions. In this paper, we present an exploratory (though well advanced) test done at a major Italian Tier2, at INFN-Pisa, where a considerable fraction of the resources and services has been moved to Docker. The results obtained are definitely encouraging, and Pisa is transitioning all of its Worker Nodes and services to Docker containers. Work is currently being expanded into the preparation of suitable images for a completely virtualized Tier2, with no dependency on local configurations.

  11. Wilms′ Tumor Experience at King Hussein Medical Center

    Directory of Open Access Journals (Sweden)

    Haddadin Isam

    2000-01-01

    Full Text Available This is a retrospective study designed to find out the clinical profile of children with Wilms′ tumor admitted to King Hussein Medical Center over a 6.5-year period. There were 26 patients (eight males and 18 females with a median age of three years (range 1-8 years, at the time of diagnosis. Twenty children went into complete remission for a period ranging from 4-80 months (mean 46 months. Six children relapsed locally or with distant metastasis. All the six children with relapse died because of progressive disease. The overall relapse free survival was 77% for all stages (100%, 90%, 66.6%, 0% and 100% for stage I, II, III, IV and V respectively. This is similar to the international figures for stage I & II but is still behind for stage III & IV.

  12. Blunt pancreatic trauma: experience at a rural referral center.

    Science.gov (United States)

    Timberlake, G A

    1997-03-01

    The objective of this study was to compare mechanism of injury, treatment methods, and outcome of blunt pancreas trauma patients transferred from another hospital to those of patients brought directly from the scene. A retrospective review was conducted of 6078 patients treated at a Level I trauma center from 1/1/90 to 12/31/94. Blunt pancreas injury was found in 39 (0.64%) patients (mean age, 33.2 years). Mechanism of injury included 34 (87%) motor vehicle crashes, 3 (8%) motorcycle crashes, and 2 (5%) other injuries. There were 11 transfer patients (28%), and 28 (72%) admitted directly from the scene. Eighty-two per cent of the motor vehicle crash patients were unrestrained, and 35 per cent had ethanol intoxication. Exploratory laparotomy was performed on 32 (82%); eight (25%) required repair or resection; 22 (69%) had trivial injuries, at most requiring drainage; and two (6.3%) exsanguinated. No patients required Whipple resection or pancreatiocojejunostomy. At operation, an average of 2.5 associated intra-abdominal injuries were found. Overall survival was 35 of 39 (90%). Among the patients brought directly to the trauma center, 93 per cent survived, whereas survival among transferred patients was 82 per cent (chi2 = 0.19; P = 0.66). Blunt pancreatic injuries vary in severity, but radical resection is rarely required. Lack of safety restraint and ethanol use are major risk factors. Despite the high likelihood of associated injuries, survivability is high. No difference in outcome was seen between directly admitted and transferred patients. PMID:9036900

  13. Head and Neck Sarcomas: A Comprehensive Cancer Center Experience

    Directory of Open Access Journals (Sweden)

    Margaret von Mehren

    2013-07-01

    Full Text Available Head/neck sarcomas are rare, accounting for about 1% of head/neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group, due to anatomic constraints leading to difficulty in completely excising tumors, with high rates of local recurrence. We retrospectively analyzed cases of head/neck soft tissue sarcomas (STS and osteogenic sarcomas managed in a multi-disciplinary setting at Fox Chase Cancer Center from 1999–2009 to describe clinicopathologic characteristics, treatment, outcomes, and prognostic factors for disease control and survival. Thirty patients with STS and seven patients with osteogenic sarcoma were identified. Most STS were high grade (23 and almost all were localized at presentation (28. Common histologies were synovial cell (6, rhabdomyosarcoma (5, angiosarcoma (4, liposarcoma (4 and leiomyosarcoma (3. The type of primary therapy and disease outcomes were analyzed. Cox proportional hazards regression analysis was performed to identify predictors of disease-free survival (DFS and overall survival (OS. The HR and 95% CI for Cox model and median DFS/OS analyzed by Kaplan-Meier curves were calculated.

  14. Portal hypertensive biliopathy: A single center experience and literature review.

    Science.gov (United States)

    Suárez, Vanessa; Puerta, Andrés; Santos, Luisa Fernanda; Pérez, Juan Manuel; Varón, Adriana; Botero, Rafael Claudino

    2013-03-27

    Portal hypertensive biliopathy (PHB) is characterized by anatomical and functional abnormalities of the intrahepatic, extrahepatic and pancreatic ducts, in patients with portal hypertension associated to extrahepatic portal vein obstruction and less frequently to cirrhosis. These morphological changes, consisting in dilatation and stenosis of the biliary tree, are due to extensive venous collaterals occurring in an attempt to decompress the portal venous blockage. It is usually asymptomatic until it progresses to more advanced stages with cholestasis, jaundice, biliary sludge, gallstones, cholangitis and finally biliary cirrhosis. Imaging modalities of the biliary tree such as Doppler ultrasound, computed tomography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are essential to establish the diagnosis and the need of therapeutical interventions. Once the diagnosis is established, treatment with ursodesoxycholic acid seems to be beneficial. Decompression of the biliary tree to dilate, remove stones or implant biliary prosthesis by endoscopic or surgical procedures (hepato-yeyunostomy) usually resolves the cholestatic picture and prevents septic complications. The ideal treatment is the decompression of the portal system, with transjugular intrahepatic porto-systemic shunt or a surgical porto-systemic shunt. Unfortunately, few patients will be candidates for these procedures due to the extension of the thrombotic process. The purpose of this paper is to report the first 3 cases of PHB seen in a Colombian center and to review the literature. PMID:23556047

  15. Experience report: a training center for health response

    International Nuclear Information System (INIS)

    The Professor Nelson Valverde Training Center was created within FEAM (The ELETRONUCLEAR Medical Assistance Foundation) with the objective of capacitating Radio Nuclear Accident Responders for the Health Area in the Almirante Alvaro Alberto Nuclear Central (Angra dos Reis - RJ - Brazil). The first step was structuring the contents for this training using IAEA's Manuals as base (EPR Medical - 2005, EPR First Responders - 2006 and TMT - Handbook - 2009) and data from REAC/TS. The second step was to capacitate instructors. The third step was the integration with the Company's Radiological Protection Division, giving radiological assessment. Finally, the development of training applications, ending with Drills, Tests and Assessment, gathering data and suggestions, objectifying the constant improvement. Training Programs with pre and post evaluations have been started. Since 2004 training internal courses were ministered for 125 professionals with annual re-training and were ministered to 130 professionals from several external institutions. During the same period training courses were ministered to 140 trainees from the Radiological Protection Division of The Nuclear Power Plant of Angra dos Reis, as First Lay Responders, objectifying the improvement of the quality of the emergency response. (author)

  16. Surgical complications of hemolytic uremic syndrome: Single center experiences

    Directory of Open Access Journals (Sweden)

    Hooman Nakysa

    2007-01-01

    Full Text Available Purpose: To determine the prevalence, outcome and prognostic factors in children with hemolytic uremic syndrome (HUS who underwent laparotomy. Materials and Methods: The medical records of 104 patients with HUS who presented to our center between 1986 and 2003 were reviewed retrospectively. Data were analyzed using Student′s t test for comparing means, Fisher′s exact test for frequencies and Pearson′s correlation for finding the correlations. Results: 78% of cases presented with vomiting and diarrhea. Seven out of 104 needed surgical exploration. The indications of surgery were acute abdomen, severe abdominal distention and the sign of peritonitis. The findings at laparotomy were intussusceptions, perforation (colon, ileum, gangrene of entire colon, rectosigmoidal tearing, duodenal obstruction and toxic megacolon. Pathological findings were transmural infarction in two cases in which staged surgical management was performed (cecostomy, resection, later anastomosis. Four out of seven patients died because of pulmonary failure, coma and multiple organ failure ( P< 0.05 compared to those who did not need laparotomy. The patients requiring surgery were young (< 3 years, had high leukocyte count (>20000 mm 3 and low albumin level (< 3g/dl ( P< 0.05. Conclusion: Surgical complications of HUS are rare but are assorted with high mortality due to respiratory failure and multiple organ failure. Early decision of laparotomy associated with intensive care, including mechanical ventilation, adequate dialysis and ultrafiltration, are recommended.

  17. Establishing Group Autonomy through Self-Access Center Learning Experiences

    Directory of Open Access Journals (Sweden)

    Harumi Kimura

    2014-03-01

    Full Text Available In this article, I argue that a self-access center (SAC should be able to foster group autonomy, although SACs were originally developed for individually autonomous L2 learning experiences—i.e., each student studying L2 on his or her own. Along with offering learning materials and chances for individual self-study, a SAC should provide opportunities for building and maintaining a learner community. The data obtained by a narrative frame and subsequent e-mail correspondence demonstrated that active users often come to SACs to do homework and prepare for classes. They are happy to work together and have opportunities to make friends with students in different classes and in different year groups—i.e., mutual peer support is vital. Fun activities for establishing rapport and boosting L2 learning motivation are worth implementing. Learner autonomy ultimately involves interdependence between learners in a well-functioning learner community, and for this purpose a SAC can and should be a physical space where students can comfortably spend time and interact with other students, as well as with counselors and teachers.

  18. Location-based solutions in the experience center

    DEFF Research Database (Denmark)

    Witzner Hansen, Dan; Alapetite, Alexandre; Holdgaard, Nanna;

    2009-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm [1] experience centre in Denmar...... using a combination of Bluetooth, Near field communication (NFC), GPS and QR-codes. Bluetooth, NFC, and GPS are used for location-based information and QR-codes are used to convey user preferences. [1] http://naturbornholm.dk...

  19. Beam-Based Alignment Measurements of the LANSCE Linac

    CERN Document Server

    McCrady, R C

    2004-01-01

    We have made measurements of the alignment of the LANSCE Drift Tube linac (DTL) and Side Coupled linac (SCL) using beam position measurements and analyzing them with linear models. In the DTL, we varied the injection steering, measured the beam position after each DTL tank, and analyzed the data with a linear model using R-matrices that were computed by the Trace-3D computer program. The analysis model allowed for tank-to-tank misalignments. The measurements were made similarly in the SCL, where the analysis model allowed for misalignments of each quadrupole doublet lens. We present here the analysis techniques, the resulting alignment measurements and comparisons to measurements made with optical instruments.

  20. Status of a new switchyard design for LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Garnett, R.W.; Rose, C.; Shelley, F.; Zumbro, J.D.

    1998-12-31

    Funding was recently received to study modifications of a section of the LANSCE beam switchyard. At present, the switchyard is used to deliver a proton beam to experimental Area A and an H{sup {minus}}-ion beam down Line D. The total H{sup {minus}} repetition rate is 120 Hz, 100 Hz is transported to the Weapons Neutron Research (WNR) area. The remaining 20 Hz is injected into the Proton Storage Ring (PSR). In order to provide H{sup {minus}} beam to other experimental areas without interfering with the PSR operations, a new design of the switchyard is in progress. The authors are presently investigating a solution that would use pulsed kicker magnets to deflect a fraction of the WNR H{sup {minus}} beam down a separate existing beam-line at the demand of the experimenters.

  1. A Qualitative Examination of Connections between Learner-Centered Teaching and Past Significant Learning Experiences

    Science.gov (United States)

    Brackenbury, Tim

    2012-01-01

    Learner-centered teaching is a collection of instructional practices that shift the emphasis of courses from the instructors' goals and methods of delivery to the knowledge and skills that the students develop. This study examined potential commonalities between features of learner-centered teaching and the past significant learning experiences of…

  2. Transverse match of high peak-current beam into the LANSCE DTL using PARMILA

    International Nuclear Information System (INIS)

    A new algorithm that uses a multiparticle PARMILA-based code to match high peak current H+ beam (∼21 mA) into the Los Alamos Neutron Science Center (LANSCE) drift tube linac (DTL) has been developed. Two single cell rf bunchers in the low energy beam transport (LEBT) prepare the initially unbunched beam for DTL capture. The transverse distribution at the entrance to the DTL is set with four quadrupoles in the 1.26 m between the last transverse emittance measuring station and the DTL entrance. Previous matching algorithms used TRACE and TRACE 3-D to determine these quadrupole strengths. PARMILA simulation show this procedure produces non-zero mismatch and additional emittance growth through the DTL for high current beams. Because of strong space-charge forces and a rapidly forming longitudinal bunch, simple envelope calculations do not model the beam evolution in the LEBT well. A PARMILA model of this region was combined with ant iterative search routine to set the LEBT quadrupole strengths to achieve a better transverse match into the DTL. Simulations predict a significant reduction in transverse emittance at the exit of the DTL over the typical TRACE 3-D result

  3. New high power 200 MHz RF system for the LANSCE drift tube linac

    International Nuclear Information System (INIS)

    The Los Alamos Neutron Science Center (LANSCE) linac provides an 800 MeV direct H+ proton beam, and injects H- to the upgraded proton storage ring for charge accumulation for the Short Pulse Spallation Source. Accelerating these interlaced beams requires high average power from the 201.25 MHz drift tube linac (DTL) RF system. Three power amplifiers have operated at up to three Megawatts with 12% duty factor. The total number of electron power tubes in the RF amplifiers and their modulators has been reduced from fifty-two to twenty-four. The plant continues to utilize the original design of a tetrode driving a super power triode. Further increases in the linac duty factor are limited, in part, by the maximum dissipation ratings of the triodes. A description of the system modifications proposed to overcome these limitations includes new power amplifiers using low-level RF modulation for tank field control. The first high power Diacrode reg-sign is being delivered and a new amplifier cavity is being designed. With only eight power tubes, the new system will deliver both peak power and high duty factor, with lower mains power and cooling requirements. The remaining components needed for the new RF system will be discussed

  4. Experiences of running dCache at a Tier-1 Center

    International Nuclear Information System (INIS)

    The GridKa computing center is Germany's Tier-1 center for all four LHC experiments. The storage system is managed by dCache a joint development of Desy and FNAL. The dCache tape connection is managed by IBM's Tivoly Storage Manager (TSM). DCache allows fast and reliable storage and retrieval of data and supports among others the SRM interface. The talk will focus on experiences using dCache at Forschungszentrum Karlsruhe and on future plans

  5. Juvenile DermatomyositisKing Hussein Medical Center Experience

    Directory of Open Access Journals (Sweden)

    Zeyad Habahbeh

    2014-04-01

    Full Text Available Background: Juvenile dermatomyositis (JDM is an uncommon, often chronic, and potentially serious childhood systemic autoimmune vasculopathy affecting primarily skin and muscles. It is characterized by pathognomonic rash, and symmetrical proximal muscle weakness. Objective: In this retrospective study, we reviewed the clinical, laboratory profiles, treatment and outcome of Jordanian children diagnosed with JDM in the past 8 years in a tertiary facility in Amman, Jordan. Methods: Sixteen (16 JDM patients, diagnosed based on criteria of Bohan and Peter, and have attended the pediatric rheumatology clinic in King Hussein Medical Center, from January 2006 to September 2013, were recruited. Their medical records were studied for clinical and biochemical profile, radiological and electrophysiological data were studied as well. Treatment and outcome were also reviewed. Results: Our cohort includes 16 patients, 9(56 % males, and 7 (44% females (M: F 1.3:1, their age ranges between 2 to 9 years, with average age at diagnosis of 5.4 years. Time to diagnosis varies from 2 months to 12 months, and averages at 4.6 months. Proximal muscle weakness was present at time of diagnosis in 14(87.5 % cases. Cutaneous signs in form of either poikiloderma in malar distribution, Gottron’s sign and /or heliotrope sign were apparent in all the 16(100% patients at time of diagnosis, periungual erythema was evident in 10(63% patients while abnormal nailbed capillaries pattern was only reported in 6(38% cases. Skin and soft tissue calcification, crusting and ulceration were seen in 3(19 % patients. Serum Lactate dehydrogenase, (LDH was elevated in 94% and creatininine phosphokinase (CPK in 88%. Elevated SGOT (AST was seen in almost all subjects, while ESR was high in 14 (87.5% patients. All patients treated with corticosteroids and methotrexate (MTX. Two (12.5% patients died in our series, complete remission was achieved in 4(25% of patients, while partial remission was

  6. Five years' experience with capsule endoscopy in a single Center

    Institute of Scientific and Technical Information of China (English)

    Taylan Kav; Yusuf Bayraktar

    2009-01-01

    Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its efficacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases.Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bidirectional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.

  7. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Shpend Idrizi

    2015-08-01

    Full Text Available BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74% of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg to 39.1 mmHg (20-80 mmHg. Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9% required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55% patients, and four (9% patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.

  8. A ventral visual stream reading center independent of visual experience.

    Science.gov (United States)

    Reich, Lior; Szwed, Marcin; Cohen, Laurent; Amedi, Amir

    2011-03-01

    The visual word form area (VWFA) is a ventral stream visual area that develops expertise for visual reading. It is activated across writing systems and scripts and encodes letter strings irrespective of case, font, or location in the visual field with striking anatomical reproducibility across individuals. In the blind, comparable reading expertise can be achieved using Braille. This study investigated which area plays the role of the VWFA in the blind. One would expect this area to be at either parietal or bilateral occipital cortex, reflecting the tactile nature of the task and crossmodal plasticity, respectively. However, according to the metamodal theory, which suggests that brain areas are responsive to a specific representation or computation regardless of their input sensory modality, we predicted recruitment of the left-hemispheric VWFA, identically to the sighted. Using functional magnetic resonance imaging, we show that activation during Braille reading in blind individuals peaks in the VWFA, with striking anatomical consistency within and between blind and sighted. Furthermore, the VWFA is reading selective when contrasted to high-level language and low-level sensory controls. Thus, we propose that the VWFA is a metamodal reading area that develops specialization for reading regardless of visual experience. PMID:21333539

  9. Mycophenolate mofetil in pediatric renal transplantation: a single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2012-02-01

    We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  10. Bombs, Bosons and Beer Cans-Research at the Los Alamos Neutron Science Center

    Science.gov (United States)

    Pynn, Roger

    1997-04-01

    The neutron scattering community is justifiably proud of the contributions it has made to basic research in many areas of science. Information obtained using neutrons has contributed strongly to our basic understanding of phenomena in diverse systems of interest to physicists, chemists and biologists - think, for example, of how little we would know about excitations in quantum fluids, the spin-density-wave state of chromium, electronic back-donation in the bonding of organometallic compounds, or the conformation of proteins and DNA in nucleosomes without neutron scattering. However, illustrious as this history of neutron scattering may be, it is not the only type of contribution neutrons have made to our modern scientific and technological enterprise. Increasingly in recent years, we have witnessed the application of neutrons to later parts of the R&D cycle, to problems that have been called ''strategic research'' and even in areas that are ''applied research'' or ''product development''. The purpose of my talk at this meeting is to illustrate this aspect of research at spallation neutron sources, using examples of work that has been done at the Los Alamos Neutron Science Center (LANSCE). Some of this work is driven by the fact that our principal funding agency, the Office of Defense Programs within the U.S. Department of Energy, has a need to master the science behind technologies relevant to nuclear weapons. Even so, most of the examples I have picked are equally relevant to the industrial sector and several would not shame even the most devout proponent of ''pure'' research. To demonstrate the breadth of the research performed at LANSCE, I will describe examples of recent experiments in the following areas: materials texture; temperature and particle velocity measurement in reacting high explosives; radiographic imaging with protons; chemical bonding in metal-dihydride complexes; and the structure of thin adhesive layers. LANSCE operates a user program and

  11. Experience with Evans syndrome in an academic referral center

    Directory of Open Access Journals (Sweden)

    José Carlos Jaime-Pérez

    2015-08-01

    Full Text Available OBJECTIVE: To document the experience of one referral service with patients diagnosed with Evans syndrome, the treatment and response and to briefly review current treatment strategies and results.METHODS: Patients enrolled in this study fulfilled criteria for Evans syndrome. Data were retrieved from the clinical files and electronic databases of the Department of Hematology, Hospital Universitario "Dr. José Eleuterio González". Treatment modalities and response and the use of additional therapies were evaluated. The literature was reviewed in the context of the clinical course of the studied patients.RESULTS: Six patients were diagnosed with Evans syndrome in the study period. Patient 1 was treated with steroids, relapsed twice and was again treated with steroids. Patient 2 treated initially with steroids plus intravenous immunoglobulin was subsequently lost to follow-up. A good response was achieved in Patients 3 and 4, who were treated with steroids plus rituximab; patient 4 also received danazol as a second-line therapy. However both relapsed and subsequently underwent splenectomy at ten and nine months, respectively. One patient, number 5, treated with steroids, danazol and rituximab did not relapse within four years of follow-up and Patient 6, who received steroids plus danazol did not relapse within three years of follow-up.CONCLUSION: Evans syndrome is an uncommon hematologic condition rarely diagnosed and not widely studied. Clinicians must have it in mind when evaluating a patient with a positive direct antiglobulin test, anemia and thrombocytopenia, since prognosis depends on its early recognition and opportune therapy, but even this leads to variable results.

  12. MRI-guided stereotactic amygdalohippocampectomy: a single center experience

    Directory of Open Access Journals (Sweden)

    Vojtěch Z

    2015-02-01

    Full Text Available Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Liščák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.Results: At their last postsurgical visit, 43 (70.5% patients were Engel class I, six (9.8% class II, nine (14.8% class III, and three (4.9% class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%. Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ scores of 4, 3, and 4 IQ points, respectively (P<0.05. Five (17.2%, four (13.8%, and four (13.3% patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05. Global memory improved in three (10.3% patients, verbal memory in one (3.4%, and one patient (3.3% showed deterioration in visual memory.Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a

  13. Ecology-Centered Experiences among Children and Adolescents: A Qualitative and Quantitative Analysis

    Science.gov (United States)

    Orton, Judy

    2013-01-01

    The present research involved two studies that considered "ecology-centered experiences" (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the…

  14. LANSCE wire scanner AFE: analysis, design, and fabrication

    International Nuclear Information System (INIS)

    The goal of the design LANSCE-R Wire-Scanner Analog Front-end Electronics is to develop a high-performance, dual-axis wire-scanner analog front-end system implemented in a single cRIO module. This new design accommodates macropulse widths as wide as 700 μs at a maximum pulse rate of 120Hz. A lossey integrator is utilized as the integration element to eliminate the requirement for providing gating signals to each wire scanner. The long macropulse and the high repetition rate present conflicting requirements for the design of the integrator. The long macropulse requires a long integration time constant to assure minimum integrator droop for accurate charge integration, and the high repetition rate requires a short time constant to assure adequate integrator reset between macropulses. Also, grounding is a serious concern due to the small signal levels. This paper reviews the basic Wire Scanner AFE system design implemented in the cRIO-module form factor to capture the charge information from the wire sensors and the grounding topology to assure minimum noise contamination of the wire signals.

  15. Opiate Dependents’ Experiences of the Therapeutic Relationship in Methadone Centers; A Qualitative Study

    OpenAIRE

    Banazadeh, Nabi; Kheradmand, Ali; Abedi, Heidarali

    2009-01-01

    Background: Methadone maintenance therapy is a treatment of choice for opiate addiction. Understanding opiate dependents’ experiences of patients' treatment is a key to continue the treatment and can provide help to revise the standards of methadone centers and improve the quality of treatment. This study aimed to describe the essence and structure of opiate dependents’ experiences with methadone maintenance therapy. Methods: It was a qualitative phenomenological study, in which participants ...

  16. Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center

    OpenAIRE

    McLaughlin, Jacqueline E.; Amerine, Lindsey B.; Chen, Sheh-Li; Luter, David N.; Arnall, Justin; Smith, Shayna; Roth, Mary T.; Rodgers, Philip T.; Williams, Dennis M.; Pinelli, Nicole R.

    2015-01-01

    Objective. To examine student outcomes associated with the Student Medication and Reconciliation Team (SMART) program, which was designed to provide second-year student pharmacists at the University of North Carolina (UNC) Eshelman School of Pharmacy direct patient care experience at UNC Medical Center.

  17. Neutron Capture Experiments Using the DANCE Array at Los Alamos

    International Nuclear Information System (INIS)

    The Detector for Advanced Neutron Capture Experiments (DANCE) is designed for neutron capture measurements on very small and/or radioactive targets. The DANCE array of 160 BaF2 scintillation detectors is located at the Lujan Center at the Los Alamos Neutron Science Center (LANSCE). Accurate measurements of neutron capture data are important for many current applications as well as for basic understanding of neutron capture. The gamma rays following neutron capture reactions have been studied by the time-of-flight technique using the DANCE array. The high granularity of the array allows measurements of the gamma-ray multiplicity. The gamma-ray multiplicities and energy spectra for different multiplicities can be measured and analyzed for spin and parity determination of the resolved resonances.

  18. Center of mass correction to an error-prone undergraduate centripetal force experiment

    Science.gov (United States)

    Ronhovde, Peter; Sirochman, Rudy

    2003-02-01

    In this undergraduate laboratory experiment we measure the centripetal force acting on a bob in uniform circular motion. As the experiment was originally designed, it consistently yielded large errors due to a subtle twist of the bob as the mass was increased incrementally. This error is due to the fact that the center of mass changes relative position as the mass is incremented; therefore, the spring that provides the centripetal force for the apparatus causes an unintended torque on the bob. A solution to the problem consists of positioning the incremental masses so that the center of mass does not change position. This simple correction provides a useful lesson on redesigning an undergraduate laboratory experiment to obtain better agreement with theory.

  19. Cyberattack analysis through Malaysian Nuclear Agency experience as nuclear research center

    International Nuclear Information System (INIS)

    As a nuclear research center, Nuclear Malaysia is one of the Critical National Information Infrastructure (CNII) in the country. One of the easiest way to launch a malicious attack is through the online system, whether main web site or online services. Recently, we also under port scanning and hack attempts from various sources. This paper will discuss on analysis based on Nuclear Malaysia experience regarding these attempts which keep arising nowadays. (author)

  20. OCCUPATIONAL THERAPY EXPERIENCES IN THE FAMILY HEALTH SUPPORT CENTERS (NASF) IN THE DISTRITO FEDERAL

    OpenAIRE

    Kelly Ranyelle Alves Araujo; Thiara Dias Café Alves; Thais Lima; Vagner Dos Santos; Andrea Donatti Gallassi

    2013-01-01

    To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF). The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how student...

  1. Early outcomes of transcatheter aortic valve replacement in patients with severe aortic stenosis: single center experience

    OpenAIRE

    Bozkurt, Engin; KELEŞ, TELAT; Durmaz, Tahir; Akçay, Murat; Sari, Cenk; Ayhan, Hüseyin; Bayram, Nihal Akar; Aslan, Abdullah Nabi; Baştuğ, Serdal; Bilen, Emine

    2014-01-01

    Introduction Transcatheter aortic valve implantation is a promising alternative to high risk surgical aortic valve replacement. The procedure is mainly indicated in patients with severe symptomatic aortic stenosis who cannot undergo surgery or who are at very high surgical risk. Aim Description early results of our single-center experience with balloon expandable aortic valve implantation. Material and methods Between July 2011 and August 2012, we screened in total 75 consecutive patients wit...

  2. Women’s experience regarding the role of health centers in empowering them for family planning

    OpenAIRE

    Kohan, Shahnaz; Simbar, Masoumeh; Taleghani, Fariba

    2012-01-01

    Background: Nowadays, the concept of family planning has been detached from the population control and it is expressed as an essential element in women’s reproductive rights, empowering them and promoting their status in society. Family planning services have an important role in fertility decisions using contraception methods in women. This study was carried out to explore the experience of women from the role of health centers in empowering them for family planning. Materials and Methods: T...

  3. Health professionals’ experiences of person-centered collaboration in mental health care

    OpenAIRE

    Sommerseth, Rita; Dysvik, Elin

    2008-01-01

    Objective The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation. Method The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as ...

  4. Health professionals’ experiences of person-centered collaboration in mental health care

    OpenAIRE

    Rita Sommerseth; Elin Dysvik

    2008-01-01

    Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design ...

  5. Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.

    OpenAIRE

    Erkan, Murat Mert; Michalski, Christoph W.; Kong, Bo; Jaeger, Carsten; Kloe, Silke; Beier, Barbara; Braren, Rickmer; Esposito, Irene; Friess, Helmut; Kleeff, Jorg

    2015-01-01

    RESEARCH ARTICLE Open Access Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience Christoph W. Michalski1,4, Bo Kong1, Carsten Jäger1, Silke Kloe1, Barbara Beier1, Rickmer Braren2, Irene Esposito3,5, Mert Erkan1,6, Helmut Friess1† and Jorg Kleeff1*† Abstract Background: Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the ...

  6. Preparing an Academic Medical Center to Manage Patients Infected with Ebola: Experiences of a University Hospital

    OpenAIRE

    Schultz, Ch.; Koenig, KL; Alassaf, W

    2015-01-01

    © 2015 Society for Disaster Medicine and Public Health, Inc. As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered t...

  7. Nursing at ground zero: experiences during and after September 11 World Trade Center attack.

    Science.gov (United States)

    Dickerson, Suzanne Steffan; Jezewski, Mary Ann; Nelson-Tuttle, Christine; Shipkey, Nancy; Wilk, Nancy; Crandall, Blythe

    2002-01-01

    The purpose of this study is to discover shared perceptions, feelings, and common experiences of nurses after the September 11th World Trade Center terrorist attack through interpretive analysis of narrative stories of seventeen nurses. Six themes and one constitutive pattern describe the experiences: (a) Loss of a symbol and regaining new meaning, (b) Disaster without patients, (c) Coordinating with and without organizations, (d) Rediscovering the pride in nursing, (e) Traumatic Stress, and (f) Preparing for the future. The constitutive pattern is that nursing enables a humanitarian disaster response. PMID:12146085

  8. LOS ALAMOS NEUTRON SCIENCE CENTER CONTRIBUTIONS TO THE DEVELOPMENT OF FUTURE POWER REACTORS

    Energy Technology Data Exchange (ETDEWEB)

    GAVRON, VICTOR I. [Los Alamos National Laboratory; HILL, TONY S. [Los Alamos National Laboratory; PITCHER, ERIC J. [Los Alamos National Laboratory; TOVESSON, FREDERIK K. [Los Alamos National Laboratory

    2007-01-09

    The Los Alamos Neutron Science Center (LANSCE) is a large spallation neutron complex centered around an 800 MeV high-currently proton accelerator. Existing facilities include a highly-moderated neutron facility (Lujan Center) where neutrons between thermal and keV energies are produced, and the Weapons Neutron Research Center (WNR), where a bare spallation target produces neutrons between 0.1 and several hundred MeV.The LANSCE facility offers a unique capability to provide high precision nuclear data over a large energy region, including that for fast reactor systems. In an ongoing experimental program the fission and capture cross sections are being measured for a number of minor actinides relevant for Generation-IV reactors and transmutation technology. Fission experiments makes use of both the highly moderated spallation neutron spectrum at the Lujan Center, and the unmoderated high energy spectrum at WNR. By combininb measurements at these two facilities the differential fission cross section is measured relative to the {sup 235}U(n,f) standard from subthermal energies up to about 200 MeV. An elaborate data acquisition system is designed to deal with all the different types of background present when spanning 10 energy decades. The first isotope to be measured was {sup 237}Np, and the results were used to improve the current ENDF/B-VII evaluation. Partial results have also been obtained for {sup 240}Pu and {sup 242}Pu, and the final results are expected shortly. Capture cross sections are measured at LANSCE using the Detector for Advanced Neutron Capture Experiments (DANCE). This unique instrument is highly efficient in detecting radiative capture events, and can thus handle radioactive samples of half-lives as low as 100 years. A number of capture cross sections important to fast reaction applications have been measured with DANCE. The first measurement was on {sup 237}Np(n,{gamma}), and the results have been submitted for publication. Other capture

  9. Financial Planning for Military Child Care Centers: A Guidebook Based on the Experiences of the Fort Lewis Child Care Center.

    Science.gov (United States)

    Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs (DOD), Washington, DC.

    Good record keeping--along with a constant and detailed knowledge of expenses, income, profit, and loss--is the first step toward profitable management of a child care center. Good record keeping is especially important in a center that provides "drop-in" or occasional care because income may fluctuate greatly as a result of the variable number of…

  10. Modeling and Deciphering on Recent Spin-polariton Entanglement Experiments in NV center of diamond

    CERN Document Server

    Qi, Xiaodong

    2011-01-01

    This work is a discussion on the spin-polariton (polarized single photon) entanglement in nitrogen vacancy (NV) center in diamond with modeling and comparison to recent published experiments. A Jaynes-Cummings model is applied to analyze the off- and on-resonant dynamics of the electronic spin and polarized photon system. Combined with the analysis on the NV center's electron structure and transition rules, this model explained the Faraday effect, Optical Stark effect, pulse echo technology and energy level engineering technology to finally realize the spin-polariton entanglement. All theoretical results are compared mainly with two updated experimental reports \\cite{Buckley2010} \\cite{Togan2010} published in {\\it {Science}} and {\\it {Nature}} several months ago, and work well on explaining the reported phenomena and data. Meanwhile, the analysis also reveals some possible mistakes hidden in the original analysis of these two experimental reports. This essay essentially aims at practicing the fundamental skil...

  11. Influence of paramagnetic centers on the nuclear spin lattice relaxation in NQR experiments

    International Nuclear Information System (INIS)

    We investigated the influence of paramagnetic centers on the nuclear spin relaxation in NQR experiments. 35Cl NQR spectra, spin-lattice relaxation times in laboratory and rotating frames T1 and T1e and spin-spin relaxation time T2 in NaClO3 have been measured at 77 Κ. for a large range of PI concentration. Paramagnetic centers were developed by g-irradiation with doses of 0.2, 1, 3, 5, 10, 20 and 50 Mrad. Nonirradiated NaClO3 sample has been also studied. The amount and origin of PI were controlled by ESR measurements. NQR frequency and line width in nonirradiated sample at 77 Κ. were found to be 30.63245 MHz and 1.2 khz, respectively. Line width shows linear dependence on the dose of irradiation in the whole range of irradiation, while larger doses result in a deviation of line shift from the linear law. These frequency and line width variations result from the distortion of electric field gradient; a static broadening may be also caused by the dipole-dipole interaction between the unpaired magnetic moments of the paramagnetic centers and the magnetic moments of the resonant nuclei. The value of spin-spin relaxation time T2=0.8 ms does not vary with irradiation within the accuracy of the experiment. Spin-lattice relaxation time T1 Shows no visible changes up to 3 Mrad. By fitting the M(t) decay with a stretched exponent given by the expression Mo [1 - Bexp(-(t/T1 )α)], we found the parameter a around 0.83 [1]. However, further irradiation reduces both T1 and a. These changes are attributed to the influence of paramagnetic centers and may be explained in the frames of the theory of relaxation via paramagnetic centers in the absence of spin diffusion. Measurements of T1e show that magnetization decay is two-exponential for the delay between pulses > 50 ms and becomes close to one-exponential when reduce the delay s. Analysis of one-exponential decay with a stretched exponent shows visible dependence of T1e and a on the dose of irradiation which are attributed to

  12. Post-Transplant Lymphoproliferative Disorder in Kidney Transplant Recipients: A Single-Center Experience in Japan.

    Science.gov (United States)

    Ishihara, Hiroki; Shimizu, Tomokazu; Unagami, Kohei; Hirai, Toshihito; Toki, Daisuke; Omoto, Kazuya; Okumi, Masayoshi; Imai, Yoichi; Ishida, Hideki; Tanabe, Kazunari

    2016-04-01

    Post-transplant lymphoproliferative disorder is a serious complication of solid organ transplantation; however, few large studies have been performed in Asian institutions. We review our single-center experience with post-transplant lymphoproliferative disorder patients in Japan. We retrospectively evaluated patients with post-transplant lymphoproliferative disorder following kidney transplantation between January 1985 and December 2013. The patients were divided into early-onset post-transplant lymphoproliferative disorder ( 10 years after transplantation; therefore, long-term monitoring of patients is needed. PMID:26948427

  13. Two center experiences of Paget's disease of the breast in a sunny coastal city

    OpenAIRE

    Doğru, Volkan; Akgül, Nedim; Sezer, Cem; Arıcı, Ayşe Gülbin; Tutuş, Birsel; Bülbüller, Nurullah; Arıcı, Cumhur

    2015-01-01

    SUMMARYPaget’s disease of the breast, is a rare disease of the breast which involves nipple and areola complex. There is often an underlying in situ or invasive breast cancer. This article compares and discuss information related to Paget’s disease of the breast obtained from the medical literature with the experience gained from cases followed in two seperate centers, in a southern costal city of Turkey, Antalya where there is a climate with abundant sun exposure most of the year. Sun exposu...

  14. Lessons learned enhancing EPICS CA for LANSCE timed and flavored data

    Energy Technology Data Exchange (ETDEWEB)

    Hill, Jeffrey O [Los Alamos National Laboratory

    2009-01-01

    A previous paper described an upgrade to EPICS enabling client side tools at LANSCE to receive subscription updates filtered selectively to match a logical configuration of LANSCE beam gates, as configured by the control room. The upgrade required fundamental changes in the EPICS core components. First, the event queue in the EPICS server was upgraded to buffer record (function block) and device specific parameters accessed generically via software interfaces for introspection of 3rd party data. In contrast, event queues in previous versions of EPICS were strictly limited to buffering only value, timestamp, and alarm status tuples. Second, the Channel Access server is being upgraded to filter subscription updates. In this follow on paper some necessary design changes mid-project and the lessons learned during the software development will be described.

  15. HISTORICAL AND THEORETICAL BACKGROUND TO THE FORMATION OF A TOURIST CENTER: INTERNATIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Ye.K.Bulatova

    2015-02-01

    Full Text Available Statement of the problem. Nowadays tourismis a multi-faceted social phenomenon and its influ-ence on the architecture includes both positive and negative aspects that must be investigated. While studying different historical stages of tourism in the city structure, we seek for a causal link of thephenomenon of reorientation of dominant recreational functions of the territory, and try to define optimal functional organization of a tourist center. In order to do so, cutting-edge overseas experiences in the development of tourist and recreational institutions from the start of mass tour-ism up to this day.Results and conclusions. The major historical periods of forming a tourist system were studied: types of tourist activities and of tourist and recreational objects which were classed according to their level of influence on the organization of tourism. Theways of the formation of tourist estab-lishments and complexes on different historical stages were examined in order to define evolution-al typological tourist formations from a single tourist establishment to a city tourist center. A city as a tourist center was regarded as the main and the most optimal type of a tourist system in the modern hierarchical city structure of the tourist establishments.

  16. Development of a RAMI model for LANSCE and high power APT accelerators

    International Nuclear Information System (INIS)

    Assessment of the reliability, availability, maintainability and inspectability (RAMI) of all high power, high cost systems is important to justify and improve the cost effectiveness of these systems. For the very large (over 100 MW) accelerator systems associated with APT, a RAMI model is very valuable in guiding the design and allocation of resources. A RAMI model of an existing machine is also valuable, since machine improvement funds must be allocated to increase the availability by the largest amount. The authors have developed a RAMI model using the critical subsystems of the LANSCE accelerator and beam delivery complex as an example and to evaluate the effectiveness for estimating reliability and beam availability. LAMPF and LANSCE together provide most of the features required for the accelerator and beam delivery part of a high-power APT machine, but LANSCE is pulsed, rather than CW. This complex is capable of a 1-MW average power H- beam, and it is the most powerful proton accelerator in the US built to date

  17. Cryoablation for the treatment of drug refractory symptomatic atrial fibrillation: A regional medical center experience.

    Directory of Open Access Journals (Sweden)

    Robert Tonks, MD; Hiba-tul-kareem Sayed, MD; Ashley Adams, BA; William T. Smith, MD, FACC

    2016-02-01

    Full Text Available Introduction: PVI is an effective, guideline-based treatment for drug refractory symptomatic AF. Balloon cryoablation has been shown to be a safe and effective method for PVI. In the STOP-AF trial, data was produced from practitioners performing PVI with significant experience at high volume centers. This study evaluates the effectiveness and safety of treating symptomatic, drug refractory AF with PVI via cryoablation after implementation in a regional medical center. Method: This represents a retrospective analysis of outcomes after cryoablation treatment for AF in 71 patients over 354.7 +/- 164.4 days. Reported and recorded episodes of AF were categorized into a representative percent of AF “burden” for each 90 day period. Primary effectiveness and safety end points paralleled those of the STOP-AF trial. Results: Patients undergoing cryoablation had a 91% reduction of AF burden at 6 months following the procedure with an event-free survival rate of 45.5 % at a mean follow up of 12 months. The mean burden reduction was 3.21% per quarter. Anti-arrhythmic and anticoagulant medication use was reduced by 14.3% and 26.8% respectively. Significant complications included one report of pulmonary vein stenosis, one report of pseudoaneurysm and 5.5% of patients had transient pericarditis or pericardial effusion following the procedure. Conclusion: The results of this study were comparable to those of the high volume multi-center STOP-AF trial. PVI via cryoablation is a safe and effective alternative treatment of drug refractory symptomatic AF in the setting of a regional medical center. Abbreviations: Atrial fibrillation (AF, pulmonary vein isolation (PVI

  18. Uncovering paradoxes from physicians' experiences of patient-centered ward-round.

    Science.gov (United States)

    Bååthe, Fredrik; Ahlborg, Gunnar; Edgren, Lars; Lagström, Annica; Nilsson, Kerstin

    2016-05-01

    Purpose The purpose of this paper is to uncover paradoxes emerging from physicians' experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician's professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician's professional identity was centered. Physicians with more of a We-perspective experienced challenges with the new round, while physicians with more of an I-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered. Practical implications For change processes affecting physicians' professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure. Originality/value This paper provides increased understanding about how physicians' professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement. PMID:27198705

  19. Health professionals’ experiences of person-centered collaboration in mental health care

    Directory of Open Access Journals (Sweden)

    Rita Sommerseth

    2008-10-01

    Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

  20. Group Violence and Migration Experience among Latin American Youths in Justice Enforcement Centers (Madrid, Spain).

    Science.gov (United States)

    Martínez García, José Manuel; Martín López, María Jesús

    2015-01-01

    Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support. PMID:26514376

  1. [Experience of extracorporeal membrane oxygenation in critical care of respiratory failure in newborn with congenital diaphragmatic hernia in perinatal center].

    Science.gov (United States)

    Burov, A A; Nikiforov, D V; Podurovskaia, Iu L; Dorofeeva, E I; Abramian, M A; Makhalin, M V; Shatalov, K V; Nikiforov, V S; Degtiarev, D N

    2013-01-01

    The article deals with an experience of veno-arterial extracorporeal membrane oxygenation use in preterm infants with congenital diaphragmatic hernia during postoperative period in the perinatal center. PMID:24749262

  2. Atmospheric monitoring of a perfluorocarbon tracer at the 2009 ZERT Center experiment

    Science.gov (United States)

    Pekney, Natalie; Wells, Arthur; Rodney Diehl, J.; McNeil, Matthew; Lesko, Natalie; Armstrong, James; Ference, Robert

    2012-02-01

    Field experiments at Montana State University are conducted for the U.S. Department of Energy as part of the Zero Emissions Research and Technology Center (ZERT) to test and verify monitoring techniques for carbon capture and storage (CCS). A controlled release of CO 2 with an added perfluorocarbon tracer was conducted in July 2009 in a multi-laboratory study of atmospheric transport and detection technologies. Tracer plume dispersion was measured with various meteorological conditions using a tethered balloon system with Multi-Tube Remote Samplers (MTRS) at elevations of 10 m, 20 m, and 40 m above ground level (AGL), as well as a ground-based portable tower with monitors containing sorbent material to collect the tracer at 1 m, 2 m, 3 m, and 4 m AGL. Researchers designed a horizontal grid of sampling locations centered at the tracer plume source, with the tower positioned at 10 m and 30 m in both upwind and downwind directions, and the MTRS spaced at 50 m and 90 m downwind and 90 m upwind. Tracer was consistently detected at elevated concentrations at downwind sampling locations. With very few exceptions, higher tracer concentrations correlated with lower elevations. Researchers observed no statistical difference between sampling at 50 m and 90 m downwind at the same elevation. The US EPA AERMOD model applied using site-specific information predicted transport and dispersion of the tracer. Model results are compared to experimental data from the 2009 ZERT experiment. Successful characterization of the tracer plume simulated by the ZERT experiment is considered a step toward demonstrating the feasibility of remote sampling with unmanned aerial systems (UAS's) at future sequestration sites.

  3. Development of PET in Latin America. Experience of the first PET-Cyclotron Center

    International Nuclear Information System (INIS)

    Aim: Describe the experience of the first PET-Cyclotron Center in Latin America. Demonstrate the viability of running a PET Center in Argentina despite the economic crisis. Materials and Methods: For this study, we used a UGM/GE Quest 250 PET scan, a RDS 112 cyclotron and a Radiosynthesis Laboratory installed at the (FUESMEN) Nuclear Medicine School Foundation, located in Mendoza City, in the middle-west of Argentina. From January 1999 to March 2002, 741 studies were obtained, 731 were 18FluorDeoxyGlucose-PET studies and 10 phantoms for calibration purposes. We used acquisition and imaging processing standard protocols, as well as research protocols designed according to the pathology under investigation. To better correlate anatomical and functional images, we used fusion techniques with (CT) Computed Tomography in some (WB) whole-body PET scans. Results: A total of 731 patients were retrospectively analyzed and classified according to statistics variables such as: 1-sex: 317 women and 414 men, 2-type of scan: 439 WB cases, 267 brain studies and 25 cardiac. From this data we divided them as PET indications and resulted in 17 cases as healthy volunteers, 422 oncological cases, 267 neurological studies and 25 cardiac for myocardial viability. According to the origin they were classified as patients coming from Mendoza 544, Buenos Aires 112, other argentine provinces 60 and foreign (Chile, Brazil and Uruguay) 15 cases. In terms of billing, 181 studies were done free of charge, 95 under research protocols were also done free of charge and 451 were charged. Conclusion: Not only the economical and political factors play an important role limiting the advances of PET Imaging in Latin America, but also the lack of a neighboring cyclotron that circumscribe many hospitals to have access to the radiopharmaceutical agent. FUESMEN was established in 1991 by three governmental entities: the (CONEA) National Commission of Atomic Energy, the (UNC) National University of Cuyo and

  4. Computational researches about a problem of experiments on target complex TS-1

    International Nuclear Information System (INIS)

    A benchmark problem presented at the '10th International meetings of the working group on advanced nuclear reactors thermal-hydraulics' in Obninsk, Russia, in 2001, is the starting point for some computational researches validated against experiments on target complex TS-1. The window model of the Accelerator Driven System (ADS) target TS-1, is under development in the State Scientific Center of Russian Federation Institute of Physics and Power Engineering (SSC RF IPPE) and Joint Design Bureau 'Gidropress' for accelerator LANSCE in Los Alamos National Laboratory. The experiments were carried out with sodium-potassium eutectic alloy: 22% Na + 78% K. Different grids, different turbulence models, and different assumptions were tried using the CFD (Computational Fluid Dynamics) codes STAR-CD and FLUENT. It is a big challenge for these CFD codes, to simulate flows with low Prandtl number fluids, such as the liquid metals. (author)

  5. Assessing exploitation experiences of girls and boys seen at a Child Advocacy Center

    Science.gov (United States)

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B.; Saewyc, Elizabeth

    2015-01-01

    The primary aim of this study was to describe the abuse experiences of sexually exploited runaway adolescents seen at a Child Advocacy Center (N = 62). We also sought to identify risk behaviors, attributes of resiliency, laboratory results for sexually transmitted infection (STI) screens, and genital injuries from colposcopic exams. We used retrospective mixed-methods with in-depth forensic interviews, together with self-report survey responses, physical exams and chart data. Forensic interviews were analyzed using interpretive description analytical methods along domains of experience and meaning of sexual exploitation events. Univariate descriptive statistics characterized trauma responses and health risks. The first sexual exploitation events for many victims occurred as part of seemingly random encounters with procurers. Older adolescent or adult women recruited some youth working for a pimp. However, half the youth did not report a trafficker involved in setting up their exchange of sex for money, substances, or other types of consideration. 78% scored positive on the UCLA PTSD tool; 57% reported DSM IV criteria for problem substance use; 71% reported cutting behaviors, 75% suicidal ideation, and 50% had attempted suicide. Contrary to common depictions, youth may be solicited relatively quickly as runaways, yet exploitation is not always linked to having a pimp. Avoidant coping does not appear effective, as most patients exhibited significant symptoms of trauma. Awareness of variations in youth’s sexual exploitation experiences may help researchers and clinicians understand potential differences in sequelae, design effective treatment plans, and develop community prevention programs. PMID:25982287

  6. Assessing exploitation experiences of girls and boys seen at a Child Advocacy Center.

    Science.gov (United States)

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B; Saewyc, Elizabeth

    2015-08-01

    The primary aim of this study was to describe the abuse experiences of sexually exploited runaway adolescents seen at a Child Advocacy Center (N=62). We also sought to identify risk behaviors, attributes of resiliency, laboratory results for sexually transmitted infection (STI) screens, and genital injuries from colposcopic exams. We used retrospective mixed-methods with in-depth forensic interviews, together with self-report survey responses, physical exams and chart data. Forensic interviews were analyzed using interpretive description analytical methods along domains of experience and meaning of sexual exploitation events. Univariate descriptive statistics characterized trauma responses and health risks. The first sexual exploitation events for many victims occurred as part of seemingly random encounters with procurers. Older adolescent or adult women recruited some youth working for a pimp. However, half the youth did not report a trafficker involved in setting up their exchange of sex for money, substances, or other types of consideration. 78% scored positive on the UCLA PTSD tool; 57% reported DSM IV criteria for problem substance use; 71% reported cutting behaviors, 75% suicidal ideation, and 50% had attempted suicide. Contrary to common depictions, youth may be solicited relatively quickly as runaways, yet exploitation is not always linked to having a pimp. Avoidant coping does not appear effective, as most patients exhibited significant symptoms of trauma. Awareness of variations in youth's sexual exploitation experiences may help researchers and clinicians understand potential differences in sequelae, design effective treatment plans, and develop community prevention programs. PMID:25982287

  7. Training for life science experiments in space at the NASA Ames Research Center

    Science.gov (United States)

    Rodrigues, Annette T.; Maese, A. Christopher

    1993-01-01

    As this country prepares for exploration to other planets, the need to understand the affects of long duration exposure to microgravity is evident. The National Aeronautics and Space Administration (NASA) Ames Research Center's Space Life Sciences Payloads Office is responsible for a number of non-human life sciences payloads on NASA's Space Shuttle's Spacelab. Included in this responsibility is the training of those individuals who will be conducting the experiments during flight, the astronauts. Preparing a crew to conduct such experiments requires training protocols that build on simple tasks. Once a defined degree of performance proficiency is met for each task, these tasks are combined to increase the complexity of the activities. As tasks are combined into in-flight operations, they are subjected to time constraints and the crew enhances their skills through repetition. The science objectives must be completely understood by the crew and are critical to the overall training program. Completion of the in-flight activities is proof of success. Because the crew is exposed to the background of early research and plans for post-flight analyses, they have a vested interest in the flight activities. The salient features of this training approach is that it allows for flexibility in implementation, consideration of individual differences, and a greater ability to retain experiment information. This training approach offers another effective alternative training tool to existing methodologies.

  8. Postchemotherapy Retroperitoneal Lymph Node Dissection in Patients With Nonseminomatous Testicular Cancer: A Single Center Experiences

    Directory of Open Access Journals (Sweden)

    Nowroozi

    2015-09-01

    Full Text Available Background Testicular cancer accounts for about 1 - 1.5% of all malignancies in men. Radical orchiectomy is curative in 75% of patients with stage I disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. All patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND. Objectives Treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. We described our experience about postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in our center. Patients and Methods In a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in Imam Khomeini hospital were evaluated. All patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. We reviewed retrospectively clinical, pathological, and surgical parameters associated with PC-RPLND in our center. Results Twenty-one patients underwent bilateral PC-RPLND. Mean age was 26.3 years (ranged 16 - 47. Mean size of retroperitoneal mass after chemotherapy was 7.6 cm. Mean operative time was 198 minutes (120 - 246 minutes. Mean follow-up time was 38.6 months. Pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%, 10 (47.6% and 3 (14.28% patients, respectively. One patient in postoperative period of surgery and three patients in two first years after surgery were expired. Of 17 alive patients, only two (11.8% had not retrograde ejaculation. Conclusions PC-RPLND is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. In appropriate cases, PC-RPLND was associated with good cancer specific survival in tertiary oncology center.

  9. Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

    2011-03-15

    Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

  10. Academic Career Selection and Retention in Radiation Oncology: The Joint Center for Radiation Therapy Experience

    International Nuclear Information System (INIS)

    Purpose: The United States healthcare system has witnessed declining reimbursement and increasing documentation requirements for longer than 10 years. These have decreased the time available to academic faculty for teaching and mentorship. The impact of these changes on the career choices of residents is unknown. The purpose of this report was to determine whether changes have occurred during the past decade in the proportion of radiation oncology trainees from a single institution entering and staying in academic medicine. Methods and Materials: We performed a review of the resident employment experience of Harvard Joint Center for Radiation Therapy residents graduating during 13 recent consecutive years (n = 48 residents). The outcomes analyzed were the initial selection of an academic vs. nonacademic career and career changes during the first 3 years after graduation. Results: Of the 48 residents, 65% pursued an academic career immediately after graduation, and 44% remained in academics at the last follow-up, after a median of 6 years. A later graduation year was associated with a decrease in the proportion of graduates immediately entering academic medicine (odds ratio, 0.78; 95% confidence interval, 0.65-0.94). However, the retention rate at 3 years of those who did immediately enter academics increased with a later graduation year (p = 0.03). Conclusion: During a period marked by notable changes in the academic healthcare environment, the proportion of graduating Harvard Joint Center for Radiation Therapy residents pursuing academic careers has been declining; however, despite this decline, the retention rates in academia have increased

  11. The Real Astronomy Experience: Making the IVO Effective for International Planetaria and Science Centers

    Science.gov (United States)

    Pennypacker, Carl

    The Real Astronomy Experience, or RAE, is a new exhibit just beginning development in the late fall of 2002, hopefully to be funded by the US National Science Foundation. RAE will allow public visitors in science centers, museums, and planetaria to operate and acquire images from a either a remote telescope in the southern hemisphere or from IVO data bases. RAE can operate from Europe and North America during daylight at the exhibit site. This project will be implemented also by international Global Hands-On Universe ("GHOU") collaborators. Greater international success will be facilitated by other GHOU nations joining the collaboration to build a viable network of small, inexpensive telescopes, and federating their data bases for the IVO.

  12. Teaching about vulnerable populations: nursing students' experience in a homeless center.

    Science.gov (United States)

    Stanley, Mary Jo

    2013-10-01

    Cultural competence is not limited to ethnicity, religion, or race but is inclusive of vulnerable groups, such as the homeless. The complex health and social issues related to homelessness requires educational instruction that supports students' ability to address and care for the multidimensional elements that surround this group. Exposure to homeless populations provides nursing students with increased awareness of the issues related to health disparities, while promoting introspective reflection on one's values and beliefs. To increase student exposure to working with homeless clients, a service-learning project using a critical social theory (CST) lens was offered at a homeless center. The students' response that clients were "just like" them, coupled with ambiguity regarding the complex social-economic-political issues surrounding the homeless, may indicate a need for further education regarding cultural understanding, sensitivity, and vulnerability. This project demonstrates the need for learning experiences that support advocacy and social responsibility for vulnerable groups. PMID:24040771

  13. Young's double-slit experiment using two-center core-level photoemission: Photoelectron recoil effects

    International Nuclear Information System (INIS)

    Core-level photoemission from N2 can be considered an analogue of Young's double-slit experiment (YDSE) in which the double-slit is replaced by a pair of N 1s orbitals. The measured ratio between the 1σg and 1σu photoionization cross-sections oscillates as a function of photoelectron momentum, due to two-center YDSE interference, exhibiting a remarkable dependence on the vibrational sub-levels of the core ionized state. We theoretically demonstrate that the recoil of the photoelectron given to the ionized N atom strongly influences this interference pattern. The reason for this is that the momentum transfer affects the phases of the photoionization amplitudes

  14. Local experience on radionuclide myocardial imaging in the Philippines at the Philippine Heart Center for Asia

    International Nuclear Information System (INIS)

    The Nuclear Medicine Department of the Philippine Heart Center has introduced the detection of coronary heart disease through myocardiac perfusion imaging. The cardiovascular procedures are availed of free-of-charge to registered PHCA patients excepting for the costly TI-201 imaging. In summary, coronary perfusion in imaging should be an integral part of coronary arteriography. Barring the expensive cost of TI-120, myocardial perfusion imaging is ideal for detection of coronary heart disease. Experience shows better sensitivity of TI-201 than exercise ECG for detection of ischemia. Another non-invasive procedure for the detection of acute infarction is the radionuclide imaging using a bone radiopharmaceutical Tc99m prophosphate. In conclusion, acute infarct imaging is a valuable adjunct to ECG and enzyme studies. (RTD)

  15. Laparoscopy Versus Robotic Surgery for Colorectal Cancer: A Single-Center Initial Experience.

    Science.gov (United States)

    Ferrara, Francesco; Piagnerelli, Riccardo; Scheiterle, Maximilian; Di Mare, Giulio; Gnoni, Pasquale; Marrelli, Daniele; Roviello, Franco

    2016-08-01

    Background Minimally invasive approach has gained interest in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience of a single center. Materials and Methods Clinico-pathological data of 100 patients surgically treated for colorectal cancer from March 2008 to April 2014 with laparoscopy and robotics were analyzed. The procedures were right colonic, left colonic, and rectal resections. A comparison between the laparoscopic and robotic resections was made and an analysis of the first and the last procedures in the 2 groups was performed. Results Forty-two patients underwent robotic resection and 58 underwent laparoscopic resection. The postoperative mortality was 1%. The number of harvested lymph nodes was higher in robotics. The conversion rate was 7.1% for robotics and 3.4% for laparoscopy. The operative time was lower in laparoscopy for all the procedures. No differences were found between the first and the last procedures in the 2 groups. Conclusions This initial experience has shown that robotic surgery for the treatment of colorectal adenocarcinoma is a feasible and safe procedure in terms of oncologic and clinical outcomes, although an appropriate learning curve is necessary. Further investigation is needed to demonstrate real advantages of robotics over laparoscopy. PMID:26721500

  16. Crack-Detection Experiments on Simulated Turbine Engine Disks in NASA Glenn Research Center's Rotordynamics Laboratory

    Science.gov (United States)

    Woike, Mark R.; Abdul-Aziz, Ali

    2010-01-01

    The development of new health-monitoring techniques requires the use of theoretical and experimental tools to allow new concepts to be demonstrated and validated prior to use on more complicated and expensive engine hardware. In order to meet this need, significant upgrades were made to NASA Glenn Research Center s Rotordynamics Laboratory and a series of tests were conducted on simulated turbine engine disks as a means of demonstrating potential crack-detection techniques. The Rotordynamics Laboratory consists of a high-precision spin rig that can rotate subscale engine disks at speeds up to 12,000 rpm. The crack-detection experiment involved introducing a notch on a subscale engine disk and measuring its vibration response using externally mounted blade-tip-clearance sensors as the disk was operated at speeds up to 12 000 rpm. Testing was accomplished on both a clean baseline disk and a disk with an artificial crack: a 50.8-mm- (2-in.-) long introduced notch. The disk s vibration responses were compared and evaluated against theoretical models to investigate how successful the technique was in detecting cracks. This paper presents the capabilities of the Rotordynamics Laboratory, the baseline theory and experimental setup for the crack-detection experiments, and the associated results from the latest test campaign.

  17. A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

    Directory of Open Access Journals (Sweden)

    Rakhee Sodhi

    2016-03-01

    Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

  18. Outcomes of adult-to-adult living donor liver transplantation:a single center experience

    Institute of Scientific and Technical Information of China (English)

    FENG Xi; YUAN Ding; WEI Yong-gang; LI Fu-qiang; WEN Tian-fu; ZENG Yong; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing; YANG Jia-yin; MA Yu-kui; CHEN Zhe-yu; YE Hui; YAN Lü-nan; LI Bo

    2009-01-01

    Background Since January 2002,adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers.This study presents a detailed analysis of the outcomes of AALDLT in a single center.Methods A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007.Among these,67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts.Three-dimensional volumetric computed tomography,magnetic resonance imaging with angiography and cholangiography were performed preoperatively.Recipient operation time,intraoperative transfusion requirement,length of intensive care unit stay,length of hospital stay,liver function tests,coagulation tests and surgical outcomes were routinely investigated throughout this study.Results All donors survived the procedure with an overall complication rate of 15.3%.Overall recipient 1-year survival and complication rates were 87.1% and 34.2%,respectively.Among the 70 cases,average graft recipient weight ratio was 0.94% (0.72%-1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74%-71.68%).All residual liver volumes exceeded 35%.Liver function and coagulation recovered rapidly within the first 7 days after transplantation.Conclusions AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease.Patient selection and timely decision-making for transplantation are essential in achieving good outcomes.With accumulation of experience in surgery and clinical management,timely feedback and proper modification,we foresee better outcomes in the future.

  19. Congenital duodenal obstruction in neonates:a decade's experience from one center

    Institute of Scientific and Technical Information of China (English)

    Qing-Jiang Chen; Zhi-Gang Gao; Jin-Fa Tou; Yun-Zhong Qian; Min-Ju Li; Qi-Xing Xiong; Qiang Shu

    2014-01-01

    Background: Congenital duodenal obstruction (CDO) is one of the most common anomalies in newborns, and accounting for nearly half of all cases of neonatal intestinal obstruction. This study aimed to review our single-center experience in managing congenital duodenal obstruction while evaluate the outcomes. Methods: We conducted a retrospective analysis of the records of all neonates dianogsed with congenital duodenal obstruction admitted to our center between January 2003 and December 2012. We analyzed demographic criteria, clinical manifestations, associated anomalies, radiologic findings, surgical methods, postoperative complications, and fi nal outcomes. Results: The study comprised 287 newborns (193 boys and 94 girls). Birth weight ranged from 950 g to 4850 g. Fifty-three patients were born prematurely between 28 and 36 weeks' gestation. Malrotation was diagnosed in 174 patients, annular pancreas in 66, duodenal web in 55, duodenal atresia or stenosis in 9, preduodenal portal vein in 2, and congenital band compression in 1. Twenty patients had various combinations of these conditions. Presenting symptoms included bilious vomiting, dehydration, and weight loss. X-rays of the upper abdomen demonstrated the presence of a typical doublebubble sign or air-fl uid levels in 68.64% of patients, and confi rmatory upper and/or lower gastrointestinal contrast studies were obtained in 64.11%. Multiple associated abnormalities were observed in 50.52% of the patients. Various surgical approaches were used, including Ladd's procedure, duodenoplasty, duodenoduodenostomy, duodenojejunostomy, or a combination of these. Seventeen patients died postoperatively and 14 required re-operation. Conclusions: Congenital duodenal obstruction is a complex entity with various etiologies and often includes multiple concomitant disorders. Timely diagnosis and aggressive surgery are key to improving prognosis. Care should be taken to address all of the causes of duodenal obstruction and

  20. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    International Nuclear Information System (INIS)

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  1. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

    2010-10-15

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  2. Nuclear Energy Experiments to the Center for Global Security and Cooperation.

    Energy Technology Data Exchange (ETDEWEB)

    Osborn, Douglas M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-06-01

    This is to serve as verification that the Center 6200 experimental pieces supplied to the Technology Training and Demonstration Area within the Center of Global Security and Cooperation are indeed unclassified unlimited released for viewing.

  3. Comparison of Bragg-Edge neutron-transmission spectroscopy at ISIS and LANSCE

    CERN Document Server

    Santisteban, J R; Priesmeyer, H G; Vogel, S

    2002-01-01

    The Bragg edges appearing in the neutron-transmission spectra of a polycrystalline material represent its coherent-scattering response at 2 theta=180 . Structural information such as texture, phase content or strain may be derived from the intensity and position of these edges. Transmission diffractometers have been recently developed at both LANSCE and ISIS and used for studying the dynamics of phase transformations and strain imaging, respectively. The incident neutron spectra vary due to the different neutron moderators and flight paths used in the two instruments. This paper reports a comparative study of the two instruments and their analysis software. (orig.)

  4. Review of the Lujan neutron scattering center: basic energy sciences prereport February 2009

    Energy Technology Data Exchange (ETDEWEB)

    Hurd, Alan J [Los Alamos National Laboratory; Rhyne, James J [Los Alamos National Laboratory; Lewis, Paul S [Los Alamos National Laboratory

    2009-01-01

    The Lujan Neutron Scattering Center (Lujan Center) at LANSCE is a designated National User Facility for neutron scattering and nuclear physics studies with pulsed beams of moderated neutrons (cold, thermal, and epithermal). As one of five experimental areas at the Los Alamos Neutron Science Center (LANSCE), the Lujan Center hosts engineers, scientists, and students from around the world. The Lujan Center consists of Experimental Room (ER) 1 (ERl) built by the Laboratory in 1977, ER2 built by the Office of Basic Energy Sciences (BES) in 1989, and the Office Building (622) also built by BES in 1989, along with a chem-bio lab, a shop, and other out-buildings. According to a 1996 Memorandum of Agreement (MOA) between the Defense Programs (DP) Office of the National Nuclear Security Agency (NNSA) and the Office of Science (SC, then the Office of Energy Research), the Lujan Center flight paths were transferred from DP to SC, including those in ERI. That MOA was updated in 2001. Under the MOA, NNSA-DP delivers neutron beam to the windows of the target crypt, outside of which BES becomes the 'landlord.' The leveraging nature of the Lujan Center on the LANSCE accelerator is a substantial annual leverage to the $11 M BES operating fund worth approximately $56 M operating cost of the linear accelerator (LINAC)-in beam delivery.

  5. The Fernald Preserve Visitors Center The Fernald Experience-Revealing, Engaging, and Preserving

    International Nuclear Information System (INIS)

    The U.S. Department of Energy (DOE) Office of Legacy Management's public involvement activities at the Fernald, Ohio, site include continued communication about groundwater remediation, the management of legacy waste, and the future of the Fernald site. The completion of the Fernald Preserve Visitors Center, in August 2008, ensures that information continues to be readily available and effectively communicated to the public. A primary goal of the Visitors Center is to function as an informational and educational center within the surrounding community, with the information available at the Visitors Center serving as an institutional control. By offering information on a variety of topics, from the site's history to its current condition, the Visitors Center increases public awareness and helps prevent unsafe disturbances to and uses of the site. The Office of Legacy Management maintains and operates the Visitors Center, continues to solicit stakeholder opinion, and will periodically reevaluate the use of the Visitors Center and its programming. (authors)

  6. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    Science.gov (United States)

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients. PMID:25162618

  7. Stent treatment for basilar artery dissection: A single-center experience of 21 patients.

    Science.gov (United States)

    Li, Li; Li, Tianxiao; Xue, Jiangyu; Wang, Ziliang; Bai, Weixing; Zhu, Liangfu; Feng, Guang; Xu, Gangqin; Yang, Bowen

    2016-06-01

    Basilar artery dissection is a rare disease with high morbidity and mortality. No well-established management strategy exists for this lesion. Endovascular reconstructive therapy using stents (with or without coiling) may be the optimum strategy.We describe our center's experience for this treatment strategy in 21 patients with basilar artery dissection from January 2009 to July 2014 (17 men, four women; age range, 18-70 years; median age, 56 years). We divided patients into two groups: Group 1 patients received stent-assisted coiling treatment, and Group 2 patients received stent-only treatment. Pre-treatment, peri-operation and follow-up evaluation were investigated for complications, clinical outcome and angiographic results. The median follow-up time was 20 months (range, 3-67 months).All patients were treated endovascularly by stent-assisted coiling (14 patients) or stent only (seven patients). Immediate angiography showed: in Group 1, five of 14 lesions were completely occluded, five were partially occluded, four revealed retention of contrast media; in Group 2, all patients (seven of seven) had contrast retention. At the follow-up visit (median seven months, 3-29 months), the aneurysms were angiographically improved in five of 13 patients in Group 1 compared with immediately post-operation, while six of sevenimproved in Group 2. Five patients (all in Group 1) had ischemic or hemorrhage peri-operation complications. Long-term good clinical outcomes (modified Rankin Scale score (mRS) ≤ 2) were achieved in all patients except three death cases (two in Group1, one in Group 2).In our experience, endovascular reconstructive therapy using stents (with or without coiling) for basilar artery dissection is effective and safe. Stent-only treatment seems have a better safety profile during the peri-operation period. PMID:26842610

  8. Presentation and Management of Paroxysmal Nocturnal Hemoglobinuria: A Single-Center Experience.

    Science.gov (United States)

    Dal, Mehmet Sinan; Karakuş, Abdullah; Ekmen, Mehmet Önder; Ayyildiz, Orhan

    2016-03-17

    Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder characterized by intravascular hemolysis. Real-world experience of PNH management is largely unreported. A retrospective analysis was undertaken based on medical records from six patients with PNH [two with aplastic anemia (AA)] treated at our center, Dicle University, Turkey. Diagnosis was based on granulocyte PNH clones, ranging from 93% to 66%. All patients had symptoms consistent with PNH. One patient was managed adequately with supportive measures only. Five were treated with the complement inhibitor eculizumab. Follow-up data (<1 year) were available in four cases (the fifth had received only three infusions by final follow-up). Hemoglobin level in these four patients increased from 4.1-7.2 g/dL to 8.3-13.0 g/dL. Lactate dehydrogenase, a marker for hemolysis, decreased profoundly in the two non-AA patients, with more minor improvements in the two AA patients. Weakness and fatigue improved in all eculizumab-treated patients. Four of the five treated patients became transfusion independent, including the patient given only three infusions. In the remaining case, a patient with AA, transfusion requirement decreased, and abdominal pain and dysphagia resolved. No adverse events occurred. PNH can be successfully managed in routine practice. PMID:27103981

  9. OCCUPATIONAL THERAPY EXPERIENCES IN THE FAMILY HEALTH SUPPORT CENTERS (NASF IN THE DISTRITO FEDERAL

    Directory of Open Access Journals (Sweden)

    Kelly Ranyelle Alves Araujo

    2013-09-01

    Full Text Available To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF. The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how students and practitioners of occupational therapy falls within that service, identifying the main limitations and the work that advances the health care setting. Results: The students and occupational therapist service sought to develop an integrated and intersectoral. Actions were part of the home visits, group approaches with different community groups, active search for users and partnerships in the community. Thus, the work is still very limited assistance and connected to the matricial point of view, as recommended. We conclude that, despite the NASF be a new field of labor for occupational therapists, the actions of social inclusion, empowerment and citizenship developed can encourage healthy habits, but practices need to be revised to follow the proposal of this device.

  10. Pathology of pediatric liver tumors, a single center experience from south of Iran

    Directory of Open Access Journals (Sweden)

    Geramizadeh Bita

    2010-07-01

    Full Text Available Background: Pediatric hepatic malignancies are rare, accounting for 1-4% of all solid childhood tumors. The histopathology of childhood hepatic tumors guides the treatment and prognosis, and is the cornerstone for precise diagnosis. Until now, there has been no documented study on pediatric liver tumor cases from this center; in this report, we show our experience about the common types of childhood hepatic tumors during five years (2002-2007 and compare them with other studies. Materials and Methods: During five years (2002-2007, all the hepatic tumors of childhood (under 18 year-old from the pathology file of Namazi Hospital of Shiraz University of Medical Sciences are recorded. This includes both resected specimens and biopsies. All the slides were reviewed and the pathologic diagnosis was confirmed. Results: We detected 53 liver tumor cases in children (below 18 years of age. Among these tumors, 36 (67.9% were malignant. Male to female ratio was 1.5 to 1. Hepatoblastoma was the most common liver tumor in this age group accounting for 22 patients (41.5%. The second most common primary tumor was hepatocellular carcinoma (HCC, with five patients. Another malignant tumor was embryonal sarcoma. Benign tumors included adenoma, mesenchymal hamartoma, vascular tumors, focal nodular hyperplasia, and inflammatory pseudo tumor. There were also seven metastatic tumors during these five years. Conclusions: The spectrum of hepatic tumors in children is different from that found in the older age group (adults and also different in different populations.

  11. Pharmacomechanical Thrombolysis for the Treatment of Thrombosed Native Arteriovenous Fistula: A Single-Center Experience

    International Nuclear Information System (INIS)

    Native arteriovenous fistula is one of the important routes for hemodialysis patients because of increased long-term survival and preservation of quality of life. We reported on a single-center experience with using pharmacomechanical thrombolysis for the treatment of thrombosed native arteriovenous fistula. This was a retrospective study of 12 hemodialysis patients (8 males and 4 females) with 14 thrombosed distal forearm Brescia-Cimino radiocephalic fistulas who were referred for pharmacomechanical thrombolytic treatment in the intervention unit of the Radiology Department, from 1 January 2010 to 30 December 2011. Demographic data, technical success rates, clinical success rates and complications were evaluated. The patency was evaluated by Kaplan-Meier analysis. The technical and clinical success was found in 12 thrombosed fistulas. Only 3 procedures had minor complications including small amounts of adjacent soft tissue hematoma. There were no procedure-related major complications. The primary patency rates at 6 and 12 months were 67% and 50%. The secondary patency rates at 6 and 12 months were 75% and 67%. Pharmacomechanical thrombolysis is a minimally invasive, effective, durable, and safe procedure for the treatment of thrombosed native arteriovenous fistula. This procedure can be considered as an alternative treatment for thrombosed dialysis fistulas

  12. An Experience Using Performance-Centered Mobile Learning to Enhance Fieldwork Education

    Directory of Open Access Journals (Sweden)

    Silviya Stoyanova-Petrova

    2011-11-01

    Full Text Available Mobile performance support system (mPSS focuses on helping students to perform an authentic task with minimum support of others, providing them with sufficient information such as expert advice and procedures, just-in-time. Providing this support on a mobile device enables students to make their learning more efficient and relevant. Fieldwork has long been identified as providing students undertaking professional studies with a means of implementing theory into real life situations. In many ways there is a natural link between fieldwork and mobile technology. This paper reports our experience using performance-centered mobile learning to enhance active, fieldwork education and the investigation of its impact on students learning. Fieldwork education is vital for many engineering courses. Two case studies held outside the classroom are presented. In the first case, the students are admitted to the technical equipment in a base station of a Bulgarian mobile operator outside the city of Plovdiv. In the second case, students visit an electronics manufacturing plant and directly inspect the production process.

  13. Three-Year Experience of an Academic Medical Center Ombuds Office.

    Science.gov (United States)

    Raymond, John R; Layde, Peter M

    2016-03-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues. PMID:26675192

  14. Early liver retransplantation versus late liver retransplantation:analysis of a single-center experience

    Institute of Scientific and Technical Information of China (English)

    CHEN Gui-hua; ZHANG Jun-feng; ZHANG Tong; WANG Guo-ying; FU Bin-sheng; YANG Yang; CAI Chang-jie; LU Min-qiang; LI Hua; WANG Gen-shu; YI Shu-hong; XU Chi

    2008-01-01

    Background Orthotopic liver retransplantation (re-OLT) is the only effective therapy for irreversible failure of a liver graft. Early and late graft failure gives way to two different clinical conditions that should be discussed separately. This study was designed to compare early and late re-OLT for patients with poor graft function after primary transplantation at our center and sum up our clinical experience in re-OLT.Methods The clinical data of 31 re-OLTs at our center from January 2004 to February 2007 were analyzed retrospectively, consisting of the first group with 14 cases of early re-OLT and the second group with 17 cases of late re-OLT.Results Biliary tract complications were the main indications for early re-OLT (57.1%) and late re-OLT (52.9%). Other common indications were vascular complications in early re-OLT and recurrence of primary diseases in late re-OLT. No significant differences were found between the groups with regard to the volume of bleeding during operation, cold ischemia time, operative duration, and perioperative mortality; except for the model of end-stage liver disease (MELD) score. Outcome was fatal for 7 patients in early re-OLT and 9 patients in late re-OLT. Two deaths were due to multiple organ failure with 3 deaths due to severe sepsis-related disease in early re-OLT, and 4 deaths were due to severe sepsis-related disease with 3 deaths due to recurrence of hepatocellular carcinoma (HCC) in late re-OLT. One and 2-year actuarial survival rates after re-OLT were 55.2% and 36.9%, respectively, for patients in early re-OLT, and 65.1% and 52% respectively, for patients in late re-OLT. No significant differences were found regarding survival rates between the two groups.Conclusions Similar clinical results can be achieved in early and late re-OLT. Proper indications and optimal operation timing, adequate preoperative preparation, experienced surgical procedures, and effective perioperative anti-infection strategy contribute to the

  15. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  16. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

    Directory of Open Access Journals (Sweden)

    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  17. Living Related Donor Kidney Transplantation in Libya: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Elusta Ahmed

    2008-01-01

    Full Text Available The aim of this study is to report the experience from a single center in Libya, on the prevailing live-related kidney transplantation program. The results of three years work on kidney transplantation at the Tripoli Central Hospital (National Organ Transplant Program in Libya were evaluated. The transplant program was launched on 17 th August, 2004 and 135 patients have been transplanted since then till 17 th August, 2007. All donors and recipients were screened thoroughly prior to transplant and monitored closely in the post-transplant period. Our immuno-suppressive protocol was cyclosporine-based. Among the 135 accepted pairs, donors and reci-pients were genetically-related in 133 cases (98.5% and emotionally-related in two others. The mean donor age was 37 ± 9.5 years (range 18-56 years and recipient age 37 ± 13.6 years (range 7-67 years. There were 95 males (70.4% and 40 females (29.6% among the recipients while among the donors, there were 102 males (75.6% and 33 females (24.4%. Delayed graft function was seen in three patients (2.2%, acute rejection in six (4.4%, post-transplant urinary tract infection in six (4.4%, pneumonia in three (2.2%, ureteric kink in two (1.5% and urine leak in four (3.0%. Graft survival at 36 months was 93.3% while patient survival at the same period was 96.3%. This report indicates that the results of our transplant program are good and comparable with other international programs.

  18. Laparoscopic splenectomy: a single center experience. Unusual cases and expanded inclusion criteria for laparoscopic approach.

    Science.gov (United States)

    Marte, Gianpaolo; Scuderi, Vincenzo; Rocca, Aldo; Surfaro, Giuseppe; Migliaccio, Carla; Ceriello, Antonio

    2013-06-01

    Laparoscopic splenectomy (LS) is nowadays considered as the gold standard for most hematological diseases where splenectomy is necessary, but many questions still remain. The aim of this study was to analyze our 5-years experiences consisting of 48 consecutive LS cases in order to assess the optimal approach and the feasibility of the procedure also in malignant diseases and unusual cases such as a primary spleen lymphoma, a big splenic artery aneurism, or a spleen infarct due to a huge pancreatic pseudo-cyst. Forty-eight consecutive patients underwent LS from January 2006 to January 2011 with at least 1-year follow-up. Clinical data and immediate outcome were retrospectively recorded; age, diagnosis, operation time, perioperative transfusion requirement, conversion rate, accessory incision, hospital stay, and complications were analyzed. We had 14 cases of malignant splenic disease, the most frequent malignant diagnosis was non-Hodgkin's lymphoma (12/14, 85.7 %). Splenomegaly (interpole diameter (ID) >20 cm) was observed in 12 cases (25 %) and massive splenomegaly (ID >25 cm) in 3 cases (6.25 %). Conversion to laparotomy occurred in two patients (4.16 %), both associated to uncontrollable bleeding in patients with splenomegaly. Mean operative time was 138 ± 22 min. Mean hospital stay was 4.5 days. Postoperative morbidity rate was 8.8 % for the benign group and 35.7 % in the malignant group. Mortality occurred in 1/48 patients (2.08 %), as a result of overwhelming post-splenectomy infection (OPSI). LS can be performed safely for malignant splenic disease and splenomegaly without any statistically significant increase of morbidity and mortality rate. Conversion rate is increased for massive splenomegaly. LS should be considered as the preferential approach even in patients with malignant disease, splenomegaly, or unusual cases. Massive splenomegaly should be considered as relative contraindication to LS even at experienced centers. PMID:23355349

  19. Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience

    Institute of Scientific and Technical Information of China (English)

    JIAO Li-qun; SONG Gang; LI Shen-mao; MIAO Zhong-rong; ZHU Feng-shui; JI Xun-ming; YIN Guo-yang

    2013-01-01

    Background Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies.This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed.Postoperative 30-day complication rates were analyzed and compared with those of other studies.Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction (MI),stroke,and death.Results The overall 30-day rate of MI,stroke,and death after CAS was 2.53%.In univariate analysis,patients who were symptomatic,had a neurological deficit (modified Rankin score (mRS) ≥3; P=0.001),and who were not taking statins experienced a significantly increased rate of MI,stroke,and death (P=-0.017).In multivariate Logistic regression analysis,the presence of symptoms (odds ratio (OR)=2.485; 95% confidence interval (CI)=1.267-4.876; P=0.008) and a neurological deficit (mRS ≥3) (OR=3.025; 95% CI=1.353-6.763; P=0.007) were independent risk factors for perioperative MI,stroke,and death.Conclusions According to this single-center experience,CAS may effectively prevent and treat carotid artery stenosis that would otherwise lead to stroke.Being symptomatic and having a neurological deficit (mRS ≥3) increased the risk of perioperative MI,stroke,and death.

  20. Outcome of deceased donor renal transplantation - A single-center experience from developing country

    Directory of Open Access Journals (Sweden)

    Himanshu V Patel

    2013-01-01

    Full Text Available Renal transplantation (RTx is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD. Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr, rejection episodes, and delayed graft function (DGF. Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%, diabetes (12.7%, and hypertension (10.6%. Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.

  1. Acute promyelocytic leukemia, study of predictive factors for Differentiation Syndrome, single center experience

    International Nuclear Information System (INIS)

    Reports about patients with acute promyelocytic leukemia from the Middle East are few; in this study we are reporting our single center experience of treating 29 patients over 6 years. Acute promyelocytic leukemia treatment response is markedly improved after the introduction of ATRA. Treatment related complication is still an important issue particularly Differentiation Syndrome. Prediction to its occurrence has been tried by other groups. We aimed to study all the possible predictive factors of acute promyelocytic leukemia. Our chemotherapy induction protocol is AIDA protocol which includes ATRA 45 mg/m2/d in divided doses every 12h, and Idarubicin 12 mg/ m2/d IV on days 3, 5, 7, and 9. Differentiation Syndrome occurred in 48.3% of patients and was mainly presented by pulmonary symptoms in 55.2%, 6 cases died during induction. None of the predictive factors studied showed a statistically significant difference between patients who developed Differentiation Syndrome and those who did not. Differentiation Syndrome did not affect overall survival. Cox regression showed an inverse yet a non significant association between PET- HEMA and overall survival probability (P = 0.168). In conclusion, Differentiation Syndrome has no clear predictive factor to date. The best approach is to hold ATRA and give dexamethasone which is quite effective as reported in the literature. PETHEMA risk model has a moderately significant prognostic value look for all possible predictive factors of Differentiation syndrome (DS) which were first described in 1992 by frankel et al. (4) and represented the major complication through this disease course: studies had reported conflicting results about this (5,6). In addition we will compare our data to other areas of the world

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

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2016-01-01

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

  3. 47. A cardiac center experience with Brugada syndrome who survived sudden cardiac death

    Directory of Open Access Journals (Sweden)

    I. Suliman

    2016-07-01

    Full Text Available Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern, here we describe 3 cases of Brugada who survived sudden cardiac death (SCD cardiac center experience with survived Brugada syndrome patients – case series. First Case: The Father 45 years old male, presented in 2005 after involvement in unprovoked motor vehicle accident, the patient was the driver who lost consciousness and rushed to the hospital. On arrival to our ER and putting the patient on the bed, the ER doctor observed a brief episode of VF on the monitor. The patient was taken to the catheterization Lab , his coronaries were normal. The diagnosis of Brugada was established and the patient received a defibrillator. At That Time all family members were screened and were negative. Second Case: The Son of the first patient 5 years later his 23 years old male rushed to our ER after he lost consciousness, he was passenger in the car of his friend. Third Case: The pilot A military pilot aged a male 35 years old was in very good health when he lost consciousness and brought to the hospital after resuscitation in 2005. He had full invasive cardiac evaluation, subsequently he received a defibrillator in the same admission period, till 2015 he is doing fine. Brugada syndrome is associated with high tendency for sudden cardiac death. In our three cases the first clinical presentation was survived sudden cardiac death (SCD and all three male patients survived. We did not encounter a female patient who survived sudden cardiac death.

  4. Spontaneous Resolution of Vesicoureteral Reflux (VUR in Iranian Children, a Single Center Experience in 533 Cases

    Directory of Open Access Journals (Sweden)

    B. Hatamian

    2009-06-01

    Full Text Available Background and ObjectivesExperience with vesicoureteral reflux (VUR differs in different centers and there are lots of controversies surrounding this issue. The aim of this study was to evaluate Spontaneous resolution and prognosis of the disease among Iranian children.MethodsIn this case series study, 1278 children with urinary tract infection and visited at pediatric nephrology clinic in Tehran, Iran during 1999-2007 were studied. Primary VUR was found in 533 Patients. Following the diagnosis, the patients received prophylactic antibiotic and were annually followed with radionucleo cystography (RNC. Patients underwent surgery in case the medical treatment failed (breakthrough infection or new renal scar formation.Results533 patients with VUR were studied. Patients’ mean age with VUR was 3.7±2.4 years (range: 2 days to 18 years old. During an average follow-up duration of 3.3+2.2 years, spontaneous resolution was observed in 40% of 279 patients who had follow-up RNCs. The mean interval between VUR diagnosis and spontaneous resolution was 1.5+ 1 years (range: 2 months to 6 years. The resolution rate was decreased with increment of reflux grade so that for grades I to V, VUR was resolved in 63%, 57%, 27%, 22% and 10% of the cases, respectively. Anti reflux surgery was performed in 27(10% of patients during follow-up.ConclusionBased on the excellent results obtained from clinical therapy using low dose antibiotics, it is recommended that VUR grades 1 to 4 be managed medically with low-dose oral antibiotic prophylaxis and close follow-ups.Keywords: Urinary Tract Infection; Vesico-Ureteral Reflux; Spontaneous Resolution; Child.

  5. Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications

    Directory of Open Access Journals (Sweden)

    Yazmin Yaacob

    2013-01-01

    Full Text Available Purpose: To report our early experience in image-guided chemoport insertions by interventional radiologists. Materials and Methods: This was a cross-sectional study conducted in a tertiary center with 161 chemoport insertions done from June 2008 to June 2010. The chemoports were inserted either at the angiography suite or at the mobile operation theater unit. Ninety percent of the chemoports had right internal jugular vein (IJV as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava. Immediate and early complications were recorded. All insertions were performed under image guidance with the aid of ultrasound and fluoroscopy. Results: The technical success rate was 99.4%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. Twenty-six early complications were recorded. The most common early complication was catheter blockage (12/161; 7.4%, followed by catheter-related infection (9/161; 5.6%. Other complications were catheter malposition, venous thrombosis and catheter dislodgement or leak. A total of 11 (6.8% chemoports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the angiography suite and the mobile operation theater unit. Conclusion: Image-guided chemoport insertion by interventional radiologist gives low periprocedural complication rates. Using right IJV as the entry site, the image guidance gives good success rate with least complication.

  6. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

    Directory of Open Access Journals (Sweden)

    Suhr OB

    2012-08-01

    Full Text Available Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have emerged based on increased insights into amyloid formation. With the increased possibilities for treatment of amyloidosis caused by transthyretin (TTR amyloid deposits comes the need for diagnostic procedures for early diagnosis and better tools to follow disease progression. This is of particular importance in clinical trials evaluating the efficacy of new treatments. Until recently, the treatment of TTR amyloidosis (ATTR was based solely on liver transplantation, a procedure that has halted disease progression in many patients. Liver transplantation has been especially effective in patients under the age of 50 years carrying the TTR V30M mutation, whereas the outcome of the procedure has been variable for others, particularly elderly male patients and those carrying a non-V30M mutation. This review concentrates on new insights derived from our center's experience with liver transplantation, how to implement this experience in evaluation of new treatment modalities for ATTR, and how to facilitate early diagnosis of neuropathy with easily available diagnostic tools. Attention has focused on manifestations of the disease that involve the heart and the peripheral nervous system; change in peripheral nerve function has been the primary endpoint in two controlled clinical trials, one finished and one ongoing. New insights into the amyloid formation process and the lessons learned from liver transplantation give the opportunity to design potentially effective treatment modalities for ATTR

  7. Recent study on μSR experiment. Muonium center in crystalline semiconductors under illumination

    International Nuclear Information System (INIS)

    Positive muon and muonium atom serve as pseudo-isotopes of proton and hydrogen, providing very sensitive probes to study the electronic structure and dynamics of hydrogen isotopes in the material where the hydrogen plays an essential role in determining its property. A recent study on muonium centers in crystalline semiconductors is reviewed as an example of such systems. We have found that the muonium center at the tetrahedral interstitial site (MuT) is rapidly converted into bond center muonium (MuBC) with supervening fast spin relaxation under illumination at lower temperatures, evidensing that the bond center site is the ground state for the muonium while MuT is a metastable center. (author)

  8. Status of the Ultracold neutron source upgrade at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Pattie, Robert Wayne Jr. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-10-31

    Several slides show the source and flux of ultracold neutrons produced. In summary, an upgraded UCN source has been designed, and parts are currently being fabricated. Nickel phosphorus-coated guides will improve transport to the experiment hall. The source will be installed in the spring of 2016 and commissioned in the fall of 2016.

  9. Young-type experiment using a single-electron source and an independent atomic-size two-center interferometer.

    Science.gov (United States)

    Chesnel, J-Y; Hajaji, A; Barrachina, R O; Frémont, F

    2007-03-01

    Evidence is given for Young-type interferences caused by a single electron acting on a given double-center scatterer analogous to an atomic-size double-slit system. The electron is provided by autoionization of a doubly excited He atom following the capture of the electrons of H2 by a He2+ incoming ion. The autoionizing projectile is a single-electron source, independent of the interferometer provided by the two H+ centers of the fully ionized H2 molecule. This experiment resembles the famous thought experiment imagined by Feynman in 1963, in which the quantum nature of the electron is illustrated from a Young-like double-slit experiment. Well-defined oscillations are visible in the angular distribution of the scattered electrons, showing that each electron interferes with itself. PMID:17358516

  10. Staff's experiences of a person-centered health education group intervention for people with a persistent mental illness.

    Science.gov (United States)

    Jormfeldt, Henrika; Brunt, David Arthur; Rask, Mikael; Bengtsson, Agneta; Svedberg, Petra

    2013-07-01

    Patient education in mental health care is a conventional intervention to increase patients' knowledge about their illness and treatment. A provider-centered focus in patient education may put patients in a passive role, which can counteract their processes of recovery. There is an increasing emphasis on recovery-oriented practice, an approach that is aligned with the service user perspective, but little is known about health care staff's perspectives on person-centered mental health care. A qualitative approach was used to describe staff's experiences of being group leaders in a person-centered health education intervention in municipal services for persons with a persistent mental illness. The analysis of staff experiences revealed three core categories: (1) implications of the division of responsibility among local authorities, (2) awareness of facilitating factors of growth, and (3) the meaning of dialogue. These formed the theme Preconditions for Person-Centered Care. Further research is required to explore larger economic, political, and social structures as backdrops to person-centered mental health care, from the perspective of service users, families, health professionals, and the community at large. PMID:23875550

  11. Centering Ability and Influence of Experience When Using WaveOne Single-File Technique in Simulated Canals

    Directory of Open Access Journals (Sweden)

    Mathieu Goldberg

    2012-01-01

    Full Text Available Introduction. WaveOne is a single endodontic instrument that reciprocates with a dedicated motor to shape root canal systems. The present study assessed the centering ability of this simplified protocol along with the effect of experience in simulated plastic canals. Methods. One experienced operator shaped two groups of simulated canals. Groups 1 and 3 each comprised 30 blinded L-shaped canals or S-shaped canals, respectively. Photographs were taken before and after shaping and digitally assessed centering after superimposition of the pictures. Time of shaping, number of passes, canal aberrations, and instrument degradation were recorded. In group 2 shaping was done on 30 blinded L-shaped canals by 30 different students with no prior experience with WaveOne. Results. All three groups yielded satisfactory, reproducible shaping. Centering ratios were low and homogeneous in all groups, with no significant differences between the experienced operator and the students. Apical transportation values were very low (≤0.138 mm with no instances of blockage or separation. The average shaping time was short (43 to 101,6 sec. Conclusions. Within the limits of the study, the WaveOne instrument had excellent centering ability with a low risk of fracture or blockage and a short shaping time, regardless of the operator’s level of experience.

  12. Spent fuel storage facility at science and technical center 'Sosny': Experience of ten years activity

    International Nuclear Information System (INIS)

    Spent fuel storage of the Academic Science and Technical Center in Minsk is in operation already more then 10 years. In the paper aspects of its design, operation practice, problems and decisions for future are discussed. (author)

  13. Culturally Focused Community-Centered Service Learning: An International Cultural Immersion Experience

    Science.gov (United States)

    Tomlinson-Clarke, Saundra M.; Clarke, Darren

    2010-01-01

    An immersion training model is described that incorporates culturally focused community-centered service in South Africa as an experiential learning approach. Recommendations for developing international cultural immersion training with a goal of developing cultural competencies are suggested.

  14. Treatment of patients with metastatic pancreatic cancer: Experience from a tertiary Indian cancer center

    OpenAIRE

    Sirohi, B; S Dawood; S. Rastogi; Pandey, A.; Bal, M; N Shetty; Shrikhande, S. V.

    2015-01-01

    Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS) was computed using the Kaplan–Meir product limit method and compared across groups using the...

  15. An Academic Medical Center Experience with a Computerized Hospital Information System: The First Four Years

    OpenAIRE

    Reynolds, Robert E.; Heller, Edward E.

    1980-01-01

    Rush-Presbyterian-St. Luke's Medical Center (RPSLMC) obtained and implemented an on-line, real time medical information system (MIS), SPECTRA 2000, in 1976 in its branch hospital, the Sheridan Road Pavilion. After several years of successful operation and minor modifications, the system was evaluated with regard to installing it throughout the rest of the RPSLMC. A group of specified enhancements were outlined to make the system suitable to the needs of the large academic medical center. Impl...

  16. Selecting a commercial clinical information system: an academic medical center's experience.

    OpenAIRE

    Wong, E.T.; Abendroth, T. W.

    1994-01-01

    Choosing a commercial clinical information system to meet the information needs of patient care, research, education, administration, finance, and ongoing changes of the healthcare system of an academic medical center is a challenging task. For the past six months, The Milton S. Hershey Medical Center undertook this task through (i) establishing a task force, (ii) assessing end-user information needs, (iii) understanding future institutional development and strategies, (iv) conceptualizing th...

  17. Upgrades to the Polarized Neutron Reflectometer Asterix at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Pynn, Roger

    2015-03-16

    We have upgraded the polarized neutron reflectometer, Asterix, at the Lujan Neutron Scattering Center at Los Alamos for the benefit of the research communities that study magnetic and complex-fluid films, both of which play important roles in support of the DOE’s energy mission. The upgrades to the instrument include: • A secondary spectrometer that was integrated with a Huber sample goniometer purchased with other funds just prior to the start of our project. The secondary spectrometer provides a flexible length for the scattered flight path, includes a mechanism to select among 3 alternative polarization analyzers as well as a support for new neutron detectors. Also included is an optic rail for reproducible positioning of components for Spin Echo Scattering Angle Measurement (SESAME). The entire secondary spectrometer is now non-magnetic, as required for neutron Larmor labeling. • A broad-band neutron polarizer for the incident neutron beam based on the V geometry. • A wide-angle neutron polarization analyzer • A 2d position-sensitive neutron detector • Electromagnetic coils (Wollaston prisms) for SESAME plus the associated power supplies, cooling, safety systems and integration into the data acquisition system. The upgrades allowed a nearly effortless transition between configurations required to serve the polarized neutron reflectometry community, users of the 11 T cryomagnet and users of SESAME.

  18. Retinoblastoma: experience of a referral center in the North Region of Portugal

    Directory of Open Access Journals (Sweden)

    Rocha-Bastos R

    2014-05-01

    Full Text Available RA da Rocha-Bastos,1 JR Araújo,1 RS Silva,2 MJ Gil-da-Costa,2 E Brandão,1 NJ Farinha,2,3 F Falcão-Reis,1,4 T Dinah-Bragança1 1Department of Ophthalmology, Hospital São João, 2Hematology and Oncology Unit, Pediatric Hospital, Hospital São João, 3Pediatrics Department, Faculty of Medicine, University of Porto, 4Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To describe the experience of the Ophthalmology Department of Hospital São João (HSJ, a tertiary health care center in North Region, Portugal, in terms of the diagnosis, treatment, and follow-up of retinoblastoma. Methods: This was a retrospective study of patients diagnosed with retinoblastoma in Hospital São João, between 1978 and 2012. Results: Fifty patients with retinoblastoma were evaluated in our institution between 1978 and 2012. Four patients were excluded due to loss of follow-up. Among the 46 retinoblastoma cases, 33 (71.7% were unilateral and 13 (28.3% bilateral, with a mean age at diagnosis of 22.19 months and 6.92 months, respectively (P<0.001. Leukocoria was the most common presenting sign (36.9%, followed by strabismus (19.6%, a combination of leukocoria and strabismus (8.7%, and buphthalmia (2.2%. Between 1978 and 1992, nine retinoblastoma cases were referred to our hospital, all of them unilateral, and, in each case, enucleation was performed, with or without salvage therapy. Between 1993 and 2012, 18 eyes with retinoblastoma were successfully managed with conservative treatment. Conclusion: Demographic results were generally coincident with previous reports. It is crucial to screen leukocoria in pediatric practice, even in asymptomatic children. The outcome of retinoblastoma treatment in our hospital is similar to other series in developed countries. Keywords: retinoblastoma, leukocoria, strabismus, enucleation, pediatric cancer

  19. Axial lumbar interbody fusion: a 6-year single-center experience

    Directory of Open Access Journals (Sweden)

    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  20. Spontaneous Resolution of Vesicoureteral Reflux (VUR in Iranian Children, a Single Center Experience in 533 Cases

    Directory of Open Access Journals (Sweden)

    M Sharifian

    2012-05-01

    Full Text Available

    Background and Objectives

    Experience with vesicoureteral reflux (VUR differs in different centers and there are lots of controversies surrounding this issue. The aim of this study was to evaluate Spontaneous resolution and prognosis of the disease among Iranian children.

     

    Methods

    In this case series study, 1278 children with urinary tract infection and visited at pediatric nephrology clinic in Tehran, Iran during 1999-2007 were studied. Primary VUR was found in 533 Patients. Following the diagnosis, the patients received prophylactic antibiotic and were annually followed with radionucleo cystography (RNC. Patients underwent surgery in case the medical treatment failed (breakthrough infection or new renal scar formation.

     

    Results

    533 patients with VUR were studied. Patients’ mean age with VUR was 3.7±2.4 years (range: 2 days to 18 years old. During an average follow-up duration of 3.3+2.2 years, spontaneous resolution was observed in 40% of 279 patients who had follow-up RNCs. The mean interval between VUR diagnosis and spontaneous resolution was 1.5+ 1 years (range: 2 months to 6 years. The resolution rate was decreased with increment of reflux grade so that for grades I to V, VUR was resolved in 63%, 57%, 27%, 22% and 10% of the cases, respectively. Anti reflux surgery was performed in 27(10% of patients during follow-up.

     

    Conclusion

    Based on the excellent results obtained from clinical therapy using low dose antibiotics, it is recommended that VUR grades 1 to 4 be managed medically with low-dose oral antibiotic prophylaxis and close follow-ups.

  1. Alternative funding for academic medicine: experience at a Canadian Health Sciences Center.

    Science.gov (United States)

    Rosenbaum, Paul; Shortt, S E D; Walker, D M C

    2004-03-01

    In 1994 the School of Medicine of Queen's University in Kingston, Ontario, its clinical teachers, and the three principal teaching hospitals initiated a new approach to funding, the Alternative Funding Plan, a pragmatic response to the inability of fee-for-service billing by clinical faculty to subsidize the academic mission of the health sciences center. The center was funded to provide a package of service and academic deliverables (outputs), rather than on the basis of payment for physician clinical activity (inputs). The new plan required a new governance structure representing stakeholders and raised a number of important issues: how to reconcile the preservation of physician professional autonomy with corporate responsibilities; how to gather requisite information so as to equitably allocate resources; and how to report to the Ontario Ministry of Health and Long-term Care in order to demonstrate accountability. In subsequent iterations of the agreement it was necessary to address issues of flexibility resulting from locked-in funding levels and to devise meaningful performance measures for departments and the center as a whole. The authors conclude that the Alternative Funding Plan represents a successful innovation in funding for an academic health sciences center in that it has created financial stability, as well as modest positive effects for education and research. The Ontario government hopes to replicate the model at the province's other four health sciences centers, and it may have applicability in any jurisdiction in which the costs of medical education outstrip the capacity of faculty clinical earnings. PMID:14985191

  2. Min Bei Irradiation Center. Food and Agriculture organization project experience, Jianou, Fujian Province, China

    International Nuclear Information System (INIS)

    The Food and Agriculture Organization (FAO), a United Nations Organization, in an effort to increase food supplies by post harvest irradiation treatment, participated in the development of the Min Bei Irradiation Center (MBIC) located in Fujian Province, China. FAO in conjunction with Shanghai Nuclear Energy Research and Design Institute (SNERDI), MBIC staff, and the Ministry of Agriculture completed Project TCP CPR 6763/8961 culminating in the recent commissioning of one of China's newest irradiation facilities. From the feasibility phase initiated in 1986, through the construction period and the eventual commissioning in 1991, FAO participated in the technical overview of the irradiation center. MBIC was developed both as a research and development center as well as a production irradiation facility for the primary purpose of reduction of post harvest food loss in Fujian Province. This retrospective review of the project provides a hindsight view for the development of MBIC. (author)

  3. Measuring User Experience of the Student-Centered e-Learning Environment

    Science.gov (United States)

    Santoso, Harry B.; Schrepp, Martin; Isal, R. Yugo Kartono; Utomo, Andika Yudha; Priyogi, Bilih

    2016-01-01

    The aim of the current study is to develop an adapted version of User Experience Questionnaire (UEQ) and evaluate a learning management system. Although there is a growing interest on User Experience, there are still limited resources (i.e. measurement tools or questionnaires) available to measure user experience of any products, especially…

  4. Experiences of CFD simulations at Foster Wheeler Energia Oy`s Karhula R and D center

    Energy Technology Data Exchange (ETDEWEB)

    Hyppaenen, T. [Foster Wheeler Energia Oy, Karhula (Finland). Karhula R and D Center

    1996-12-31

    Karhula R and D Center is specialized in the research of solid fuel combustion based on circulating fluidized bed technology. Since the 1970`s, numerical models have been utilized in process development to enhance fundamental understanding of the technology. Both own and commercial computer models have been used. Until now, a special problem in circulating fluidized beds has been the modeling of dense phase multiphase flow, especially for industrial solid-fuel boilers. This has prevented the Karhula R and D Center from using commercial codes, and as a consequence, own modeling approaches have been necessary. This presentation describes some main points of the modeling activities in circulating fluidized bed boilers. (author)

  5. Multi-objective particle swarm and genetic algorithm for the optimization of the LANSCE linac operation

    International Nuclear Information System (INIS)

    Particle swarm optimization (PSO) and genetic algorithm (GA) are both nature-inspired population based optimization methods. Compared to GA, whose long history can trace back to 1975, PSO is a relatively new heuristic search method first proposed in 1995. Due to its fast convergence rate in single objective optimization domain, the PSO method has been extended to optimize multi-objective problems. In this paper, we will introduce the PSO method and its multi-objective extension, the MOPSO, apply it along with the MOGA (mainly the NSGA-II) to simulations of the LANSCE linac and operational set point optimizations. Our tests show that both methods can provide very similar Pareto fronts but the MOPSO converges faster

  6. Multi-objective particle swarm and genetic algorithm for the optimization of the LANSCE linac operation

    Energy Technology Data Exchange (ETDEWEB)

    Pang, X., E-mail: xpang@lanl.gov; Rybarcyk, L.J.

    2014-03-21

    Particle swarm optimization (PSO) and genetic algorithm (GA) are both nature-inspired population based optimization methods. Compared to GA, whose long history can trace back to 1975, PSO is a relatively new heuristic search method first proposed in 1995. Due to its fast convergence rate in single objective optimization domain, the PSO method has been extended to optimize multi-objective problems. In this paper, we will introduce the PSO method and its multi-objective extension, the MOPSO, apply it along with the MOGA (mainly the NSGA-II) to simulations of the LANSCE linac and operational set point optimizations. Our tests show that both methods can provide very similar Pareto fronts but the MOPSO converges faster.

  7. Experiences of Multidisciplinary Development Team Members During User-Centered Design of Telecare Products and Services: A Qualitative Study

    OpenAIRE

    Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura MJ; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P.

    2014-01-01

    Background User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. Objective The primary objective of this study was t...

  8. Immediate thoracotomy for penetrating injuries: ten years’ experience at a Dutch level I trauma center

    OpenAIRE

    Waes, Oscar; Riet, Priscilla; Lieshout, Esther; Hartog, Dennis

    2012-01-01

    textabstractBackground: An emergency department thoracotomy (EDT) or an emergency thoracotomy (ET) in the operating theater are both beneficial in selected patients following thoracic penetrating injuries. Since outcome-descriptive European studies are lacking, the aim of this retrospective study was to evaluate ten years of experience at a Dutch level I trauma center. Method: Data on patients who underwent an immediate thoracotomy after sustaining a penetrating thoracic injury between Octobe...

  9. Single-center experience in pediatric renal transplantation using thymoglobulin induction and steroid minimization.

    Science.gov (United States)

    Warejko, Jillian K; Hmiel, S Paul

    2014-12-01

    Our center has offered thymoglobulin induction with steroid minimization to our pediatric renal transplant patients for the last 10 yr. Steroid minimization or avoidance has shown favorable results in survival, kidney function, and growth in previous studies of pediatric patients. We report our experience with this protocol over the past 10 yr with respect to patient/graft survival, acute rejection episodes, renal function, linear growth, bone density, cardiovascular risk factors, and opportunistic infections. A retrospective chart review was performed for pediatric renal transplant patients on the steroid-minimized protocol between January 2002 and December 2011 on an intention to treat basis. Patient demographics, height, weight, serum creatinine, iGFR, biopsies, and survival data were collected. Height and weight z-scores were calculated with EpiInfo 7, using the CDC 2000 growth charts. Survival was calculated using Kaplan-Meier analysis. eGFR was calculated using the original and modified Schwartz equations. Forty-four pediatric patients were identified, aged 13 months to 19 yr. Five-yr survival was 95.5% for males and 94.4% for females. Only five patients had biopsy-proven ACR, two of which were at more than 12 months post-transplantation. Height delta z-scores from transplant to one, three, and five yr were 0.34, 0.38, and 0.79, respectively. Weight delta z-scores from transplant to one, three, and five yr were 0.87, 0.79, and 0.84, respectively. Mean original Schwartz eGFR was 84.3 ± 15.8 mL/min/1.73 m(2) , modified Schwartz eGFR was 59.3 ± 11.5 mL/min/1.73 m(2) , and iGFR was 64.2 ± 8.5 mL/min/1.73 m(2) at three yr. Of 18 subjects who had a bone density exam, none had a z-score less than -2 on DEXA exam at one-yr post-transplantation. Fifty-one percent of patients were on antihypertensives at the time of transplant compared with 43% at one-yr post-transplantation. Three yr post-transplantation, the average LDL was <100 mg/dL, and

  10. Intergenerational Learning at a Nature Center: Families Using Prior Experiences and Participation Frameworks to Understand Raptors

    Science.gov (United States)

    Zimmerman, Heather Toomey; McClain, Lucy Richardson

    2014-01-01

    Using a sociocultural framework to approach intergenerational learning, this inquiry examines learning processes used by families during visits to one nature center. Data were collected from videotaped observations of families participating in an environmental education program and a follow-up task to draw the habitat of raptors. Based on a…

  11. Bacteremia in Cancer Patients: A Two Center Experience of Isolates and Spectrum of Antibiotic Resistance Pattern

    OpenAIRE

    Naseh; Marashi; Asgari; Aghabarari; Mahmudi; Asadi; Hatami; Kalantar

    2015-01-01

    Background; Bacteremia is a frequent condition in cancer patients with a significant morbidity and mortality worldwide, which is a medical crisis that needs broad-spectrum antibiotic treatment. Objectives This study examined bacteremia in cancer patients from two medical centers regarding isolates and spectrum of antibiotic resistance pattern. Patients and Methods This was a prospe...

  12. Social and Architectural Aspects of Revitalization of Historic Urban Centers: Foreign Experience

    Directory of Open Access Journals (Sweden)

    Indrė Gražulevičiutė-Vileniškė

    2011-03-01

    Full Text Available The structure and architecture of many European cities has started their development during the Middle Ages or even earlier. The historic cores gradually had become centers of contemporary cities and are constantly evolving. They are affected by the tendencies of destruction, initiatives and movements of preservation are also taking place there. The comprehensive works of rehabilitation of Lithuanian historic urban centers were carried out during the period of soviet occupation. The insularity of the Soviet empire, ideological reasons and the absence of the private property has determined certain architectural expressions and solutions for the social problems. After the restoration of the country‘s independence the problems and tendencies typical to Western city centers, such as commercialization and gentrification, started to appear in Lithuanian historic urban cores. This justifies the aim of the article which is to analyze the tendencies of revitalization of historic city centers in Western countries with the main attention to the social and architectural aspects.Article in Lithuanian

  13. The Structure and Functioning of a Low-Budget Center for Applied Linguistics: The Brazilian Experience.

    Science.gov (United States)

    Gomes de Matos, Francisco

    1980-01-01

    Describes the structure and functioning of the "Centro de Linguistica Aplicada do Instituto de Idiomas Yazigi" of Sao Paulo and comments on its role in promoting applied linguistics studies in Latin America. Also outlines the Center's historical background and its educational services, particularly those related to the teaching of English. (MES)

  14. Family Centered Health Care--A Viable Reality? The Denver Experience.

    Science.gov (United States)

    Cowen, David L:; Sbarbaro, John A.

    In early 1966, the Denver Department of Health and Hospitals embarked on a city-wide, decentralized health program in an effort to provide family centered "team" health care to medically indigent patients. The program encompasses 28 different clinics and facilities. Factors hindering or influencing the final pattern of health care delivery…

  15. Understanding and Engagement in Places of Science Experience: Science Museums, Science Centers, Zoos, and Aquariums

    Science.gov (United States)

    Schwan, Stephan; Grajal, Alejandro; Lewalter, Doris

    2014-01-01

    Science museums, science centers, zoos, and aquariums (MCZAs) constitute major settings of science learning with unique characteristics of informal science education. Emphasis will be given to the analysis of four specific characteristics of MCZAs that seem relevant for educational research and practice, namely, conditions of mixed motives and…

  16. A Proposed Experiment to Study Relaxation Formation of a Spherical Tokamak with a Plasma Center Column

    CERN Document Server

    Hsu, S C

    2006-01-01

    A spherical tokamak (ST) with a plasma center column (PCC) can be formed via driven magnetic relaxation of a screw pinch plasma. An ST-PCC could in principle eliminate many problems associated with a material center column, a key weakness of the ST reactor concept. This work summarizes the design space for an ST-PCC in terms of flux amplification, aspect ratio, and elongation, based on the zero-beta Taylor-relaxed analysis of Tang & Boozer [Phys. Plasmas 13, 042514 (2006)]. The paper will discuss (1) equilibrium and stability properties of the ST-PCC, (2) issues for an engineering design, and (3) key differences between the proposed ST-PCC and the ongoing Proto-Sphera effort in Italy.

  17. Post–Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

    DEFF Research Database (Denmark)

    Ambrus, R B; Svendsen, Lars Bo; Hillingsø, J G;

    2015-01-01

    BACKGROUND: Complications in the biliary tract occur in 5%-30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation...... patients are not well described. Our objective was to define the frequency of post-ERCP complications in liver transplantation patients at the Abdominal Center, Rigshospitalet, the only Liver Transplantation Center in Denmark. METHODS: Retrospective study of all ERCPs performed in liver transplantation...... cholangitis occurred after two procedures, respectively. Multivariate analysis concerning overall complications identified biliary sphincterotomy (p = 0.006) and time since liver transplantation within 90 days postoperatively (p = 0.044) as risk factors for post-ERCP complications. Specifically concerning...

  18. Clinical Characteristics of Bowel Obstruction in Southern Iran; Results of a Single Center Experience

    OpenAIRE

    Majid Akrami; Ali Ghaeini Hesarooeih; Maryam Barfei; Vahid Zangouri; Zahra Alborzi

    2015-01-01

    Objective: To determine the epidemiological, clinical, laboratory characteristics as well as outcome of 411 patients with bowel obstruction in Southern Iran. Methods: This was a cross-sectional study being performed in Shahid Faghihi hospital of Shiraz between 2006 and 2012. We reviewed the medical charts of the 411 patients with initial diagnosis of bowel obstruction who were admitted to our center during the study period. The patients’ demographic, clinical and laboratory findings as wel...

  19. Short-term Outcome of Open Appendectomy in Southern Iran: A Single Center Experience

    OpenAIRE

    Shahram Bolandparvaz; Fariborz Ghaffarpasand; Hamid Reza Abbasi; Armin Akbarzadeh; Alireza Manafi; Parisa Javidi Parsijani; Shahram Paydar

    2013-01-01

    Objectives: To evaluate the short-term outcome of open appendectomy, the rate of negative appendectomy as well as pathology reports after surgery in patients with suspected acute appendicitis.Methods: This was a retrospective cross-sectional study being performed in Nemazee hospital affiliated with Shiraz University of Medical Science during a 2-year period between 2008 and 2010. The medical records of all consecutive patients who underwent open appendectomy in our center due to acute appendi...

  20. Robotic Mobile Manipulation Experiments at the U.S. Army Maneuver Support Center

    Energy Technology Data Exchange (ETDEWEB)

    BENNETT, PHIL C.; ANDERSON, ROBERT J.

    2002-06-01

    This activity brought two robotic mobile manipulation systems developed by Sandia National Laboratories to the Maneuver Support Center (MANSCEN) at Ft. Leonard Wood for the following purposes: Demonstrate advanced manipulation and control capabilities; Apply manipulation to hazardous activities within MANSCEN mission space; Stimulate thought and identify potential applications for future mobile manipulation applications; and Provide introductory knowledge of manipulation to better understand how to specify capability and write requirements.

  1. Aligning Incentives in Orthopaedics: Opportunities and Challenges—the Case Medical Center Experience

    OpenAIRE

    Marcus, Randall E.; Zenty, Thomas F.; Adelman Esq., Harlin G.

    2009-01-01

    For 30 years, the orthopaedic faculty at Case Western Reserve University worked as an independent private corporation within University Hospitals Case Medical Center (Hospital). However, by 2002, it became progressively obvious to our orthopaedic practice that we needed to modify our business model to better manage the healthcare regulatory changes and decreased reimbursement if we were to continue to attract and retain the best and brightest orthopaedic surgeons to our practice. In 2002, our...

  2. Sports hernia: the experience of Baylor University Medical Center at Dallas

    OpenAIRE

    Preskitt, John T.

    2011-01-01

    Groin injuries in high-performance athletes are common, occurring in 5% to 28% of athletes. Athletic pubalgia syndrome, or so-called sports hernia, is one such injury that can be debilitating and sport ending in some athletes. It is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor occurring with athletic activity. Over the past 12 years, we have operated on >100 patients with this injury at Baylor University Medical Center at Dallas. These patients...

  3. Lupus and Pregnancy. 15 Years of Experience in a Tertiary Center

    OpenAIRE

    Ambrósio, P; Lermann, R; Cordeiro, A.; Borges, A.; Nogueira, I.; Serrano, F.

    2010-01-01

    This retrospective study was designed to evaluate the outcome of pregnancies in women diagnosed with systemic lupus erythematosus (SLE) followed in a tertiary fetal–maternal center. Data were collected from clinical charts between January 1993 and December 2007, with a total of 136 pregnancies (107 patients). Mean maternal age was 29 years, with the vast majority of patients being Caucasian. Most patients were in remission 6 months prior to pregnancy (93%) and the most frequently affect...

  4. Various anatomic locations of surgically proven endometriosis: A single-center experience

    OpenAIRE

    Lee, Hyun Ju; Park, Ye Mi; Jee, Byung Chul; Kim, Yong Beom; Suh, Chang Suk

    2015-01-01

    Objective To report the various anatomic locations of surgically and pathologically proven endometriosis. Methods Pathologic reports (n=1,376) of women who underwent surgeries at a single center between April 2005 and March 2013 were retrieved from the electronic medical record system of the hospital. Pathologic reports were included after performing a search by using the key-words "endometrial cyst," "endometriotic cyst," "endometriosis," or "endometrioma." Only reports dealing with female p...

  5. Sensory Stimuli and their Meaning for the Consumer: Investigating an Atmosphere of Service Centered on Experience

    Directory of Open Access Journals (Sweden)

    Edvan Cruz Aguiar

    2014-11-01

    Full Text Available The research sought to identify the meanings attributed by consumers to sensory stimuli in an atmosphere of service centric experience. From a qualitative approach, the case study method with phenomenological inspiration was used. Through techniques of observation, interview, analysis of content and discourse, it was possible to characterize the case and apprehend the consumer perception related to their consumption experience. Although be intrinsic to the individual as to the interpretation of consumption experience, from sensory stimuli, there was a sharing of meanings, which implies the success of the case investigated when establishing its atmosphere and proposal experience. The work contributes to a better understanding of the influence of store atmosphere on consumer behavior and provides an alternative perspective to the investigation of consumption experience phenomenon in retailing contexts. 

  6. Congenital cystic lesions of the lungs: The perils of misdiagnosis - A single-center experience

    Directory of Open Access Journals (Sweden)

    V Shankar Raman

    2015-01-01

    Full Text Available Background: A majority of cystic lesions in the western world are detected antenatally, whereas, the diagnosis in our setup occurs once the child becomes symptomatic. Surgical management is primarily dictated by the presence of symptoms, recurrent infection, and rarely by the potential risk of malignant transformation. Materials and Methods: A retrospective analysis was carried out on all consecutive patients with cystic lung lesions managed at our center from January 2000 through June 2011 for antenatal diagnosis, presentation, diagnostic modalities, treatment, and complications. Results: Forty cystic lung lesions were identified. Only 8% were antenatally detected. Out of 40, the final diagnosis was congenital cystic adenomatoid malformation in 19, congenital lobar emphysema in 11, and bronchogenic cysts and pulmonary sequestration in five each. Of these, 20% had received a course of prior antitubercular therapy and 30% had an intercostal drain inserted prior to referral to our center. Postoperative morbidity in the form of bronchopleural fistula, pneumothorax, and non-expansion of the residual lung was noted in 10% of the patients. Conclusion: Antenatal diagnosis of these lesions is still uncommon in third world countries. Prior to referral to a pediatric surgical center a large number of patients received antitubercular drugs and an intercostal drain insertion, due to incorrect diagnosis.

  7. Can record and verify systems eliminate radiotherapy delivery errors? The Rambam Medical Center experience

    International Nuclear Information System (INIS)

    Full text: The use of record and verify (R and V) systems in radiotherapy departments has been well known for a long period of time. These tools, originally created for recording and verifying radiation field parameters, have developed into comprehensive systems that now allow for completely paper-less radiotherapy clinics. In the Radiotherapy Unit at Rambam Medical Center, 190 patients are treated daily (08:00- 19:00) with four linear accelerators (linacs). During the last two years, three of our accelerators (ELEKTA Precise, VARIAN 600C and VARIAN 1800) have been connected to the IMPAC MultiAccess system. Because of technology differences between the accelerators, the implementation and connection to the IMPAC system was not identical for the different linacs. However, in all cases, recording and verification of treatment parameters were possible. Twenty palliative patients are treated on a Varian 6-100 machine that was not connected to the IMPAC system because of its old technology and planned replacement. We also expected that administrative aspects, such as patient's treatment scheduling, would be improved. The implementation of the system was not meant to replace our 'paper' radiotherapy chart but to be used in parallel with it. As a result we expected an increase in the workload of the staff involved in the treatment planning and delivery process. Until the introduction of the system, the workflow of the patient's treatment parameters was as follows: I - Treatment dose is prescribed by the physician and written in the chart; II - Treatment plan is performed (2D or 3D), and all treatment parameters (setup and dosimetry) are defined/calculated by the technologist/physicist or dosimetrist and written in the chart; III - Treatment dosimetric parameters are checked by a senior physicist; IV - Treatment setup parameters are checked by a senior technologist; V - Treatment is delivered and manually recorded. In the above described process, we can find several weak

  8. Communication for heath behavior change: experiences lived at the Center for Communication Programs at Johns Hopkins University.

    Directory of Open Access Journals (Sweden)

    Ana Carolina de Oliveira Monteiro dos SANTOS

    2016-01-01

    Full Text Available Sharing experiences is the best way to learn and contribute to the construction of knowledge. It is with this intention that arises this article, a result of the lived experience of the author in workshop taught by the Center for Communication Programs - CCP (Communication Programs Center at Johns Hopkins University in Baltimore, USA, in June 2014. In this workshop intensive of 20 days, with daily classes full-time, the author had the opportunity to study and share experiences with great thinkers and professionals from Johns Hopkins. This promoted contact with the philosophy of the institution and the methodologies they developed and implemented in countries around the world, in order to promote improvements in the health status of populations through strategic planning focused on behavior change communication. This was an experience not just in study and planning communication, but a leadership training experience, withmore aware, engaged and complete professionals and, above all, of self-knowledge and personal growth. An article would not be enough to describe all this experience, so we chose to focus on issues about the institution’s vision on health, the practice of health communication, behavior change and an overview of the essential aspects the methodology developed and used by them, called P process. In this article, the reader will come across a breach of academic theoretical reflections promoted by further technical discussions practices, managerial characteristics. This ends up reflecting the logic implemented by the CCP, which develops the practice based on a broad theoretical framework. And in the same way that the institution does not close in their theories and allows to reinvent itself, this article will also feature the author’s own reflections about some of the issues presented.

  9. Environmental center for integrated waste management: an experience in the Amazon

    Energy Technology Data Exchange (ETDEWEB)

    Jaramillo V, Jairo; Banalcazar, Fernando L.; Noboa Garcia, Gabriel [EnCanEcuador S.A., Houston, TX (United States)

    2004-07-01

    The creation of a large amount of both solid and liquid waste within the petroleum industry should be the reason for providing a facility that makes it possible to apply proper treatment to the waste matter, depending on the degree of complexity, especially if these operations are taking place within or in the area of influence of a national park or a biosphere reserve. EnCanEcuador has invested $1 200,000 in the construction of facilities and equipment for an integrated environmental management center, which will allow us to create in-house resources for the management of waste control. Organic waste is grinded, homogenized with sawdust and placed in a dynamic sanitary fill to form fertilizer. The leachates material will be used as foliage fertilizer. Inorganic waste is classified, grinded, compacted, packed and sent to different recycling companies or in some cases incinerated in a low emission incinerator. Drilling waste: Drilling mud water based potassium nitrate is treated through a de-nitrification process using bioremediation methods. Liquid waste: from well completion, washing vehicles, drains from production stations, is passed through an API separator system into two physical-chemical treatment pits for its later re-injection. Contaminated soil: that may be caused by petroleum activity is treated in a pit where the greatest possible amount of hydrocarbon is recovered by means of hot hydro-washing and is then treated with native bacteria in two land farming centers. Dangerous solid waste is transported to a secure fill for its confinement. Laboratory and Meteorological Station: For the control and monitoring of petroleum activities and to determine climatic variations. Plant nursery: it will have a capacity to produce 300,000 plants a year. Community Cooperatives will manage the center, enforcing our Social responsibility in our daily activities. (author)

  10. Experience in procurement and processing of heart valves at the Northwest Tissue Center

    International Nuclear Information System (INIS)

    The Northwest Tissue Center established a human heart valve program in 199 1. It is one of four non-profit tissue banks and one for-profit program that recover and process heart valves in the United States. During the eight years in which the Northwest Tissue Center has been involved in heart valve banking, there have been a total of 673 hearts procured for processing. The age of the donors ranged from <1 to 44 years with a mean of 26.2 years, 66% werw male,and 6.5% of the hearts procered were discarded due to a variety of medical and criteria reason. The primary reasons for differal were questions of possible cancer and questions of high risk behavior/social history. Of the 1,264 cardiovascular tissues processed, 6% were lost because of donor history, 17% were lost because of microbiology results, and 5% were lost because of donor serology . There were total a total of 190 aortic valves and 48 pulmonic conduits transplanted over this time period. The mean age of the recipients was 23.4 with a median or 23 years; 102 of the recipients were less than one year of age. Males comprised 62% of the recipients. Since 1993, there has been a clear shift towards more use of pulmonic valves over aortic valves as a results of the acceptance of the Ross procedure. Early in the program, reports were received from surgeons that some heart valves appeared to have cracks in the conduits. Experimentations in the laboratory led to the discovery that thawing too rapidly would result in cracking of these materials. Packaging was designed to reduce the rate of thawing and this has resolved the problem with cracking. The heart valve program at the Northwest Tissue Center has been very successful in providing the necessary valves for patients in the Northwest Region of the United States

  11. Acute kidney injury in severe acute pancreatitis: An experience from a tertiary care center

    OpenAIRE

    Ravindra Kumar; Naresh Pahwa; Neeraj Jain

    2015-01-01

    Acute kidney injury (AKI) is an important cause of morbidity and mortality in severe acute pancreatitis (SAP). We aimed in our study to explore the risk factors of AKI in patients with SAP and assess the prognosis of patients with SAP and AKI. This is a retrospective study consisting of analysis of outcome and complications encountered in 72 severe acute pancreatitis patients admitted to a tertiary care center at Indore, India, from May 2011 to April 2012. We encountered 14 AKI cases in the S...

  12. BNL ALARA Center experience with an information exchange system on dose control at nuclear power plants

    International Nuclear Information System (INIS)

    The essential elements of an international information exchange system on dose control at nuclear power plants are summarized. Information was collected from literature abstracting services, by attending technical meetings, by circulating data collection forms, and through personal contacts. Data are assembled in various databases and periodically disseminated to several hundred interested participants through a variety of publications and at technical meetings. Immediate on-line access to the data is available to participants with modems, commercially available communications software, and a password that is provided by the Brookhaven National Laboratory (BNL) ALARA Center to authorized users of the system. Since January 1992, rapid access also has been provided to persons with fax machines. Some information is available for ''polling'' the BNL system at any time, and other data can be installed for polling on request. Most information disseminated to data has been through publications; however, new protocols, simplified by the ALARA Center staff, and the convenience of fax machines are likely to make the earlier availability of information through these mechanisms increasingly important

  13. Treatment of patients with metastatic pancreatic cancer: Experience from a tertiary Indian cancer center

    Directory of Open Access Journals (Sweden)

    B Sirohi

    2015-01-01

    Full Text Available Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS was computed using the Kaplan–Meir product limit method and compared across groups using the log-rank statistics. Cox proportional hazards model, adjusted for a number of patient and tumor characteristics, was then used to determine factors prognostic for OS. Results: Median age at diagnosis was 55 years (range: 21–81 years. 57.4% (n = 58 of patients were male, 22% (n = 22 had performance status (PS of <2 at diagnosis and 89% received first-line chemotherapy, while the rest received best supportive care. For the whole cohort, 6 month and 1-year OS was 57% (95% confidence interval [CI]: 46–66% and 47% (95% CI: 35–57%, respectively. In a multivariable model, PS <2 and oligometastatic disease were associated with a significantly decreased risk of death. Conclusion: Results from our analysis indicate that the prognostic outcome among Indian patients with metastatic pancreatic cancer is poor with survival outcomes similar to those reported in North America and Europe.

  14. Exclusion Reasons of Living Kidney Donor Candidates: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Ayşegül ORUÇ

    2014-05-01

    Full Text Available OBJECTIVE: Due to severe organ shortage, living kidney donors are important choices for transplantation. In Muslim countries, such as Turkey, living kidney donors are the main source of donor pool. In the literature, reasons for living donor exclusion are reported from several countries. However, there is no published study that focused on exclusion reasons of donor candidates in Turkey where living kidney transplantation rate is 73.4%. The goal of this retrospective study was to examine the exclusion reasons for donation among living kidney donor candidates at a single center in Turkey. MATERIAL and METHODS: A total 538 adults were evaluated as a living kidney donor candidate between December 1988 and January 2012. Evaluation outcome, exclusion reasons and demographic data were examined from electronic file system and immunology laboratory records. RESULTS: In this period 451 kidney transplantations (38.6% cadaveric, 61.4% living donor was performed. Overall 261 (48.5% donor candidates who underwent evaluation could not donate. We were able to find the precise cause of exclusion of 86 donors (33%. Among excluded donor candidates the most common exclusion reason was medical causes (64% such as diabetes mellitus, low glomerular filtration rate and hypertension. CONCLUSION: Our study suggests that medical causes are significant exclusion reasons for living kidney donation at our center.

  15. Urinary tract infections following renal transplantation: A single-center experience

    Directory of Open Access Journals (Sweden)

    Samia Barbouch

    2012-01-01

    Full Text Available Urinary tract infection (UTI is the most frequent infectious complication among renal transplant recipients and a frequent cause of bacteremia, sepsis and acute graft failure. To evaluate the incidence, risk factors, type of pathogens and long-term effect of UTIs on graft and patient survivals in our center, we performed a retrospective cohort study reviewing the medical records of patients who received a renal transplant at our center from June 1986 to December 2009, excluding patients who lost their grafts in the first month due to arterial or veins thrombosis and acute antibody-mediated rejection. We studied 393 kidney-transplanted recipients; at least one UTI occurred in 221 (53.69% patients during the follow-up period. The most frequent pathogens isolated in urine culture were Escherichia coli (n = 39, 18.4% and Klebsiella pneumonia (n = 31, 14.6%. When patients with UTIs were compared with those without UTIs, female gender and use of mycophenolate mofetil or azathioprine seemed to be risk factors for UTIs on univariate analysis. However, female gender was the only independent risk factor on multivariate analysis RR = 1.964 (1.202-3.207, P = 0.007. This study confirmed that UTIs remain a major problem in renal transplant recipients, and female gender was the only independent risk factor.

  16. Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

    Science.gov (United States)

    Trestrail, J H; al-Mahasneh, Q M

    1989-04-01

    From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world. PMID:2929130

  17. Acute kidney injury in severe acute pancreatitis: An experience from a tertiary care center

    Directory of Open Access Journals (Sweden)

    Ravindra Kumar

    2015-01-01

    Full Text Available Acute kidney injury (AKI is an important cause of morbidity and mortality in severe acute pancreatitis (SAP. We aimed in our study to explore the risk factors of AKI in patients with SAP and assess the prognosis of patients with SAP and AKI. This is a retrospective study consisting of analysis of outcome and complications encountered in 72 severe acute pancreatitis patients admitted to a tertiary care center at Indore, India, from May 2011 to April 2012. We encountered 14 AKI cases in the SAP study patients. There was a significant association of diabetes and alcohol with AKI in patients with SAP. Alcohol was found to be an independent significant risk factor for AKI in SAP. All the eight patients with SAP who expired had AKI. None of the patients of SAP without AKI expired during the study. We conclude that the patients with SAP with AKI have a greater mortality rate as compared with the SAP patients without AKI.

  18. NASA Glenn Research Center Experience Using DOE Midwest Region Super ESPC

    Science.gov (United States)

    Zala, Laszlo F.

    2000-01-01

    The energy crisis of 1973 prompted the Federal Government and private industry to look into alternative methods to save energy. At the same time the constant reduction of operations and maintenance funds during the last 5 years forced Glenn Research Center (GRC) to look for alternative funding sources to meet the mandate to reduce energy consumption. The Super Energy Savings Performance Contract (ESPC) was chosen as a viable source of facility improvement funding that can create larger project scope and help replace aging, inefficient equipment. This paper describes Glenn's participation in the Department of Energy (DOE) Super ESPC program. This program provided Glenn cost savings in the performance of energy audits, preparation of documents, evaluation of proposals, and selection of energy service company (ESCO).

  19. Experience Transitioning Models and Data at the NOAA Space Weather Prediction Center

    Science.gov (United States)

    Berger, Thomas

    2016-07-01

    The NOAA Space Weather Prediction Center has a long history of transitioning research data and models into operations and with the validation activities required. The first stage in this process involves demonstrating that the capability has sufficient value to customers to justify the cost needed to transition it and to run it continuously and reliably in operations. Once the overall value is demonstrated, a substantial effort is then required to develop the operational software from the research codes. The next stage is to implement and test the software and product generation on the operational computers. Finally, effort must be devoted to establishing long-term measures of performance, maintaining the software, and working with forecasters, customers, and researchers to improve over time the operational capabilities. This multi-stage process of identifying, transitioning, and improving operational space weather capabilities will be discussed using recent examples. Plans for future activities will also be described.

  20. 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.

  1. Primary breast cancer: The experience of the joint center for radiation therapy

    International Nuclear Information System (INIS)

    While radiation therapy began to be administered in the treatment of breast cancer shortly after the discovery of X rays in 1895, the efficacious use of external beam radiation for early breast cancer required supervoltage radiation in order to get effective doses to the tumor, as well as the skin sparing, required for satisfactory cosmetic results. The use of interstitial radiation began shortly after the discovery of radium by the Curies. The first systematic report of such an approach was presented by Goeffrey Keynes, who reported equivalent results with radium implants as compared to those with mastectomy. These two techniques, supervoltage and interstitial radiation, have been used in the modern era of radiotherapy and reported by a number of centers, some of which are presented in this symposium

  2. Establishing effective working relations with a potential user community - NASA Lewis Research Center experience

    Science.gov (United States)

    Foster, P.

    1977-01-01

    The NASA Lewis Research Center has held a series of six major and unique technology utilization conferences which were major milestones in planned structured efforts to establish effective working relationships with specific technology user communities. These efforts were unique in that the activities undertaken prior to the conference were extensive, and effectively laid the groundwork for productive technology transfer following, and as a direct result of, the conferences. The effort leading to the conference was in each case tailored to the characteristics of the potential user community, however, the common factors comprise a basic framework applicable to similar endeavors. The process is essentially a planned sequence of steps that constitute a technical market survey and a marketing program for the development of beneficial applications of aerospace technology beyond the aerospace field.

  3. DISSEMINATING AGRICULTURAL INFORMATION THROUGH THE INTERNET: INDONESIAN CENTER FOR AGRICULTURAL LIBRARY AND TECHNOLOGY DISSEMINATION EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Bambang Winarko

    2011-12-01

    Full Text Available The Indonesian Center for Library and Technology Dissemination (ICALTD has a duty to disseminate agricultural information to researchers, extension workers, academicians, and other general users. Previously, the dissemination was based on printed publications. However, along with the penetration and development of the internet, the method of dissemination has changed to ITC-based dissemination. CD/VCD and internet technology application plays an important role in ICALTD’s dissemination of agricultural information. The involvement of internet technology in the dissemination of agricultural information ranges from purchasing online electronic journals for the main library collection to electronic-based processing and internet-based services. Efforts to educate stakeholders, such as administrators, content providers, and users, are carried out to ensure the successful dissemination of agricultural information.

  4. Group Project Work and Student-centered Active Learning: Two Different Experiences.

    Science.gov (United States)

    Livingstone, David; Lynch, Kenneth

    2000-01-01

    Compared experiences with group-based student projects in a Geographical Information Systems degree taught by one faculty member and in geography degree modules taught by another. Concludes that care must be taken in the design and execution of these projects to avoid problems that might reinforce myths about negative effects of team-based…

  5. Online Digital Archives Technology That Supports Rich, Student-Centered Learning Experiences

    Science.gov (United States)

    Hofer, Mark

    2004-01-01

    Today's students watch the newest movie trailers on the Web, share music files, play video games with other players over the Internet, and swap digital pictures of the latest teen idols. Donald Tapscott points out in his book Growing Up Digital that as this rich multimedia experience becomes more a part of students' lives outside of school, they…

  6. Blood blister-like aneurysms: Single center experience and systematic literature review

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Ana Marcos; Narata, Ana Paula; Yilmaz, Hasan [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Bijlenga, Philippe; Radovanovic, Ivan; Schaller, Karl [Service of Neurosurgery, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes, E-mail: vitormpbr@hotmail.com [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland)

    2014-01-15

    Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity–mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy.

  7. Carotid Artery Stenting: Retrospective Evaluation of Experience of an Invasive Tertiary Center

    Directory of Open Access Journals (Sweden)

    Faruk Ertaş

    2016-03-01

    Full Text Available Objective: Carotid artery stenting (CAS is being applied more frequently as an alternative mode of treatment to carotid endarterectomy. We aimed to present the short-term clinical outcomes of the patients admitted to our clinic with a diagnosis of carotid artery disease and revas­cularized by CAS. Methods: The study was retrospective and a single-centered study. Between June 2013-January 2016 the patients with an indication for carotid artery intervention and accepted CAS procedure were included in the study. Clinical characteristics and procedural data of the patients were obtained by scanning patient files. After discharge, hospital records were scanned and patients were called to learn whether or not patients were alive and that they have suffered a recent stroke. Results: We included 82 patients that meet the inclusion criteria in the study. 59% of patients were male with a mean age of 68±9 years. 56% of patients were symp­tomatic. In all patients, stents were used. 85% of patients distal embolic protection devices and 15% MOMA were used. 64 right, 18 left, and two bilateral carotid arteries were stented with a total of 82 patient of 84 successful CAS. Due to residual stenosis a second stent was im­planted only in one patient. One patient experienced a partial muscle weakening in upper extremity due to an air embolism and 2 patients received opac material which recovered spontaneously in 24 hours. Conclusion: CAS is being successfully applied with a very low risk of complications in experienced centers. Short-term clinical results of CAS are quite satisfactory.

  8. De novo cancers following liver transplantation: a single center experience in China.

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    Songfeng Yu

    Full Text Available BACKGROUND: De novo cancers are a growing problem that has become one of the leading causes of late mortality after liver transplantation. The incidences and risk factors varied among literatures and fewer concerned the Eastern population. AIMS: The aim of this study was to examine the incidence and clinical features of de novo cancers after liver transplantation in a single Chinese center. METHODS: 569 patients who received liver transplantation and survived for more than 3 months in a single Chinese center were retrospectively reviewed. RESULTS: A total of 18 de novo cancers were diagnosed in 17 recipients (13 male and 4 female after a mean of 41 ± 26 months, with an overall incidence of 3.2%, which was lower than that in Western people. Of these, 8 (3.32% cases were from 241 recipients with malignant liver diseases before transplant, while 10 (3.05% cases were from 328 recipients with benign diseases. The incidence rates were comparable, p = 0.86. Furthermore, 2 cases developed in 1 year, 5 cases in 3 years and 11 cases over 3 years. The most frequent cancers developed after liver transplantation were similar to those in the general Chinese population but had much higher incidence rates. CONCLUSIONS: Liver transplant recipients were at increased risk for developing de novo cancers. The incidence rates and pattern of de novo cancers in Chinese population are different from Western people due to racial and social factors. Pre-transplant malignant condition had no relationship to de novo cancer. Exact risk factors need further studies.

  9. The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jeong-Ho [Keimyung University Dongsan Medical Center, Department of Neurology (Korea, Republic of); Kang, Jihoon; Yeo, Min-Ju; Kim, Beom Joon; Jang, Min Uk; Bae, Hee-Joon [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of); Kwon, O-Ki; Hwang, Gyo Jun; Oh, Chang Wan [Seoul National University Bundang Hospital, Department of Neurosurgery (Korea, Republic of); Jung, Cheolkyu [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of); Lee, Ji Sung [Soonchunhyang University Medical Center, Biostatistical Consulting Unit (Korea, Republic of); Han, Moon-Ku, E-mail: mkhan@snu.ac.kr [Seoul National University College of Medicine, Department of Neurology, Stroke Center, Seoul National University Bundang Hospital (Korea, Republic of)

    2015-04-15

    PurposeCarotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.MethodsWe collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.ResultsThe mean age was 68.8 years (82.8 % males; range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.ConclusionsOur study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.

  10. Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review

    OpenAIRE

    Muhammad Rizwan Sardar; Andrea Greway; Michael DeAngelis; Erin O'Malley Tysko; Shawn Lehmann; Melinda Wohlstetter; Riti Patel

    2015-01-01

    Eating disorders have multiple medical sequelae, including potentially life-threatening cardiovascular complications. This article describes our cardiology practice experience of treating adults with eating disorders in the outpatient setting and documents baseline cardiac findings in this complex patient population. We describe our findings in patients across the spectrum of eating disorders; past studies have generally focused on anorexia only. This article also includes a review of the cur...

  11. Conjoined twins – twenty years' experience at a reference center in Brazil

    OpenAIRE

    Ana Cristina Aoun Tannuri; Julio Americo Pereira Batatinha; Manoel Carlos Prieto Velhote; Uenis Tannuri

    2013-01-01

    OBJECTIVE: This study reports on the experience of one hospital regarding the surgical aspects, anatomic investigation and outcomes of the management of 21 conjoined twin pairs over the past 20 years. METHODS: All cases of conjoined twins who were treated during this period were reviewed. A careful imaging evaluation was performed to detail the abdominal anatomy (particularly the liver), inferior vena cava, spleen and pancreas, either to identify the number of organs or to evaluate the degree...

  12. Anesthetic management of conjoined twins undergoing one-stage surgical separation: A single center experience

    OpenAIRE

    Zhong, He-Jiang; Li, Hong; Du, Zhi-Yong; Huan, He; Yang, Tian-De; Qi, Yue-Yong

    2013-01-01

    Objective: To summarize our experience in the anesthetic management of conjoined twins undergoing one-stage surgical separation. Methodology: Medical records of conjoined twins admitted to our hospital for treatment and considered for surgical separation from 1996 to present were retrospectively reviewed. Four cases of conjoined twins underwent one-stage surgical separation under general anesthesia. Preoperative evaluation was performed to determine the extent of anatomical conjunction and as...

  13. Minimally invasive video-assisted thyroidectomy: experience of 200 cases in a single center

    OpenAIRE

    Haitao, Zheng; Jie, Xu; Lixin, Jiang

    2014-01-01

    Introduction Minimally invasive techniques in thyroid surgery including video-assisted technique originally described by Miccoli have been accepted in several continents for more than 10 years. Aim To analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and to evaluate the feasibility and effects of this method in a general department over a 4-year period. Material and methods Initial experience was presented based on a series of 200 patients selected f...

  14. Cardiac side effects of trastuzumab in breast cancer patients – single centere experiences

    OpenAIRE

    Huszno, Joanna; Leś, Dominika; Sarzyczny-Słota, Danuta; Nowara, Elżbieta

    2013-01-01

    Aim of the study The aim of this study was to present our own experiences concerning risk factors for cardiac side effects in the study group. Material and methods The study was performed in 120 patients with HER2-overexpressing breast cancer who received immunotherapy in the Clinical and Experimental Oncology Department, between 2006 and 2011. Results LVEF reduction > 10% of the baseline fraction was observed in 10 (8%) patients. Symptomatic heart failure occurred in two individuals. Due to ...

  15. COMBREX-DB: an experiment centered database of protein function: knowledge, predictions and knowledge gaps

    OpenAIRE

    Chang, Yi-Chien; Hu, Zhenjun; Rachlin, John; Anton, Brian P.; Kasif, Simon; Roberts, Richard J.; Steffen, Martin

    2015-01-01

    The COMBREX database (COMBREX-DB; combrex.bu.edu) is an online repository of information related to (i) experimentally determined protein function, (ii) predicted protein function, (iii) relationships among proteins of unknown function and various types of experimental data, including molecular function, protein structure, and associated phenotypes. The database was created as part of the novel COMBREX (COMputational BRidges to EXperiments) effort aimed at accelerating the rate of gene functi...

  16. A 5-year retrospective analysis of Necrotizing fasciitis: A single center experiences

    Directory of Open Access Journals (Sweden)

    Kiralj Aleksandar I

    2015-01-01

    Full Text Available Background/Aim. Necrotizing fasciitis (NF is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. Methods. The medical records of patients treated for acute NF localized on a different parts of the body in Clinical Center of Vojvodina, Novi Sad, Serbia, during a 5- year period (from January 2008 to December 2012 were retrospectively evaluated. This study enrolled patients admitted via Emergency Center of Vojvodina with the diagnosis of acute NF either as the primary diagnosis or with the diagnosis at discharge after surgical treatment. Results. During a 5-year period there were 216 patients with final diagnosis of acute NF. Most of our patients (140 - 64.81% were admitted with the initial diagnosis of cellulitis, abscesses, phlegmons or sepsis. Unfortunately, the clinical symptoms of acute NF were atypical at time of initial examination. Pain and swelling of the affected localization were the most presented bias of symptoms (183 - 84.72%. The majority of our patients were male (164 - 75.92%. Among the 216 patients, the most common pre-existing single factor was drug abuse (39 - 18.05%, followed by obesity (38 - 17.59% and diabetes mellitus (31 - 14.35%. Trauma was most common etiological factor (22 - 10.8% in infected wounds, followed by abdominal (15 - 6.94% and orthopedic (11 - 5.09% surgical intervention. In the present study idiopathic acute NF was diagnosed in 22 (10.18% patients and more than one etiological factor were diagnosed in 20 (9.25% patients. The majority of our patients had type I acute NF

  17. Efficacy of liver transplantation for acute hepatic failure:a single-center experience

    Institute of Scientific and Technical Information of China (English)

    Xian-Jie Shi; Hong-Bin Xu; Wen-Bin Ji; Yu-Rong Liang; Wei-Dong Duan; Lei He; Ming-Jun Wang; Zhi-Ming Zhao

    2011-01-01

    BACKGROUND: Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality rate. The outcome of AHF varies with etiology, but liver transplantation (LT) can significantly improve the prognosis and survival rate of such patients. This study aimed to detect the role of LT and artificial liver support systems (ALSS) for AHF patients and to analyze the etiology and outcome of patients with this disease. METHODS: A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center. We analyzed and compared the etiology, outcome, prognosis, and survival rates of patients between the transplantation (LT) group and the non-transplantation (N-LT) group. RESULTS: AHF was due to viral hepatitis in 25 patients (52.1%; hepatitis B virus in 22), drug or toxic reactions in 14 (29.2%; acetaminophen in 6), Wilson disease in 4 (8.3%), unknown reasons in 3 (6.3%), and miscellaneous conditions in 2 (4.2%). In the LT group, 36 patients (7 underwent living donor LT, and 29 cadaveric LT) had an average model for end-stage liver disease score (MELD) of 35.7. Twenty-eight patients survived with good graft function after a follow-up of 27.3± 4.5 months. During the waiting time, 6 patients were treated with ALSS and 2 of them died during hospitalization. The 30-day, 12-month, and 18-month survival rates were 77.8%, 72.2%, and 66.7%, respectively. In the N-LT group, 12 patients had an average MELD score of 34.5. Four patients were treated with ALSS and all died during hospitalization. The 90-day and 1-year survival rates were only 16.7% and 8.3%, respectively. CONCLUSIONS: Hepatitis is the most prominent cause of AHF at our center. Most patients with AHF, who fulfill the Kings College Criteria for LT, did not survive longer without LT. ALSS did not improve the prognosis of AHF patients, but may extend the waiting time for a donor. Currently, LT is still the most effective way to improve the prognosis

  18. Analysis of patterns of palliative radiotherapy in north west India: A regional cancer center experience

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    Akhil Kapoor

    2015-01-01

    Full Text Available Background: Palliative radiotherapy (PRT is the eventual requirement in 30-50% of all cancer patients. PRT is primarily aimed to relieve pain and prevent/treat collapse or fracture in case of bone metastasis, to reduce edema in patients with cranial metastasis, and to control distressing symptoms of rapid primary growth. An audit of PRT planned in a busy cancer center can help in the characterization of the requirements of the patients and the formulation of institutional policies. Materials and Methods: In total, 516 patients who received PRT in our regional cancer center from January 2012 to December 2012 and whose complete records were available for analysis were selected for this retrospective study. Medical records and radiotherapy files were analyzed to obtain data such as sociodemographic parameters, prescription of PRT, and follow up. Descriptive statistics were evaluated in terms of frequencies and percentages to allow comparisons. Results: Of the 516 patients, 73% patients were male; the median age of the patients receiving PRT was 62 years (range 13-83 years. About 48% ( n = 248 patients received PRT at the primary site while rest (52% were given PRT at the metastatic site. The most common indication of PRT was pain (56.8% cases, followed by cytostatic PRT (19.8% and raised ICT (12.4%. The median dose prescribed was 30 Gy (range 8-36 Gy delivered in 1-12 fractions over the duration of 1-18 days. The overall response rate was about 43% at 2 weeks of completion of PRT; the median follow-up of the patients was 154 days (range 9-256 days. The long-term symptom relief at median follow up was 8%. Conclusions: Good clinical judgment and expertise is required in prescribing correct fractionation schedule to achieve effective symptom palliation with lowest possible cost and inconvenience to the patients and relatives. Hypofractionated radiotherapy is a feasible treatment option in patients with advanced incurable disease to achieve effective

  19. Cochlear implant surgery at the Clinical Center of Vojvodina - ten-year experience

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    Dankuc Dragan

    2014-01-01

    Full Text Available Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9% and in 15 (15.1%, respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4% children, whereas in four (4.6% children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75% manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%, hereditary factor in six (6.06%, and bacterial meningitis in four (4.04% patients. Somewhat less common causes were perinatal hypoxia in three (3.03%, premature birth in three (3.03%, Down syndrome in one (1.01%, and chronic otitis media in one (1.01% patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5% were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative

  20. Clinical and experimental studies of multiple sclerosis in Russia: experience of the leading national research centers

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    Zavalishin IA

    2015-08-01

    Full Text Available Igor A Zavalishin,1 Alexey A Belogurov Jr,2–4 Yakov A Lomakin,2 Natalia A Ponomarenko,2 Sofia N Morozova,1 Zinaida A Suslina,1,† Michael A Piradov,1 Sergey N Illarioshkin,1 Alexander G Gabibov2–5 1Research Center of Neurology, 2Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 3Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, 4Institute of Gene Biology, RAS, 5Chemistry Department, Moscow State University, Moscow, Russia †Dr Zinaida A Suslina passed away on June 22, 2014 Abstract: Mechanisms of axonal damage and adaptive capacity in multiple sclerosis (MS, including cortical reorganization, have been actively studied in recent years. The lack of regenerative capabilities and the irreversibility of neurodegeneration in MS are critical factors for the optimization of MS treatment. In this study, we present the results of clinical and basic studies in the field of MS by two leading Russian centers. Clinical and neuroimaging correlations show that spinal damage in MS is accompanied by functional reorganization of the cerebral cortex, which is determined not only by the efferent component but also by the afferent component. Comparative analysis of MS treatment with both interferon β1b (IFN-β1b and IFN-β1a at a dosage of 22 µg for 3 years through subcutaneous administration and glatiramer acetate showed equally high efficiency in reducing the number of exacerbations in relapsing-remitting MS and secondary-progressive MS. We demonstrate a reduced risk of disability in relapsing-remitting MS and secondary-progressive MS patients in all groups treated with IFN-β1 and glatiramer acetate. MS appears to be a disease that would greatly benefit from the development of personalized therapy; thus, adequate molecular predictors of myelin degradation are greatly needed. Therefore, novel ideas related to the viral hypothesis of the etiology of MS and new targets for

  1. Attending an activity center: positive experiences of a group of home-dwelling persons with early-stage dementia

    Directory of Open Access Journals (Sweden)

    Söderhamn U

    2014-11-01

    Full Text Available Ulrika Söderhamn,1 Live Aasgaard,2 Bjørg Landmark2,3 1Centre for Caring Research Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Institute of Research and Development for Nursing and Care Services, Municipality of Drammen, 3Faculty of Health, Buskerud and Vestfold University College, Drammen, Norway Background: In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers.Methods: The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis.Results: Four categories, ie, “appreciated activities”, “praised nurses and volunteers”, “being more active”, and “being included in a fellowship”, as well as the overall theme “participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being” emerged in the analysis. The informants appreciated the adapted physical and social activities and expressed their enjoyment and gratitude. They found the physical activities useful, and they felt themselves to be included in a fellowship through cheerful nurses and volunteers. The nurses were able to create a good atmosphere and spread joy in the center together with the volunteers. The informants felt themselves valued as the persons they were. These findings indicated that such activities may have had a positive influence on the informants’ health and well-being.Conclusion: In order to succeed with this kind of activity center, it is decisive that the nurses are able to

  2. [De novo malignant tumors following liver transplantation. A single-center experience in Argentina].

    Science.gov (United States)

    Antinucci, Florencia; Anders, Margarita; Orozco, Federico; Mella, José; Cobos, Manuel; McCormack, Lucas; Mastai, Ricardo

    2015-01-01

    The aim of the present study was to evaluate the incidence and clinical features of de novo tumors in patients undergoing liver transplantation in our center as well as to assess survival. We retrospectively analyzed 168 liver transplantations (159 patients) performed from May 2006 to May 2014. The incidence of de novo tumors was 7.5% (n = 12). The mean age at diagnosis was 63 ± 7 years. The most frequent neoplasms were non melanoma skin tumors and adenocarcinomas. Fifty percent of the tumors developed in the second and third year after transplantation. Type of immunosuppression did not influence tumoral type, although most patients receive tacrolimus in combination with mycofenolate and/or corticoids. The mean duration of follow-up after diagnosis of the tumor was 25 ± 29 months (range 0-76) and the mortality was 41%. The actuarial probability of survival at 1 and 5 years was 83 and 55%, respectively. De novo tumors are frequent after liver transplantation and their clinical course differs from that in the general population. Because their clinical course is more aggressive, regular follow up of these patients is essential for early diagnosis. PMID:25637895

  3. Delay in seeking specialized care for oral cancers: Experience from a tertiary cancer center

    Directory of Open Access Journals (Sweden)

    P Joshi

    2014-01-01

    Full Text Available Objective: Advanced oral cancers are a challenge for treatment, as they require complex procedures for excision and reconstruction. Despite being occurring at a visible site and can be detected easily, many patients present in advanced stages with large tumors. Timely intervention is important in improving survival and quality of life in these patients. The aim of the present study was to find out the causes of delay in seeking specialist care in advanced oral cancer patients. Materials and Methods: A prospective questionnaire based study was done on 201 consecutive advanced oral squamous cancer patients who underwent surgery at our hospital. All patients had either cancer of gingivobuccal complex (GBC or tongue and had tumors of size more than 4 cm (T3/T4 and were treatment naοve at presentation. RESULTS: Even though most patients observed abnormal lesions in their mouth, majority delayed the decision to visit a physician early. A significant percentage of patients (50% also reported a delayed diagnosis by the primary care physician before being referred to a tertiary care center for definitive treatment. The average total duration from symptoms to treatment was 7 months. Conclusion: The main reasons of this delay in receiving treatment were due to patients themselves (primary delay or due to time taken by the primary physician to diagnose the condition (secondary delay. Oral self-examination can be helpful in detecting oral cancers early.

  4. Frequency of kidney diseases and clinical indications of pediatric renal biopsy: A single center experience.

    Science.gov (United States)

    Imtiaz, S; Nasir, K; Drohlia, M F; Salman, B; Ahmad, A

    2016-01-01

    Kidney biopsy occupies a fundamental position in the management of kidney diseases. There are very few renal pathology studies available in the literature from developing world. This study scrutinized the frequency and clinicopathological relationship of kidney biopsies done at the kidney center from 1997 to 2013 amongst pediatric patients. Kidney allograft biopsy were excluded. The specimen was examined under light microscopy and immunofluorescence while electron microscopy was not done. The study includes 423 patients, mean age was 10.48 ± 4.58 years, males 245 (57.9%) were more than females 178 (42.1%). Nephrotic syndrome 314 (74.2%) was the most common clinical presentation followed by acute nephritic syndrome 35 (8.3%) and acute renal failure 24 (5.7%). Primary glomerulonephritis (PGN) was the most common group of diseases, seen in 360 (85.1%) followed by secondary glomerulonephritis (SGN) in 27 (6.4%) and tubulointerstitial nephritis in 21 (5.0%). Among PGN, minimal change disease (MCD) was the most dominant disease, with 128 (30.3%) cases followed by focal segmental glomerulosclerosis FSGS in 109 (25.8%) and membranous glomerulonephropathy in 27 (6.4%). Lupus nephritis (LN) was the leading cause of glomerular disease in SGN followed by hemolytic uremic syndrome. In conclusion, MCD is the most common histological finding, especially in younger children and FSGS is second to it. SGN is rare, and the most common disease in this category is LN while tubulointerstitial and vascular diseases are infrequent. PMID:27194835

  5. Genotypic and phenotypic features of citrin deficiency: five-year experience in a Chinese pediatric center.

    Science.gov (United States)

    Song, Yuan-Zong; Deng, Mei; Chen, Feng-Ping; Wen, Fang; Guo, Li; Cao, Shui-Liang; Gong, Jian; Xu, Hao; Jiang, Guang-Yu; Zhong, Le; Kobayashi, Keiko; Saheki, Takeyori; Wang, Zi-Neng

    2011-07-01

    Citrin is a liver-type aspartate/glutamate carrier (AGC) encoded by the gene SLC25A13. Two phenotypes for human citrin deficiency have been described, namely the adult-onset citrullinemia type II (CTLN2) and the neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). However, citrin deficiency currently remains a perplexing and poorly recognized disorder. In particular, description of post-NICCD clinical presentations before CTLN2 onset is rather limited. Analysis of SLC25A13 mutations, identification of dysmorphic erythrocytes, hepatobiliary scintigraphic imaging and investigation of post-NICCD clinical presentations were performed in a citrin-deficient cohort comprised of 51 cases of children diagnosed with citrin deficiency in a Chinese pediatric center. Twelve SLC25A13 mutations were detected in this cohort, including the novel V411M and G283X mutations. Among the 51 citrin-deficient subjects, 7 cases had echinocytosis, which was associated with more severe biochemical abnormalities. Delayed hepatic discharge and bile duct/bowel visualization were common scintigraphic findings. Moreover, 9 of the 34 post-NICCD cases demonstrated concurrent failure to thrive and dyslipidemia, constituting a clinical phenotype different from NICCD and CTLN2. The novel mutations, echinocytosis, hepatobiliary scintigraphic features and the novel clinical phenotype in this study expanded the genotypic and phenotypic spectrum of citrin deficiency, and challenge the traditionally-assumed 'apparently healthy' period after the NICCD state for this disease entity. PMID:21424115

  6. Kratom abuse in Ramathibodi Poison Center, Thailand: a five-year experience.

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    Trakulsrichai, Satariya; Tongpo, Achara; Sriapha, Charuwan; Wongvisawakorn, Sunun; Rittilert, Panee; Kaojarern, Sming; Wananukul, Winai

    2013-01-01

    Kratom (Mitragyna speciosa Korth), a native tree in Southeast Asia, is misused as an abuse drug and becomes legally widespread to several countries. Currently, it is available through the online market or by some shops. The clinical manifestations of Kratom's effects are not well-defined and the clinical studies are limited. This study was designed to identify the characteristics of Kratom poisoning and withdrawal cases from Kratom exposure cases in Ramathibodi Poison Center (RPC), Thailand, during a five-year period. We used a retrospective review of Kratom exposure cases from the RPC toxic surveillance system. A total of 52 Kratom exposure cases were identified. The trend of case consultations has been increasing. There were Kratom poisoning cases (76.9%) and withdrawal cases (23.1%). Common presenting symptoms in the poisoning group were palpitation (22.5%), followed by seizure (17.5%). For the withdrawal group, the common presenting symptoms were myalgia (33.3%), insomnia (16.67%), fatigue (16.67%), and chest discomfort (16.67%). There was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route. There were no deaths in either group. Kratom abuse can cause either poisoning or withdrawal. Most cases in both groups had good prognostic outcome. PMID:24592666

  7. Comparison of Capsule Endoscopy Findings to Subsequent Double Balloon Enteroscopy: A Dual Center Experience

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    Amandeep S. Kalra

    2015-01-01

    Full Text Available Background. There has been a growing use of both capsule endoscopy (CE and double balloon enteroscopy (DBE to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective study of patients who underwent sequential CE and DBE, at two separate tertiary care academic centers from May 2007 to December 2011, was performed. Results. 116 patients were included in the study. The mean age ± SD was 66.6 ± 13.2 years. There were 56% males and 43.9% females. Measure of agreement between prior capsule and DBE findings was performed using kappa statistics, which gave kappa value of 0.396 with P<0.001. Also contingency coefficient was calculated and was found to be 0.732 (P<0.001. Conclusions. Our study showed good overall agreement between DBE and CE. Findings of angioectasia had maximum agreement of 69%.

  8. Acute lymphoblastic leukemia: A single center experience with Berlin, Frankfurt, and Munster-95 protocol

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    Venkatraman Radhakrishnan

    2015-01-01

    Full Text Available Background: There is a paucity of data on the outcome following the treatment for acute lymphoblastic leukemia (ALL from developing countries. Materials and Methods: Two hundred and thirty-eight consecutive patients with ALL <30 years of age diagnosed between January 2005 and December 2011 were analyzed retrospectively. Patients were treated modified Berlin, Frankfurt, and Munster 95 protocol. Event-free survival (EFS was calculated using Kaplan-Meier survival analysis and variables were compared using log-rank test. Results: The EFS was 63.4% at a median follow-up was 32.7 months. On univariate analysis National Cancer Institute (NCI risk stratification, sex, white blood cell count, day 8 blast clearance, and income were significantly associated with EFS. However, on multivariate analysis only female sex (P = 0.01 and day 8 blast clearance (P = 0.006 were significantly associated with EFS. Seventy-four of 238 (31% patients had recurrent leukemia. The common sites of relapse were bone marrow in 55/74 (75% patients and central nervous system in 11/74 (20% patients. Conclusion: Compared to western data, there was an increased proportion of NCI high-risk patients and T-cell immunophenotype in our study. There has been an improvement in outcome of patients with ALL at our center over the last 2 decades. Female sex and clearance of blast in peripheral blood by day 8 of induction was associated with better EFS.

  9. Sports hernia: the experience of Baylor University Medical Center at Dallas.

    Science.gov (United States)

    Preskitt, John T

    2011-04-01

    Groin injuries in high-performance athletes are common, occurring in 5% to 28% of athletes. Athletic pubalgia syndrome, or so-called sports hernia, is one such injury that can be debilitating and sport ending in some athletes. It is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor occurring with athletic activity. Over the past 12 years, we have operated on >100 patients with this injury at Baylor University Medical Center at Dallas. These patients have included professional athletes, collegiate athletes, competitive recreational athletes, and the occasional "weekend warrior." The repair used is an open technique using a lightweight polypropylene mesh. Patient selection is important, as is collaboration with other experienced and engaged sports health care professionals, including team trainers, physical therapists, team physicians, and sports medicine and orthopedic surgeons. Of the athletes who underwent surgery, 98% have returned to competition. After a minimum of 6 weeks for recovery and rehabilitation, they have usually returned to competition within 3 months. PMID:21566750

  10. Perinatal Diagnostic Approach to Fetal Skeletal Dysplasias: Six Years Experience of a Tertiary Center.

    Science.gov (United States)

    Toru, Havva Serap; Nur, Banu Guzel; Sanhal, Cem Yasar; Mihci, Ercan; Mendilcioğlu, İnanç; Yilmaz, Elanur; Yilmaz, Gulden Tasova; Ozbudak, Irem Hicran; Karaali, Kamil; Alper, Ozgul M; Karaveli, Fatma Şeyda

    2015-01-01

    Skeletal dysplasias (SDs) constitute a group of heterogeneous disorders affecting growth morphology of the chondro-osseous tissues. Prenatal diagnosis of SD is a considerable clinical challenge due to phenotypic variability. We performed a retrospective analysis of the fetal autopsies series conducted between January 2006 and December 2012 at our center. SD was detected in 54 (10%) out of 542 fetal autopsy cases which included; 11.1% thanatophoric dysplasia (n = 6), 7.4% achondroplasia (n = 4), 3.7% osteogenesis imperfect (n = 2), 1.9% Jarcho-Levin Syndrome (n = 1), 1.9% arthrogryposis (n = 1), 1.9% Dyggve-Melchior-Clausen syndrome (n = 1), 72.1% of dysostosis cases (n = 39). All SD cases were diagnosed by ultrasonography. In 20 of the cases, amniocentesis was performed, 4 cases underwent molecular genetic analyses. Antenatal identification of dysplasia is important in the management of pregnancy and in genetic counseling. Our data analysis showed that SD is usually detected clinically after the 20th gestational week. Genetic analyses for SD may provide early diagnosis and management. PMID:26376227

  11. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

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    Kristoffer Watten Brudvik

    2013-01-01

    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  12. The Characteristics and Surgical Approach in Post-Traumatic Diaphragmatic Hernia: A Single Center Experience

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    Mushtaq Ahmed Chowdhary

    2013-07-01

    Full Text Available Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS, Kashmir, India. We included all patients with post traumatic diaphragmatic hernia undergoing operation in our center from May 2009 to November2011. A detailed history was taken for each patient along with comprehensive general, physical, systemic and local examination of all cases. Operative findings included associated intra-abdominal injuries, and herniated intra-abdominal organs. Post-operative complications, mortality and survival were recorded and reported. Results: The mean age of the patients was 32±1 years and there were 16 (76.1% men and 5 (23.8% women among the patients. Thoracotomy was performed in 14 patients (66.7%, laparotomy in 6 patients (28.6% and combined procedure was used in 1 patient (4.7%. The reduction of hernia contents with repair of diaphragmatic rent was done in 11 (52.2% of the patients and splenectomy with repair of rent in 6 (28.6%. Traumatic diaphragmatic hernia had 81.8% survival rate, no pre-operative mortality and 14.3% post operative mortality rate.Conclusion: Thoracotomy is the most common approach in post traumatic diaphragmatic hernia. Laparotomy is preferred in patients having acute trauma with associated intra-abdominal injuries.

  13. Escalating therapy of cutaneous side effects of EGFR inhibitors: experience of German reference centers.

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    Homey, Bernhard; Gerber, Peter Arne; Wollenberg, Andreas; Dirschka, Thomas; Hassel, Jessica C; Bölke, Edwin; Hauschild, Axel; Gutzmer, Ralf

    2012-08-01

    Recommendations for the management of cutaneous adverse effects of inhibitors of the epidermal growth factor receptor (EGFR) are urgently needed. In this context an expert panel of German dermatologists recently proposed a 3-step management concept based on personal experience and a current literature consensus. While steps 1 and 2 addressed general and preventive measures, as well as the therapy that can be performed by the primary treating physician, here we address the management of challenging cases (step 3) that do not respond well to basic measures and should be referred to an experienced dermatologist. PMID:22672156

  14. Development of Fusion and Plasma Diagnostics Center - synchrotron radiation experiment, (2)

    International Nuclear Information System (INIS)

    A beam line for radiometric calibration has been constructed at BL5B of UVSOR facility. The beam line was designed for the calibration of optical components, detectors, and spectrometers for plasma diagnostic devices in the VUV and soft X-ray spectral regions. It consists of a plane grating monochromator and a calibration chamber. The calibration chamber is equipped with a differential pumping system and a reflectometer. Spectral distribution, higher order contribution, and resolution of the monochromator were measured by experiments on photoemission and photo-ionization of rare gases and various solids. Some applications for the characterization of multilayer reflectors and channel electron multipliers are demonstrated. (author)

  15. REPEATED LIVER TRANSPLANTATION: EXPERIENCE OF RUSSIAN SCIENTIFIC CENTER OF RADIOLOGY AND SURGICAL TECHNOLOGY (RSCRST

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    D. A. Granov

    2011-12-01

    Full Text Available The article gives the report about the experience in repeated liver transplantation (LT. Totally 99 LT including 6 repeated operation at five patients performed between june 1999 and june 2011. In 3 of 6 cases bile ducts necroses was the indication to repeated LT. Retransplantations were connected with difficulties, enlargement of duration and replacement therapy volume, also explained high number of complication after operation. It is demonstrated that chronic biliary infection and bad condition of patients are the main reasons of complication and poor prognosis after repeated liver transplantation. 

  16. Is Antibiotic Usage Necessary after Donor Nephrectomy? A Single Center Experience

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    Zomorrodi Afshar

    2008-01-01

    Full Text Available Proper management of living kidney donors is a very important aspect of all renal transplants. To date, approximately 60,000 living donor nephrectomies have been performed worldwide and about 20 deaths directly related to the operation have been reported. The most common cause of death has been pulmonary embolism. Wound infection following surgery is the third most common nosocomial infection, and is dependent on the surgeon and his/her team, the operating room, number and virulence of contaminated bacteria, patient characteristics (immunity and defense, as well as time and duration of administration of antibiotics. Approach to the prophylaxis of wound infection in kidney donors varies in different transplant centers. This study was conducted at the Emam Hospital, Tabriz, Iran in order to delineate the protocol regarding antibiotic usage after donor nephrectomy. One hundred kidney donors were enrolled in the study. They were classified randomly in two groups: Group-1, comprising 50 donors, who received antibiotics immediately following surgery and for at least seven days thereafter. Group-2, comprised of 50 donors, in whom one gram of cephazoline was injected intravenously before anesthesia and continued for 24 hours after surgery. The patients were followed-up for one month with particular emphasis on occurrence of wound infection. One patient in Group-1, and two in Group-2 had wound infection; the difference was not statistically significant (p = > 0.5. Our study suggests that antibiotic prophylaxis started before incision and continued for 24 hours after donor nephrectomy is safe and effective in preventing wound infection.

  17. Cryptococcal meningitis in HIV infected: Experience from a North Indian tertiary center

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    Kumar Susheel

    2008-01-01

    Full Text Available Background: Cryptococcal meningitis is a common opportunistic infection in Human Immunodeficiency Virus (HIV-infected individuals. There is little information specifically addressing cryptococcal meningitis in HIV-infected patients from North India. Aims: To determine clinical presentation, hospital course, response to treatment, complications developed, in-hospital mortality, any recurrence of cryptococcal meningitis and reasons of recurrence during follow-up. Settings and Design: A retrospective observational study undertaken in a large tertiary care center. Materials and Methods: Patient′s demographic data, presenting clinical symptomatology, physical findings, laboratory parameters, cerebrospinal fluid (CSF examination findings, side-effects of treatment, development of any complications and hospital outcome were analyzed. During follow-up any recurrence of cryptococcal meningitis, possible reasons of recurrence, type of treatment received, complications developed and outcome was recorded as well. Results: Forty patients diagnosed to have cryptococcal meningitis were analyzed. Twenty-two (55% patients had acute/ subacute presentation. Thirty-six (90% patients presented with headache and 18 (45% had altered sensorium. Twenty (50% patients had no cells in the CSF. Hypoglycorrhchia was seen in 30 (75% patients. Cryptococcal meningitis was the first acquired immune deficiency syndrome (AIDS-defining illness in 30 (75% patients. Thirty-five patients developed some adverse effects to amphotericin-B. Thirty-three patients improved with treatment while three patients died. Four patients had recurrence of cryptococcal meningitis within six months of first episode. Non-compliance of fluconazole therapy was the reason for recurrence in all of these patients. Conclusions: Cryptococcal meningitis is a common initial AIDS-defining illness. Acute and/or subacute presentation of cryptococcal meningitis is not uncommon in HIV-infected individuals. An early

  18. Chromogranin A as Serum Marker for Gastroenteropancreatic Neuroendocrine Tumors: A Single Center Experience and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Nölting, Svenja; Kuttner, Axel [Department of Internal Medicine II, Campus Grosshadern, University-Hospital of the Ludwig-Maximilians-University of Munich, Munich 81377 (Germany); Lauseker, Michael [Institute of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich 81377 (Germany); Vogeser, Michael [Department of Clinical Chemistry, Campus Grosshadern, University-Hospital of the Ludwig-Maximilian-University of Munich, Munich 81377 (Germany); Haug, Alexander [Clinic of Nuclear Medicine, Campus Grosshadern, University-Hospital of the Ludwig-Maximilian-University of Munich, Munich 81377 (Germany); Herrmann, Karin A. [Institute of Radiology, Campus Grosshadern, University-Hospital of the Ludwig-Maximilian-University of Munich, Munich 81377 (Germany); Hoffmann, Johannes N. [Department of Surgery, Campus Grosshadern, University-Hospital of the Ludwig-Maximilians-University of Munich, Munich 81377 (Germany); Spitzweg, Christine; Göke, Burkhard; Auernhammer, Christoph J., E-mail: christoph.auernhammer@med.uni-muenchen.de [Department of Internal Medicine II, Campus Grosshadern, University-Hospital of the Ludwig-Maximilians-University of Munich, Munich 81377 (Germany)

    2012-02-15

    The aim of this study was to assess the clinical sensitivities of the tumor markers chromogranin A (CgA), urinary 5-hydroxyindoleacetic acid (5-HIAA) and alkaline phosphatase (AP) in neuroendocrine tumors (NETs) of the GastroEnteroPancreatic-(GEP-) system depending on tumor primary location and metastatic spread. In a retrospective single-center series, sensitivities were evaluated in serum samples from 110 patients with midgut (n = 62) and pancreatic (n = 48) NETs. CgA levels were analyzed by a commercially-available immunoradiometric assay (CIS-bio) during routine follow-up in the years 2000–2009. CgA showed a higher sensitivity for midgut (68%) than pancreatic (54%) NETs. A higher CgA sensitivity and significantly higher median CgA values were found in patients with liver metastases than in those without, and in patients with hepatic and additionally extra-hepatic metastases than in those with hepatic and nodal metastases alone, respectively. We found an overall sensitivity for elevated 5HIAA excretion of 69% for midgut NETs and a significant correlation between median CgA and 5-HIAA values. The sensitivity of AP and the correlations of AP/CgA-data-pairs were low in both midgut and pancreatic NETs, although highest for metastatic pancreatic NETs. The sensitivity of CgA measurement depends on the NET primary location and spread of disease. 5-HIAA and CgA showed comparable sensitivity in midgut NETs, while AP does not seem to be useful as a tumor marker in GEP-NETs.

  19. Occult Hepatitis C Virus Infection in Haemodialysis Unit: A Single-center Experience

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    Abdel Hamid A. Serwah1, Waleed S. Mohamed1, Mohamed Serwah1, Awateif Edreis2, Ahmad El Zaydi3

    2014-07-01

    Full Text Available Background & Aims: Detection of hepatitis C virus RNA in peripheral blood mononuclear cells (PBMC and/or hepatocytes in the absence of HCV RNA in serum, designated as ‘occult HCV infection’, has been a matter of controversy in the recent years. Occult hepatitis C virus (HCV infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis (CHD patients in a single heamodialysis center at Al-Taif, KSA. Methods: We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. Results: In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells (PBMNCs, was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. Conclusions: The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups. Abbreviations HCV, Hepatitis C Virus ; antibody against HCV; PBMC, peripheral blood mononuclear cells; rRT-PCR, real time reverse transcriptase polymerase chain reaction; CHD, chronic

  20. Percutaneous CT-guided radiofrequency ablation of solitary small renal masses. A single center experience

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    Pieper, C.C.; Fischer, S.; Strunk, H.; Meyer, C.; Thomas, D.; Willinek, W.A.; Schild, H. [Univ. Bonn (Germany). Dept. of Radiology; Hauser, S. [Univ. Bonn (Germany). Dept. of Urology; Nadal, J. [Univ. Bonn (Germany). Inst. for Medical Biometry; Wilhelm, K. [Johanniter Hospital Bonn (Germany). Dept. of Radiology

    2015-07-15

    To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. 38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors. RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression.

  1. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    International Nuclear Information System (INIS)

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology

  2. Perinatal Outcomes in Women with Preeclampsia: Experience of a Tertiary Referral Center

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    Semra Eroglu

    2015-11-01

    , pregestational medical evaluation and regular antenatal follow-up visits especially for high-risk women should be emphasized. Whenever possible, women diagnosed with severe preeclampsia or HELLP syndrome should be transferred to a tertiary medical center with adequate capabilities for maternal and neonatal intensive care in order to decrease perinatal morbidities.

  3. Conversion from temporary to tunneled catheters by nephrologists: report of a single-center experience

    Science.gov (United States)

    Silva, Bruno C; Rodrigues, Camila E; Abdulkader, Regina CRM; Elias, Rosilene M

    2016-01-01

    Background Nephrologists have increasingly participated in the conversion from temporary catheters (TC) to tunneled-cuffed catheters (TCCs) for hemodialysis. Objective To prospectively analyze the outcomes associated with TCC placement by nephrologists with expertise in such procedure, in different time periods at the same center. The impact of vancomycin or cefazolin as prophylactic antibiotics on the infection outcomes was also tested. Patients and methods Hemodialysis patients who presented to such procedure were divided into two cohorts: A (from 2004 to 2008) and B (from 2013 to 2015). Time from TC to TCC conversion, prophylactic antibiotics, and reasons for TCC removal were evaluated. Results One hundred and thirty patients were included in cohort A and 228 in cohort B. Sex, age, and follow-up time were similar between cohorts. Median time from TC to TCC conversion was longer in cohort A than in cohort B (14 [3; 30] vs 4 [1; 8] days, respectively; P⩽0.0001). Infection leading to catheter removal occurred in 26.4% vs 18.9% of procedures in cohorts A and B, respectively, and infection rate was 0.93 vs 0.73 infections per 1,000 catheter-days, respectively (P=0.092). Infection within 30 days from the procedure occurred in 1.4% of overall cohort. No differences were observed when comparing vancomycin and cefazolin as prophylactic antibiotics on 90-day infection-free TCC survival in a Kaplan–Meier model (log-rank = 0.188). TCC removal for low blood flow occurred in 8.9% of procedures. Conclusion Conversion of TC to TCC by nephrologists had overall infection, catheter patency, and complications similar to data reported in the literature. Vancomycin was not superior to cefazolin as a prophylactic antibiotic. PMID:27114715

  4. Allogeneic hematopoietic cell transplantation in patients with myelofibrosis: A single center experience.

    Science.gov (United States)

    Schmohl, Joerg U; Groh, Christiane; Faul, Christoph; Vogel, Wichard; Möhle, Robert; Wirths, Stefan; Schneidawind, Dominik; Kanz, Lothar; Bethge, Wolfgang A

    2016-05-01

    Myelofibrosis (MF) is a rare disease responsible for an increasing ineffective hematopoesis by a progressive fibrosing process in the bone marrow. The only curative treatment option is allogeneic hematopoietic cell transplantation (HCT). In this single-center analysis, we evaluated retrospectively 54 consecutive patients suffering from primary or secondary MF which underwent HCT from 1997 to 2014 after either myeloablative (MAC, n = 19) or reduced-intensity conditioning (RIC, n = 35). Overall survival (OS) and disease-free survival (DFS) after 3 years was 54/53 % for RIC versus 63/58 % for MAC (p = 0.8/0.97). Cumulative incidence of relapse was 34 % after RIC and 8 % after MAC (p = 0.16). Three-year non-relapse mortality (NRM) was 15 % after RIC and 34 % after MAC (p = 0.29). We found that RIC was associated with a lower incidence of acute graft versus host disease (GvHD; II-IV 26 vs. 0 %, p = 0.004). Evaluation of prognostic relevance of the Dynamic International Prognostic Scoring System (DIPSS) score showed a significant better OS in patient with risk score ≤3 versus >3 (after 3 years, 71 vs. 39 %, p = 0.008). While similar OS and DFS were observed with MAC or RIC, the use of RIC resulted in lower incidence of acute GvHD. RIC regimens may be therefore the preferred conditioning approach for allogeneic HCT in patients with MF. PMID:27021303

  5. A single-center experience in radioembolization as salvage therapy of hepatic metastases of uveal melanoma

    International Nuclear Information System (INIS)

    Overall survival (OS) of patients with hepatic metastases of uveal melanoma is strongly linked with hepatic tumor control. Due to the lack of an effective systemic chemotherapy, locoregional therapies like radioembolization should play an increasingly important role. To report complications and response rates of radioembolization as salvage therapy for hepatic uveal melanoma metastases. Between October 2006 and January 2014, eight patients (age, 59.1 ± 15.3 years; 5 men) with histologically proven uveal melanoma and hepatic metastases received radioembolization with glass microspheres at a single center. All patients had been heavily pretreated with multiple systemic/locoregional therapies resulting in a long median interval between diagnosis of hepatic metastases and radioembolization (17.1 months; range, 6.4–23.2 months). Follow-up consisted of clinical assessment, laboratory tests and tri-phasic computed tomography (CT) before and 1, 3, 6, 9, and 12 months after radioembolization. Response to therapy was evaluated by CT using RECIST version 1.1 and by survival time. Safety (laboratory and clinical toxicity) was rated according to Common Terminology Criteria for Adverse Events 4.03. Using Kaplan-Meier analysis time to progression of hepatic metastases (hTTP) and OS were calculated. One month after radioembolization 50% of patients presented with stable and 50% with progressive disease. Median hTTP and OS after radioembolization were 4.3 weeks (range, 3.4–28.6 weeks) and 12.3 weeks (range, 3.7–62.6 weeks), respectively. Median OS after diagnosis of hepatic metastases was 19.9 months (range, 7.3–31.4 months). Radioembolization was tolerated well in all patients without toxicity higher than grade 2. Radioembolization is a safe salvage therapy even in heavily pretreated hepatic metastases of uveal melanoma

  6. Clinical outcomes of liver transplantation for polycystic liver disease: a single center experience.

    Science.gov (United States)

    Chandok, Natasha; Uhanova, Julia; Marotta, Paul

    2010-01-01

    Polycystic liver disease (PLD) is a celiopathy characterized by progressive growth of multiple hepatic cysts. In a minority of patients, severe symptomatic hepatomegaly necessitates liver transplantation (LT). The purpose of this study is to describe the postoperative and long-term outcomes of all patients transplanted for PLD at our center. All patients who underwent LT for PLD were identified through our database. Using patient charts, data were extracted on patient demographics and medical history, postoperative surgical and medical complications, length of hospitalization, prevalence of chronic kidney failure, and patient and graft survival. Subjects were contacted in April 2010 to verify their survival and confirm their need, if any, for hemodialysis and/or kidney transplantation. Descriptive statistics for patient and graft survival were performed. From 1993 to 2010, 14 subjects underwent LT and 1 subject underwent combined kidney and LT; all subjects were female and the mean age was 49.0 years. 10 (66.7%) subjects had polycystic kidney disease. Patients experienced a high rate of vascular complications, including hepatic artery thrombosis (HAT) or stenosis in 3 (20%) and 2 (13.3%) subjects, respectively. One subject had early graft loss due to HAT and underwent re-transplantation. The mean length of hospitalization was 18.8 days. After a mean of 66.8 months of follow-up (3-200), 13 (86.7%) subjects are alive with satisfactory graft function, and no patients had renal failure. In conclusion, patients who underwent LT for PLD had a high rate of postoperative vascular complications. However, long-term patient and graft survival, and kidney function, is excellent. PMID:20720268

  7. Neurological complications of dengue fever: Experience from a tertiary center of north India

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    Rajesh Verma

    2011-01-01

    Full Text Available Introduction: Dengue, an acute viral disease transmitted by Aedes mosquitoes, is highly endemic in many tropical and subtropical areas of the world. Neurological complications of dengue infection have been observed more frequently in the recent past and some studies highlighted varied neurological complications arising in the course of dengue illness. In this retrospective study, we report various neurological complications observed during the last 2 years in patients of dengue fever. Materials and Methods: The patients presenting with neurological complications with positive serology (IgM antibody for dengue infection were consecutively recruited from the Department of Neurology/Medicine from a tertiary center of Lucknow, India. These patients were subjected to a detailed clinical evaluation, laboratory assessment including blood count, hematocrit, coagulation parameters, biochemical assays, serology for dengue fever, enzyme-linked immunosorbent assay for human immunodeficiency virus and other relevant investigations. Results: Twenty-six patients with neurological complications associated with confirmed dengue infection were observed during the last 2 years. Eighteen of these patients were male. Of the 26 patients, 10 patients were suffering from brachial neuritis, four patients had encephalopathy, three patients were consistent with the diagnosis of Guillain Barre syndrome, three patients had hypokalemic paralysis associated with dengue fever and two patients had acute viral myositis. Opsoclonus-myoclonus syndrome was diagnosed in two patients, myelitis in one patient and acute disseminated encephalo-myelitis also in one patient. Conclusion: Dengue fever was associated with widespread neurological complications. Brachial neuritis and opsoclonus-myoclonus syndrome were observed for the first time in this study.

  8. Neonates born to mothers with immune thrombocytopenic purpura: a single-center experience of 20 years.

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    Bayhan, Turan; Tavil, Betül; Korkmaz, Ayşe; Ünal, Şule; Hanalioğlu, Damla; Yiğit, Şule; Gümrük, Fatma; Çetin, Mualla; Yurdakök, Murat

    2016-01-01

    Neonates born to mothers with immune thrombocytopenic purpura (ITP) have an increased risk of having thrombocytopenia and bleeding. The aim of our study was to determine maternal and fetal factors that can predict bleeding risk in neonates born to mothers with ITP, and effective treatment strategies by retrospective analysis of our single-center data. We performed a retrospective data review of neonates that were recorded as 'neonates born to mothers with ITP' in the Neonatal ICU of Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey. Medical records of 36 neonates born from 35 mothers were analyzed. Among the 36 neonates born to mothers with ITP, thrombocytopenia (platelet count of less than 150 × 10/l) was detected in 20 (56.0%) neonates on the first day of life. Twelve of the 20 neonates with thrombocytopenia (60.0%) required treatment to increase the platelet counts. Clinical findings related to thrombocytopenia occurred in three (15.0%) neonates, but none of them presented with severe bleeding. There was no statistically significant association between neonatal lowest platelet count and maternal lowest platelet count, maternal platelet count at the time of delivery, and duration of thrombocytopenia, respectively. Neonates born to mothers with ITP have an increased tendency to develop thrombocytopenia, but severe bleeding is very rare in these neonates. Clinicians should pay special attention to follow these neonates. According to our results, both intravenous immunoglobulin and methyl prednisolone were found to be in equivalent efficacy for the treatment of neonatal thrombocytopenia due to maternal ITP. PMID:26258676

  9. Hepatic Steatosis Following Pancreatic Surgery: A Swedish Centers Experience with Demographics, Risks and Outcome

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    Tommy Ivanics

    2015-11-01

    Full Text Available Objective Non-alcoholic fatty liver disease encompasses a spectrum of fatty changes in the liver ranging from simple steatosis to nonalcoholic steatohepatitis. Certain patients may develop hepatic steatosis following pancreatic resections. The aim of our study was to investigate factors possibly associated with steatosis after pancreatic resection and to see if the survival of patients was influenced by its development. Methods 182 consecutive patients that underwent pancreatic surgery (between 2010-2013 in a Swedish high volume pancreatic center were retrospectively reviewed from the preoperative work-up until at least 6 months postoperatively. Pre-versus postoperative values of Hounsfield Units were checked on CT scans and utilized as a proxy for development of hepatic steatosis. Demographic data and a number of possible risk factors were recorded together with survival after surgery. Results 17 percent of our patient group developed hepatic steatosis within the first year of surgery. The development of steatosis occurred significantly more frequently in females and in patients over the age of 70. Hepatic steatosis was positively associated with increased levels of alanine amino transferase (ALT after surgery. No association was noted between grade of weight loss and steatosis. Nor were there any correlations between the incidence of steatosis and the type of operation. Post-operative hepatic steatosis did not adversely affect overall survival. Conclusion Our results demonstrate that certain demographic and laboratory values are associated with the development of hepatic steatosis after pancreatic resections. However, despite its development, hepatic steatosis is of no apparent clinical significance and does not affect overall survival following pancreatic surgery.

  10. Management of autoimmune hemolytic anemia in children and adolescents: A single center experience

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    Nazan Sarper

    2011-09-01

    Full Text Available Objective: To present and discuss the treatment of autoimmune hemolytic anemia (AIHA. Materials and Methods: The medical records of all patients (n=19 diagnosed in a tertiary hematology center between 1999 and 2010 were retrospectively reviewed.Results: Median age at diagnosis of AIHA was 5 years (range: 4 months-17 years. In all, 13 patients had primary (idiopathic AIHA, whereas 2 had primary Evans Syndrome (ES, 2 had autoimmune lymphoproliferative syndrome (ALPS+ES, and 1 had Wiskott-Aldrich syndrome (WAS+AIHA. Among the 13 primary idiopathic AIHA patients, 9 recovered following a 4-8-week course of prednisolone treatment without relapses, whereas 3 patients required a longer course of prednisolone. One AIHA patient that was very resistant to prednisolone recovered after cyclosporine A was added to the treatment. All patients with primary idiopathic AIHA were in remission for a median of 3 years (range: 4 months-10 years at the time this manuscript was written. Among the patients with primary ES, 2 had relapses similar to the ALPS patients. Splenectomy was performed in 1 primary ES patient, who at the time this report was written was also in remission. One ALPS patient required the addition of mycophenolate mofetil due to prednisolone resistance. The WAS patient was treatment resistant and died due to septicemia.Conclusions: Primary AIHA in pediatric patients generally has an acute onset and good response to corticosteroids. Primary or secondary ES has a chronic or relapsing course, and treatment may require other immunosuppressive agents in addition to corticosteroids. Complications of splenectomy must not be underestimated in patients with underlying immunodeficiency. AIHA often causes considerable morbidity and mortality in WAS.

  11. Evaluation of Sensorimotor Nerve Damage in Patients with Maxillofacial Trauma; a Single Center Experience

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    Behnaz Poorian

    2016-04-01

    Full Text Available Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, Iran Methods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate. Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1% women among the patients. The frequency of nerve injuries was 67.7% (336 patients. The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%. Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1% was the most common involved branch followed by infraorbital branch (135 patients 27.2%. Mandibular fracture was the most common injured bone being reported in 376 patient (75.9% patients followed by zygomatic bone in 100 patient (20%. Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.

  12. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Silber, Toni; Ziemann, Ulf [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany); Ernemann, Ulrike [Department of Diagnostic and Interventional Neuroradiology, University of Tübingen (Germany); Bischof, Felix, E-mail: felix.bischof@uni-tuebingen.de [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany)

    2014-12-15

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

  13. Initial clinical experience with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO)

    International Nuclear Information System (INIS)

    We report the initial toxicity data with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO). In September 2011, CNAO commenced patient treatment with scanned proton beams within two prospective Phase II protocols approved by the Italian Health Ministry. Patients with chondrosarcoma or chordoma of the skull base or spine were eligible. By October 2012, 21 patients had completed treatment. Immobilization was performed using rigid non-perforated thermoplastic-masks and customized headrests or body-pillows as indicated. Non-contrast CT scans with immobilization devices in place and MRI scans in supine position were performed for treatment-planning. For chordoma, the prescribed doses were 74 cobalt grey equivalent (CGE) and 54 CGE to planning target volume 1 (PTV1) and PTV2, respectively. For chondrosarcoma, the prescribed doses were 70 CGE and 54 CGE to PTV1 and PTV2, respectively. Treatment was delivered five days a week in 35-37 fractions. Prior to treatment, the patients' positions were verified using an optical tracking system and orthogonal X-ray images. Proton beams were delivered using fixed-horizontal portals on a robotic couch. Weekly MRI incorporating diffusion-weighted-imaging was performed during the course of proton therapy. Patients were reviewed once weekly and acute toxicities were graded with the Common Terminology Criteria for Adverse Events (CTCAE). Median age of patients =50 years (range, 21-74). All 21 patients completed the proton therapy without major toxicities and without treatment interruption. Median dose delivered was 74 CGE (range, 70-74). The maximum toxicity recorded was CTCAE Grade 2 in four patients. Our preliminary data demonstrates the clinical feasibility of scanned proton beams in Italy. (author)

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

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    Marina Cavalcanti Maroja Silvino

    2013-08-01

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

  15. BRAIN METASTASES OF GERM CELL TUMORS. THE RUSSIAN CANCER RESEARCH CENTER'S EXPERIENCE

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    A. A. Tryakin

    2014-07-01

    Full Text Available This paper analyzes the experience in treating 20 patients with nonseminomatous germ cell tumors metastasizing to the brain. It presents brain metastasis-associated factors: multiple lung metastases; IGCCCG poor prognosis; and a baseline human chorionic gonadotropin level of > 50000 mIU/ml. The authors have identified a group to be screened for brain metastasis, which includes patients with intermediate/poor prognosis and multiple lung metastases. Long-term survival was achieved in 45 % of patients with baseline brain damage and in 22 % of those with metastases revealed after first-line chemotherapy. The positive prognostic factors associated with long-term survival were a single brain lesion, no neurological symptoms, and achievement of clinical complete personse in the brain.

  16. Wellbeing in healthcare environments : a human-centered design research approach to improving the cancer patient experience during radiation therapy

    OpenAIRE

    Mullaney, Tara; Nyholm, Tufve; Edvardsson, David

    2011-01-01

    Healthcare and medical products are often designed with the singular focus of providing the best treatment available to patients. However, research has shown that this treatment-based approach does not result in quality care. There are many factors that play into making a healthcare experience patient-centered, and this paper explores the use of human-centered design research to understand this experience. This paper presents a case-study of a Radiotherapy Department at a University Hospital,...

  17. Radiological safety experience in nuclear fuel cycle operations at Bhabha Atomic Research Center, Trombay, Mumbai, India

    International Nuclear Information System (INIS)

    Activities at Bhabha Atomic Research Centre (BARC), Mumbai, cover nuclear fuel cycle operations based on natural uranium as the fuel. The facilities include: plant for purification and production of nuclear grade uranium metal, fuel fabrication, research reactor operation, fuel reprocessing and radioactive waste management in each stage. Comprehensive radiation protection programmes for assessment and monitoring of radiological impact of these operations, both in occupational and public environment, have been operating in BARC since beginning. These programmes, based on the 1990 ICRP Recommendations as prescribed by national regulatory body, the Atomic Energy Regulatory Board (AERB), are being successfully implemented by the Health, Safety and Environment Group, BARC. Radiation Hazards Control Units attached to the nuclear fuel cycle facilities provide radiation safety surveillance to the various operations. The radiation monitoring programme consists of measurement and control of external exposures by thermoluminescent dosimeters (TLDs), hand-held and installed instruments, and internal exposures by bioassay and direct whole body counting using shadow shield counter for beta gamma emitters and phoswich detector based system for plutonium. In addition, an environmental monitoring programme is in place to assess public exposures resulting from the operation of these facilities. The programme involves analysis of various matrices in the environment such as bay water, salt, fish, sediment and computation of resulting public exposures. Based on the operating experience in these plants, improved educating and training programmes for plant operators, have been designed. This, together with the application of new technologies have brought down individual as well as average doses of occupational workers. The environmental releases remain a small fraction of the authorised limits. The operating health physics experience in some of these facilities is discussed in this paper

  18. Clinical Characteristics of Bowel Obstruction in Southern Iran; Results of a Single Center Experience

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    Majid Akrami

    2015-01-01

    Full Text Available Objective: To determine the epidemiological, clinical, laboratory characteristics as well as outcome of 411 patients with bowel obstruction in Southern Iran. Methods: This was a cross-sectional study being performed in Shahid Faghihi hospital of Shiraz between 2006 and 2012. We reviewed the medical charts of the 411 patients with initial diagnosis of bowel obstruction who were admitted to our center during the study period. The patients’ demographic, clinical and laboratory findings as well as their management and outcome was recorded in data gathering forms. The data were then analyzed according to the outcome and clinical characteristics. Results: Among the 411 patients with initial diagnosis of bowel obstruction, 253 (61.5% were men and 158 (38.5% were women. The mean age of the patients was 48.2±19.7 years. Besides, 73.6% were observed and 26.4% were operated. Those who were operated had those who underwent operation had significantly lower frequency of obstipation (28.1% vs. 71.9%; p=0.045 and abdominal distention (32.3% vs. 67.7%; p=0.007. Intraoperative findings included adhesion band formation in 50 (48.1%, mass 18 (17.3%, and hernia 7 (6.7%. We found that the frequency of malignancy was significantly higher in those who were managed conservatively compared to those undergoing operation (64.3% vs. 35.7%; p=0.042. The mean hospital stay was significantly higher in those who underwent operation (8.1±7.5 vs. 2.6±2.2 days; p=0.035. Conclusion: The results of this study demonstrates although some signs and symptoms, such as abdominal pain, vomiting, abdominal tenderness, abdominal distention, and obstipation, were more common among the patients with bowel obstruction, they were not sensitive and specific enough for definite diagnosis. Due to the lack of positive predictive value of clinical signs and symptoms in diagnosis of bowel obstruction, a reasonable and logical modality is needed for bowel obstruction diagnosis with better

  19. Conversion from temporary to tunneled catheters by nephrologists: report of a single-center experience

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    Silva BC

    2016-04-01

    Full Text Available Bruno C Silva, Camila E Rodrigues, Regina CRM Abdulkader, Rosilene M Elias Nephrology Division, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil Background: Nephrologists have increasingly participated in the conversion from temporary catheters (TC to tunneled-cuffed catheters (TCCs for hemodialysis. Objective: To prospectively analyze the outcomes associated with TCC placement by nephrologists with expertise in such procedure, in different time periods at the same center. The impact of vancomycin or cefazolin as prophylactic antibiotics on the infection outcomes was also tested. Patients and methods: Hemodialysis patients who presented to such procedure were divided into two cohorts: A (from 2004 to 2008 and B (from 2013 to 2015. Time from TC to TCC conversion, prophylactic antibiotics, and reasons for TCC removal were evaluated. Results: One hundred and thirty patients were included in cohort A and 228 in cohort B. Sex, age, and follow-up time were similar between cohorts. Median time from TC to TCC conversion was longer in cohort A than in cohort B (14 [3; 30] vs 4 [1; 8] days, respectively; P<0.0001. Infection leading to catheter removal occurred in 26.4% vs 18.9% of procedures in cohorts A and B, respectively, and infection rate was 0.93 vs 0.73 infections per 1,000 catheter-days, respectively (P=0.092. Infection within 30 days from the procedure occurred in 1.4% of overall cohort. No differences were observed when comparing vancomycin and cefazolin as prophylactic antibiotics on 90-day infection-free TCC survival in a Kaplan–Meier model (log-rank = 0.188. TCC removal for low blood flow occurred in 8.9% of procedures. Conclusion: Conversion of TC to TCC by nephrologists had overall infection, catheter patency, and complications similar to data reported in the literature. Vancomycin was not superior to cefazolin as a prophylactic antibiotic. Keywords: renal dialysis, tunneled catheters, interventional nephrology

  20. Spectrum of intradialytic complications during hemodialysis and its management: A single-center experience

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    Prabhakar

    2015-01-01

    Full Text Available Hemodialysis (HD is one of the important modalities of renal replacement therapy in acute renal failure (ARF as well as chronic renal failure (CRF. This study was performed to evaluate the various intradialytic complications that occur during HD and their management. This is a retrospective study performed in patients who underwent conventional HD during the period of 1 January 2000 to 31 December 2011 at our center. Clinical details, various complications faced and their management were retrieved from dialysis case sheets. A total of 2325 patients of renal failure (790 ARF and 1535 CRF patients were assessed for the intradialytic complications of HD. During the study period, there were 12,785 bicarbonate dialyses performed on these patients. In the ARF patients, the common intradialytic complications were: Hypotension, seen in 1296 sessions (30.4%, nausea and vomiting seen in 1125 sessions (26.4%, fever and chills seen in 818 sessions (19.2%, headache seen in 665 sessions (15.6%, cramps seen in 85 sessions (2.0%, chest pain and back pain seen in 82 sessions (1.92%, hypoglycemia seen in 77 sessions (1.8%, first-use syndrome seen in 72 sessions (1.7% and femoral hematoma seen in 31 sessions (0.73%. In the CRF group, common complications were hypotension in 2230 sessions (26.1%, nausea and vomiting in 1211 sessions (14.2%, fever and chills in 1228 sessions (14.4%, chest pain and back pain in 1108 cases (13.0%, hypertension in 886 sessions (10.4%, headache in 886 sessions (10.4%, cramps in 256 sessions (3.0%, hematoma in 55 sessions (0.64%, intracerebral hemorrhage in three sessions (0.03% and catheter tip migration in three sessions (0.03%. There is a need for special attention for the diagnosis and management of intradialytic complications of HD because such complications could be managed successfully without the need for termination of the dialysis procedure.

  1. Impact of hepatitis C infection on renal transplant patients: A single-center experience in Libya

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    Abdel-Naser Y Elzouki

    2014-01-01

    Full Text Available The objective of this study was to assess the effect of hepatitis C virus (HCV infection on graft and patient survival in a cohort of Libyan renal transplant recipients. Medical records of 241 renal transplant (RT patients who have been followed-up at the Benghazi Nephrology Center up to February 2010 were reviewed. Based on the presence or absence of anti-HCV antibodies and HCV-RNA in the serum, patients were divided into two groups: HCV-positives and HCV-negatives. Anti-HCV antibodies were detected by the enzyme-linked immunosorbent assay technique and HCV-RNA by the polymerase chain reaction. Of the 241 RT patients, 162 were male and 79 were female. One hundred and ten patients (45.6% were HCV-positives and 131 (54.4% were HCV-negatives. Acute graft rejection was significantly higher among HCV-negative than HCV-positive patients (42 patients versus 28 patients, respectively; P < 0.001. Conversely, chronic graft rejection was higher among HCV-positives than that among HCV-negative patients (35 patients versus 24 patients, respectively; P <0.05, and this difference became more significant after a 12-month period of transplantation (P <0.01. Seventeen patients died during the follow-up: Seven HCV-positives (6.3% and 10 HCV-negatives (7.6%, and there was no significant difference in the death rate following RT between the two groups (P = 0.08. Among the seven deaths of HCV-positives, liver disease-related complications were the main cause of death in three (42.8% HCV-positive patients compared with none in the HCV-negative patients. The presence of HCV infection influenced chronic graft survival in RT patients and a higher proportion of HCV-infected patients had hepatic dysfunctions after RT. An increase in fatal liver complications was noted in HCV-positive patients with RT. In addition to pre-RT-specific therapy of HCV infection, all measures should be taken to prevent HCV infection pre- and post-RT. HCV-infected RT recipients need close

  2. Epilepsia Partialis Continua over last 14 years: experience from a tertiary care center from south India.

    Science.gov (United States)

    Sinha, S; Satishchandra, P

    2007-04-01

    Epilepsia Partialis Continua (EPC), a subtype of status epilepticus has varied etiology and the outcome depends on the cause. The aim of this study was to analyze the demographic, semiology, etiology, radiological findings, therapeutic response and outcome of EPC. This is a retrospective analysis of 76 patients (M:F: 46:30; mean age: 30.2+/-23.4 years; median age: 26 years) evaluated at our center over last 14 years. Twenty-three subjects (30.3%) had epilepsy for a mean of 25.8+/-52.3 months (range: 1-81 years; median: 14) before developing EPC and in half of them, seizures were controlled with anti-epileptic drugs (AEDs). Rest 53 (69.3%) manifested as de novo. The mean duration of EPC was 47.02+/-188.2 days (range: 1h to 48 months; median: 3 days). One patient of generalized convulsive SE (GCSE) evolved into EPC while five patients of EPC evolved into GCSE. CT scan of brain (n-76) was abnormal in 53 (69.7%) while all the 11 MRI scans which were available were abnormal. EEG (n-21) was abnormal in all but one, however it was non-specific in 7. The diagnoses were-idiopathic: 17, ischemic stroke: 15, meningo-encephalitis: 8, Rasmussen's encephalitis (RE): 7, granuloma: 6, diabetic-non-ketotic-hyperosmolar-coma (DNKHC): 6, CNS malignancies (primary/secondary): 4, birth injury: 4, cerebral venous thrombosis: 3, CNS tuberculosis: 2, and cerebritis, HIV-related, toxemia of pregnancy, and MERRF one each. Patients of >40 years (n=21) had stroke (10), idiopathic (6), DNKHC (4) and metastasis (1) as common causes. Only 12 of them received single AED, while others required 2 or more AEDs to control the seizures. The outcome (n=72) was-controlled: 43 (59.7%); uncontrolled: 26 (36.1%) (RE: 7, idiopathic: 5, birth injury: 4, encephalitis: 3, malignancy: 2, granuloma and MERRF: 1 each) and three patients succumbed (encephalitis: 2, idiopathic: 1). Causes of EPC are varied and it depends on age. Underlying cause determined the outcome and could be refractory in RE, idiopathic, and

  3. Patient radiation dose in diagnostic and interventional procedures for intracranial aneurysms: Experience at a single center

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    Chun, Chang Woo; Kim, Bum Soo; Lee, Cheol Hyoun; Ihn, Yon Kwon; Shin, Yong Sam [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul(Korea, Republic of)

    2014-12-15

    To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms in a large sample size from a single center. We studied a sample of 439 diagnostic and 149 therapeutic procedures for intracranial aneurysms in 480 patients (331 females, 149 males; median age, 57 years; range, 21-88 years), which were performed in 2012 with a biplane unit. Parameters including fluoroscopic time, dose-area product (DAP), and total angiographic image frames were obtained and analyzed. Mean fluoroscopic time, total mean DAP, and total image frames were 12.6 minutes, 136.6 +/- 44.8 Gy-cm{sup 2}, and 251 +/- 49 frames for diagnostic procedures, 52.9 minutes, 226.0 +/- 129.2 Gy-cm{sup 2}, and 241 frames for therapeutic procedures, and 52.2 minutes, 334.5 +/- 184.6 Gy-cm{sup 2}, and 408 frames for when both procedures were performed during the same session. The third quartiles for diagnostic reference levels (DRLs) were 14.0, 61.1, and 66.1 minutes for fluoroscopy time, 154.2, 272.8, and 393.8 Gy-cm{sup 2} for DAP, and 272, 276, and 535 for numbers of image frames in diagnostic, therapeutic, and both procedures in the same session, respectively. The proportions of fluoroscopy in DAP for the procedures were 11.4%, 50.5%, and 36.1%, respectively, for the three groups. The mean DAP for each 3-dimensional rotational angiographic acquisition was 19.2 +/- 3.2 Gy-cm{sup 2}. On average, rotational angiography was used 1.4 +/- 0.6 times/session (range, 1-4; n = 580). Radiation dose in our study as measured by DAP, fluoroscopy time and image frames did not differ significantly from other reported DRL studies for cerebral angiography, and DAP was lower with fewer angiographic image frames for embolization. A national registry of radiation-dose data is a necessary next step to refine the dose reference level.

  4. The LANL/LLNL Program to Measure Prompt Fission Neutron Spectra at LANSCE

    Science.gov (United States)

    Haight, Robert; Wu, Ching Yen; Lee, Hye Young; Taddeucci, Terry; Mosby, Shea; O'Donnell, John; Fotiades, Nikolaos; Devlin, Mattew; Ullmann, John; Nelson, Ronald; Wender, Stephen; White, Morgan; Solomon, Clell; Neudecker, Denise; Talou, Patrick; Rising, Michael; Bucher, Brian; Buckner, Matthew; Henderson, Roger

    2015-10-01

    Accurate data on the spectrum of neutrons emitted in neutron-induced fission are needed for applications and for a better understanding of the fission process. At LANSCE we have made important progress in understanding systematic uncertainties and in obtaining data for 235U on the low-energy part of the prompt fission neutron spectra (PFNS), a particularly difficult region because down-scattered neutrons go in this direction. We use a double time-of-flight technique to determine energies of incoming and outgoing neutrons. With data acquisition via waveform digitizers, accidental coincidences between fission chamber and neutron detector are measured to high statistical accuracy and then subtracted from measured events. Monte Carlo simulations with high performance computers have proven to be essential in the design to minimize neutron scattering and in calculating detector response. Results from one of three approaches to analyzing the data will be presented. This work is funded by the US Department of Energy, National Nuclear Security Administration and Office of Nuclear Physics.

  5. LANSCE-R WIRE-SCANNER ANALOG FRONT-END ELECTRONICS

    International Nuclear Information System (INIS)

    A new AFE is being developed for the new LANSCE-R wire-scanner systems. The new AFE is implemented in a National Instruments Compact RIO (cRIO) module installed a BiRa 4U BiRIO cRIO chassis specifically designed to accommodate the cRIO crate and all the wire-scanner interface, control and motor-drive electronics. A single AFE module provides interface to both X and Y wire sensors using true DC coupled transimpedance amplifiers providing collection of the wire charge signals, real-time wire integrity verification using the normal dataacquisition system, and wire bias of 0V to +/-50V. The AFE system is designed to accommodate comparatively long macropulses (>1ms) with high PRF (>120Hz) without the need to provide timing signals. The basic AFE bandwidth is flat from true DC to 50kHz with a true first-order pole at 50kHz. Numeric integration in the cRIO FPGA provides real-time pulse-to-pulse numeric integration of the AFE signal to compute the total charge collected in each macropulse. This method of charge collection eliminates the need to provide synchronization signals to the wire-scanner AFE while providing the capability to accurately record the charge from long macropulses at high PRF.

  6. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H(+) RFQ project.

    Science.gov (United States)

    Fortgang, C M; Batygin, Y K; Draganic, I N; Garnett, R W; McCrady, R C; Rybarcyk, L J

    2016-02-01

    The 750-keV H(+) Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H(+) current with an emittance work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication. PMID:26932079

  7. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H+ RFQ project

    Science.gov (United States)

    Fortgang, C. M.; Batygin, Y. K.; Draganic, I. N.; Garnett, R. W.; McCrady, R. C.; Rybarcyk, L. J.

    2016-02-01

    The 750-keV H+ Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H+ current with an emittance work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication.

  8. Tolerability of sirolimus: a decade of experience at a single cardiac transplant center.

    Science.gov (United States)

    Thibodeau, Jennifer T; Mishkin, Joseph D; Patel, Parag C; Kaiser, Patricia A; Ayers, Colby R; Mammen, Pradeep P A; Markham, David W; Ring, William Steves; Peltz, Matthias; Drazner, Mark H

    2013-01-01

    Sirolimus is used in cardiac transplant recipients to prevent rejection, progression of cardiac allograft vasculopathy, and renal dysfunction. However, sirolimus has many potential side effects and its tolerability when used outside of clinical trials is not well established. We describe a decade of experience with sirolimus in cardiac transplant recipients at our institution. We retrospectively reviewed records of all adult cardiac transplant recipients living between September 1999 and February 2010 (n = 329) and identified 67 patients (20%) who received sirolimus. The indications for sirolimus were cardiac allograft vasculopathy (67%), renal dysfunction (25%), rejection (4%), and intolerability of tacrolimus (3%). One-third of patients discontinued sirolimus at a median (25th, 75th percentiles) of 0.9 (0.2, 1.6) yr of duration. Over 70% of subjects experienced an adverse event attributed to sirolimus. Adverse events were associated with higher average sirolimus levels (9.1 ng/mL vs. 7.1 ng/mL, p = 0.004). We conclude that sirolimus is frequently used in cardiac transplant recipients (20%) and commonly causes side effects, often necessitating discontinuation. Higher average sirolimus levels were associated with adverse events, suggesting that tolerability may improve if levels are maintained within the lower end of the current therapeutic range; however, the improvement in tolerability would need to be balanced with the potential for decreased efficacy. PMID:24304376

  9. Determination of Significant Composite Processing Factors by Designed Experiment (MSFC Center Director's Discretionary Fund)

    Science.gov (United States)

    Finckenor, J. L.

    2003-01-01

    To determie composite material properties' effects from porcessing variables, a 3 factorial designed experiment with two replicates was conducted. The factors were cure method (oven versus autoclave), layup (hand versus tape-laying machine), and thickness (8 versus 52 ply). Four material systems were tested: AS4/3501-6, IM7/8551-7, IM7/F655 bismaleimide (BMI), and shear tests on IM7/F584. Material properties were G(sub 12), v(sub 12), E(sub 1c) and E(sub 2c). Since the samples were necessarily nonstandard, strengths, though recorded, cannot be considered valid. Void content was also compared. Autoclave curing helped material properties for the low modulus fiber material but showed little benefit for higher stiffness fibers. The number of plies was very important for epoxy composites but not for the BMI. E(sub 1) was generally unaffected by any factor. Particularly high void content did correlate to reduced properties. Autoclave curing reduced void content over oven curiing but a moderate amount of voids, less than 1 percent void content, didnot correlate with material properties. Oven cures and hand layups can produce high-quality parts. Part thickness of epoxy composites is important, though cure optimization may improve performance. Significant variations can be caused by processing and it is important that test coupons always reflect the layup and processes of the final part.

  10. Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience

    Directory of Open Access Journals (Sweden)

    Armin D. Goralczyk

    2009-01-01

    Full Text Available Adult living donor liver transplantations (ALDLTs across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR. Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety.

  11. COMBREX-DB: an experiment centered database of protein function: knowledge, predictions and knowledge gaps.

    Science.gov (United States)

    Chang, Yi-Chien; Hu, Zhenjun; Rachlin, John; Anton, Brian P; Kasif, Simon; Roberts, Richard J; Steffen, Martin

    2016-01-01

    The COMBREX database (COMBREX-DB; combrex.bu.edu) is an online repository of information related to (i) experimentally determined protein function, (ii) predicted protein function, (iii) relationships among proteins of unknown function and various types of experimental data, including molecular function, protein structure, and associated phenotypes. The database was created as part of the novel COMBREX (COMputational BRidges to EXperiments) effort aimed at accelerating the rate of gene function validation. It currently holds information on ∼ 3.3 million known and predicted proteins from over 1000 completely sequenced bacterial and archaeal genomes. The database also contains a prototype recommendation system for helping users identify those proteins whose experimental determination of function would be most informative for predicting function for other proteins within protein families. The emphasis on documenting experimental evidence for function predictions, and the prioritization of uncharacterized proteins for experimental testing distinguish COMBREX from other publicly available microbial genomics resources. This article describes updates to COMBREX-DB since an initial description in the 2011 NAR Database Issue. PMID:26635392

  12. Robotic versus conventional laparoscopic colorectal operations: a-single center experience

    Science.gov (United States)

    Bozkurt, Mehmet Abdussamet; Kocataş, Ali; Gemici, Eyüp; Kalaycı, Mustafa Uygar; Alış, Halil

    2016-01-01

    Objective: Robotic surgery was first introduced in 2000 especially to overcome the limitations of low rectum cancer surgery. There is still no consensus regarding the standard method for colorectal surgery. The aim of this study was to compare robotic surgery with laparoscopic colorectal surgery. Material and Methods: This is a retrospective study. Data of patients with a diagnosis of colon or rectal cancer were analyzed for robotic colorectal surgery and laparoscopic colorectal surgery. Results: The cost of robotic surgery group was statistically higher than the laparoscopic surgery group (p=0.032). The average operation duration was 178 minutes in the laparoscopic surgery group and 228 minutes in the robotic surgery group, and this difference was statistically significant (p=0.044). There was no statistically significant difference between the groups regarding other parameters. Discussion: Disadvantages of robotic surgery seem to be its higher cost and longer operation duration as compared to laparoscopic surgery. We claim that an increase in the number of cases and experience may shorten the operation time while the increase in commercial interest may decrease the cost disadvantage of robotic surgery.

  13. Results of candidemia treatment in children with hematologic malignancies: single center experience

    Directory of Open Access Journals (Sweden)

    I. I. Kalinina

    2014-07-01

    Full Text Available Candidemia is one of the most serious infectious complications in children with hematological malignancies and has a high morta lity rate.Seven-year experience of candidemia diagnosis and therapy in patients with various hematologic malignancies w as analyzed. Candidemia registered in 37 patients (AML and MDS — 14, ALL — 10, solid tumors — 5, histocytic syndromes — 4, AA — 3, other non-malignancy diseases— 2. C. non-albicans (36 isolates from 32 patients was common cause of, while C. albicans isolated in 5 patients (8 strains. Antifungal prophylactic therapy was applied to 31 patients. 22 patients at the time of candidemia have neutropenia (< 0.5 × 10 9/l. Main clinical manifestations were febrile fever (100 % cases and pneumonia (21.6 % cases. Less frequent multiorgan failure (8.1 %, septic shoc k (5.4 %, chronic disseminated candidiasis (5.4 % and meningitis (2.7 % were registered. All patients received antifungal therapy (monotherapy — 17, combination therapy — 20. Central venous catheter removed in 21 patients. In 14 patients hematopoietic recovery w as registered, none of these patients died, while from group of patients without hematopoietic recovery 6 patients died (p = 0.0001. Recurrent candidemia episodes were seen in 4 patients. Overall survival was 0.37 ± 0.09.

  14. Experience of a single center with congenital hepatic fibrosis: A review of the literature

    Directory of Open Access Journals (Sweden)

    Ali Shorbagi, Yusuf Bayraktar

    2010-02-01

    Full Text Available Congenital hepatic fibrosis (CHF is an autosomal recessive inherited malformation defined pathologically by a variable degree of periportal fibrosis and irregularly shaped proliferating bile ducts. It is one of the fibropolycystic diseases, which also include Caroli disease, autosomal dominant polycystic kidney disease, and autosomal recessive polycystic kidney disease. Clinically it is characterized by hepatic fibrosis, portal hypertension, and renal cystic disease. CHF is known to occur in association with a range of both inherited and non-inherited disorders, with multiorgan involvement, as a result of ductal plate malformation. Because of the similarities in the clinical picture, it is necessary to differentiate CHF from idiopathic portal hypertension and early liver cirrhosis, for which a liver biopsy is essential. Radiological tests are important for recognizing involvement of other organ systems. With regards to our experience at Hacettepe University, a total of 26 patients have been diagnosed and followed-up between 1974 and 2009 with a diagnosis of CHF. Presentation with Caroli syndrome was the most common diagnosis, with all such patients presenting with symptoms of recurrent cholangitis and symptoms related to portal hypertension. Although portal fibrosis is known to contribute to the ensuing portal hypertension, it is our belief that portal vein cavernous transformation also plays an important role in its pathogenesis. In all patients with CHF portal vein morphology should be evaluated by all means since portal vein involvement results in more severe and complicated portal hypertension. Other associations include the Joubert and Bardet-Biedl syndromes.

  15. Phenylketonuria. Experience at one center in the first year of screening in California.

    Science.gov (United States)

    Peterson, R M; Koch, R; Schaeffler, G E; Wohlers, A; Acosta, P B; Boyle, D

    1968-05-01

    One year's experience with phenylketonuria during the calendar year 1966, the first year for compulsory newborn screening in California, was reviewed. The over-all prevalence rate from reported cases in California during this period was one case per 19,500 persons tested. Fifty-seven persons suspected of having pku were evaluated, and 25 of them were determined to be phenylketonuric. Eleven of the 25 were infants in whom the abnormality was detected through the newborn screening program or because it was detected in a sibling through a screening program. All the newborn phenylketonuric patients were developing normally at the time of last report (although the follow-up periods were short). In nine of the other children, pku was detected because they were retarded. Five retarded children who were diagnosed as phenylketonuric at another clinic were given dietary assistance. Five additional infants had elevated serum phenylalanines but did not have the classic biochemical findings of pku and are being evaluated further. Nine infants with positive screening tests exhibited biochemical and clinical findings consistent with transient tyrosinemia. Eighteen other children were evaluated and found to have no metabolic abnormality. The newborn screening program for pku is of decided benefit in early identification of a group of infants who have a high rate of potentially serious metabolic disease. Early identification permits treatment soon enough to prevent mental retardation. Newly identified patients should be evaluated in a medical setting capable of careful pediatric, biochemical and nutritional surveillance. PMID:5652755

  16. Phenylketonuria—Experience at One Center in the First Year of Screening in California

    Science.gov (United States)

    Peterson, Raymond M.; Koch, Richard; Schaeffler, Graciela E.; Wohlers, Audrey; Acosta, Phyllis B.; Boyle, David

    1968-01-01

    One year's experience with phenylketonuria during the calendar year 1966, the first year for compulsory newborn screening in California, was reviewed. The over-all prevalence rate from reported cases in California during this period was one case per 19,500 persons tested. Fifty-seven persons suspected of having pku were evaluated, and 25 of them were determined to be phenylketonuric. Eleven of the 25 were infants in whom the abnormality was detected through the newborn screening program or because it was detected in a sibling through a screening program. All the newborn phenylketonuric patients were developing normally at the time of last report (although the follow-up periods were short). In nine of the other children, pku was detected because they were retarded. Five retarded children who were diagnosed as phenylketonuric at another clinic were given dietary assistance. Five additional infants had elevated serum phenylalanines but did not have the classic biochemical findings of pku and are being evaluated further. Nine infants with positive screening tests exhibited biochemical and clinical findings consistent with transient tyrosinemia. Eighteen other children were evaluated and found to have no metabolic abnormality. The newborn screening program for pku is of decided benefit in early identification of a group of infants who have a high rate of potentially serious metabolic disease. Early identification permits treatment soon enough to prevent mental retardation. Newly identified patients should be evaluated in a medical setting capable of careful pediatric, biochemical and nutritional surveillance. PMID:5652755

  17. Ureteroscopy and Laser Lithotripsy for Treatment of Ureteral Stones in Pregnants: Single Center Experience

    Directory of Open Access Journals (Sweden)

    Mustafa Okan İstanbulluoğlu

    2016-03-01

    Full Text Available Objective: To report our ureteroscopic laser lithotrip­sy experiences in the treatment of symptomatic ureter stones in pregnants which do not respond to conservative treatment Methods: A total of 6 pregnants aged between 22-33 years in second or third trimester were studied. Holmium-YAG laser lithotripsy was performed with 6.5 F semirigid uretroscope. Results: The diagnosis of ureter stone was made with ab­dominal ultrasonography in 5 patients and with magnetic resonance in one patient. Adequate stone fragmentation was performed in 2 mid-ureter and 4 distal-ureter stones. J stent was applied in one patient after the fragmenta­tion process. The mean operation time was 24.8 ± 10.0 minutes after the entry of bladder with ureteroscope un­der spinal anesthesia. No urologic, anesthetic or obstetric complication was seen and all patients gave healthy birth at term. Conclusion: Fine calibrated ureteroscopes for the treat­ment of ureter stones in pregnants are fast and effective treatment modalities which decrease the operation time and remove difficulties in entering the ureter.

  18. The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

    DEFF Research Database (Denmark)

    Giebel, S; Labopin, M; Mohty, M;

    2013-01-01

    Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...... or unrelated donors for adult patients with AML in first CR were analyzed according to the level of center activity. Transplants were performed in 203 European centers between 2001 and 2007. The 2-year probability of leukemia-free survival (LFS) after RIC-HSCT performed in centers with the lowest...

  19. 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

  20. Long term outcome of acquired food allergy in pediatric liver recipients: a single center experience

    Directory of Open Access Journals (Sweden)

    Antigoni Mavroudi

    2012-01-01

    Full Text Available Food induced sensitization has been reported in pediatric liver recipients. However long term follow up has not been established so far. We report here our experience regarding 3 pediatric patients who developed acquired food allergy after liver transplantation. The first patient suffered from persistent diarrhea and eczema. The second one presented with abdominal pain with no signs of rejection, abdominal discomfort, vomiting when ingesting milk proteins and responded well to the elimination diet. The third patient presented with facial angioedema and hoarseness of voice. She had multiple food allergies and reacted to milk, egg and sesame. All the patients had elevated total Immunoglobulin E (IgE and elevated specific IgE antibodies to the implicated food allergens. The first patient presented clinical manifestations of allergy when she was 19 months old. The second patient became allergic at the age of 16 and the third patient at the age of 3. The symptoms of food allergy persisted for 8 years in the first case and for 2 years in the other two cases. Low levels of specific IgE antibodies to the implicated food allergens and an enhanced T-helper 1 cell immune response toward interferon-gamma production were markers of tolerance acquisition. The long term prognosis in our cases was excellent. Food allergy resolved in all the patients. The long term prognosis of acquired food allergy after liver transplantation is currently obscure. More studies would be needed including greater number of patients to determine whether acquired food allergy is transient in pediatric liver recipients.

  1. Conjoined twins: twenty years' experience at a reference center in Brazil

    Directory of Open Access Journals (Sweden)

    Ana Cristina Aoun Tannuri

    2013-01-01

    Full Text Available OBJECTIVE: This study reports on the experience of one hospital regarding the surgical aspects, anatomic investigation and outcomes of the management of 21 conjoined twin pairs over the past 20 years. METHODS: All cases of conjoined twins who were treated during this period were reviewed. A careful imaging evaluation was performed to detail the abdominal anatomy (particularly the liver, inferior vena cava, spleen and pancreas, either to identify the number of organs or to evaluate the degree of organ sharing. RESULTS: There were eight sets of ischiopagus twins, seven sets of thoracopagus twins, three sets of omphalopagus twins, two sets of thoraco-omphalo-ischiopagus twins and one set of craniopagus twins. Nine pairs of conjoined twins could not be separated due to the complexity of the organs (mainly the liver and heart that were shared by both twins; these pairs included one set of ischiopagus twins, six sets of thoracopagus twins and one set of thoraco-omphalo-ischiopagus twins. Twelve sets were separated, including seven sets of ischiopagus twins, three sets of omphalopagus twins, one set of thoracopagus twins and one set of craniopagus conjoined twins. The abdominal wall was closed in the majority of patients with the use of mesh instead of the earlier method of using tissue expanders. The surgical survival rate was 66.7%, and one pair of twins who did not undergo separation is currently alive. CONCLUSION: A detailed anatomic study of the twins and surgical planning must precede separation. A well-prepared pediatric surgery team is sufficient to surgically manage conjoined twins.

  2. Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience

    Directory of Open Access Journals (Sweden)

    Sirin Sait

    2011-01-01

    Full Text Available Background/Aim. Management of patients with recurrent glioblastoma (GB comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the highdose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS offers a viable noninvasive therapeutic option in palliative treatment of recurrent GB as a sophisticated modality with improved setup accuracy allowing the administration of high-dose, precise radiotherapy. The aim of the study was to, we report our experience with single-dose linear accelerator (LINAC based SRS in the management of patients with recurrent GB. Methods. Between 1998 and 2010 a total of 19 patients with recurrent GB were treated using single-dose LINAC-based SRS. The median age was 47 (23-65 years at primary diagnosis. Karnofsky Performance Score was ≥ 70 for all the patients. The median planning target volume (PTV was 13 (7-19 cc. The median marginal dose was 16 (10-19 Gy prescribed to the 80%-95% isodose line encompassing the planning target volume. The median follow-up time was 13 (2-59 months. Results. The median survival was 21 months and 9.3 months from the initial GB diagnosis and from SRS, respectively. The median progression-free survival from SRS was 5.7 months. All the patients tolerated radiosurgical treatment well without any Common Toxicity Criteria (CTC grade > 2 acute side effects. Conclusion. Single-dose LINAC-based SRS is a safe and well- tolerated palliative therapeutic option in the management of patients with recurrent GB.

  3. Initial Management of Childhood Acute Immune Thrombocytopenia: Single-Center Experience of 32 Years.

    Science.gov (United States)

    Yildiz, Inci; Ozdemir, Nihal; Celkan, Tiraje; Soylu, Selen; Karaman, Serap; Canbolat, Aylin; Dogru, Omer; Erginoz, Ethem; Apak, Hilmi

    2015-01-01

    Immune thrombocytopenia (ITP) is an acute self-limited disease of childhood, mostly resolving within 6 months irrespective of whether therapy is given or not. Treatment options when indicated include corticosteroids, intravenous immune globulin (IVIG), and anti-RhD immunoglobulin. We reviewed our 32 years' experience for first-line therapy of acute ITP. Five hundred forty-one children (mean age: 5.3 years) diagnosed and treated for ITP were evaluated retrospectively. Among 491 acute ITP patients, IVIG was used in 27%, high-dose steroids in 27%, low-dose steroids in 20%, anti-D immunoglobulin G (IgG) in 2%, and no therapy in 22%. When the initial response (platelets >50 × 10(9)/L) to first-line treatment modalities were compared, 89%, 84%, and 78% patients treated by low-dose steroids, high-dose steroids, and IVIG responded to treatment, respectively (P > .05). Mean time to recovery of platelets was 16.8, 3.8, and 3.0 days in patients treated with low-dose steroids, high-dose steroids, and IVIG, respectively (P < .0001). Thrombocytopenia recurred in 23% of low-dose steroid, 39% of high-dose steroid, and in 36% of IVIG (P < .0001) treatment groups. Of 108 patients who were observed alone, 4 (3%) had a recurrence on follow-up and only 2 of these required treatment subsequently. Recurrence was significantly less in no therapy group compared with children treated with 1 of the 3 options of pharmacotherapy (P < .0001). Response rates were similar between patients treated by IVIG and low- and high-dose steroids; however, time to response was slower in patients treated with low-dose steroids compared with IVIG and high-dose steroids. PMID:26154620

  4. Laparoscopic decortication of symptomatic renal cysts. Experience from a referral center in Iran

    International Nuclear Information System (INIS)

    The objective of this study was to present our experience with laparoscopic management of symptomatic simple renal cysts. From April 2004 to November 2006, 21 patients (10 men; 11 women) underwent laparoscopic decortication for simple renal cysts at our department and were included in the analysis. All procedures were carried out by one surgeon using a transperitoneal approach. Patients underwent radiological follow-up with computerized tomography and/or ultrasonography. Procedural success was defined as no recurrence of the cyst and complete pain relief. Symptomatic success was defined as a significant pain decrease. All 21 procedures were completed laparoscopically, without major complications or conversion to open surgery. Estimated mean blood loss during surgery was about 50 mL. Patients were hospitalized for a mean of 1.9±1.1 (range: 1-5) days. Age of the patients and size and location of the cysts, had no relationship with the duration of operation as well as the length of hospital stay (P>0.05). Patients who experienced complete pain relief had significantly larger cyst sizes compared with patients with a partial pain decrease (7.3±1.1 vs 9.1±2.0, respectively; P=0.023, F=0.606). All patients had negative cytological and pathological findings for malignancy or any other abnormalities. At 16.6 months of mean follow up, none of the patients reported symptomatic and/or radiologic failure. Laparoscopic transperitoneal decortication represents an effective and safe treatment option in the management of symptomatic renal cysts. (author)

  5. A Single-Center 10-Year Experience with Pasireotide in Cushing's Disease: Patients' Characteristics and Outcome.

    Science.gov (United States)

    Trementino, L; Michetti, G; Angeletti, A; Marcelli, G; Concettoni, C; Cardinaletti, C; Polenta, B; Boscaro, M; Arnaldi, G

    2016-05-01

    Pasireotide is the first pituitary-directed drug approved for treating patients with Cushing's disease (CD). Our 10-year experience with pasireotide in CD is reported here. Twenty patients with de novo, persistent, or recurrent CD after pituitary surgery were treated with pasireotide from December 2003 to December 2014. Twelve patients were treated with pasireotide in randomized trials and 8 patients with pasireotide sc (Signifor(®); Novartis AG, Basel, Switzerland) in clinical practice. The mean treatment duration was 20.5 months (median 9 months; range, 3-72 months). Urinary free cortisol (UFC) levels mean percentage change (± SD) at last follow-up was-40.4% (± 35.1; range, 2-92%; median reduction 33.3%) with a normalization rate of 50% (10/20). Ten patients achieved sustained normalized late night salivary cortisol (LNSC) levels during treatment. LNSC normalization was associated with UFC normalization in 7/10 patients. Serum cortisol and plasma ACTH significantly decreased from baseline to last follow-up. Body weight decrease and blood pressure improvement during pasireotide treatment were independent from UFC response. Glucose profile worsening was observed in all patients except one. The frequency of diabetes mellitus increased from 40% (8/20) at baseline to 85% (17/20) at last follow-up requiring initiation of medical treatment only in 44% of patients. Pasireotide treatment was associated with sustained biochemical and clinical benefit in about 60% of CD patients. Glucose profile alteration is a frequent complication of pasireotide treatment; however, it seems to be easy to manage with diet and lifestyle intervention in almost half of the patients. PMID:27127913

  6. Thromboprophylaxis and Outcomes for Total Joint Arthroplasty in Congenital Bleeding Disorders: A Single-Center Experience.

    Science.gov (United States)

    Holderness, Britt M; Goto, Yuika; McKernan, Laurel; Bernini, Philip; Ornstein, Deborah L

    2016-09-01

    Total joint arthroplasty (TJA) improves the quality of life for patients with end-stage osteoarthritis but is associated with an increased risk of venous thromboembolism (VTE), thus pharmacologic thromboprophylaxis is recommended for most patients. Patients with congenital bleeding disorders may develop severe arthropathies due to repeated hemarthroses and derive similar benefit from TJA as the general population. No guidelines for pharmacologic thromboprophylaxis in this population exist, however, as the risks and benefits are not well defined. We undertook the current study to assess the safety and efficacy of pharmacologic VTE prophylaxis in patients with congenital bleeding disorders undergoing TJA. We retrospectively reviewed the medical records of patients with bleeding disorders who underwent TJA at our academic institution between 1987 and 2012. We identified 28 patients who underwent 38 TJA procedures. Low-molecular-weight heparin (LMWH) was administered in 29 procedures (76%) and was discontinued early in 3 procedures (2 patients) due to nonjoint bleeding. No symptomatic VTE was identified, and no joint or deep wound infections were seen. Twenty-two patients accounting for 31 procedures were contacted to discuss their experience with TJA. All reported decreased pain, and 97% reported improved function after the surgery. Impressively, 97% stated that they would choose to have the surgery again. These results confirm the benefit of TJA in patients with congenital bleeding disorders and end-stage arthropathies and suggest that LMWH thromboprophylaxis is safe. No patient in our cohort developed symptomatic VTE, whether or not thromboprophylaxis was administered, thus necessity of thromboprophylaxis remains an unanswered question. PMID:27099385

  7. Outcomes of kidney transplant tourism in children: a single center experience.

    Science.gov (United States)

    Majid, Abdul; Al Khalidi, Lina; Ahmed, Bushra Q; Opelz, Gerhard; Schaefer, Franz

    2010-01-01

    Transplant tourism is a necessity for children with end-stage renal disease living in regions without established local transplantation programs. The use of kidneys from living unrelated donors (LURDs) was common practice in Asia prior to the recent global condemnation of commercial organ transplantation. Objective information on the outcomes of pediatric transplant tourism is scarce. Here, we report the Dubai experience with 45 renal allograft transplantations performed outside the United Arab Emirates (UAE) between 1993 and 2009. Transplantation from 33 LURDs, ten living related donors (LRDs) and two deceased donors was performed in 14 different countries. The mean number of human leukocyte antigen (HLA) A/B/DR allele matches was 1.4 +/- 0.8 in the LURD graft recipients and 3.9 +/- 0.7 in the LRD recipients. Outcomes were compared with those of a matched group of 3,150 pediatric LRD transplantations from the Collaborative Transplant Study (CTS). Ten-year patient survival was 100% in the LRD patients, 91.2% in the LURD patients, and 92% in the CTS patients. The three deaths in the LURD group occurred within the first 4 months after transplantation and were related to acute rejection. One-year and 10-year graft survival was 100% in the LRD group and 94.8% and 66.7% in the CTS-LRD groups, vs 87.8% and 43.4% in the LURD group. Major viral infections [Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella zoster (VZV)] were four-times more common in patients that had received LURD grafts than in those that had received LRD grafts. In conclusion, whereas LRD kidney transplantation performed abroad yields excellent long-term results, transplantation of LURD kidneys is fraught with a high complication rate affecting graft and even early patient survival. PMID:19727837

  8. Acute Morbidity of Proton Therapy for Prostate Cancer: The Hyogo Ion Beam Medical Center Experience

    International Nuclear Information System (INIS)

    Purpose: To investigate the incidence and influencing factors of acute genitourinary (GU) and gastrointestinal morbidities in patients with prostate cancer treated with proton therapy. Methods and Materials: A total of 287 patients with histologically proven Stage cT1-T4N0M0 prostate cancer were treated with proton therapy between 2003 and 2004. Of these, 204 (71%) received neoadjuvant androgen suppression therapy. The patients were treated with 190-230-MeV protons using lateral-opposed techniques to a dose of 74 GyE. Dose-volume histogram analyses were performed. The incidence of acute morbidity was evaluated using the National Cancer Institute Common Toxicity Criteria, version 2.0. Clinical factors, including age, clinical target volume, initial prostate-specific antigen level, T stage, presence of diabetes mellitus, and the use of androgen suppression therapy, were investigated to determine whether those affected the incidence of acute GU morbidity. Results: None developed Grade 2 or higher acute gastrointestinal morbidity. In contrast, 111 (39%) and 4 (1%) patients experienced acute Grade 2 and Grade 3 GU morbidities, respectively. However, 87% of the patients were successfully relieved by the administration of a selective α-1 blocker. Multivariate analysis showed that a larger clinical target volume (p = 0.001) and the use of androgen suppression therapy (p = 0.017) were significant factors for the prediction of acute Grade 2-3 GU morbidity. Conclusion: In our experience with proton therapy, a low incidence of acute gastrointestinal morbidity was observed. In contrast, the incidence of acute GU morbidity was similar to that in other reports of photon radiotherapy. Additional follow-up is warranted to elucidate the long-term safety and efficacy of proton therapy for prostate cancer

  9. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience

    Directory of Open Access Journals (Sweden)

    Jigish B Vyas

    2013-01-01

    Full Text Available Objectives: The safety and efficacy of transrectal ultrasound (TRUS guided aspiration of prostatic abscess (PA is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. Materials and Methods: After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS. Success was defined as complete resolution of the abscess and/or symptoms. Results: Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79 years. The DRE diagnosed PA in 22 (45.83% patients, while abdominal sonography diagnosed PA in 13 (27.08% patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100% patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8 cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml. Complete resolution after first aspiration was observed in 20 (41.66% patients. An average of 4.1 (range 1-7 aspirations was required for complete resolution which was seen in 41 patients (85.42%. Seven (14.58% patients required transurethral resection (deroofing of the abscess cavity. We formulated a treatment algorithm based on the above findings. Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are

  10. Conservative Surgery and Primary Radiotherapy for Early Breast Cancer; Yonsei Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Chang Ok; Lee, Hy De; Lee, Kyung Sik; Jung, Woo Hee; Oh, Ki Keun; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation 1991 and treated on hundred and forty patients during the next three years. Purpose: To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results: Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven patients were N0 and 27 patients were N1. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occurred at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation peumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer in proven to be safe and comfortable treatment method without

  11. Conservative Surgery and Primary Radiotherapy for Early Breast Cancer; Yonsei Cancer Center Experience

    International Nuclear Information System (INIS)

    Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation 1991 and treated on hundred and forty patients during the next three years. Purpose: To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results: Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven patients were N0 and 27 patients were N1. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occurred at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation peumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer in proven to be safe and comfortable treatment method without

  12. [Post-transplant lymphoproliferative disease in liver transplant recipients--Merkur University Hospital single center experience].

    Science.gov (United States)

    Filipec-Kanizaj, Tajana; Budimir, Jelena; Colić-Cvrlje, Vesna; Kardum-Skelin, Ika; Sustercić, Dunja; Naumovski-Mihalić, Slavica; Mrzljak, Anna; Kolonić, Slobodanka Ostojić; Sobocan, Nikola; Bradić, Tihomir; Dolić, Zrinka Misetić; Kocman, Branislav; Katicić, Miroslava; Zidovec-Lepej, Snjezana; Vince, Adriana

    2011-09-01

    favoring the diagnosis. The management of PTLD poses a major therapeutic challenge and although there is reasonable agreement about the overall principles of treatment, there is still considerable controversy about the optimal treatment of individual patients. EBV-related PTLDs are a significant cause of mortality in patients undergoing orthotopic liver transplantation with the observed mortality rate of up to 50%. This paper presents the experience acquired at Merkur University Hospital in the diagnosis and treatment of patients with liver transplantation and PTLD. PMID:23126028

  13. CMS software distribution and installation systems: concepts, practical solutions and experience at Fermilab as a CMS tier 1 center

    International Nuclear Information System (INIS)

    The CMS Collaboration of 2000 scientists involves 150 institutions from 31 nations spread all over the world. CMS software system integration and release management is performed at CERN. Code management is based on CVS, with read or write access to the repository via a CVS server. Software configuration, release management tools (SCRAM) are being developed at CERN. Software releases are then distributed to regional centers, where the software is used by a local community for a wide variety of tasks, such as software development, detector simulation and reconstruction and physics analysis. Depending on specific application, the system environment and local hardware requirements, different approaches and tools are used for the CMS software installation at different places. This presentation describes concepts and practical solutions for a variety of ways of software distribution, with an emphasis on the CMS experience at Fermilab. Installation and usage of different models used for the production farm, for code development and for physics analysis are described

  14. Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Quigley DD

    2015-07-01

    Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the

  15. Domestic cooperation in combating illegal nuclear traffic - Experience of the Emergency Service Center

    International Nuclear Information System (INIS)

    Full text: Poland's experience in combating illicit trafficking in nuclear and radioactive materials dates from the end of 1990 when the government decided to expand detection capabilities at the border check-points and initiated a gradual deployment of the portal radiation devices to detect all attempts of imported commodities with raised radiation level. Although the country had already had well-developed regulations in place as well as accountability and control systems over nuclear material, radiation sources and devices, the need to enforce the control activities and to strengthen cooperation among the nuclear safety and radiological protection bodies and the law enforcement authorities appeared. Then, besides the importation of the post Chernobyl contamination transports, Poland experienced: the lost and vagabonding nuclear materials or radioactive sources from the former Soviet/Russian military bases deployed in Poland; the tourism trafficking in radioactive materials The task of combating illegal radioactive traffic has been entrusted to: the Border Guard and Customs services - at the borders; the Police and State Security services - mainly within the state Some contribution to that action have had also the recycling of metallurgical scrap plants, which decided to install fixed radiation control devices to protect their products from the presence of radioactive isotopes. The duty of the coordinator as well as providing an immediate assistance in case of a seizure or a suspicion about the seizure of unknown radioactive material, fulfils the Emergency Service Centre (ODSA) at the Central Laboratory for Radiological Protection (CLOR). ODSA has been established in the mid-60s and its fundamental responsibility is to collect notifications on radiological emergency events and to organize help to liquidate consequences of a radiation incident with involved sources. All users of radiation sources and the law enforcement officers are obliged to inform ODSA about

  16. Study of X-ray and gamma ray sources observed by the SIGNE (Prognoz 6 Satellite) experiment in the regions of the galactic center and anticenter

    International Nuclear Information System (INIS)

    Characteristics of the SIGNE II MP 6 experiment are reported and procedures to obtain the fluxes detected from all the sources are described. We next present deconvolution method used to isolate the galactic center sources. In the last chapter we present and discuss the photon spectra of the sources observed by the SIGNE II MP 6 experiment

  17. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H+ RFQ project

    International Nuclear Information System (INIS)

    The 750-keV H+ Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H+ current with an emittance <0.02 π-cm-mrad (rms, norm) for injection into the RFQ. Parts for the new source have been fabricated and assembly is in process. We will use the existing duoplasmatron source with a newly designed extraction system and low energy beam transport (LEBT) for beam injection into the RFQ. In addition to source modifications, we need a new LEBT for transport and matching into the RFQ. The LEBT uses two magnetic solenoids with enough drift space between them to accommodate diagnostics and a beam deflector. The LEBT is designed to work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication

  18. 9/11-Related Experiences and Tasks of Landfill and Barge Workers: Qualitative Analysis from the World Trade Center Health Registry

    OpenAIRE

    Cone James E; Scheu Katherine E; Ekenga Christine C; Stellman Steven D; Farfel Mark R

    2011-01-01

    Abstract Background Few studies have documented the experiences of individuals who participated in the recovery and cleanup efforts at the World Trade Center Recovery Operation at Fresh Kills Landfill, on debris loading piers, and on transport barges after the September 11, 2001 terrorist attack. Methods Semi-structured telephone interviews were conducted with a purposive sample of workers and volunteers from the World Trade Center Health Registry. Qualitative methods were used to analyze the...

  19. Distance to the Center of the Milky Way Galaxy: An Experiment for Intermediate-Level Students Using Research Data and Professional Analysis Tools

    Science.gov (United States)

    Fitzgerald, M. T.; Feteris, S. M.; Gillessen, S.; Eisenhauer, F.

    2008-01-01

    The most recent data on stars orbiting Sagittarius A*, the black hole at the center of the Milky Way galaxy, have been used in an experiment undertaken by second-year university students to determine the distance R[theta] to the center of the galaxy. Students applied each of Kepler's 17th-century laws, in turn, to 21st-century data. The…

  20. Telework Centers. An Evaluation of the North American and Japanese Experience. Workscape 21: The Ecology of New Ways of Working.

    Science.gov (United States)

    Becker, Franklin; Rappaport, Andrew J.; Quinn, Kristen L.; Sims, William R.

    Telework Centers are work locations used by firms to acommodate staff who live near the telework center location. A study examined the impact of using telework centers on communication, work groups/departments, performance, supervision, travel/environment, and type of work done in various locations. A case study approach was used to investigate 10…

  1. Review of the High Performance Antiproton Trap (HiPAT) Experiment at the Marshall Space Flight Center

    Science.gov (United States)

    Pearson, J. B.; Sims, Herb; Martin, James; Chakrabarti, Suman; Lewis, Raymond; Fant, Wallace

    2003-01-01

    The significant energy density of matter-antimatter annihilation is attractive to the designers of future space propulsion systems, with the potential to offer a highly compact source of power. Many propulsion concepts exist that could take advantage of matter-antimatter reactions, and current antiproton production rates are sufficient to support basic proof-of-principle evaluation of technology associated with antimatter- derived propulsion. One enabling technology for such experiments is portable storage of low energy antiprotons, allowing antiprotons to be trapped, stored, and transported for use at an experimental facility. To address this need, the Marshall Space Flight Center's Propulsion Research Center is developing a storage system referred to as the High Performance Antiproton Trap (HiPAT) with a design goal of containing 10(exp 12) particles for up to 18 days. The HiPAT makes use of an electromagnetic system (Penning- Malmberg design) consisting of a 4 Telsa superconductor, high voltage electrode structure, radio frequency (RF) network, and ultra high vacuum system. To evaluate the system normal matter sources (both electron guns and ion sources) are used to generate charged particles. The electron beams ionize gas within the trapping region producing ions in situ, whereas the ion sources produce the particles external to the trapping region and required dynamic capture. A wide range of experiments has been performed examining factors such as ion storage lifetimes, effect of RF energy on storage lifetime, and ability to routinely perform dynamic ion capture. Current efforts have been focused on improving the FW rotating wall system to permit longer storage times and non-destructive diagnostics of stored ions. Typical particle detection is performed by extracting trapped ions from HiPAT and destructively colliding them with a micro-channel plate detector (providing number and energy information). This improved RF system has been used to detect various

  2. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience

    Directory of Open Access Journals (Sweden)

    Linda Thomas-Hemak

    2015-02-01

    Full Text Available Purpose. The effect of patient centered medical home (PCMH curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24 Internal Medicine residents—12 Traditional (TR track residents and 12 Teaching Health Center (THC track residents—began training in Academic Year (AY 2011 at the Wright Center for Graduate Medical Education (WCGME. They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.

  3. Quality assurance of 3-D conformal radiation therapy for a cooperative group trial - RTOG 3D QA center initial experience

    International Nuclear Information System (INIS)

    PURPOSE: 3-D conformal radiation therapy (3DCRT) holds promise in allowing safe escalation of radiation dose to increase the local control of prostate cancer. Prospective evaluation of this new modality requires strict quality assurance (QA). We report the results of QA review on patients receiving 3DCRT for prostate cancer on a cooperative group trial. MATERIALS and METHODS: In 1993 the NCI awarded the ACR/RTOG and nine institutions an RFA grant to study the use of 3DCRT in the treatment of prostate cancer. A phase I/II trial was developed to: a) test the feasibility of conducting 3DCRT radiation dose escalation in a cooperative group setting; b) establish the maximum tolerated radiation dose that can be delivered to the prostate; and c) quantify the normal tissue toxicity rate when using 3DCRT. In order to assure protocol compliance each participating institution was required to implement data exchange capabilities with the RTOG 3D QA center. The QA center reviews at a minimum the first five case from each participating center and spot checks subsequent submissions. For each case review the following parameters are evaluated: 1) target volume delineation, 2) normal structure delineation, 3) CT data quality, 4) field placement, 5) field shaping, and 6) dose distribution. RESULTS: Since the first patient was registered on August 23, 1994, an additional 170 patients have been accrued. Each of the nine original approved institutions has participated and three other centers have recently passed quality assurance bench marks for study participation. Eighty patients have been treated at the first dose level (68.4 Gy minimum PTV dose) and accrual is currently ongoing at the second dose level (73.8 Gy minimum PTV dose). Of the 124 cases that have undergone complete or partial QA review, 30 cases (24%) have had some problems with data exchange. Five of 67 CT scans were not acquired by protocol standards. Target volume delineation required the submitting institution

  4. Cyclosporine C2-Monitoring for Optimisation of Immunosuppression in Renal Transplantation – Recommendations According to First Experience in German Centers

    Directory of Open Access Journals (Sweden)

    B. Nashan

    2003-06-01

    Full Text Available Cyclosporine has been worldwide the mainstay of immunosuppressive therapy in organ transplant recipients for prevention of acute and chronic rejection in the past two decades. The dosage is usually adjusted on the basis of whole blood through level (C0 level monitoring. However, it became evident after the development of the microemulsion formulation that a better correlation of the drug level taken two hours after medication (C2 level reflects the improved bioavailability of Cyclosporine much better. Interpatient variability in absorption as well as improved identification of over- or underdosing offer the opportunity of an individualized monitoring in order to improve drug exposure. C2 levels published in the international literature mainly represent North-American clinical experience and practice with traditionally higher cyclosporine dosing in comparison to Europe. Since C2-Monitoring has been introduced in german centers since last year, there was anonymous agreement for a consensus meeting to discuss recommendations for cyclosporine monitoring, better reflecting the German practice. The presented consensus focuses on immunosuppression in renal transplantation.

  5. Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2014-01-01

    Full Text Available Background and Aim: Rigid bronchoscopy is often an indispensable procedure in the therapeutic management of a wide variety of tracheobronchial disorders. However, it is performed at only a few centers in adult patients in India. Herein, we report our initial 1-year experience with this procedure. Materials and Methods: A prospective observational study on the indications, outcomes, and safety of various rigid bronchoscopy procedures performed between November 2009 and October 2010. Improvement in dyspnea, cough, and the overall quality of life was recorded on a visual analog scale from 0 to 100 mm. A systematic review of PubMed was performed to identify studies reporting the use of rigid bronchoscopy from India. Results: Thirty-eight rigid bronchoscopies (50 procedures were performed in 19 patients during the study period. The commonest indication was benign tracheal stenosis followed by central airway tumor, and the procedures performed were rigid bronchoplasty, tumor debulking, and stent placement. The median procedure duration was 45 (range, 30-65 min. There was significant improvement in quality of life associated with therapeutic rigid bronchoscopy. Minor procedural complications were encountered in 18 bronchoscopies, and there was no procedural mortality. The systematic review identified 15 studies, all on the role of rigid bronchoscopy in foreign body removal. Conclusions: Rigid bronchoscopy is a safe and effective modality for treatment of a variety of tracheobronchial disorders. There is a dire need of rigid bronchoscopy training at teaching hospitals in India.

  6. MSSM A-funnel and the galactic center excess: prospects for the LHC and direct detection experiments

    Science.gov (United States)

    Freese, Katherine; López, Alejandro; Shah, Nausheen R.; Shakya, Bibhushan

    2016-04-01

    The pseudoscalar resonance or " A-funnel" in the Minimal Supersymmetric Standard Model (MSSM) is a widely studied framework for explaining dark matter that can yield interesting indirect detection and collider signals. The well-known Galactic Center excess (GCE) at GeV energies in the gamma ray spectrum, consistent with annihilation of a ≲ 40 GeV dark matter particle, has more recently been shown to be compatible with significantly heavier masses following reanalysis of the background. In this paper, we explore the LHC and direct detection implications of interpreting the GCE in this extended mass window within the MSSM A-funnel framework. We find that compatibility with relic density, signal strength, collider constraints, and Higgs data can be simultaneously achieved with appropriate parameter choices. The compatible regions give very sharp predictions of 200-600 GeV CP-odd/even Higgs bosons at low tan β at the LHC and spin-independent cross sections ≈ 10-11 pb at direct detection experiments. Regardless of consistency with the GCE, this study serves as a useful template of the strong correlations between indirect, direct, and LHC signatures of the MSSM A-funnel region.

  7. Recent Experiences of the NASA Engineering and Safety Center (NESC) GN and C Technical Discipline Team (TDT)

    Science.gov (United States)

    Dennehy, Cornelius J.

    2010-01-01

    The NASA Engineering and Safety Center (NESC), initially formed in 2003, is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. The GN&C Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA projects. This paper will then describe selected recent experiences, over the period 2007 to present, of the GN&C TDT in which they directly performed or supported a wide variety of NESC assessments and consultations.

  8. Endovascular treatment of central venous obstruction as a complication of prolonged hemodialysis – Preliminary experience in a tertiary care center

    Science.gov (United States)

    Yadav, Mukesh K; Sharma, Madhurima; Lal, Anupam; Gupta, Vivek; Sharma, Ashish; Khandelwal, Niranjan

    2015-01-01

    Background: Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency. Aim: To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis. Settings and Design: This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow-up was variable. Materials and Methods: Eleven patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between July 2012 and July 2014. All the patients underwent endovascular treatment and were analyzed retrospectively. Results and Conclusion: A total of 11 patients (4 male and 7 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Eight stenotic segments were in brachiocephalic vein, three in subclavian vein, and two in axillary veins. The technical success rate for endovascular treatment was 81.8%. Two patients underwent percutaneous transluminal angioplasty (PTA) alone and presented with restenosis later. Balloon angioplasty followed by stenting was done in seven patients, two of which required reintervention during follow-up. We found endovascular treatment safe and effective in treating central venous disease. PMID:26752817

  9. Outcomes Following Iodine-125 Monotherapy for Localized Prostate Cancer: The Results of Leeds 10-Year Single-Center Brachytherapy Experience

    International Nuclear Information System (INIS)

    Purpose: This study reports the 10-year experience of permanent brachytherapy monotherapy at a single UK center. Methods and Materials: Between March 1995 and September 2004, 1,298 patients underwent trans-rectal ultrasound (TRUS) planned transperineal brachytherapy delivering 145 Gy using I-125. No patient received supplemental external beam; 44.2% received neoadjuvant hormones. In 688, CT postimplant dosimetry was available. Outcome data were analyzed in terms of overall survival (OS), disease specific survival (DSS), and PSA relapse-free survival (PSA-RFS). Results: The mean age was 62.9 (range, 34-83) years. Median follow-up was 4.9 years (range, 2.03-11.7 years). OS and DSS were 85% and 95%, respectively, at 10 years. Twenty-one patients died from prostate cancer (1.6%) and 34 (2.5%) from unrelated causes. Seventy-four (5.7%) developed evidence of clinical failure. Overall PSA-RFS was 79.9% and 72.1% at 10 years (American Society for Therapeutic Radiology and Oncology [ASTRO] and Nadir+2 definitions, respectively). Higher presenting PSA or Gleason score and use of neoadjuvant hormones were associated with an increased risk of biochemical failure (p 90 ≥140 Gy and in 78% of patients with D90 90 with biochemical control.

  10. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2011-01-01

    Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

  11. CMS Software Distribution and Installation Systems:Concepts,Practical Solutions and Experience at Fermilab as a CMS Tier 1 Center

    Institute of Scientific and Technical Information of China (English)

    NataliaM.Ratnikova; GregoryE.Graham

    2001-01-01

    The CMS Collaboration of 2000 scientists involves 150 institutions from 31 nations spread all over the world.CMS software system integration and release management is performed at CERN.Code management is based on CVS,with read or write access to the repository via a CVS server,Software configuration,release management tools(SCRAM) are being developed at CERN.Software releases are then distributed to regional centers,where the software is used by a local community for a wide variety of tasks,such as software development detector simulation and reconstruction and physics analysis.Depending on specific application,the system environment and local hardware requirements,different approaches and tools are used for the CMS software installation at different places.This presentation describes concepts and reactial solutions for a variety of ways of software distribution,with an emphasis on the CMS experience at Fermilab,Installation and usage of different models used for the production farm,for code development and for physics analysis are described.

  12. Tritium production by fast neutrons on oxygen. An integral experiment

    International Nuclear Information System (INIS)

    This report describes an integral experiment of tritium production in water by neutrons from the LANSCE/WNR spallation neutron source. Neutron energies covered the range from 1 MeV to about 300 MeV. The neutron fluence was determined with a 238U fission chamber. After irradiation, the water samples were analyzed for tritium. The results are compared with calculations and agreement is found to within a factor of 2. (author)

  13. Success with antiretroviral treatment for children in Kigali, Rwanda: Experience with health center/nurse-based care

    OpenAIRE

    Gazille Claire; Asiimwe Anita; Uwera Jeanine; De Naeyer Ludwig; van Griensven Johan; Reid Tony

    2008-01-01

    Abstract Background Although a number of studies have shown good results in treating children with antiretroviral drugs (ARVs) in hospital settings, there is limited published information on results in pediatric programs that are nurse-centered and based in health centers, in particular on the psychosocial aspects of care. Methods Program treatment and outcome data were reported from two government-run health centers that were supported by Médecins Sans Frontières (MSF) in Kigali, Rwanda betw...

  14. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    Energy Technology Data Exchange (ETDEWEB)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

    2007-11-15

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

  15. Demystifying the Chemistry Literature: Building Information Literacy in First-Year Chemistry Students through Student-Centered Learning and Experiment Design

    Science.gov (United States)

    Bruehl, Margaret; Pan, Denise; Ferrer-Vinent, Ignacio J.

    2015-01-01

    This paper describes curriculum modules developed for first-year general chemistry laboratory courses that use scientific literature and creative experiment design to build information literacy in a student-centered learning environment. Two curriculum units are discussed: Exploring Scientific Literature and Design Your Own General Chemistry…

  16. Asian-American Students' Severity of Problems and Willingness To Seek Help from University Counseling Centers: Role of Previous Counseling Experience, Gender, and Ethnicity.

    Science.gov (United States)

    Solberg, V. Scott; And Others

    1994-01-01

    Examined concerns and help-seeking likelihood of Asian American college students (n=596). Results indicated that previous counseling experience was related to higher ratings for substance abuse concerns and willingness to seek help from university counseling center to address academic, interpersonal, and substance abuse concerns. Asian American…

  17. Pedagogies, Perspectives, and Practices: Mobile Learning through the Experiences of Faculty Developers and Instructional Designers in Centers for Teaching and Learning

    Science.gov (United States)

    Hosler, Kim A.

    2013-01-01

    The purpose of this qualitative case study was to explore the experiences, perceptions, and pedagogy of nine self-identified faculty developers and instructional designers who work in centers for teaching and learning supporting faculty members requesting assistance with mobile learning. With the ever-increasing use of mobile devices across…

  18. Sonography in Children with Acute Abdominal Pain: 5 Years Experience in Only Children Medical Center in Khorasan

    Directory of Open Access Journals (Sweden)

    S. A. Alamdaran

    2008-01-01

    Full Text Available Background/Objective: acute abdominal pain is one important dilemma in pediatric patients. The purpose of this paper is to present our experience about diagnostic value of sonography in children with acute abdominal pain."nPatients and Methods: During a period of 5 years (march 2002 to march 2007; we studied clinical, sonographical and surgical data of more than 5000 children with acute abdominal pain in only children medical center in khorasan at Dr. Sheikh Children hospital."nResults: Approximately in more than 90% children with acute abdominal pain, mesenteric lymphadenitis [enlarged mesenteric lymph nodes (≥4mm and/or mural thickening of the terminal ileum (≥8mm] and gastroenteritis (enlarged mesenteric lymph nodes with generalize thickened bowel wall were sonographic diagnosis. In all this patients, sonographic diagnosis was documented with clinical course and outcome, except in three that pelvic appendicitis was final surgical diagnosis. "nAppendicitis, intussusception and bowel obstruction [mainly due to inflammatory or tumoral mass] were uncommon causes. The rare sonographic diagnoses were peritonitis in 8, malrotation (abnormal mesenteric vessels position in 3, pancratitis in 3, diaphragmatic hernia with gastric volvulus (abnormal mesenteric vessels position in 2, ovarian torsion in 2, pylonephritis in 1, mechel diveticulitis in 1. Final clinical and surgical diagnosis in three patients with peritonitis diagnosis was gastroenteritis. In children with acute abdominal pain, there was normal sonography report only in few cases. "nConclusion: common and uncommon causes of acute abdominal pain in children are limited and in almost all of these patients, sonographic diagnosis is completely reliable.

  19. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    International Nuclear Information System (INIS)

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  20. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D. [Emory University Hospital, Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David J. [University Hospitals Case Medical Center, Departments of Radiology and Biomedical Engineering, Cleveland, OH (United States)

    2014-11-15

    The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

  1. From US NAVY Mate to Division Leader for Operations - Requirements, Development and Career Paths of LANL/LANSCE Accelerator Operators

    International Nuclear Information System (INIS)

    There are opportunities for advancement within the team. Operators advance by: (1) Becoming fully qualified - following the LANSCE Accelerator Operator Training Manual, Operator trainees go through 5 levels of qualification, from Radiation Security System to Experimental Area Operator. Must obtain Knowledge and Performance checkouts by an OSS or AOSS, and an End-of-Card checkout by the team leader or RSS engineer (level I). Program was inspired by US NAVY qualification program for nuclear reactor operators. Time to complete: 2-2.5 years. (2) Fully qualified operators are eligible to apply for vacant (OSS)/AOSS positions; and (3) Alternatively, experienced operators can sign up for the voluntary Senior Operator Qualification Program. They must demonstrate in-depth knowledge of all areas of the accelerator complex. Time to complete is 2-3 years (Minimum 4 years from fully qualified). Eligible for promotion to level between qualified operator and AOSS.

  2. 'Damage control orthopaedics' in patients with delayed referral to a tertiary care center: experience from a place where Composite Trauma Centers do not exist

    Directory of Open Access Journals (Sweden)

    Tabish Amin

    2008-01-01

    Full Text Available Abstract Background Management of orthopaedic injuries in polytrauma cases continues to challenge the orthopaedic traumatologist. Mass disasters compound this challenge further due to delayed referral. Recently there has been increasing evidence showing that damage control surgery has advantages that are absent in the early total care modality. We studied the damage control modality in the management of polytrauma cases with orthopaedic injuries who had been referred to our hospital after more than 24 hours of sustaining their injuries in an earthquake. This study was conducted on 51 cases after reviewing their records and complete management one year after the trauma. Results At one year, out of the 62 fractures, 3 were still under treatment, while the others had united. As per the radiological and functional scoring there were 20 excellent, 29 good, 5 fair and 5 poor results. In spite of the delayed referral there was no mortality. Conclusion In situations of delayed referral in areas where composite trauma centers do not exist the damage control modality provides an acceptable method of treatment in the management of polytrauma cases.

  3. 9/11-Related Experiences and Tasks of Landfill and Barge Workers: Qualitative Analysis from the World Trade Center Health Registry

    Directory of Open Access Journals (Sweden)

    Cone James E

    2011-05-01

    Full Text Available Abstract Background Few studies have documented the experiences of individuals who participated in the recovery and cleanup efforts at the World Trade Center Recovery Operation at Fresh Kills Landfill, on debris loading piers, and on transport barges after the September 11, 2001 terrorist attack. Methods Semi-structured telephone interviews were conducted with a purposive sample of workers and volunteers from the World Trade Center Health Registry. Qualitative methods were used to analyze the narratives. Results Twenty workers and volunteers were interviewed. They described the transport of debris to the Landfill via barges, the tasks and responsibilities associated with their post-9/11 work at the Landfill, and their reflections on their post-9/11 experiences. Tasks included sorting through debris, recovering human remains, searching for evidence from the terrorist attacks, and providing food and counseling services. Exposures mentioned included dust, fumes, and odors. Eight years after the World Trade Center disaster, workers expressed frustration about poor risk communication during recovery and cleanup work. Though proud of their contributions in the months after 9/11, some participants were concerned about long-term health outcomes. Conclusions This qualitative study provided unique insight into the experiences, exposures, and concerns of understudied groups of 9/11 recovery and cleanup workers. The findings are being used to inform the development of subsequent World Trade Center Health Registry exposure and health assessments.

  4. O doador marginal: experiência de um centro de transplante de fígado The marginal donor: a single-center experience in orthotopic liver transplantation

    Directory of Open Access Journals (Sweden)

    Olival Cirilo Lucena da Fonseca-Neto

    2008-03-01

    Full Text Available RACIONAL: Desde que o uso de enxertos marginais é solução aceita para escassez de órgãos para transplante, ele tornou-se muito comum em todo mundo e a literatura vem mostrando efetividade desses enxertos no transplante de fígado. OBJETIVO: Apresentar a experiência do Serviço de Transplante Hepático do Hospital Universitário Oswaldo Cruz, em transplante de fígado com o uso de doadores marginais. MÉTODOS: Estudo retrospectivo em 137 transplantes ortotópicos de fígado, usando enxertos marginais entre 1999 e 2006, com acompanhamento mínimo de 180 dias. Os receptores foram classificados de acordo com a função inicial do enxerto no pós-operatório como normal (FN e disfunção primária (DP. RESULTADOS: Não foi observada diferença estatisticamente significante entre os grupos FN e DP com os seguintes parâmetros dos doadores: idade, sódio sérico, tempo de protrombina, esteatose hepática, transaminases sérica, pressão sanguínea, drogas vasoativas, índice de massa corpórea, parada cardíaca antes da doação de órgão, doador em assistolia e tempo de isquemia quente. Análise da curva de sobrevida (Kaplan-Meier de pacientes e de enxertos de fígado de pacientes que receberam fígado de doadores ideais versus doadores marginais não mostrou diferença com significância estatística. CONCLUSÃO: Pode ser recomendado o uso de enxertos marginais para transplantes hepáticos, inclusive os provenientes de doadores com o coração parado.BACKGROUND: Since marginal grafts are a solution to deal with the shortage of organ donors, its use became more common worldwide, and the literature had shown its effectiveness in the liver transplantation (LT outcomes. AIM: To present a single center experience, at the Liver Transplantation Unit of Oswaldo Cruz University Hospital, with orthotopic LT using marginal organ donors. METHODS: Retrospectivety review of 137 orthotopic LT using marginal grafts between 1999 and 2006, with a minimum 180

  5. Success with antiretroviral treatment for children in Kigali, Rwanda: Experience with health center/nurse-based care

    Directory of Open Access Journals (Sweden)

    Gazille Claire

    2008-10-01

    Full Text Available Abstract Background Although a number of studies have shown good results in treating children with antiretroviral drugs (ARVs in hospital settings, there is limited published information on results in pediatric programs that are nurse-centered and based in health centers, in particular on the psychosocial aspects of care. Methods Program treatment and outcome data were reported from two government-run health centers that were supported by Médecins Sans Frontières (MSF in Kigali, Rwanda between October 2003 and June 2007. Interviews were held with health center staff and MSF program records were reviewed to describe the organization of the program. Important aspects included adequate training and supervision of nurses to manage ARV treatment. The program also emphasized family-centered care addressing the psychosocial needs of both caregivers and children to encourage early diagnosis, good adherence and follow-up. Results A total of 315 children ( Conclusion This report suggests that providing ARVs to children in a health center/nurse-based program is both feasible and very effective. Adequate numbers and training of nursing staff and an emphasis on the psychosocial needs of caregivers and children have been key elements for the successful scaling-up of ARVs at this level of the health system.

  6. Multistatic SAR Imaging: First Results of a Four Phase Center Experiment with TerraSAR-X and TanDEM-X

    OpenAIRE

    Kraus, Thomas; Bräutigam, Benjamin; Bachmann, Markus; Krieger, Gerhard

    2016-01-01

    Multichannel synthetic aperture radar (SAR) imaging offers the possibility to overcome the pulse repetition frequency (PRF) constraints inherent to single-channel SAR systems. The multichannel approach enables the acquisition of wide swathes with high azimuth resolution. Using a constellation or swarm of small satellites, a cost efficient, faulttolerant system can be envisaged. This paper describes the first results of a multistatic four phase center experiment conducted with TerraSAR-X an...

  7. Long-term effects and colectomy rates in ulcerative colitis patients treated with infliximab: A Danish single center experience

    DEFF Research Database (Denmark)

    Teisner, A.S.; Ainsworth, M.A.; Brynskov, J.

    2010-01-01

    provide further data on the long-term effect of IFX for acute, severe and chronic, refractory UC in unselected patients treated at a single center. Material and Methods. A retrospective analysis of all patients (n = 52) treated with IFX for UC before February 2009 was performed. The material comprised 19...

  8. The role of dosimetry audits in radiotherapy quality assurance: The 8 year experience in Greek radiotherapy and brachytherapy centers

    International Nuclear Information System (INIS)

    Twenty six (26) radiotherapy (RT) centers (public and private) operate in Greece up to date (Apr. 2010), where 36 linacs and 8 Co-60 teletherapy units are being used, producing 64 photon beams (Co60, 6-23 MV) and 126 electron beams (4-21 MeV) in total. Furthermore, 7 HDR Ir192 and 2 MDR/LDR Cs137 remote afterloading brachytherapy systems operate. The Ionizing Radiation Calibration Laboratory (IRCL) of the Greek Atomic Energy Commission (GAEC) runs dosimetry audits in all Greek radiotherapy centers by means of on-site visits, in order to assess the dose accuracy, to identify and resolve problems on dosimetry, to provide intercomparisons to hospitals and disseminate the IAEA TRS 398 protocol. Additionally, the GAEC's IRCL calibrates the reference dosimetry equipment of all RT centers, in terms of absorbed dose in water at Co60 beam quality and air kerma strength at Ir192 qualities. The GAEC's dosimetry audit is a continuous process: The 1st round has been completed for the photons beams (2002 - 2006), electrons (2002 - 2008) and brachytherapy (2006-2009). The 2nd round is at the final stage for photons (2006-2010) and in progress for the rest, while a 3rd round for photons has already been initiated. The audit results for the photons 1st round have been published. This work presents the results of these audits and focuses on the improvements of RT centers' dosimetry during the successive audit rounds

  9. Higher Rates of Retinopathy of Prematurity after Increasing Oxygen Saturation Targets for Very Preterm Infants: Experience in a Single Center.

    Science.gov (United States)

    Manley, Brett J; Kuschel, Carl A; Elder, James E; Doyle, Lex W; Davis, Peter G

    2016-01-01

    Randomized trials of oxygen saturation target ranges for extremely preterm infants showed increased survival but increased retinopathy of prematurity with higher compared with lower target ranges. In our center, changing from a target range of 88%-92% to 91%-95% has been associated with increased rates and severity of retinopathy of prematurity. PMID:26548746

  10. Trans disciplinary cardiovascular and cancer health disparities training: Experiences of the centers for population health and health disparities

    OpenAIRE

    Golden, SH; Ferketich, A; Boyington, J; Dugan, S.; Garroutte, E; Kaufmann, PG; Krok, J; Kuo, A; Ortega, AN; Purnell, T; Srinivasan, S

    2015-01-01

    The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, heal...

  11. The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study: a single-center experience

    OpenAIRE

    Falcone, Adam M.; Bose, Rahul; Stoler, Robert C; Kim, Michael; Laible, Emily; Kang, Lucy; Waters, Kim; Dunkerley, Janet; Choi, James W.

    2011-01-01

    The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study is a multicenter randomized prospective controlled trial evaluating the safety of and patient satisfaction with same-day discharge following ambulatory percutaneous intervention with a closure device. This article reviews the findings from a single center, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, from October 2008 through April 2010, with 23 patients in the same-day discharge group and 21 patients in th...

  12. The grand experiment, a historical account of a museum/school partnership: The Alexander Science Center School of Los Angeles

    Science.gov (United States)

    Heughins, Andrew R.

    This study tells the history of The Alexander Science Center School, a museum/school partnership between the Los Angeles Unified School District and the California Science Center created with the goal of becoming a national model in elementary science education. To provide a background to the development of the school, this study explores the definition of what constitutes a museum school, including the existence of a formal partnership between a school district and a museum and systemic change in the partner institutions leading to a marriage of formal and informal learning styles. In addition, the literature review explores the unique models of museum/school partnerships developed in the United States. The history of the Alexander Science Center School is told in a narrative style using documentation from the schools development and through interviews with individuals who played key roles, from the schools inception through its opening. The study covers the initiation of concept, architectural design, formation of the partnership, and development of the curriculum. The study also identifies the roadblocks encountered in the schools development and makes recommendations for school districts and institutions seeking to create future museum school projects. In addition, a comparison is made other recently studied museum schools to provide a context for the school's historical and programmatic development.

  13. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-03-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. PMID:26858008

  14. Clinicopathological correlates of primary central nervous system lymphoma: Experience from a tertiary care center in South India

    Directory of Open Access Journals (Sweden)

    Bimal Patel

    2015-01-01

    Full Text Available Background: Primary central nervous system lymphomas (PCNSL constitute a rare group of extranodal non-Hodgkin′s lymphomas (NHLs. Aim: To study the clinical and immunophenotypic profile of patients with a PCNSL who presented between the years 2000 and 2013 in a tertiary care center in South India. Materials and Methods: This was a retrospective study. Demographic and clinical data were obtained from the clinical case records. Inclusion criteria: Cases of PCNSL involving brain. Exclusion criteria: Cases of PCNSL involving the spinal cord, meninges and orbit as well as intravascular large B-cell lymphoma, lymphomas with evidence of systemic disease or secondary lymphomas. Archived slides and tissue blocks were retrieved. All cases had hematoxylin and eosin stained sections and immunohistochemistry for CD20, CD3, and MIB-1. Additional immunohistochemistry was performed for CD10, BCL6, and MUM1 on paraffin blocks with sufficient tissue. Results: There were a total of 73 cases with the mean age of presentation being 45.9 years (range 8-71 years and with a male predominance (male: female (M:F = 2.3:1. Headache was the commonest presenting complaint. The mean duration of symptoms was 10.6 weeks. All patients were immunocompetent. Most tumors were supratentorial in location. Out of 73 cases, 70 presented with a diffuse large B-cell lymphoma (DLBCL, two with a Burkitt′s lymphoma, and one with a lymphomatoid granulomatosis. Only 51 of the DLBCL cases had sufficient tissue for additional studies. Non-germinal center was the most common phenotype seen in 65.7% (33/51 of cases. Germinal center B-cell (GCB phenotype was seen in 18/51 cases (34.3%. Conclusion: DLBCL constituted the majority of PCNSLs and although non-germinal center was the predominant phenotype, more than a third of the cases were of the GCB phenotype. As the germinal center phenotype is known to have a better prognosis, further studies to explore its relevance in the Asian population are

  15. Experience to the center of radiations hygiene and protection and Hygiene in the training as regards radiological protection

    International Nuclear Information System (INIS)

    The CPHR comes carrying out for several years a group activities among them regular courses for the basic formation as regards radiological protection the personnel with responsibilities as for the security the nuclear facilities. Presently work summary these experiences

  16. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  17. The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans

    OpenAIRE

    Bailey, Martha J.; Andrew Goodman-Bacon

    2015-01-01

    This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest tha...

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

    OpenAIRE

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

    1997-01-01

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

  19. Implementing health information technology in a patient-centered manner: patient experiences with an online evidence-based lifestyle intervention.

    Science.gov (United States)

    Lyden, Jennifer R; Zickmund, Susan L; Bhargava, Tina D; Bryce, Cindy L; Conroy, Molly B; Fischer, Gary S; Hess, Rachel; Simkin-Silverman, Laurey R; McTigue, Kathleen M

    2013-01-01

    The patient-centered care (PCC) model and the use of health information technology (HIT) are major initiatives for improving U.S. healthcare quality and delivery. A lack of published data on patient perceptions of Internet-based care makes patient-centered implementation of HIT challenging. To help ascertain patients' perceptions of an online intervention, patients completing a 1-year web-based lifestyle intervention were asked to complete a semistructured interview. We used qualitative methodology to determine frequency and types of interview responses. Overall satisfaction with program features was coded on a Likert-type scale. High levels of satisfaction were seen with the online lifestyle coaching (80%), self-monitoring tools (57%), and structured lesson features (54%). Moderated chat sessions and online resources were rarely used. Frequently identified helpful aspects were those that allowed for customized care and shared decision-making consistent with the tenets of PCC. Unhelpful program aspects were reported less often. Findings suggest that despite challenges for communicating effectively in an online forum, the personalized support, high-tech data management capabilities, and easily followed evidence-based curricula afforded by HIT may be a means of providing PCC and improving healthcare delivery and quality. PMID:24004039

  20. Low-cost semirigid ureteroscopy is effective for ureteral stones: Experience of a single high volume center

    Directory of Open Access Journals (Sweden)

    Roberto Giulianelli

    2014-06-01

    Full Text Available Aim of the study: To demonstrate how, in a center with a large number of patients, as our center is, it is possible to perform ureterolithotripsy using a limited set of instruments. Methods: We evaluated medical charts of our center related to semirigid ureteral ureteroscopy (URS with ureterolithotripsy using Holmium laser performed from July 2004 to July 2011. Overall, 658 URS for ureteral stones were performed in 601 patients, of which 204 in proximal ureter (31%, 86 in the mid (13.06% and 368 (57.76% in the distal ureter. In 504 patients (76.5% ureterohydronephrosis (Grade II-III was observed. In 57 patients (8.6%, we performed a bilateral approach at the same time, but most patients had a solitary distal ureteral stone. 106 patients (16.1% had more than one stone in their distal ureter and 96 (14.8% had a proximal ureteral stone treated in the same surgery as well. Results: The overall stone-free rate for ureteral stones was 86.1% (567/658. Success rates for proximal, medial and distal ureteral stones were 68.13% (139/204 patients, 84.8% (73/86 patients and 96.4% (355/368 patients, respectively. One hundred and twenty patients (18.3% required additional surgical treatment for their stones beyond the initial URS, including a second URS in 97 patients (14.74% and URS plus Retrograde Intra-Renal Surgery (RIRS in 23 patients (3.54%. The overall stonefree rate after the second treatment was 99.3%. Intra-operative complications accounted for 5.92% and consisted of ureteral perforations in 16 pts (2.4%, erosions of urothelium leading to significant bleeding in 15 pts (2.27%, severe pain in 4 pts (0.6%, fever in 3 pts (0.45% and one case of ureteral avulsion (0.15%. Conclusions: This study demonstrates that the use of Holmium laser lithotripsy is a safe and effective means of treating ureteral stones regardless of sex, age, stone location, or stone size. The instrumentation we used was extremely limited, in order to reduce costs related to the

  1. Moving Toward Patient-Centered Care in Africa: A Discrete Choice Experiment of Preferences for Delivery Care among 3,003 Tanzanian Women.

    Directory of Open Access Journals (Sweden)

    Elysia Larson

    Full Text Available In order to develop patient-centered care we need to know what patients want and how changing socio-demographic factors shape their preferences.We fielded a structured questionnaire that included a discrete choice experiment to investigate women's preferences for place of delivery care in four rural districts of Pwani Region, Tanzania. The discrete choice experiment consisted of six attributes: kind treatment by the health worker, health worker medical knowledge, modern equipment and medicines, facility privacy, facility cleanliness, and cost of visit. Each woman received eight choice questions. The influence of potential supply- and demand- side factors on patient preferences was evaluated using mixed logit models.3,003 women participated in the discrete choice experiment (93% response rate completing 23,947 choice tasks. The greatest predictor of health facility preference was kind treatment by doctor (β = 1.13, p<0.001, followed by having a doctor with excellent medical knowledge (β = 0.89 p<0.001 and modern medical equipment and drugs (β = 0.66 p<0.001. Preferences for all attributes except kindness and cost were changed with changes to education, primiparity, media exposure and distance to nearest hospital.Care quality, both technical and interpersonal, was more important than clinic inputs such as equipment and cleanliness. These results suggest that while basic clinic infrastructure is necessary, it is not sufficient for provision of high quality, patient-centered care. There is an urgent need to build an adequate, competent, and kind health workforce to raise facility delivery and promote patient-centered care.

  2. Association of interatrial septal abnormalities with cardiac impulse conduction disorders in adult patients: experience from a tertiary center in Kosovo.

    Directory of Open Access Journals (Sweden)

    Zaim Gashi

    2011-06-01

    Full Text Available Interatrial septal disorders, which include: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Intera trial septal anomalies were detected in around 85% of the examined patients.

  3. Transdisciplinary cardiovascular and cancer health disparities training: experiences of the centers for population health and health disparities.

    Science.gov (United States)

    Golden, Sherita Hill; Ferketich, Amy; Boyington, Josephine; Dugan, Sheila; Garroutte, Eva; Kaufmann, Peter G; Krok, Jessica; Kuo, Alice; Ortega, Alexander N; Purnell, Tanjala; Srinivasan, Shobha

    2015-07-01

    The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, health care systems or health care delivery, community-based participatory research, and implementation science. We reviewed the acquisition of the skill sets described in the training components; these skill sets will position trainees to become leaders capable of effecting significant change because they provide tools that can be used to address the complexities of issues that promote health disparities. PMID:25905828

  4. LabView Based Nuclear Physics Laboratory experiments as a remote teaching and training tool for Latin American Educational Centers

    International Nuclear Information System (INIS)

    A virtual laboratory via internet to provide a highly iterative and powerful teaching tool for scientific and technical discipline is given. The experimenter takes advantage of a virtual laboratory and he can execute nuclear experiment at introductory level e.g. Gamma ray detection with Geiger-Mueller Counter at remote location using internet communication technology

  5. Training Consumer Educators: A Curriculum and Program Handbook. A Report on the Experience of the Consumer Law Training Center.

    Science.gov (United States)

    New York Law School, NY. Consumer Law Training Center.

    Information is presented on the administration of consumer education programs to train teachers and community group leaders who will be teaching consumer education in their own communities. Suggestions and examples are based on experience in creating and teaching such a program in consumer law in New York City. The first three chapters give…

  6. Gastrointestinal Fistulas in Acute Pancreatitis With Infected Pancreatic or Peripancreatic Necrosis: A 4-Year Single-Center Experience.

    Science.gov (United States)

    Jiang, Wei; Tong, Zhihui; Yang, Dongliang; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou

    2016-04-01

    Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN).Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes.Over 4 years, a total of 928 AP patients were admitted into our center, of whom 119 patients with IPN were diagnosed with GI fistula and they developed 160 GI fistulas in total. Colonic fistula found in 72 patients was the most common form of GI fistula followed with duodenal fistula. All duodenal fistulas were managed by nonsurgical management. Ileostomy or colostomy was performed for 44 (61.1%) of 72 colonic fistulas. Twenty-one (29.2%) colonic fistulas were successfully treated by percutaneous drainage or continuous negative pressure irrigation. Mortality of patients with GI fistula did not differ significantly from those without GI fistula (28.6% vs 21.9%, P = 0.22). However, a significantly higher mortality (34.7%) was observed in those with colonic fistula.GI fistula is a common finding in patients of AP with IPN. Most of these fistulas can be successfully managed with different procedures depending on their sites of origin. Colonic fistula is related with higher mortality than those without GI fistula. PMID:27057908

  7. PRELIMINARY PROJECT PLAN FOR LANSCE INTEGRATED FLIGHT PATHS 11A, 11B, 12, and 13

    Energy Technology Data Exchange (ETDEWEB)

    D. H. BULTMAN; D. WEINACHT - AIRES CORP.

    2000-08-01

    This Preliminary Project Plan Summarizes the Technical, Cost, and Schedule baselines for an integrated approach to developing several flight paths at the Manual Lujan Jr. Neutron Scattering Center at the Los Alamos Neutron Science Center. For example, the cost estimate is intended to serve only as a rough order of magnitude assessment of the cost that might be incurred as the flight paths are developed. Further refinement of the requirements and interfaces for each beamline will permit additional refinement and confidence in the accuracy of all three baselines (Technical, Cost, Schedule).

  8. PRELIMINARY PROJECT PLAN FOR LANSCE INTEGRATED FLIGHT PATHS 11A, 11B, 12, and 13

    International Nuclear Information System (INIS)

    This Preliminary Project Plan Summarizes the Technical, Cost, and Schedule baselines for an integrated approach to developing several flight paths at the Manual Lujan Jr. Neutron Scattering Center at the Los Alamos Neutron Science Center. For example, the cost estimate is intended to serve only as a rough order of magnitude assessment of the cost that might be incurred as the flight paths are developed. Further refinement of the requirements and interfaces for each beamline will permit additional refinement and confidence in the accuracy of all three baselines (Technical, Cost, Schedule)

  9. New data acquisition system for the lujan center

    International Nuclear Information System (INIS)

    To meet the data acquisition requirements for six new neutron scattering instruments at the Los Alamos Science Center (LANSCE), we are building systems using Web tools, commercial hardware and software, software developed by the controls community, and custom hardware developed by the neutron scattering community. To service these new instruments as well as seven existing instruments, our data acquisition system needs common software and hardware core capabilities and the means to flexibly integrate them while differentiating the needs of the diverse instrument suite. Neutron events are captured and processed in VXI modules while controls for sample environment and beam line setup are processed with PCs. Typically users access the system through web browsers. (author)

  10. Transcatheter arterial embolization for unresectable symptomatic giant hepatic hemangiomas: single-center experience using a lipiodol-ethanol mixture

    OpenAIRE

    Denis Szejnfeld; Thiago Franchi Nunes; Vinicius Adami Vayego Fornazari; Carla Adriana Loureiro de Matos; Adriano Miziara Gonzalez; Giuseppe D’Ippolito; Ivonete Sandra de Souza e Silva; Suzan Menasce Goldman

    2015-01-01

    Abstract Objective: The present article is aimed at reporting the author’s experience with transcatheter arterial embolization using a lipiodol-ethanol mixture in three cases of unresectable symptomatic giant hepatic hemangiomas. Materials and Methods: The cases of three patients with giant unresectable symptomatic hepatic hemangiomas embolized in the period 2009–2010 were retrospectively reviewed. In all the cases, transarterial embolization was performed with an ethanol-lipiodol mixture. Re...

  11. The Impact of Labour Epidural Analgesia on the Childbirth Expectation and Experience at a Tertiary Care Center in Southern India.

    OpenAIRE

    Bhatt, Hitanshu; Pandya, Sunil; Kolar, Geeta; Nirmalan, Praveen Kumar

    2014-01-01

    Background: Labour epidural analgesia is increasingly used as a means of pain relief for women during labour and delivery. The significant pain during labour and delivery can be terrifying for mothers-to-be and the prospect of relief from pain can help reduce fear of childbirth to an extent. However, it is not necessary that reduced fear of childbirth may lead to an increased satisfaction with the childbirth experience.

  12. Overview of the first Multi-center Airborne Coherent Atmospheric Wind Sensor (MACAWS) experiment: Conversion of a ground-based lidar for airborne applications

    Energy Technology Data Exchange (ETDEWEB)

    Howell, J.N.; Hardesty, R.M. [National Oceanic and Atmospheric Administration, Boulder, CO (United States). Environmental Technology Lab.; Rothermel, J. [Marshall Space Flight Center, Huntsville, AL (United States); Menzies, R.T. [Jet Propulsion Lab., Pasadena, CA (United States)

    1996-12-31

    The first Multi-center Airborne Coherent Atmospheric Wind Sensor (MACAWS) field experiment demonstrated an airborne high energy TEA CO{sub 2} Doppler lidar system for measurement of atmospheric wind fields and aerosol structure. The system was deployed on the NASA DC-8 during September 1995 in a series of checkout flights to observe several important atmospheric phenomena, including upper level winds in a Pacific hurricane, marine boundary layer winds, cirrus cloud properties, and land-sea breeze structure. The instrument, with its capability to measure three-dimensional winds and backscatter fields, promises to be a valuable tool for climate and global change, severe weather, and air quality research. In this paper, the authors describe the airborne instrument, assess its performance, discuss future improvements, and show some preliminary results from September experiments.

  13. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Science.gov (United States)

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  14. Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers

    Directory of Open Access Journals (Sweden)

    Daniela Sandoval

    2012-01-01

    Full Text Available Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP. Design. A cross-sectional and multicenter study. Setting. 52 primary care centers, metropolitan area of Santiago, Chile. Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients. Key Measurements. Demographic information, blood pressure (BP measurements, and CVRF were extracted from medical records of patients followed for a 12-month period. Results. 59.7% of patients reached target BP <140/90 mmHg. More women were captured in the sampling (2.1 : 1, achieving better BP control than men. Diabetic patients (26.4% had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control. Conclusions. The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics.

  15. Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kose, Fatih, E-mail: fatihkose@gmail.com [Baskent University Faculty of Medicine, Department of Medical Oncology, Adana (Turkey); Oguzkurt, Levent [Department of Interventional Radiology, Adana (Turkey); Besen, Ayberk; Sumbul, Taner; Sezer, Ahmet; Karadeniz, Cemile; Disel, Umut; Mertsoylu, Huseyin; Ozyilkan, Ozgur [Baskent University Faculty of Medicine, Department of Medical Oncology, Adana (Turkey)

    2012-08-15

    Purpose: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. Material and methods: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. Results: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p = 0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. Conclusion: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

  16. Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience

    International Nuclear Information System (INIS)

    Purpose: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. Material and methods: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. Results: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p = 0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. Conclusion: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

  17. Matrix support strategies: the experience of two Family Health Support Centers (NASFs) in São Paulo, Brazil.

    Science.gov (United States)

    Barros, Juliana de Oliveira; Gonçalves, Rita Maria de Abreu; Kaltner, Ronaldo Pires; Lancman, Selma

    2015-09-01

    The aim of Family Health Support Centers (NASFs) is to expand and qualify primary health care initiatives. Working together with Family Health Teams (EqSFs) they use matrix support strategies. This paper discusses how NASF professionals develop their work, emphasizing how matrix support approaches are appropriated and incorporated into daily working practices. The results that are presented are based on a case study of the work process of NASFs in a region of the city of São Paulo, Brazil. In order to investigate this issue, specific questions were introduced at different stages of the ergonomic work analysis. The implementation of the NASF, without a review of the guidance documents provided by the EqSF, created the following paradoxes: the different requirements of productivity and the working strategies between the NASF and the EqSF; the different demands of care for the population and different priorities for action, which were reflected in the division of tasks and the time allocated to each of them, etc. The practices that have been accumulated since the creation of the NASF suggests a review of these documents in order to transform the organization of planned work of these organizations in order to create better conditions for shared working practices. PMID:26331516

  18. Determinants of graft survival in pediatric and adolescent live donor kidney transplant recipients: a single center experience.

    Science.gov (United States)

    El-Husseini, Amr A; Foda, Mohamed A; Shokeir, Ahmed A; Shehab El-Din, Ahmed B; Sobh, Mohamed A; Ghoneim, Mohamed A

    2005-12-01

    To study the independent determinants of graft survival among pediatric and adolescent live donor kidney transplant recipients. Between March 1976 and March 2004, 1600 live donor kidney transplants were carried out in our center. Of them 284 were 20 yr old or younger (mean age 13.1 yr, ranging from 5 to 20 yr). Evaluation of the possible variables that may affect graft survival were carried out using univariate and multivariate analyses. Studied factors included age, gender, relation between donor and recipient, original kidney disease, ABO blood group, pretransplant blood transfusion, human leukocyte antigen (HLA) matching, pretransplant dialysis, height standard deviation score (SDS), pretransplant hypertension, cold ischemia time, number of renal arteries, ureteral anastomosis, time to diuresis, time of transplantation, occurrence of acute tubular necrosis (ATN), primary and secondary immunosuppression, total dose of steroids in the first 3 months, development of acute rejection and post-transplant hypertension. Using univariate analysis, the significant predictors for graft survival were HLA matching, type of primary urinary recontinuity, time to diuresis, ATN, acute rejection and post-transplant hypertension. The multivariate analysis restricted the significance to acute rejection and post-transplant hypertension. The independent determinants of graft survival in live-donor pediatric and adolescent renal transplant recipients are acute rejection and post-transplant hypertension. PMID:16269048

  19. Liquid Metal Processing and Casting Experiences at the U.S. Department of Energy's Albany Research Center

    Energy Technology Data Exchange (ETDEWEB)

    Jablonski, Paul D.; Turner, Paul C.

    2005-09-01

    In this paper we will discuss some of the early pioneering work as well as some of our more recent research. The Albany Research Center (ARC) has been involved with the melting and processing of metals since it was established in 1942. In the early days, hardly anything was known about melting refractory or reactive metals and as such, virtually everything had to be developed in-house. Besides the more common induction heated air-melt furnaces, ARC has built and/or utilized a wide variety of furnaces including vacuum arc remelt ingot and casting furnaces, cold wall induction furnaces, electric arc furnaces, cupola furnaces and reverberatory furnaces. The melt size of these furnaces range from several grams to a ton or more. We have used these furnaces to formulate custom alloys for wrought applications as well as for such casting techniques as spin casting, investment casting and lost foam casting among many. Two early spin-off industrializations were Wah Chang (wrought zirconium alloys for military and commercial nuclear applications) and Oremet (both wrought and cast Ti). Both of these companies are now part of the ATI Allegheny Ludlum Corporation.

  20. Donor safety in adult living donor liver transplantation using the right lobe:Single center experience in China

    Institute of Scientific and Technical Information of China (English)

    Fu-Gui Li; Lu-Nan Yan; Yong Zeng; Jia-Yin Yang; Qi-Yuan Lin; Xiao-Zhong Jiang; Bin Liu

    2007-01-01

    AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China.METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2±7.4years. Residual liver volume was 42.1%±4.7%. Mean operative time was 420±76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4±8.6 d; and mean follow-up period, 6 mo.RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2,and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required reoperation. Return to pre-donation activity occurred within 5-8 wk.CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

  1. Three Experiments Examining the Use of Electroencephalogram,Event-Related Potentials, and Heart-Rate Variability for Real-Time Human-Centered Adaptive Automation Design

    Science.gov (United States)

    Prinzel, Lawrence J., III; Parasuraman, Raja; Freeman, Frederick G.; Scerbo, Mark W.; Mikulka, Peter J.; Pope, Alan T.

    2003-01-01

    Adaptive automation represents an advanced form of human-centered automation design. The approach to automation provides for real-time and model-based assessments of human-automation interaction, determines whether the human has entered into a hazardous state of awareness and then modulates the task environment to keep the operator in-the-loop , while maintaining an optimal state of task engagement and mental alertness. Because adaptive automation has not matured, numerous challenges remain, including what the criteria are, for determining when adaptive aiding and adaptive function allocation should take place. Human factors experts in the area have suggested a number of measures including the use of psychophysiology. This NASA Technical Paper reports on three experiments that examined the psychophysiological measures of event-related potentials, electroencephalogram, and heart-rate variability for real-time adaptive automation. The results of the experiments confirm the efficacy of these measures for use in both a developmental and operational role for adaptive automation design. The implications of these results and future directions for psychophysiology and human-centered automation design are discussed.

  2. Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience

    OpenAIRE

    Kharazi, A; Emkanjoo, Z; A. Alizadeh; Nikoo, MH; Jorat, MV; Sadr-Ameli, MA

    2007-01-01

    Background Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increase risk of sudden cardiac death. Risk stratification for the life-threatening arrhythmic events in Brugada syndrome is not yet established. In the present study, we report our experience in patients with Brugada syndrome, following an ICD implantation. Methods and Results A total of 12 patients (11 men, 1 woman) with a mean age of 46.5±11....

  3. Allogeneic hematopoietic SCT performed in non-HEPA filter rooms: initial experience from a single center in India.

    Science.gov (United States)

    Kumar, R; Naithani, R; Mishra, P; Mahapatra, M; Seth, T; Dolai, T K; Bhargava, R; Saxena, R

    2009-01-01

    In developing countries, it is important to ascertain the safety of performing allogeneic hematopoietic SCT (HSCT) in single rooms without high-efficiency particulate air (HEPA) filters. We present our experience of performing 40 such transplants from July 2004 to November 2007. Source of stem cells was peripheral blood in 33, bone marrow in six and combined in one. G-CSF started from day +1. The indications were SAA-18, CML-7, AML-7, ALL-2, myelodysplastic syndrome-2 and thalassemia major-4. The median age was 19 years (range 2.2-46) with 29 male and 11 female participants. Antibacterial and antifungal prophylaxis was administered along with conditioning, and at the onset of fever, systemic antibiotics were started. Antifungal agents were added if fever persisted for 3 days. Median time for neutrophil engraftment was 10 days (range 8-17). Fever occurred in 38 (95%) for a median of 5 days (range 1-38), and blood cultures were positive in seven (17.5%). Systemic antibiotics were used in 95% and antifungals in 57.5% cases. The 30-day mortality was nil, and 100-day mortality was 1 (2.5%). After day 100, there were eight fatalities (20%) due to chronic GVHD-3, relapse-2, graft rejection-2, disseminated tuberculosis and aspergillosis-1. Our experience suggests that allogeneic HSCT can be safely performed in non-HEPA filter rooms in India. PMID:18794872

  4. Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

    Science.gov (United States)

    Nazarbaghi, Surena; Amiri-Nikpour, Mohammad Reza; Mahmodlou, Rahim; Arjmand, Nasim; Rezaei, Yousef

    2015-01-01

    Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA) criteria, response to therapy was defined as complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestation (MM) as secondary endpoints. Results: Majority of the patients were male (60%) and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60%) and 10 patients (40%) had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months). The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584). Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia. PMID:26713298

  5. Clinical outcomes of myasthenia gravis with thymoma and thymic hyperplasia undergoing extended transsternal thymectomy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Surena Nazarbaghi

    2015-01-01

    Full Text Available Background: Despite the widespread use of thymectomy in myasthenia gravis (MG patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA criteria, response to therapy was defined as complete stable remission (CSR, pharmacologic remission (PR, and minimal manifestation (MM as secondary endpoints. Results: Majority of the patients were male (60% and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60% and 10 patients (40% had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months. The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584. Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia.

  6. Association of interatrial septal abnormalities with cardiac impulse conduction disorders in adult patients: experience from a tertiary center in Kosovo.

    Science.gov (United States)

    Bakalli, Aurora; Pllana, Ejup; Koçinaj, Dardan; Bekteshi, Tefik; Dragusha, Gani; Gashi, Masar; Musliu, Nebih; Gashi, Zaim

    2011-01-01

    INTERATRIAL SEPTAL DISORDERS, WHICH INCLUDE: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Interatrial septal anomalies were detected in around 85% of the examined patients. Patent foramen ovale was encountered in 32% of the patients, and in combination with atrial septal aneurysm in an additional 11.3% of cases. Atrial septal aneurysm and atrial septal defect were diagnosed with equal frequency in 20.7% of our study population. Impulse conduction disorders were significantly more suggestive of interatrial septal anomalies than clinical signs and symptoms observed in our patients (84.91% vs 30.19%, P=0.002). Right bundle branch block was the most frequent impulse conduction disorder, found in 41 (77.36%) cases. We conclude that interatrial septal anomalies are highly associated with impulse conduction disorders, particularly with right bundle branch block. Impulse conduction disorders are more indicative of interatrial septal abnormalities in earlier stages than can be understood from the patient's clinical condition. PMID:21977304

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

    Science.gov (United States)

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

    2016-01-01

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

  8. 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

  9. Radiological imaging features and clinicopathological correlation of hemosiderotic fibrolipomatous tumor: experience in a single tertiary cancer center

    Energy Technology Data Exchange (ETDEWEB)

    O' Driscoll, Dearbhail; Athanasian, Edward; Hameed, Meera; Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2015-05-01

    To determine the imaging features of hemosiderotic fibrolipomatous tumor (HFLT), which has a propensity towards local recurrence and the potential to transform into myxoinflammatory fibroblastic sarcoma (MIFS). The study included 8 patients with a diagnosis of HFLT and imaging at a tertiary cancer center. Imaging studies included radiographs (n = 2), ultrasound (n = 3), and MRI (n = 16). Imaging features were evaluated including location, calcification, sonographic echogenicity, vascular flow, size, border, signal characteristics, contrast enhancement, and blooming on MRI. The HFLT was located in the ankle/foot in 4 out of 8 and was subcutaneous in 8 out of 8, ranging in size from 2 to 18 cm. Histology at initial diagnosis was HFLT in 5 out of 8 and HFLT with MIFS in 3 out of 8. None was calcified on radiography. On ultrasound 2 out of 3 were heterogeneously echogenic with ≥10 foci of vascular flow. Two out of 8 patients had MRI only at local recurrence. The tumor border was infiltrative in 4 out of 6 at initial diagnosis and in 2 patients with MRI at recurrence only. Fat and septae were present in 7 out of 8 at initial diagnosis and at recurrence. Signal intensity was iso-/hypointense to muscle on T1-weighted sequences in more than two thirds of the tumor in 4 out of 7 and hyperintense to muscle in at least one third of the tumor on fluid-sensitive sequences in 6 out of 8. Contrast enhancement was heterogeneous in 7 out of 7; blooming in two thirds of the tumor on gradient-echo sequence MRI indicated hemorrhage. The HFLT commonly presents as a mass with an infiltrative border, interspersed fat and septations at initial diagnosis and local recurrence on MRI regardless of histology of HFLT alone or with MIFS. Hemosiderin deposits may be detected as blooming on gradient-echo sequences. (orig.)

  10. Initial CT-guided needle biopsy of extremity skeletal lesions: Diagnostic performance and experience of a tertiary musculoskeletal center

    Energy Technology Data Exchange (ETDEWEB)

    Nouh, Mohamed Ragab, E-mail: mragab73@yahoo.com [Department of Radiology, Faculty of Medicine, Alexandria University (Egypt); Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait); Abu Shady, Hamdy Mohamed, E-mail: hamdi_abushadi@yahoo.com [Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait)

    2014-02-15

    Introduction: Appendicular long bones are the target for a wide spectrum of bony lesions with variable clinical presentations. Biopsy procedures are needed for subsequent proper patient's management. Most of the available literature globally assessed musculoskeletal biopsies with inclusion of repeat biopsy results. We thought to retrospectively assess the diagnostic performance of initial CT-guided percutaneous core needle biopsy (PCNB) of extremity long bone lesions in a tertiary musculoskeletal referral center. Patients and methods: We retrospectively analyzed the outcome of initial CT-guided PCNB of 49 patients who presented with extremity long bone lesions which were biopsied in our hospital during a 36 months’ time period. The diagnostic performance was assessed in terms of diagnostic yield and accuracy. Results: There were 34 males and 15 females with a mean age of 33.69 years (range from 4 to 77 years). The overall diagnostic yield of initial biopsies was 87.75% with a diagnostic accuracy of 82.85% derived from the surgically proven cases. The higher diagnostic yield was recorded with malignancy, presence of extra-osseous soft-tissue component as well as mixed and sclerotic lesions. The pathologies of the non-diagnostic biopsies included large-cell lymphoma, giant-cell tumor, langerhans cell histiocytosis, osteoid osteoma and a non-ossifying fibroma. Conclusion: Initial CT-guided PCNB in extremities’ long bones lesions showed high diagnostic performance in malignant, mixed and/or sclerotic lesions as well as lesions with extra-osseous exophytic tissue growth. Lack of extra-osseous components, benign and lytic lesions all had worse diagnostic performance.

  11. Implantable cardioverter defibrillator therapy in pediatric and congenital heart disease patients: a single tertiary center experience in Korea

    Directory of Open Access Journals (Sweden)

    Bo Kyung Jin

    2013-03-01

    Full Text Available Purpose: The use of implantable cardioverter defibrillators (ICDs to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was 14.5±5.4 years (range, 2 to 22 years. The follow-up duration was 28.9±20.4 months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1, cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years. Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia.During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

  12. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience

    Directory of Open Access Journals (Sweden)

    Hassan Al-Thani

    2016-07-01

    Full Text Available Objectives: A thyroglossal duct cyst (TDC is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. Methods: A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients’ demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. Results: We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6–13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%, thyroid function test (44%, and fine-needle aspiration cytology (10%. The median size of the cyst was 25 (2–60 mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%, followed by fistula (9%, infection (2%, and dysphagia (2%. Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9–60 vs. 22 (2–55 mm; p = 0.005 and required prolonged operation time (69 (1–169 vs. 32.5 (1–140 mins; p = 0.004 compared to the pediatric group. Conclusion: The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the

  13. Preparation of a one-curie 171Tm target for the detector for advanced neutron capture experiments (DANCE)

    International Nuclear Information System (INIS)

    Approximately one curie of 171Tm (T1/2 = 1.92a) has been produced and purified for the purpose of making a nuclear target for the first measurements of its neutron capture cross section. Target preparation consisted of three key steps: (1) material production; (2) separation and purification; and (3) electrodeposition onto a suitable backing material. Approximately 1.5 mg of the target material (at the time of separation) was produced by irradiating ca. 250 mg of its stable enriched 170Er lanthanide neighbour with neutrons at the ILL reactor in France. This production method resulted in a 'difficult-to-separate' 1:167 mixture of near-neighboring lanthanides, Tm and Er. Separation and purification was accomplished using high-performance liquid chromatography (HPLC), with a proprietary cation-exchange column (Dionex, CS-3) and alphahydroxyisobutyric acid (α-HIB) eluent. This technique yielded a final product of ∼95% purity with respect to Tm. A portion (20 μg) of the Tm was electrodeposited onto thin Be foil and delivered to the Los Alamos Neutron Science Center (LANSCE) for preliminary analysis of its neutron capture cross section using the Detector for Advanced Neutron Capture Experiments (DANCE). This paper discusses the major hurdles associated with the separation and purification step, including scale-up issues related to the use of HPLC for material separation and purification of the target material from α-HIB and 4-(2-pyridylazo)resorcinol (PAR) colorant. (author)

  14. Preparation of a one-curie 171Tm target for the Detector for Advanced Neutron Capture Experiments (DANCE)

    Energy Technology Data Exchange (ETDEWEB)

    Schwantes, Jon M.; Taylor, Wayne A.; Rundberg, Robert S.; Vieira, David J.

    2008-05-15

    Roughly one curie of 171Tm (t1/2=1.92a) has been produced and purified for the purpose of making a nuclear target for the first measurements of its neutron capture cross section. Target preparation consisted of three key steps: (1) material production; (2) separation and purification; and (3) electrodeposition onto a suitable backing material. Approximately 1.5 mg of the target material (at the time of separation) was produced by irradiating roughly 250 mg of its stable enriched 170Er lanthanide neighbor with neutrons at the ILL reactor in France. This production method resulted in a “difficult-to-separate” 1:167 mixture of near-neighboring lanthanides, Tm and Er. Separation and purification was accomplished using high-performance liquid chromatorgraphy (HPLC), with a proprietary cation exchange column (Dionex, CS-3) and alpha-hydroxyisobutyric acid (a-HIB) eluent. This technique yielded a final product of ~95% purity with respect to Tm. A portion (20 ug) of the Tm was electrodeposited on thin Be foil and delivered to the Los Alamos Neutron Science CEnter (LANSCE) for preliminary analysis of its neutron capture cross section using the Detector for Advanced Neutron Capture Experiments (DANCE). This paper discusses the major hurdles associated with the separation and purification step including, scale-up issues related to the use of HPLC for material separation and purification of the target material from a-HIB and 4-(2-pyridylazo)resorcinol (PAR) colorant.

  15. The concept of negative pressure wound therapy (NPWT after poststernotomy mediastinitis – a single center experience with 54 patients

    Directory of Open Access Journals (Sweden)

    Vogt Peter M

    2009-01-01

    Full Text Available Abstract Deep sternal infections, also known as poststernotomy mediastinitis, are a rare but often fatal complication in cardiac surgery. They are a cause of increased morbidity and mortality and have a significant socioeconomic aspect concerning the health system. Negative pressure wound therapy (NPWT followed by muscular pectoralis plasty is a quite new technique for the treatment of mediastinitis after sternotomy. Although it could be demonstrated that this technique is at least as safe and reliable as other techniques for the therapy of deep sternal infections, complications are not absent. We report about our experiences and complications using this therapy in a set of 54 patients out of 3668 patients undergoing cardiac surgery in our institution between January 2005 and April 2007.

  16. Transcatheter arterial embolization for unresectable symptomatic giant hepatic hemangiomas: single-center experience using a lipiodol-ethanol mixture*

    Science.gov (United States)

    Szejnfeld, Denis; Nunes, Thiago Franchi; Fornazari, Vinicius Adami Vayego; de Matos, Carla Adriana Loureiro; Gonzalez, Adriano Miziara; D’Ippolito, Giuseppe; Silva, Ivonete Sandra de Souza e; Goldman, Suzan Menasce

    2015-01-01

    Objective The present article is aimed at reporting the author’s experience with transcatheter arterial embolization using a lipiodol-ethanol mixture in three cases of unresectable symptomatic giant hepatic hemangiomas. Materials and Methods The cases of three patients with giant unresectable symptomatic hepatic hemangiomas embolized in the period 2009–2010 were retrospectively reviewed. In all the cases, transarterial embolization was performed with an ethanol-lipiodol mixture. Results Symptoms regression and quality of life improvement were observed in all the cases. No complications were observed and all the patients were discharged within 12 hours after the procedure. Conclusion Transcatheter arterial embolization using ethanol mixed with lipiodol was a safe and effective treatment for symptomatic giant hepatic hemangiomas in this small series of patients. PMID:26185341

  17. Transcatheter arterial embolization for unresectable symptomatic giant hepatic hemangiomas: single-center experience using a lipiodol-ethanol mixture

    Directory of Open Access Journals (Sweden)

    Denis Szejnfeld

    2015-06-01

    Full Text Available Abstract Objective: The present article is aimed at reporting the author’s experience with transcatheter arterial embolization using a lipiodol-ethanol mixture in three cases of unresectable symptomatic giant hepatic hemangiomas. Materials and Methods: The cases of three patients with giant unresectable symptomatic hepatic hemangiomas embolized in the period 2009–2010 were retrospectively reviewed. In all the cases, transarterial embolization was performed with an ethanol-lipiodol mixture. Results: Symptoms regression and quality of life improvement were observed in all the cases. No complications were observed and all the patients were discharged within 12 hours after the procedure. Conclusion: Transcatheter arterial embolization using ethanol mixed with lipiodol was a safe and effective treatment for symptomatic giant hepatic hemangiomas in this small series of patients.

  18. Taquiarritmias supraventriculares no feto. Experiência de uma unidade de referência em cardiologia fetal Fetal supraventricular tachyarrhythmias. Experience of a fetal cardiology reference center

    Directory of Open Access Journals (Sweden)

    Paulo Zielinsky

    1998-05-01

    Full Text Available OBJETIVO: Avaliar a forma de apresentação, diagnóstico e tratamento das taquiarritmias supraventriculares fetais, através do relato de uma série de casos acompanhados em um centro terciário de cardiologia fetal. MÉTODOS: São descritos 25 casos de taquiarritmia supraventricular diagnosticados intra-útero, no período de janeiro/89 a outubro/97, em uma população compreendendo 3117 gestantes. RESULTADOS: Foram diagnosticados 17 casos de taquiarritmia supraventricular e 8 casos de flutter atrial fetal. As idades gestacionais variaram de 26 a 40 semanas. Doze fetos apresentavam hidropisia no momento do diagnóstico (6 com taquicardia supraventricular (TSV e 6 com flutter atrial. Quatro fetos com TSV apresentavam cardiopatias estruturais (dois casos de anomalia de Ebstein e dois com comunicação interventricular. Todos os fetos foram internados na Unidade de Cardiologia Fetal para monitorização e tratamento. Entre os 17 fetos com TSV, 12 apresentaram reversão da arritmia após administração de digoxina, mas esta medida não foi eficaz em nenhum paciente com flutter. Dois pacientes com TSV e seis com flutter necessitaram interrupção da gestação para cardioversão elétrica pós-natal. A mortalidade foi de 3/17 no grupo da TSV (incluindo dois pacientes com anomalia de Ebstein e de 0/8 no grupo com flutter. CONCLUSÃO: As taquiarritmias supraventriculares fetais são eventos raros na população geral. Entretanto, podem provocar insuficiência cardíaca e óbito intra-uterino. Como a resposta ao tratamento é satisfatória, tornam-se de extrema importância o diagnóstico precoce e o tratamento adequado.PURPOSE: To describe the presentation, diagnosis and treatment of fetal supraventricular tachyarrhythmias in a series of fetuses followed in a tertiary Fetal Cardiology Center. METHODS: Twenty-five fetuses with diagnosis of supraventricular tachyarrhytmia were reported from January 1989 to October 1997, among 3117 pregnant women

  19. Allogeneic Stem Cell Transplantation in Congenital Hemoglobinopathies Using a Tailored Busulfan-Based Conditioning Regimen: Single-Center Experience.

    Science.gov (United States)

    Zaidman, Irina; Rowe, Jacob M; Khalil, Abdalla; Ben-Arush, Myriam; Elhasid, Ronit

    2016-06-01

    Hematopoietic stem cell transplantation (HSCT) is the only proven curative option for patients with hemoglobinopathies, both thalassemia and sickle cell anemia (SCA). A busulfan-based myeloablative conditioning regimen is the standard of care for HSCT in these patients, although increased treatment-related morbidity, including veno-occlusive disease (VOD), has been demonstrated. Thirty-eight pediatric patients, median age 8 years (range, 6 months to 22 years), suffering from hemoglobinopathy were treated at Rambam Medical Center in Haifa, Israel, between 1998 and 2011. Thirty-four patients had thalassemia major and 4 had SCA. The 38 patients underwent 40 HSCTs, 34 of which were first transplants and 6 second transplants. Most transplants (32/40) were from matched sibling donors. Sources of stem cells were peripheral blood in 30 transplants, bone marrow in 7 transplants, and cord blood in 3 transplants. All received different customized busulfan-based conditioning regimens tailored by pharmacokinetic analysis of busulfan levels. Primary engraftment occurred in 37 of 40 transplants. Neutrophil engraftment (>.5 × 10(9)/L) occurred at a median of 15.3 days post-transplantation (range, 10 to 45). Platelet transfusion independence (>20 × 10(9)/L) occurred at a median of 22.3 days (range, 11 to 60). The rate of 5-year overall survival for thalassemia patients after first transplantation was 90.5% ± 5.3%. The rate of 5-year thalassemia-free survival was 81.7% ± 6.8%. Cumulative incidence of acute graft-versus-host disease (GVHD) was 17.6%. Rate of grades III to IV GVHD was 8.8%. Cumulative incidence of chronic GVHD was 23.5%, with 11.8% incidence of extensive chronic GVHD. One patient developed VOD. Full donor chimerism occurred in 36.4% of patients with class 1 + 2 thalassemia, compared with 78.6% in class 3 thalassemia (P = .049). Overall survival above 90% in patients undergoing their first transplant was demonstrated using busulfan

  20. Predictors of caregivers’ burden of Parkinson’s disease in India: experience of a tertiary care center in India

    Directory of Open Access Journals (Sweden)

    Agrawal V

    2012-11-01

    Full Text Available Vikas Agrawal,1 Vinay Goyal,2 Garima Shukla,2 Madhuri Behari21Department of Neurology, Yashoda Hospital, Secunderabad, Andhra Pradesh, India; 2Department of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaIntroduction: Parkinson’s disease (PD is a progressive neurodegenerative disorder characterized by increasing dependence on caregivers for activities of daily living that imposes a major burden upon the patients’ caregiver. Caregiver burden (CB refers to the physical, mental, and socioeconomic problems experienced by the caregivers of chronic patients.Patients and methods: This is a onetime cross-sectional observational study carried out in the movement disorder clinic of a tertiary referral center in India. Persons with PD were interviewed and information was collected regarding demographic and clinical details, treatment taken, and presence of non-motor features such as dementia, psychosis, depression, etc, on a pre-tested format and their caregivers were interviewed for self-perceived burden using Zerit’s caregivers’ burden inventory.Results: We interviewed 91 persons with PD (71 [78%] men, 20 [22%] women with their primary caregivers. The age of the patients ranged from 25 to 75 years (mean 56.66 ± 11.83 years. After regression analysis, depression in patients (beta = 0.352, 95% confidence interval [CI]: 0.275 to 0.790, high UPDRS-motor scores (beta = 0.255, 95% CI: 0.108 to 0.532, and presence of sleep disturbances in the atient (beta = 0.206, 95% CI: 0.817 to 11.823 were associated with increased caregiver burden and the presence of multiple caregivers was associated with lower caregiver burden (beta = −0.311, 95% CI: −10.155 to −3.436.Conclusion: The total number of caregivers was found to be an important predictor for reducing CB. Multiple caregivers is a phenomenon which has not been studied till now. Other factors which were found to have adverse predictive effect on caregiver burden are presence of

  1. HIPPO, the high-pressure preferred orientation diffractometer at LANSCE for characterization of bulk materials

    International Nuclear Information System (INIS)

    United States National Laboratory researchers and University of California faculty, representing a broad range of scientific disciplines, is building a novel time-of-flight (TOF) neutron diffractometer and associated in situ equipment at the Manuel Lujan Jr. Neutron Scattering Center (Lujan Center), under the auspices of the United States Department of Energy. The goal with the High-Pressure Preferred Orientation Instrument (HIPPO) is to investigate dynamic processes in heterogeneous bulk materials in a variety of environments. The instrument, which will become available in summer 2001, has the extremely high count-rates necessary to study time-dependent processes in small (1-mm diameter) and large (2-cm diameter) samples, and in a large variety of environmental conditions (10-2000 K cryostats and furnaces, 0-20 GPa pressure vessels, straining cells, goniometers, magnets, etc.). The 3-D arrangement of detectors allows direct measurements of crystal orientation distributions in polycrystalline materials. The analysis of TOF diffraction patterns with versatile Rietveld codes provides simultaneous information on crystal structure, texture, microstructure and phase proportions. While this instrument has many applications in materials science, it is also of great interest for geology and geophysics. Some applications include: kinetics of reactions, structure of silicate glasses and melts, high-pressure investigations of complex systems, evolution of texture and anisotropy during deformation and recrystallization. The Lujan Center aims at creating an instrument with high data through-put and easy access to researchers and students. While the HIPPO instrument will be part of the national user facility operated by the Lujan Center, the scientific program will be guided by the University of California consortium with the goal of satisfying national priorities and establishing an environment of scientific excellence. (author)

  2. Design and fabrication of a duoplasmatron extraction geometry and LEBT for the LANSCE H{sup +} RFQ project

    Energy Technology Data Exchange (ETDEWEB)

    Fortgang, C. M., E-mail: cfortgang@lanl.gov; Batygin, Y. K.; Draganic, I. N.; Garnett, R. W.; McCrady, R. C.; Rybarcyk, L. J. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

    2016-02-15

    The 750-keV H{sup +} Cockcroft-Walton at LANSCE will be replaced with a recently fabricated 4-rod Radio Frequency Quadrupole (RFQ) with injection energy of 35 keV. The existing duoplasmatron source extraction optics need to be modified to produce up to 35 mA of H{sup +} current with an emittance <0.02 π-cm-mrad (rms, norm) for injection into the RFQ. Parts for the new source have been fabricated and assembly is in process. We will use the existing duoplasmatron source with a newly designed extraction system and low energy beam transport (LEBT) for beam injection into the RFQ. In addition to source modifications, we need a new LEBT for transport and matching into the RFQ. The LEBT uses two magnetic solenoids with enough drift space between them to accommodate diagnostics and a beam deflector. The LEBT is designed to work over a range of space-charge neutralized currents and emittances. The LEBT is optimized in the sense that it minimizes the beam size in both solenoids for a point design of a given neutralized current and emittance. Special attention has been given to estimating emittance growth due to source extraction optics and solenoid aberrations. Examples of source-to-RFQ matching and emittance growth (due to both non-linear space charge and solenoid aberrations) are presented over a range of currents and emittances about the design point. A mechanical layout drawing will be presented along with the status of the source and LEBT, design, and fabrication.

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

    International Nuclear Information System (INIS)

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

  4. Intravenous Drug Users Can Achieve a High Sustained Virological Response Rate: experience From Croatian Reference Center for Viral Hepatitis

    Directory of Open Access Journals (Sweden)

    Ivan Kurelac

    2011-12-01

    Full Text Available Background: Hepatitis C virus (HCV is one of the major infectious disease agents among injecting drug users (IVDUs. However, most of the IVDUs are not still treated.Objectives: To examine the treatment course, adherence, tolerability and safety profiles and SVR rates in IVDUs compared to non-IVDUs.Patients and Methods: Demographic and clinical data were collected from medical records of 345 adult patients diagnosed with chronic hepatitis C (CHC who were treated with a PEG-IFN-α and ribavirin in Croatian Reference Center for Viral Hepatitis in Zagreb between January 2003 and January 2010. Efficacy, safety and tolerability treatment profiles were analyzed in IVDUs vs. non-IVDUs. Positive predictors for treatment outcome were evaluated by univariate and multivariate logistic regression.Results: A total of 106 (30.46% IVDUs were identified. The IVDUs were mainly male (81.13% vs. 52.30%, P = 0.0001, young (mean ± SD age: 32.46 ± 5.33 y vs. 46.12 ± 11.48 y, P = 0.0001, had lower fibrosis and HAI score (measured by ISHAK and shorter duration of infection (mean ± SD: 8.98 ± 5.87 vs. 16.79 ± 8.99 y, P = 0.0001 compared to non-IVDU group. In IVDUs, genotype 1a (24.52% and 3a (38.68% were predominant. There were no differences in completion rate between the two studied groups. IVDUs achieved a significantly higher rate of overall SVR (70.75% vs. 51.04%, P < 0.0009 and in genotypes 1 and 4 (65.08% vs. 48.73%, P = 0.0294 vs. non-IVDUs. Treatment discontinuation rates due to side-effects were not significantly different in IVDUs and non-IVDUs (2.83% vs. 7.11%, P = 0.1390. IVDU group had a higher rate of lost to follow-up (13.21% vs. 4.60%, P = 0.0071. There were no statistically significant differences in SVR rate between IVDUs with, or without substitution therapy (55.55% vs. 74.62%, P = 0.0866. Independent predictors of SVR were age < 40 years and genotypes 2 and 3. Type of PEG-IFN-α used was not associated with SVR.Conclusions: Treatment of CHC in

  5. Use of Self-Expanding Stents for the Treatment of Vertebral Artery Ostial Stenosis: a Single Center Experience

    International Nuclear Information System (INIS)

    To evaluate our early experience using self-expanding stents to treat atherosclerotic vertebral artery ostial stenosis (VAOS), with respect to technical feasibility and clinical and imaging follow-up results. A total of 20 lesions in 20 patients underwent stenting of the VAOS using a self-expanding stent (Precise RX; Cordis Neurovascular, Miami Lakes, FL). Two patients were asymptomatic. We analyzed the technical success rate, causes of technical failure, occurrence of any vascular or neurological event, and the occurrence of any neurological abnormality or in-stent restenosis (ISR) seen on follow-up. The imaging follow-up was performed with Doppler ultrasound (DUS) as a primary screening modality. One instance of technical failure was caused by failure of the guidewire passage. The stent diameter was 5 mm, and post-stenting balloon dilatations were necessary in all cases. Stent misplacement requiring placement of an additional stent occurred in four cases. Following a 14.8 month average clinical follow-up time, two patients showed anterior circulation ischemia, which was not attributed to the VAOS we treated. Following a 13.7 month average DUS follow-up, five patients showed a mild degree of diffuse or focal intimal thickening in the stent lumen; however, none of the stenosis showed luminal loss of more than 50% and no stent fracture was noted. The use of self-expanding stents for treating VAOS was technically feasible and helped to improve artery patency during our limited follow-up interval

  6. The role of interventional radiology in biliary complications after orthotopic liver transplantation: a single-center experience

    International Nuclear Information System (INIS)

    This study evaluated interventional radiological experience in the management of biliary complications of OLT at the National Cancer Institute of Milan. Seventeen patients who had undergone orthotopic liver transplantation in various hospital were referred to our unit with biliary complications. Group I consisted of 8 patients with anastomotic biliary fistula who came to our attention a short time after transplantation. Group II consisted of 9 patients with anastomotic strictures who came to our attention in a longer period. Two different interventional radiological approaches were used: (a) percutaneous transhepatic biliary drainage (PTBD) in the presence of fistulas in patients of group I; and (b) percutaneous transhepatic biliary drainage combined with dilatation of the strictures with a balloon catheter in patients of group II. On the whole resolution of the biliary complications was achieved in 13 of the 17 cases treated (76.5%), 5 of 8 in group I and 8 of 9 in group II. No secondary stenosis after PTBD were observed in group I, whereas two patients of group II needed a second dilatation. Percutaneous biliary drainage is indicated as a valid treatment in the management of biliary complications, either to allow closure of the fistula either to perform balloon dilatation of stenosis. (orig.)

  7. The role of interventional radiology in biliary complications after orthotopic liver transplantation: a single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Civelli, Enrico Maria; Cozzi, Guido; Milella, Marco; Suman, Laura; Severini, Aldo [Dipartimento di Immagini per Diagnosi e Terapia, Istituto Nazionale dei Tumori Milano, Via Venezian 1, 20133, Milan (Italy); Meroni, Roberta; Vercelli, Ruggero [Universita degli Studi di Milano, Milan (Italy)

    2004-04-01

    This study evaluated interventional radiological experience in the management of biliary complications of OLT at the National Cancer Institute of Milan. Seventeen patients who had undergone orthotopic liver transplantation in various hospital were referred to our unit with biliary complications. Group I consisted of 8 patients with anastomotic biliary fistula who came to our attention a short time after transplantation. Group II consisted of 9 patients with anastomotic strictures who came to our attention in a longer period. Two different interventional radiological approaches were used: (a) percutaneous transhepatic biliary drainage (PTBD) in the presence of fistulas in patients of group I; and (b) percutaneous transhepatic biliary drainage combined with dilatation of the strictures with a balloon catheter in patients of group II. On the whole resolution of the biliary complications was achieved in 13 of the 17 cases treated (76.5%), 5 of 8 in group I and 8 of 9 in group II. No secondary stenosis after PTBD were observed in group I, whereas two patients of group II needed a second dilatation. Percutaneous biliary drainage is indicated as a valid treatment in the management of biliary complications, either to allow closure of the fistula either to perform balloon dilatation of stenosis. (orig.)

  8. Home mechanical ventilation in childhood-onset hereditary neuromuscular diseases: 13 years' experience at a single center in Korea.

    Directory of Open Access Journals (Sweden)

    Young Joo Han

    Full Text Available Children with hereditary neuromuscular diseases (NMDs are at a high risk of morbidity and mortality related to respiratory failure. The use of home mechanical ventilation (HMV has saved the lives of many children with NMD but, due to a lack of studies, dependable guidelines are not available. We drew upon our experience to compare the various underlying NMDs and to evaluate HMV with regard to respiratory morbidity, the proper indications and timing for its use, and to develop a policy to improve the quality of home noninvasive ventilation (NIV.We retrospectively analyzed the medical records of 57 children with childhood-onset hereditary NMDs in whom HMV was initiated between January 2000 and May 2013 at Seoul National University Children's Hospital. The degree of respiratory morbidity was estimated by the frequency and duration of hospitalizations caused by respiratory distress.The most common NMD was spinal muscular atrophy (SMA, n = 33. Emergent mechanical ventilation was initiated in 44% of the patients before the confirmed diagnosis, and the indicators of pre-HMV respiratory morbidity (e.g., extubation trials, hypoxia, hospitalizations, and intensive care unit stay were greater in these patients than in others. The proportion of post-HMV hospitalizations (range, 0.00-0.52; median, 0.01 was lower than that of pre-HMV hospitalizations (0.02-1.00; 0.99 (P < 0.001. Eight patients were able to maintain home NIV. The main causes of NIV failure were air leakage and a large amount of airway secretions.The application of HMV helped reduce respiratory morbidity in children with childhood-onset hereditary NMD. Patients with SMA type I can benefit from an early diagnosis and the timely application of HMV. The choice between invasive and noninvasive HMV should be based on the patient's age and NIV trial tolerance. Systematic follow-up guidelines provided by a multidisciplinary team are needed.

  9. Learning to "Swim" with the Experts: Experiences of Two Patient Co-Investigators for a Project Funded by the Patient-Centered Outcomes Research Institute.

    Science.gov (United States)

    Robbins, Michele; Tufte, Janice; Hsu, Clarissa

    2016-01-01

    The Patient-Centered Outcomes Research Institute (PCORI), established in 2010, launched a new model of incorporating stakeholder perspectives into health care research. To ensure that PCORI-funded studies address issues important to health care consumers, all projects must fully involve patients and other stakeholders in every step of the research process: from planning and design to implementation and dissemination of results.As members of the first cohort of PCORI-funded researchers, our team was on the forefront of developing new approaches to engaging patients in research. One innovation we pioneered was the creation of a "patient co-investigator" role for two nonscientists who were recruited to be active members of the research team throughout the project. This commentary, based on our experiences, aims to help other research teams to 1) understand how to effectively collaborate with stakeholder team members such as patients; 2) anticipate possible challenges; and 3) offer tools for the orientation, training, and integration of patients into a scientific team. Written from the perspective of two PCORI patient co-investigators, our commentary provides lessons learned and recommendations about incorporating nonscientists into research teams.Specifically, we suggest recruiting people with a record of relevant volunteer experience and commitment; establishing a formal application process that provides candidates with details about expectations and responsibilities; and providing comprehensive orientation with ongoing training, encouragement, and support. We hope the points in this commentary help research teams that are incorporating patient co-investigators move toward a positive and productive experience. PMID:27083011

  10. Learning to “Swim” with the Experts: Experiences of Two Patient Co-Investigators for a Project Funded by the Patient-Centered Outcomes Research Institute

    Science.gov (United States)

    Robbins, Michele; Tufte, Janice; Hsu, Clarissa

    2016-01-01

    The Patient-Centered Outcomes Research Institute (PCORI), established in 2010, launched a new model of incorporating stakeholder perspectives into health care research. To ensure that PCORI-funded studies address issues important to health care consumers, all projects must fully involve patients and other stakeholders in every step of the research process: from planning and design to implementation and dissemination of results. As members of the first cohort of PCORI-funded researchers, our team was on the forefront of developing new approaches to engaging patients in research. One innovation we pioneered was the creation of a “patient co-investigator” role for two nonscientists who were recruited to be active members of the research team throughout the project. This commentary, based on our experiences, aims to help other research teams to 1) understand how to effectively collaborate with stakeholder team members such as patients; 2) anticipate possible challenges; and 3) offer tools for the orientation, training, and integration of patients into a scientific team. Written from the perspective of two PCORI patient co-investigators, our commentary provides lessons learned and recommendations about incorporating nonscientists into research teams. Specifically, we suggest recruiting people with a record of relevant volunteer experience and commitment; establishing a formal application process that provides candidates with details about expectations and responsibilities; and providing comprehensive orientation with ongoing training, encouragement, and support. We hope the points in this commentary help research teams that are incorporating patient co-investigators move toward a positive and productive experience. PMID:27083011

  11. Preliminary experience in adult-to-adult living donor liver transplantation in a single center in China

    Institute of Scientific and Technical Information of China (English)

    YAN Lunan; CHEN Zheyu; LIU Jiangwen; WU Hong; LI Bo; ZENG Yong; WEN Tianfu; ZHAO Jichun; WANG Wentao; YANG Jiayin; XU Mingqing; MA Yukui

    2007-01-01

    The aim of this paper is to report the authors'experience in performing adult-to-adult living donor liver transplantation (LDLT)by using a modified technique in using grafts of the right lobe of the liver.From January 2002 to September 2006,56 adult patients underwent LDLT using right lobe grafts at the Wlest China Hospital.Sichuan University Medical School,China.All patients underwent a modified operation designed to improve the reconstruction of the right hepatic vein (RHV)and the tributariers of the middle hepatic vein(MHV)by interposing a vessel graft,and by anastomosing the hepatic arteries and bile ducts.There were no severe complications or deaths in all donors.Fifty-two (92.8%) recipients survived the operations.Among the 56 recipients,complications were seen in 15 recipients(26.8%),including hepatic vein stricture(one case),small-for-size syndrome(one case),hepatic artery thrombosis(two cases),intestinal bleeding (one case),bile leakage(two cases),left subphrenic abscess (one case),renal failure(two cases)and pulmonary infection (five cases).Within three months after transplantation,four recipients(7.1 4%)died due to smallfor-size syndrome(one case),renal failure(one case)and multiple organ failure(two cases).All patients underwent direct anastomoses of the RHV and the inferior vena cava (IVC),and in 23 cases,reconstruction of the right inferior hepatic vein was also done.In 24 patients,the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous outflow.Trifurcation of the portal vein was seen in nine cases.Thus,veno-plasty or separate anastomoses were performed.The graft and recipient body weight ratios(GRWR)were between 0.72%and 1.43%,and in three cases it was<0.8%.The graft weight to recipient standard liver volume ratios (GV/SLV) were between 31.86%and 71.68%.among which four cases had<40%.No "small-for-size syndrome"occurred.With modification of the surgical technique,especially in the

  12. Safety of atrial fibrillation ablation with novel multi-electrode array catheters on uninterrupted anticoagulation-a single-center experience.

    LENUS (Irish Health Repository)

    Hayes, Christopher Ruslan

    2012-02-01

    INTRODUCTION: A recent single-center report indicated that the performance of atrial fibrillation ablation in patients on uninterrupted warfarin using a conventional deflectable tip electrode ablation catheter may be as safe as periprocedural discontinuation of warfarin and bridging with heparin. Novel multi-electrode array catheters for atrial fibrillation ablation are currently undergoing clinical evaluation. While offering the possibility of more rapid atrial fibrillation ablation, they are stiffer and necessitate the deployment of larger deflectable transseptal sheaths, and it remains to be determined if they increase the risk of cardiac perforation and vascular injury. Such potential risks would have implications for a strategy of uninterrupted periprocedural anticoagulation. METHOD AND RESULTS: We audited the safety outcomes of our atrial fibrillation ablation procedures using multi-electrode array ablation catheters in patients on uninterrupted warfarin (CHADS2 score>or=2) and in patients not on warfarin (uninterrupted aspirin). Two bleeding complications occurred in 49 patients on uninterrupted warfarin, both of which were managed successfully without longterm sequelae, and no bleeding complication occurred in 32 patients not on warfarin (uninterrupted aspirin). There were no thromboembolic events or other complication with either anticoagulant regimen. CONCLUSION: Despite the larger diameter and increased stiffness of multi-electrode array catheters and their deflectable transseptal sheaths, their use for catheter ablation in patients with atrial fibrillation on uninterrupted warfarin in this single-center experience does not appear to be unsafe, and thus, an adequately powered multicenter prospective randomized controlled trial should be considered.

  13. Historical Center of Quito: an experience for the preservation of courtyard houses with an emphasis on user awareness

    Directory of Open Access Journals (Sweden)

    Sanchez, Lorena Marina

    2016-03-01

    Full Text Available The early declaration of Quito as a World Heritage site in 1978, makes this city a Latin American example with a remarkable preservationist experience. Its Historical Centre composes a blend of periods and goods, emphasizing on the presence of Spanish-Aborigine syncretism stands. This hybridation survives in the buffer area, made up of different neighborhoods, through a residential property typology: the patio houses. With endless complexities to their approach, these homes comprise the residential identity of Quito, but they have only recently taken on a new protagonism within a residential protection framework. Therefore, and through a historical-architectural and social approach, has been investigated the patrimonial fragment of the neighbourhood of San Juan, which is representative of what happens in the buffer area. Diagnosisand guidelines are exposed from a conception of exploratory study, mainly qualitative and focused on users awareness. This approximation has been carried on through the observation in situ, the analysis of planimetry, bibliography, photographs, the carrying out of interviews and opinion polls. Thus, final reflections are presented along with a methodological development feasible of being adapted to other residential properties in other urban contexts. La temprana declaración de Quito como Patrimonio de la Humanidad en 1978 la convierte en un ejemplo latinoamericano con una singular experiencia preservacionista. Su Centro Histórico compone una amalgama de períodos y bienes, destacándose la presencia del sincretismo español-aborigen. Esta hibridación sobrevive en el área de amortiguación, compuesta por diferentes barrios, a través de una tipología residencial característica: las casas patio. Con un sinfín de complejidades para su tratamiento, estas viviendas componen gran parte de la identidad habitacional quiteña, aunque sólo recientemente han adquirido un nuevo protagonismo dentro del marco de protecci

  14. Irradiation studies at Los Alamos Neutron Science Center supporting the Accelerator Production of Tritium project

    International Nuclear Information System (INIS)

    Recognizing the need for definitive mechanical and physical property data supporting design work, the APT project sponsored an aggressive irradiation program at the beam stop area at the Los Alamos Neutron Science Center (LANSCE). The LANSCE beam energy is 800 MeV with a current of 2 mA. By focusing the beam, a proton flux prototype to that expected at APT was achieved. The initial irradiations focused on radiation damage effects on the mechanical and physical properties of materials selected for structural components and neutron-producing target elements. The irradiations also included models of the Pb-Al blanket module and capsules that served as models of the He gas containment system. The program was extended to include measurement of in situ corrosion0related phenomena, decay heat induced by proton bombardment of a W target, and performance of He-gas-handling equipment. These later measurements also were effective in developing instrumentation applicable to the surveillance of an operating plant. Results from these studies are becoming available and are summarized here

  15. Klystron Modulator Design for the Los Alamos Neutron Science Center Accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Reass, William A. [Los Alamos National Laboratory; Baca, David M. [Los Alamos National Laboratory; Partridge, Edward R. [retired; Rees, Daniel E. [Los Alamos National Laboratory

    2012-06-22

    This paper will describe the design of the 44 modulator systems that will be installed to upgrade the Los Alamos Neutron Science Center (LANSCE) accelerator RF system. The klystrons can operate up to 86 kV with a nominal 32 Amp beam current with a 120 Hz repetition rate and 15% duty cycle. The klystrons are a mod-anode design. The modulator is designed with analog feedback control to ensure the klystron beam current is flat-top regulated. To achieve fast switching while maintaining linear feedback control, a grid-clamp, totem-pole modulator configuration is used with an 'on' deck and an 'off' deck. The on and off deck modulators are of identical design and utilize a cascode connected planar triode, cathode driven with a high speed MOSFET. The derived feedback is connected to the planar triode grid to enable the flat-top control. Although modern design approaches suggest solid state designs may be considered, the planar triode (Eimac Y-847B) is very cost effective, is easy to integrate with the existing hardware, and provides a simplified linear feedback control mechanism. The design is very compact and fault tolerant. This paper will review the complete electrical design, operational performance, and system characterization as applied to the LANSCE installation.

  16. The National Environmental Respiratory Center (NERC) experiment in multi-pollutant air quality health research: I. Background, experimental strategy and critique.

    Science.gov (United States)

    Mauderly, Joe L

    2014-09-01

    The National Environmental Respiratory Center Program was initiated as an experiment to explore strategies for identifying the components of complex air pollution mixtures that cause health effects associated statistically with air pollution. A strategy involving multivariate analysis of a composition-concentration-response database was adopted. A novel database was created by exposing rodents daily for up to six months to one of four combustion-related mixtures and measuring respiratory, cardiovascular and general toxicological responses after one week or six months of exposure. The mixtures included multiple concentrations of diesel and gasoline engine exhaust, hardwood smoke and simulated downwind coal combustion emissions. After reporting the biological effects of each mixture and comparing effects among them, 47 significant effects were selected for multiple additive regression tree analysis to identify putative causal components. Although the four mixtures provided a database marginally sufficient for the analysis, the results suggested the putative causes of 19 significant effects with acceptable confidence. This article describes and critiques the Program and its strategy. The integrated results are presented in two accompanying papers, and mixture-specific results were presented in preceding papers, which are cited. The experiment demonstrated the potential utility of the general approach and identified certain cause-effect relationships for confirmatory studies. A follow-up study provided support for causation by the components implicated for one of those relationships. The advantages and disadvantages of the Program's management and funding strategies are discussed. PMID:25162718

  17. Lujan Center Cold Source Upgrade Studies

    International Nuclear Information System (INIS)

    The Manuel Lujan Jr. Neutron Scattering Center (Lujan Center) at the Los Alamos National Laboratory is the most powerful pulsed neutron scattering facility in North America. It currently produces the highest time-averaged cold source brightness of any pulsed neutron scattering facility in the world, and efforts are underway to increase this even further. The Lujan Center is a part of the Los Alamos Neutron Science Center (LANSCE), a complex centered around an 800-MeV proton linear accelerator capable of accelerating 1 mA beam current. The LANSCE accelerator delivers 125 μA of H¯ beam in 0.65-ms-long pulses at 20 Hz to a proton storage ring, which compresses them to a width of 300 ns, each of which contains 4 x 1013 protons per pulse. These pulses are then transported to a 90° dipole magnet which directs them vertically downward onto the Lujan Center target system. The protons induce spallation reactions in the split tungsten target, producing mostly evaporation neutrons, some of which are reflected by the surrounding Be reflector into one of six moderator. Four (three water and one liquid hydrogen) of these are arranged in flux-trap geometry between the upper and lower portions of the split tungsten target; the other two (one water and one liquid hydrogen) are located above the upper portion of the target in what is known as upstream backscattering geometry. Those arranged around the flux trap are called lower-tier moderators, and the other two are known as upper-tier moderators. The lower-tier moderators serve three flight paths each, while the upper-tier moderators serve two flight paths each, for a total of 16 flight paths. Fourteen of these flight paths have operating instruments on them, one more has an instrument under construction, and one is unassigned. The instruments serve a variety of applications, including materials science, biology, chemistry, nuclear physics, and engineering. The Lujan Center is currently operating on a third generation target

  18. Autoimmune thyroiditis, a center experience

    OpenAIRE

    Tomé, S; Bandeira, A; H. Cardoso; Borges, T

    2008-01-01

    Introdução: A doença auto-imune da tiróide é a principal causa de Hipotiroidismo adquirido na criança e adolescente, a sua incidência em idade escolar é de 1.3%1. Objectivo: Caracterizar os doentes com Tiroidite Auto-Imune da consulta de Endocrinologia Pediátrica do Hospital Geral de Santo António em seguimento no ano de 2006. Metodologia: Foi efectuado um estudo retrospectivo com revisão dos processos clínicos, considerando os seguintes parâmetros: idad...

  19. WE-G-BRE-07: Proton Therapy Enhanced by Tumor-Targeting Gold Nanoparticles: A Pilot in Vivo Experiment at The Proton Therapy Center at MD Anderson Cancer Center

    International Nuclear Information System (INIS)

    Purpose: Assess tumor-growth delay and survival in a mouse model of prostate cancer treated with tumor-targeting gold nanoparticles (AuNPs) and proton therapy. Methods: We first examined the accumulation of targeting nanoparticles within prostate tumors by imaging AuNPs with ultrasound-guided photoacoustics at 24h after the intravenous administration of goserelin-conjugated AuNPs (gAuNP) in three mice. Nanoparticles were also imaged at the cellular level with TEM in PC3 cells incubated with gAuNP for 24h. Pegylated AuNPs (pAuNP) were also imaged in vivo and in vitro for comparison. PC3 cells were then implanted subcutaneously in nude mice; 51mice with 8–10mm tumors were included. AuNPs were injected intravenously at 0.2%w/w final gold concentration 24h before irradiation. A special jig was designed to facilitate tumor irradiation perpendicular to the proton beam. Proton energy was set to 180MeV, the radiation field was 18×18cm2, and 9cm or 13.5cm thick solid-water compensators were used to position the tumors at either the beam entrance (BE) or the SOBP. Physical doses of 5Gy were delivered to all tumors on a patient beam line at MD Anderson's Proton Therapy Center. Results: The photoacoustic experiment reveled that our nanoparticles leak from the tumor-feeding vasculature and accumulate within the tumor volume over time. Additionally, TEM images showed gAuNP are internalized in cancer cells, accumulating within the cytoplasm, whereas pAuNP are not. Tumor-growth was delayed by 11 or 32days in mice receiving gAuNP irradiated at the BE or the SOBP, relative to proton radiation alone. Survival curves (ongoing experiment) reveal that gAuNPs improved survival by 36% or 74% for tumors irradiated at the BE or SOBP. Conclusion: These important, albeit preliminary, in vivo findings reveal nanoparticles to be potent sensitizers to proton therapy. Further, conjugation of AuNPs to tumor-specific antigens that promote enhanced cellular internalization improved both

  20. The Magnetospheric Multiscale (MMS) Mission Science Data Center: Technologies, Methods, and Experiences in Making Available Large Volumes of In-Situ Particle and Field Data

    Science.gov (United States)

    Pankratz, Christopher; Kokkonen, Kim; Larsen, Kristopher; Panneton, Russell; Putnam, Brian; Schafer, Corey; Baker, Daniel; Burch, James

    2016-04-01

    On September 1, 2015 the Magnetospheric MultiScale (MMS) constellation of four satellites completed their six-month commissioning period and began routine science data collection. Science operations for the mission is conducted at the Science Operations Center (SOC) at the Laboratory for Atmospheric and Space Physics, University of Colorado in Boulder, Colorado, USA. The MMS Science Data Center (SDC) is a component of the SOC responsible for the data production, management, dissemination, archiving, and visualization of the data from the extensive suite of 100 instruments onboard the four spacecraft. As of March 2016, MMS science data are openly available to the entire science community via the SDC. This includes hundreds of science parameters, and 50 gigabytes of data per day distributed across thousands of data files. Products are produced using integrated software systems developed and maintained by teams at other institutions using their own institutional software management procedures and made available via a centralized public web site and web services. To accomplish the data management, data processing, and system integration challenges present on this space mission, the MMS SDC incorporates a number of evolutionary techniques and technologies. This presentation will provide an informatics-oriented view of the MMS SDC, summarizing its technical aspects, novel technologies and data management practices that are employed, experiences with its design and development, and lessons learned. Also presented is the MMS "Scientist-in-the-Loop" (SITL) system, which is used to leverage human insight and expertise to optimize the data selected for transmission to the ground. This smoothly operating system entails the seamless interoperability of multiple mission facilities and data systems that ultimately translate scientist insight into uplink commands that triggers optimal data downlink to the ground.

  1. Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Setton, Jeremy; Caria, Nicola; Romanyshyn, Jonathan; Koutcher, Lawrence; Wolden, Suzanne L.; Zelefsky, Michael J.; Rowan, Nicholas [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Sherman, Eric J.; Fury, Matthew G.; Pfister, David G. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Wong, Richard J.; Shah, Jatin P.; Kraus, Dennis H. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shi Weiji; Zhang Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Schupak, Karen D.; Gelblum, Daphna Y.; Rao, Shyam D. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Lee, Nancy Y., E-mail: Leen2@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-01-01

    Purpose: To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia {>=}Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

  2. Observation of the intermediate vector bosons W+- and Z0 in proton-antiproton collisions at 546 GeV center of mass energy. UA2 experiment

    International Nuclear Information System (INIS)

    The Standard Model of electromagnetic and weak interactions predicts the existence of the intermediate vector bosons W+- and Z0 and gives precise predictions for their masses. Antiproton accumulation by stochastic cooling and the operation of the CERN SPS accelerator in collider mode made accessible pantip at 546 GeV center of mass energy. This thesis presents the observation of the intermediate vector bosons through their decays Z0 → e+e-, W → eν. During running periods 1982 and 1983, 8 decays Z0 → e+e- and 32 decays W → eν with an electron of Psub(T) > 25 GeV/c were observed in UA2 experiment. Cross sections of W+- and Z0 production and the weak interaction parameters: Msub(W), Msub(Z), sin2thetasub(W) and rho are determined. These results are in agreement with Standard Model predictions, thus confirming theory in a spectacular way. An upper limit to the total width of the Z0 is given. An upper limit to the number of additional neutrinos is inferred. Radiative decays of the intermediate vector bosons are discussed

  3. The International Science and Technology Center (ISTC) - Fifteen-Year Experience in Management of Innovative Nuclear and Other Programs (Information Review)

    International Nuclear Information System (INIS)

    : - Are managing internationally; - Have plans and results, available for international collaborators; - Results may be passed to international centers (OECD/NEA and/or others) for further international benchmarking. As for today - a set of demonstration and basic-type experiments, which fit closely with IAEA/ INPRO and GIF program, with EU Frame-Work programs, - had been done or under development now in the frame of ISTC projects and programs with active international collaboration. The ISTC - as a unique international tool - is ready to take part and manage further this activity. Among five thousand project proposals submitted to ISTC, there are about five hundred related to different aspects of nuclear technologies and Nuclear Fuel Cycle (NFC). Survey of the ISTC project results: The following information will be included in the review, with special attention on details of corresponding experimental programs: - Novel reactor concepts, corresponding to GIF: - Fast reactors (Sodium-, Lead-and Lead-Bismuth-cooled); - Supercritical Pressure Water aspects; - HTGR - critical modeling, engineering. - Molten salts. - Nuclear Fuel Cycle options (including Partitioning and Transmutation). - Reactor data benchmarking and verification, critical experiments. - Nuclear Power Plant life management (Reactor pressure vessel and internals control, etc.). - Nuclear data measurements. - Severe accident study (Corium modelling, Quench-effect, Chernobyl). - Sky-shine experiments. - Depleted Uranium for RAW storage. - Technical and economical analysis of NFC, including non-proliferation issues. - Novel reactor engineering systems - experimental and computer modelling (steam-generators, etc.). - Accelerator Driven Systems (experimental modeling). References: The ISTC Annual Reports - ISTC, Moscow, 1996 - 2007. Web-site: www.istcinfo.ru. (authors)

  4. International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

    Directory of Open Access Journals (Sweden)

    Chengquan Zhao

    2015-01-01

    Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

  5. Senior Centers

    Medline Plus

    Full Text Available ... to do as long as they can. Senior centers, adult day care, transportation, and meals programs are ... older adults to remain in their homes. Senior centers are places where older adults who live independently ...

  6. Time-of-flight small-angle-neutron-scattering data reduction and analysis at LANSCE (Los Alamos Neutron Scattering Center) with program SMR

    International Nuclear Information System (INIS)

    A user-friendly, integrated system, SMR, for the display, reduction and analysis of data from time-of-flight small-angle neutron diffractometers is described. Its purpose is to provide facilities for data display and assessment and to provide these facilities in near real time. This allows the results of each scattering measurement to be available almost immediately, and enables the experimenter to use the results of a measurement as a basis for other measurements in the same instrument allocation. 8 refs., 11 figs

  7. The Activity of Archive to Preserve the Memory of the Events and Participants of the Great Patriotic War: the Experience of the Documentation Center of the Modern History of the Rostov Region

    Directory of Open Access Journals (Sweden)

    Olga V. Valuyskova

    2015-07-01

    Full Text Available The article characterizes the forms of use of archival documents about World War II in order to popularize scientific knowledge and patriotic education. This article was prepared on the basis of experience of the Documentation Center of the Modern History of the Rostov Region.

  8. Excel Center

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Citigroup,one of the World top 500 companies,has now settled in Excel Center,Financial Street. The opening ceremony of Excel Center and the entry ceremony of Citigroup in the center were held on March 31.Government leaders of Xicheng District,the Excel CEO and the heads of Asia-Pacific Region leaders of Citibank all participated in the ceremony.

  9. The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O. [Depts. of Radiology, Obstetrics and Gynecology, and Urology, Cumhuriyet Univ. School of Medicine, Sivas (Turkey)

    2007-09-15

    Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction.

  10. Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

    International Nuclear Information System (INIS)

    Purpose: To update the Memorial Sloan-Kettering Cancer Center’s experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27–91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3–135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia ≥Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

  11. Feasibility and safety of combined interventional procedures in elderly patients with complex cardiovascular diseases:experience of a single medical center

    Institute of Scientific and Technical Information of China (English)

    Caiyi LU; Haiyun WU; Shiwen WANG; Xinli WU; Qiao XUE; Taohong HU; Muyang YAN; Rui CHEN; Zhongren ZHAO

    2005-01-01

    Objectives:To report the clinical experience of combined interventional procedures in the treatment of elderly patients with coexisting two or more cardiovascular diseases in our medical center, and to assess the feasibility, safety and therapeutic efficacy of this management strategy. Methods : Patients were selected to the study if: 1) age >65 years; 2) with coexistence of two or more cardiovascular diseases which are indications for interventional therapy; 3) patients' general condition and organ functions allow the performance of combined multiple procedures; 4) the predicted procedure time is within 150 min; 5) the predicted contrast medium dosage is within 300 ml. The criteria we analyzed included procedural type, rocedural time, fluoroscopy time, dosage of contrast medium, success rates of the procedures, complications and in-hospital mortality. All patients were followed up for 30.4 ± 9.3 months,to determine the all-cause mortality, recurrence rates and adverse cardiac events. Results : From January 2000 to December 2004,combined interventional procedures were performed on 136 patients, with 2 procedures on 134 patients and 3 procedures on 2 patients.The mean procedure time was 115.4±11.6 min, the mean fluoroscopy time was 35.7±9.3 min, and the mean dosage of contrast medium used was 183.6±19.4 ml. Procedural success rate was 100%, no procedure related death or major complications occurred.Conclusion: Performed by a competent team, combined interventional procedures in elderly patients with multiple cardiovascular diseases were feasible and relatively safe.

  12. Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer: lessons from the experience of a high-volume center.

    LENUS (Irish Health Repository)

    Reynolds, John V

    2012-05-01

    Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed.

  13. Job center

    Science.gov (United States)

    To better meet the needs of AGU members, a program has been started to increase the effectiveness of the Job Center activity at the Spring and Fall Meetings. As a result, participation in the Job Center at the 1988 AGU Spring Meeting in Baltimore increased substantially compared to previous Spring Meetings. The number of employers, applicants, and interviews scheduled more than doubled compared to the 1987 Spring Job Center.In order to make the meeting Job Centers even better, a survey is being conducted of employers and applicants who participated in the 1988 Spring Job Center. Evaluation of this survey will be useful in continuing increased participation in and the effectiveness of the Job Center at the 1988 Fall Meeting. Past participants and those interested in the future of the Job Center are encouraged to forward comments and suggestions to AGU, Member Programs Division, 2000 Florida Ave., N.W., Washington, DC 20009.

  14. Guidelines for the diagnosis and management of chylomicron retention disease based on a review of the literature and the experience of two centers

    Directory of Open Access Journals (Sweden)

    Castagnetti Justine

    2010-09-01

    Full Text Available Abstract Familial hypocholesterolemia, namely abetalipoproteinemia, hypobetalipoproteinemia and chylomicron retention disease (CRD, are rare genetic diseases that cause malnutrition, failure to thrive, growth failure and vitamin E deficiency, as well as other complications. Recently, the gene implicated in CRD was identified. The diagnosis is often delayed because symptoms are nonspecific. Treatment and follow-up remain poorly defined. The aim of this paper is to provide guidelines for the diagnosis, treatment and follow-up of children with CRD based on a literature overview and two pediatric centers 'experience. The diagnosis is based on a history of chronic diarrhea with fat malabsorption and abnormal lipid profile. Upper endoscopy and histology reveal fat-laden enterocytes whereas vitamin E deficiency is invariably present. Creatine kinase (CK is usually elevated and hepatic steatosis is common. Genotyping identifies the Sar1b gene mutation. Treatment should be aimed at preventing potential complications. Vomiting, diarrhea and abdominal distension improve on a low-long chain fat diet. Failure to thrive is one of the most common initial clinical findings. Neurological and ophthalmologic complications in CRD are less severe than in other types of familial hypocholesterolemia. However, the vitamin E deficiency status plays a pivotal role in preventing neurological complications. Essential fatty acid (EFA deficiency is especially severe early in life. Recently, increased CK levels and cardiomyopathy have been described in addition to muscular manifestations. Poor mineralization and delayed bone maturation do occur. A moderate degree of macrovesicular steatosis is common, but no cases of steatohepatitis cirrhosis. Besides a low-long chain fat diet made up uniquely of polyunsaturated fatty acids, treatment includes fat-soluble vitamin supplements and large amounts of vitamin E. Despite fat malabsorption and the absence of postprandial chylomicrons

  15. Study of various clinical and laboratory parameters among 178 patients affected by hooch tragedy in Ahmedabad, Gujarat (India: A single center experience

    Directory of Open Access Journals (Sweden)

    Bhavesh S Jarwani

    2013-01-01

    Full Text Available Introduction/Purpose: The outbreak of methanol poisoning described in this paper occurred in Ahmedabad, Gujarat, India in July 2009. Our intention is to share the experience of clinical features, laboratory investigations and their relation during this tragedy. Materials and Methods: Single center, retrospective study of clinical features and laboratory parameters of 178 cases of methanol toxicity treated at tertiary care hospital in Ahmedabad, Gujarat. Results: Maximum patients (39.8%, n = 45 were received in 48 h; Mean age of presentation was 41.9 ± 10.2 years. Most of them were men (175 out of 178. On presentation, 83% patients had gastro-intestinal symptoms, 46% had neurological symptoms, 73% had visual symptoms and 32% had dyspnoea. 62% had blurred vision, 10.5% had blindness. Patients with visual symptoms had high mean level of methanol (120.12 ± 23.12 vs. 55.43 ± 29.24, P = 0.014. On fundus examination 52.8% (n = 62 had bilateral hyperaemia of discs, 8.4% (n = 12 had bilateral disc pallor and 4.5% had papilledema (n = 5. Patients with hyperaemia of discs, discs pallor or papilledema, had higher mean methanol level (121.1 ± 32.2 mg% v/s 70.1 ± 23.2 mg%, P = 0.032. Mean of pH values was 7.17 ± 0.22 and bicarbonate was 12.3 ± 7.3 mmol/L. Both pH and bicarbonate levels correlated well with mortality and serum methanol level. Mean serum methanol level was 87.1 mg/dL, and correlated significantly with the mortality (53.1 ± 41 mg/dL v/s 121 ± 92 mg/dL, P value < 0.05. Conclusion: GI symptoms, neurological symptoms and breathlessness are important clue to ED physician for diagnose methanol poisoning. Visual symptoms and fundus findings correlate well with the methanol level. Arterial Blood Gas derived pH and bicarbonate levels correlate significantly with the methanol level and mortality.

  16. Functional Centering

    CERN Document Server

    Hahn, M

    1996-01-01

    Based on empirical evidence from a free word order language (German) we propose a fundamental revision of the principles guiding the ordering of discourse entities in the forward-looking centers within the centering model. We claim that grammatical role criteria should be replaced by indicators of the functional information structure of the utterances, i.e., the distinction between context-bound and unbound discourse elements. This claim is backed up by an empirical evaluation of functional centering.

  17. Distribution center

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Distribution center is a logistics link fulfill physical distribution as its main functionGenerally speaking, it's a large and hiahly automated center destined to receive goods from various plants and suppliers,take orders,fill them efficiently,and deliver goods to customers as quickly as possible.

  18. [Scientific and methodologic basis of a program for occupational control of ambient air quality within a totally sanitary protective zone at an industrial center borderline (Permsky area experience)].

    Science.gov (United States)

    Maĭ, I V; Balashov, S Iu

    2013-01-01

    The authors suggested and tested an algorithm to select optimal placement of stationary and mobile points for controlling ambient air quality on borderline of united sanitary protective zone of industrial center. The method involves claster analysis to outline sites even in levels and lists of parameters, on borderline of united sanitary protective zone of industrial center. Informative value of the occupational control parameters is evaluated through conjugated analysis of general level of surface concentration of admixtures and enterprise's contribution into pollution. For each enterprise, separate control program is provided. Tests of the method demonstrated that it is effective and conclusive in formation of minimally sufficient programs for occupational control in complicated conditions of industrial centers with single-field enterprises, when industrial releases are close in composition and in created pollution level. PMID:24640091

  19. The experience of nuclear objects of the national nuclear center of the republic of Kazakhstan vulnerability analysis conducting with the help of assess analytic system

    International Nuclear Information System (INIS)

    Full text: In the Republic of Kazakhstan there is a number of nuclear objects which are potentially attractive to terrorists and criminal groups. They are also nuclear objects of the National Nuclear Center of the Republic of Kazakhstan (NNC RK) where there are research nuclear reactors with highly enriched nuclear fuel and nuclear materials storage. Within the international collaboration in the field of non-proliferation between the Republic of Kazakhstan and the United States of America in the period of 1996-1998 scientists of the Institute of Atomic Energy (IAE) of the NNC RK together with colleagues from the USA had conducted the system of works concerning vulnerability analysis of three nuclear objects of the NNC RK (reactor complexes IGR, 'Baikal-1' and WWR-K). It also concerned working out the projects of physical protection systems of the mentioned above objects modernization based on the conducted vulnerability analysis. These works included: identification of potential outer and inner threat for nuclear objects of the NNC RK; conducting of the analysis of vulnerability and expected risk of prospective threats for nuclear objects of the NNC RK with the help of analytical program for conducting of ASSESS nuclear objects vulnerability diagnosis; expert estimation of the results received in the course of vulnerability analysis and working out of recommendations on modernization of the systems of NNC RK nuclear objects (reactor complexes IGR, 'Baikal-1' and VVR-K) physical protection; working out of conceptual projects of NNC RK nuclear objects physical protection systems modification. The key point of the work was the vulnerability analysis conducting which required detailed examination of the basic data that provide modeling of aims, routes of movement and evaluation of potential violators detection probability in the protected zones, buildings and reactor systems premises. Analytic programming system of vulnerability estimation and protection effectiveness

  20. 5 years of experience implementing a methicillin-resistant Staphylococcus aureus search and destroy policy at the largest university medical center in the Netherlands

    NARCIS (Netherlands)

    M.C. Vos (Margreet); M.D. Behrendt (Myra); D.C. Melles (Damian); F.P.N. Mollema (Femke); W. de Groot (Woutrinus); G. Parlevliet (Gerard); A. Ott (Alewijn); D. Horst-Kreft (Deborah); A.F. van Belkum (Alex); H.A. Verbrugh (Henri)

    2009-01-01

    textabstractOBJECTIVE: To evaluate the effectiveness of a rigorous search and destroy policy for controlling methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. DESIGN: Hospital-based observational follow-up study. SETTING: Erasmus University Medical Center Rotterdam, a 1,2

  1. Endoscopic, transmural drainage and necrosectomy for walled-off pancreatic and peripancreatic necrosis is associated with low mortality--a single-center experience

    DEFF Research Database (Denmark)

    Schmidt, Palle Nordblad; Novovic, Srdan; Roug, Stine; Feldager Hansen, Erik

    2015-01-01

    OBJECTIVE: Endoscopic transmural drainage and necrosectomy (ETDN) is a promising alternative to percutaneous drainage and surgical intervention in the treatment of walled-off pancreatic and peripancreatic necroses (WONs). We assessed the outcome and safety profile of ETDN in a single-center patient...

  2. Senior Centers

    Medline Plus

    Full Text Available ... variety of social and recreational activities. [Karen Albers] We provide a wide variety of activities -- physical, health, ... senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, tap dancing, ballroom dancing, ...

  3. Senior Centers

    Medline Plus

    Full Text Available ... transportation, and meals programs are long-term care services available in the community which make it easier ... about senior centers and other long-term care services available in your community, contact the Eldercare Locator ...

  4. Senior Centers

    Medline Plus

    Full Text Available ... Karen Albers] We provide a wide variety of activities -- physical, health, mental health programs with Senior Plus, cognitive ... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ...

  5. Senior Centers

    Medline Plus

    Full Text Available [Narrator] Living independently at home is something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, and meals programs are ...

  6. Senior Centers

    Medline Plus

    Full Text Available ... Living independently at home is something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, and meals programs are long- ...

  7. Senior Centers

    Medline Plus

    Full Text Available ... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ... chi, tap dancing, ballroom dancing, square dancing, chair exercise, arthritis classes, yoga, and lots of dancing. [Narrator] ...

  8. Senior Centers

    Medline Plus

    Full Text Available ... something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, ... adults who live independently can go to find a variety of social and recreational activities. [Karen Albers] ...

  9. Neutron Capture Experiments on Unstable Nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Jon M. Schwantes; Ralf Sudowe; Heino Nitsche; Darleane C. Hoffman

    2003-12-16

    A primary objective of this project is to study neutron capture cross sections for various stable and unstable isotopes that will contribute to the Science Based Stockpile Stewardship (SBSS) program by providing improved data for modeling and interpretation of nuclear device performance. The information obtained will also be important in astrophysical modeling of nucleosynthesis. During this reporting period, the emphasis has been on preparing a radioactive target of {sup 155}Eu (half-life = 4.7 years), and several stable targets, including isotopically separated {sup 154}Sm, {sup 151}Eu, and {sup 153}Eu. Measurements of their neutron capture cross sections will be conducted in collaboration with researchers at the Los Alamos Neutron Science Center (LANSCE) facility using the Detector for Advanced Neutron Capture Experiments (DANCE). A suitable backing material (beryllium) for the targets has been selected after careful calculations of its contribution to the background of the measurements. In addition, a high voltage plating procedure has been developed and optimized. Stable targets of {sup 151}Eu and {sup 153}Eu and a target of natural Eu ({approx}50% {sup 151}Eu and {approx}50% {sup 153}Eu) have each been plated to a mass thickness of >1 mg/cm{sup 2} and delivered to the DANCE collaboration at Los Alamos National Laboratory (LANL). Natural Eu targets will be tested first to confirm that the target dimensions and backing are appropriate prior to performing measurements on the extremely valuable targets of separated isotopes. In order to prepare a target of the radioactive {sup 155}Eu, it must first be separated from the {sup 154}Sm target material that was irradiated in a very high neutron flux of 1.5x1015 neutrons/cm{sup 2}/s for 50 days. The reaction is {sup 154}Sm (n,f){sup 155}Sm (half-life = 22 minutes) {sup 155}Eu. Considerable progress has been made in developing a suitable high-yield and high-purity separation method for separating Eu from targets

  10. Short-term and medium-term outcomes of transapical aortic valve implantation as a single-strategy approach: one center's experience

    OpenAIRE

    Čanádyová, Júlia; Mokráček, Aleš; Pešl, Ladislav; KURFIRST, Vojtěch; Šulda, Mirek

    2015-01-01

    Introduction Transcatheter aortic valve replacement has been developed as an alternative option for surgical high-risk or inoperable patients with severe symptomatic aortic stenosis. Aim of the study Aim of the study was to evaluate the outcomes of patients undergoing transapical aortic valve replacement as a single-strategy option by a single-center multidisciplinary heart team. Material and methods Between June 2009 and December 2014, 41 patients underwent transapical transcatheter aortic v...

  11. Increasing the operational efficiency and safety in operation control centers: the TRANSPETRO experience; Aumentando a seguranca e eficiencia operacional em centros de controle: a experiencia da TRANSPETRO

    Energy Technology Data Exchange (ETDEWEB)

    Felicio, Marco Aurelio Fierro; Frisoli, Caetano [PETROBRAS Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil)

    2009-12-19

    The increase in operational efficiency and safety in operation control centers has been traditionally obtained through direct actions in the operational activity itself and on the resources and systems used for that. Modern supervisory and control systems, sophisticated simulation software, cutting-edge last generation equipment and installations, clear and comprehensive procedures definitions and intensive and constant training of the operation teams are, usually, the chosen paths followed by control centers in their incessant quest for increased operational efficiency and safety. This paper presents the path followed by the TRANSPETRO's National Operational Control Center - Natural Gas (Centro Nacional de Controle Operacional - CNCO-Gas) - that has not only focused with the traditional aspects above, but has also made intensive investments in systems and data base integrations, aiming at eliminating data inconsistencies and redundancies and at including automation, standardization and systematization of non-operational and complementary operational activities. These investments allowed TRANSPETRO CNCO-Gas face the big challenge of growing that TRANSPETRO's gas transportation activity is facing now and will be facing in the near future: from 2,600 km to 7,000 km of gas pipelines, and a volume of transported natural gas from 35 MMm{sup 3}/day to 100 MMm{sup 3}/day. (author)

  12. Solid State Power Amplifier for 805 MegaHertz at the Los Alamos Neutron Science Center

    International Nuclear Information System (INIS)

    Particle accelerators for protons, electrons, and other ion species often use high-power vacuum tubes for RF amplification, due to the high RF power requirements to accelerate these particles with high beam currents. The final power amplifier stages driving large accelerators are unable to be converted to solid-state devices with the present technology. In some instances, radiation levels preclude the use of transistors near beamlines. Work is being done worldwide to replace the RF power stages under about ten kilowatts CW with transistor amplifiers, due to the lower maintenance costs and obsolescence of power tubes in these ranges. This is especially practical where the stages drive fifty Ohm impedance and are not located in high radiation zones. The authors are doing this at the Los Alamos Neutron Science Center (LANSCE) proton linear accelerator (linac) in New Mexico. They replaced a physically-large air-cooled UHF power amplifier using a tetrode electron tube with a compact water-cooled unit based on modular amplifier pallets developed at LANSCE. Each module uses eight push-pull bipolar power transistor pairs operated in class AB. Four pallets can easily provide up to 2,800 watts of continuous RF at 805 MHz. A radial splitter and combiner parallels the modules. This amplifier has proven to be completely reliable after over 10,000 hours of operation without failure. A second unit was constructed and installed for redundancy, and the old tetrode system was removed in 1998. The compact packaging for cooling, DC power, impedance matching, RF interconnection, and power combining met the electrical and mechanical requirements. CRT display of individual collector currents and RF levels is made possible with built-in samplers and a VXI data acquisition unit

  13. Reliability Centered Maintenance - Methodologies

    Science.gov (United States)

    Kammerer, Catherine C.

    2009-01-01

    Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

  14. Fusion engineering design center

    International Nuclear Information System (INIS)

    In the spring of 1985, the Department of Energy (DOE) directed the Design Center to take a lead responsibility in assessing the engineering feasibility of a very compact tokamak experiment with copper coils. Following this assessment, the Design Center studied the Ignitor concept at the request of DOE and arrived at a design configuration. Many features of this configuration have been incorporated into the national baseline conceptual design for a Compact Ignition Tokamak (CIT). The Design Center continued to participate in the mirror program by contributing to the Minimars design effort, a two-year program to develop and describe an attractive tandem mirror reactor concept. The Design Center's principal role is in configuration definition of the candidate concepts. The Design Center continues to lead the engineering activities for the International Tokamak Reactor program. Advanced commercial tokamaks were studied by the Design Center as part of the Tokamak Power Systems Studies project coordinated by the DOE Office of Fusion Energy. The Design Center also provided design integration of the US effort. A cost accounting system that is applicable to all magnetic fusion reactor design studies was developed and applied to different confinement concepts and types of projects. The system provides the structure for development of a fusion cost database and validated cost estimating procedures

  15. Measurement of the 238U neutron-capture cross section and gamma-emission spectra from 10 eV to 100 keV using the DANCE detector at LANSCE

    International Nuclear Information System (INIS)

    A careful new measurement of the 238U(n,γ) cross section from 10 eV to 100 keV has been made using the DANCE detector at LANSCE. DANCE is a 4π calorimetric scintillator array consisting of 160 BaF2 crystals. Measurements were made on a 48 mg/cm2 depleted uranium target. The cross sections are in general good agreement with previous measurements. The gamma-ray emission spectra, as a function of gamma multiplicity, were also measured and compared to model calculations.

  16. Measurement of the 238U neutron-capture cross section and gamma-emission spectra from 10 eV to 100 keV using the DANCE detector at LANSCE

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, John L [Los Alamos National Laboratory; Couture, A J [Los Alamos National Laboratory; Keksis, A L [Los Alamos National Laboratory; Vieira, D J [Los Alamos National Laboratory; O' Donnell, J M [Los Alamos National Laboratory; Jandel, M [Los Alamos National Laboratory; Haight, R C [Los Alamos National Laboratory; Rundberg, R S [Los Alamos National Laboratory; Kawano, T [Los Alamos National Laboratory; Chyzh, A [NORTH CAROLINA STATE UNIV; Baramsai, B [NORTH CAROLINA STATE UNIV; Wu, C Y [LLNL; Mitchell, G E [NORTH CAROLINA STATE UNIV; Becker, J A [LLNL; Krticka, M [CHARLES UNIV

    2010-01-01

    A careful new measurement of the {sup 238}U(n,{gamma}) cross section from 10 eV to 100 keV has been made using the DANCE detector at LANSCE. DANCE is a 4{pi} calorimetric scintillator array consisting of 160 BaF{sub 2} crystals. Measurements were made on a 48 mg/cm{sup 2} depleted uranium target. The cross sections are in general good agreement with previous measurements. The gamma-ray emission spectra, as a function of gamma multiplicity, were also measured and compared to model calculations.

  17. Innovation from user experience in Living Labs: revisiting the ‘innovation factory’-concept with a panel-based and user-centered approach

    OpenAIRE

    Schuurman, Dimitri; Lievens, Bram; De Marez, Lieven; Ballon, Pieter

    2012-01-01

    This paper focuses on the problem of facilitating sustainable innovation practices with a user-centered approach. We do so by revisiting the knowledge-brokering cycle and Hargadon and Sutton’s ideas on building an ‘innovation factory’ within the light of current Living Lab-practices. Based on theoretical as well as practical evidence from a case study analysis of the LeYLab-Living Lab, it is argued that Living Labs with a panel-based approach can act as innovation intermediaries where innovat...

  18. Prevalence and associated factors of dry eye: Our experience in patients above 40 years of age at a Tertiary Care Center

    OpenAIRE

    Suchi Shah; Harsha Jani

    2015-01-01

    Context: Dry eye is a very common as well as under-diagnosed ocular disorder. It is not only troublesome in terms of its symptoms but also imposes a great financial burden. Aims: To determine the prevalence of dry eye in ophthalmology out-patients at a Tertiary Care Hospital and its association with various clinico-epidemiological factors. Settings and Design: A hospital-based study at a Tertiary Care Center was conducted including 400 out-patients of age 40 years and above. Material...

  19. Person--job match among frontline staff working in residential treatment centers: the impact of personality and child psychopathology on burnout experiences.

    Science.gov (United States)

    Leon, Scott C; Visscher, Linn; Sugimura, Niwako; Lakin, Brittany L

    2008-04-01

    Prior research has shown that the personality variables extraversion and neuroticism predict burnout among frontline staff working in residential treatment centers. This study tested the hypothesis that the effect of personality on burnout would be moderated by the psychiatric characteristics of the youth served on the milieu. Two hundred and three frontline staff working in 21 residential treatment centers in Illinois serving troubled youth completed surveys regarding opinions about their jobs, the Big Five Inventory (BFI), a youth presenting problems scale for the entire milieu, and the Maslach Burnout Inventory (MBI). Results indicated that the effect of neuroticism on burnout is moderated by psychosis and posttraumatic stress disorder (PTSD); high and moderate milieu ratings of psychosis and PTSD showed a positive relationship between neurosis and burnout, while low ratings of these conditions showed no relationship. These findings suggest that the optimal work setting is a function of the interaction between specific personality characteristics and specific work environments, with implications for personnel selection and future research on person-environment fit. PMID:18954187

  20. Short-term and medium-term outcomes of transapical aortic valve implantation as a single-strategy approach: one center's experience

    Science.gov (United States)

    Mokráček, Aleš; Pešl, Ladislav; Kurfirst, Vojtěch; Šulda, Mirek

    2015-01-01

    Introduction Transcatheter aortic valve replacement has been developed as an alternative option for surgical high-risk or inoperable patients with severe symptomatic aortic stenosis. Aim of the study Aim of the study was to evaluate the outcomes of patients undergoing transapical aortic valve replacement as a single-strategy option by a single-center multidisciplinary heart team. Material and methods Between June 2009 and December 2014, 41 patients underwent transapical transcatheter aortic valve implantation (TA-TAVI) at our institution. All patients received Edwards SAPIEN balloon expandable pericardial valves (Edwards Lifesciences, Irvine, CA, USA). Our center followed a “clear transapical strategy” for all patients. Results The mean age of the patients was 79.6 years, and the mean logistic EuroSCORE was 21.06 ± 12.82%. Fifteen patients (36.6%) underwent redo operations. Complications included stroke (n = 1), re-exploration for bleeding or cardiac tamponade (n = 4), renal failure requiring temporary hemodialysis (n = 4) and permanent pacemaker implantation (n = 3). There were no myocardial infarctions or coronary obstruction. The total 30-day mortality rate was 17.1% (7 patients). Postoperative intensive care unit stay was 4.6 ± 5.7 days, and mean hospitalization was 11.6 ± 7.2 days. Conclusions The TA-TAVI approach provides good results in terms of early and midterm outcomes. This approach is feasible and safe for patients who have high surgical risk. PMID:26336490