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Sample records for early stage invasive

  1. Diagnosis and minimally invasive treatment of early stage breast carcinoma

    NARCIS (Netherlands)

    van Esser, S.

    1979-01-01

    In this thesis the diagnostic work up and minimally invasive surgical treatment of early stage breast carcinoma is studied. Although the surgical treatment of breast carcinoma has improved significantly over the past decades, there is still room for improvement. On the one hand the focus is on early

  2. Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer

    NARCIS (Netherlands)

    Knuttel, Floor; van den Bosch, Maurice A A J; Young-Afat, Danny A.; Emaus, Marleen J.; van den Bongard, Desirée H J G; Witkamp, Arjen J.; Verkooijen, Helena M.

    Background: Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated. Objectives: To assess preferences of patients with breast cancer

  3. Population genomics of a symbiont in the early stages of a pest invasion.

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    Brown, Amanda M V; Huynh, Lynn Y; Bolender, Caitlin M; Nelson, Kelly G; McCutcheon, John P

    2014-03-01

    Invasive species often depend on microbial symbionts, but few studies have examined the evolutionary dynamics of symbionts during the early stages of an invasion. The insect Megacopta cribraria and its bacterial nutritional symbiont Candidatus Ishikawaella capsulata invaded the southeastern US in 2009. While M. cribraria was initially discovered on wild kudzu plants, it was found as a pest on soybeans within 1 year of infestation. Because prior research suggests Ishikawaella confers the pest status--that is, the ability to thrive on soybeans--in some Megacopta species, we performed a genomic study on Ishikawaella from US. Megacopta cribraria populations to understand the role of the symbiont in driving host plant preferences. We included Ishikawaella samples collected in the first days of the invasion in 2009 and from 23 locations across the insect's 2011 US range. The 0.75 Mb symbiont genome revealed only 47 fixed differences from the pest-conferring Ishikawaella in Japan, with only one amino acid change in a nutrition-provisioning gene. This similarity, along with a lack of fixed substitutions in the US symbiont population, indicates that Ishikawella likely arrived in the US capable of being a soybean pest. Analyses of allele frequency changes between 2009 and 2011 uncover signatures of both positive and negative selection and suggest that symbionts on soybeans and kudzu experience differential selection for genes related to nutrient provisioning. Our data reveal the evolutionary trajectory of an important insect-bacteria symbiosis in the early stages of an invasion, highlighting the role microbial symbionts may play in the spread of invasive species.

  4. What types of early gastric cancer are indicated for endoscopic ultrasonography staging of invasion depth?

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    Watari, Jiro; Ueyama, Shigemitsu; Tomita, Toshihiko; Ikehara, Hisatomo; Hori, Kazutoshi; Hara, Ken; Yamasaki, Takahisa; Okugawa, Takuya; Kondo, Takashi; Kono, Tomoaki; Tozawa, Katsuyuki; Oshima, Tadayuki; Fukui, Hirokazu; Miwa, Hiroto

    2016-08-25

    To clarify the diagnostic efficacy and limitations of endoscopic ultrasonography (EUS) and the characteristics of early gastric cancers (EGCs) that are indications for EUS-based assessment of cancer invasion depth. We retrospectively investigated the cases of 153 EGC patients who underwent conventional endoscopy (CE) and EUS (20 MHz) before treatment. We found that 13.7% were "inconclusive" cases with low-quality EUS images, including all nine of the cases with protruded (0-I)-type EGCs. There was no significant difference in the diagnostic accuracy between CE and EUS. Two significant independent risk factors for misdiagnosis by EUS were identified-ulcer scarring [UL(+); odds ratio (OR) = 4.49, P = 0.003] and non-indication criteria for endoscopic resection (ER) (OR = 3.02, P = 0.03). In the subgroup analysis, 23.1% of the differentiated-type cancers exhibiting SM massive invasion (SM2) invasion (submucosal invasion ≥ 500 μm) by CE were correctly diagnosed by EUS, and 23.1% of the undifferentiated-type EGCs meeting the expanded-indication criteria for ER were correctly diagnosed by EUS. There is no need to perform EUS for UL(+) EGCs or 0-I-type EGCs, but EUS may enhance the pretreatment staging of differentiated-type EGCs with SM2 invasion without UL or undifferentiated-type EGCs revealed by CE as meeting the expanded-indication criteria for ER.

  5. Non-lethal effects of an invasive species in the marine environment: the importance of early life-history stages.

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    Rius, Marc; Turon, Xavier; Marshall, Dustin J

    2009-04-01

    Studies examining the effects of invasive species have focussed traditionally on the direct/lethal effects of the invasive on the native community but there is a growing recognition that invasive species may also have non-lethal effects. In terrestrial systems, non-lethal effects of invasive species can disrupt early life-history phases (such as fertilisation, dispersal and subsequent establishment) of native species, but in the marine environment most studies focus on adult rather than early life-history stages. Here, we examine the potential for an introduced sessile marine invertebrate (Styela plicata) to exert both lethal and non-lethal effects on a native species (Microcosmus squamiger) across multiple early life-history stages. We determined whether sperm from the invasive species interfered with the fertilisation of eggs from the native species and found no effect. However, we did find strong effects of the invasive species on the post-fertilisation performance of the native species. The invasive species inhibited the settlement of native larvae and, in the field, the presence of the invasive species was associated with a ten-fold increase in the post-settlement mortality of the native species, as well as an initial reduction of growth in the native. Our results suggest that larvae of the native species avoid settling near the invasive species due to reduced post-settlement survival in its presence. Overall, we found that invasive species can have complex and pervasive effects (both lethal and non-lethal) across the early life-history stages of the native species, which are likely to result in its displacement and to facilitate further invasion.

  6. Proliferation of endogenous retroviruses in the early stages of a host germ line invasion.

    Science.gov (United States)

    Ishida, Yasuko; Zhao, Kai; Greenwood, Alex D; Roca, Alfred L

    2015-01-01

    Endogenous retroviruses (ERVs) comprise 8% of the human genome and are common in all vertebrate genomes. The only retrovirus known to be currently transitioning from exogenous to endogenous form is the koala retrovirus (KoRV), making koalas (Phascolarctos cinereus) ideal for examining the early stages of retroviral endogenization. To distinguish endogenous from exogenous KoRV proviruses, we isolated koala genomic regions flanking KoRV integration sites. In three wild southern Australian koalas, there were fewer KoRV loci than in three captive Queensland koalas, consistent with reports that southern Australian koalas carry fewer KoRVs. Of 39 distinct KoRV proviral loci examined in a sire-dam-progeny triad, all proved to be vertically transmitted and endogenous; none was exogenous. Of the 39 endogenous KoRVs (enKoRVs), only one was present in the genomes of both the sire and the dam, suggesting that, at this early stage in the retroviral invasion of a host germ line, very large numbers of ERVs have proliferated at very low frequencies in the koala population. Sequence divergence between the 5'- and 3'-long terminal repeats (LTRs) of a provirus can be used as a molecular clock. Within each of ten enKoRVs, the 5'-LTR sequence was identical to the 3'-LTR sequence, suggesting a maximum age for enKoRV invasion of the koala germ line of approximately 22,200-49,900 years ago, although a much younger age is possible. Across the ten proviruses, seven LTR haplotypes were detected, indicating that at least seven different retroviral sequences had entered the koala germ line. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

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    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of); Kim, Eun Kyung [Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Seoul (Korea, Republic of)

    2000-05-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

  8. Invasion by Ligustrum lucidum (Oleaceae in NW Argentina: early stage characteristics in different habitat types

    Directory of Open Access Journals (Sweden)

    Roxana Aragón

    2003-03-01

    Full Text Available Currently biological invasions are considered one of the world’s most serious conservation problems. Ligustrum lucidum is the most abundant exotic tree in secondary forest patches of montane forests of NW Argentina. We studied the determinants of success of the early stages of its life cycle in distinct habitat types, with the hope of identifying vulnerabilities that could be exploited to control the invasion. Seed arrival, germination, seedling recruitment and survival, and sapling growth were studied in edges, gaps and forest interior. Seed arrival was also assessed under perches and in open fields. Germination was studied in forest and grass-land patches. L. lucidum seedling survival and sapling growth were compared with the most abundant native species survival and growth. Seed arrival was strongly seasonal with a peak in mid-August. Seed rain did not differ significantly among habitat types, however there was a tendency for edges to receive more seeds when only dispersed seeds were considered. Perches strongly enhanced seed arrival; more than 40 times the number of seeds were dispersed beneath citrus plants (i.e. perches than found in paired open areas. In the forest, seeds in gaps and edges had higher germination rates, but there was no difference in seedling survival. Fruits under closed canopy exhibited the lowest germination. Germination and survival were low in open areas. Neither seedling recruitment nor sapling growth differed between gaps and forest interior. L. lucidum saplings grew significantly more than saplings of the most common native species, and also showed higher seedling survival. L. lucidum is a prolific fruit producer, is capable of germinating and surviving in a broad range of forest environments, it is relatively shade tolerant and has higher survival and faster growth rate in comprison to the most common native species. All these characteristics highlight its potency as a successful invader, and point to few

  9. Towards non-invasive diagnostic imaging of early-stage Alzheimer's disease

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    Viola, Kirsten L.; Sbarboro, James; Sureka, Ruchi; de, Mrinmoy; Bicca, Maíra A.; Wang, Jane; Vasavada, Shaleen; Satpathy, Sreyesh; Wu, Summer; Joshi, Hrushikesh; Velasco, Pauline T.; Macrenaris, Keith; Waters, E. Alex; Lu, Chang; Phan, Joseph; Lacor, Pascale; Prasad, Pottumarthi; Dravid, Vinayak P.; Klein, William L.

    2015-01-01

    One way to image the molecular pathology in Alzheimer's disease is by positron emission tomography using probes that target amyloid fibrils. However, these fibrils are not closely linked to the development of the disease. It is now thought that early-stage biomarkers that instigate memory loss are composed of Aβ oligomers. Here, we report a sensitive molecular magnetic resonance imaging contrast probe that is specific for Aβ oligomers. We attach oligomer-specific antibodies onto magnetic nanostructures and show that the complex is stable and binds to Aβ oligomers on cells and brain tissues to give a magnetic resonance imaging signal. When intranasally administered to an Alzheimer's disease mouse model, the probe readily reached hippocampal Aβ oligomers. In isolated samples of human brain tissue, we observed a magnetic resonance imaging signal that distinguished Alzheimer's disease from controls. Such nanostructures that target neurotoxic Aβ oligomers are potentially useful for evaluating the efficacy of new drugs and ultimately for early-stage Alzheimer's disease diagnosis and disease management.

  10. Effectiveness of routine visits and routine tests in detecting isolated locoregional recurrences after treatment for early-stage invasive breast cancer : A meta-analysis and systematic review

    NARCIS (Netherlands)

    de Bock, GH; Bonnema, J; van der Hage, J; Kievit, J; van de Velde, CJH

    2004-01-01

    Purpose To review the effectiveness of routine visits and routine tests in detecting isolated locoregional recurrences in asymptomatic patients after treatment for early-stage invasive breast cancer. Methods Systematic review and meta-analysis. The proportion of isolated locoregional recurrences dia

  11. Seasonal dynamics of early life stages of invasive and native ctenophores give clues to invasion and bloom potential in the Baltic Sea

    DEFF Research Database (Denmark)

    Jaspers, Cornelia; Haraldsson, Matilda; Lombard, Fabien

    2013-01-01

    Recently, both the invasive ctenophore Mnemiopsis leidyi and the arctic Mertensia ovum were discovered in the Baltic Sea but their range expansion remains unclear due to misidentification of their larval stages. Supported by molecular species verification we describe seasonal abundance and distri....... leidyi population in the southern Baltic such as the Arkona and Bornholm basins...

  12. Seasonal dynamics of early life stages of invasive and native ctenophores give clues to invasion and bloom potential in the Baltic Sea

    DEFF Research Database (Denmark)

    Jaspers, Cornelia; Haraldsson, Matilda; Lombard, Fabien

    2013-01-01

    Recently, both the invasive ctenophore Mnemiopsis leidyi and the arctic Mertensia ovum were discovered in the Baltic Sea but their range expansion remains unclear due to misidentification of their larval stages. Supported by molecular species verification we describe seasonal abundance and distri...

  13. Novel circulating microRNA signature as a potential non-invasive multi-marker test in ER-positive early-stage breast cancer

    DEFF Research Database (Denmark)

    Kodahl, Annette R; Lyng, Maria Bibi; Binder, Harald

    2014-01-01

    controls using LNA-based quantitative real-time PCR (qRT-PCR). A signature of miRNAs was subsequently validated in an independent set of 111 serum samples from 60 patients with early-stage breast cancer and 51 healthy controls and further tested for reproducibility in 3 independent data sets from the GEO......INTRODUCTION: There are currently no highly sensitive and specific minimally invasive biomarkers for detection of early-stage breast cancer. MicroRNAs (miRNAs) are present in the circulation and may be unique biomarkers for early diagnosis of human cancers. The aim of this study was to investigate...... the differential expression of miRNAs in the serum of breast cancer patients and healthy controls. METHODS: Global miRNA analysis was performed on serum from 48 patients with ER-positive early-stage breast cancer obtained at diagnosis (24 lymph node-positive and 24 lymph node-negative) and 24 age-matched healthy...

  14. Early Primary Invasion Scientists

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    Spellman, Katie V.; Villano, Christine P.

    2011-01-01

    "We really need to get the government involved," said one student, holding his graph up to USDA scientist Steve Seefeldt. Dr. Steve studies methods to control "invasive" plants, plants that have been introduced to an area by humans and have potential to spread rapidly and negatively affect ecosystems. The first grader and his classmates had become…

  15. Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline

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    Harris, Lyndsay N.; McShane, Lisa M.; Andre, Fabrice; Collyar, Deborah E.; Gonzalez-Angulo, Ana M.; Hammond, Elizabeth H.; Kuderer, Nicole M.; Liu, Minetta C.; Mennel, Robert G.; Van Poznak, Catherine; Bast, Robert C.; Hayes, Daniel F.

    2016-01-01

    Purpose To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer. Methods A literature search and prospectively defined study selection sought systematic reviews, meta-analyses, randomized controlled trials, prospective-retrospective studies, and prospective comparative observational studies published from 2006 through 2014. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert panel members used informal consensus to develop evidence-based guideline recommendations. Results The literature search identified 50 relevant studies. One randomized clinical trial and 18 prospective-retrospective studies were found to have evaluated the clinical utility, as defined by the guideline, of specific biomarkers for guiding decisions on the need for adjuvant systemic therapy. No studies that met guideline criteria for clinical utility were found to guide choice of specific treatments or regimens. Recommendations In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2, the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX, EndoPredict, PAM50, Breast Cancer Index, and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer. No biomarker except for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens. Treatment decisions should also consider disease stage, comorbidities, and patient preferences. PMID:26858339

  16. Prognosis of patients with local recurrence after mastectomy or conservative surgery for early-stage invasive breast cancer.

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    Fodor, J; Major, T; Polgár, C; Orosz, Z; Sulyok, Z; Kásler, M

    2008-06-01

    Between 1983 and 1987, 1309 women with stage I or II breast cancer underwent mastectomy (n=894) or conservative surgery (CS, n=415). Of these patients, 124 developed an isolated local recurrence (ILR): chest wall, 56 and in-breast, 68. The 10-year actuarial rate of cause-specific survival after treatment for ILR was 52%. On multivariate analysis three independent prognostic factors for the risk of death after ILR were identified: operability of recurrence (operable vs. inoperable, relative risk [RR]: 5.9), age at initial diagnosis (>40 vs. 24 vs. mastectomy) and recurrent tumor grade (1-2 vs. 3) were not independent predictors of survival. In the mastectomy group, single surgical scar recurrence with initial node negative stage predicted good prognosis, and the 10-year survival was 85%. In the CS group, the 10-year survival rate was 88% with new primary tumor and 54% with true recurrence (p=0.01), and the type of salvage surgery (mastectomy vs. repeat complete excision) had no significant impact on survival (p=0.2). The majority (n=44) of CS patients developed mastectomy (n=16). The identified unfavorable prognostic factors are pointers of the forthcoming systemic progression. Patients with < or = 2 cm in-breast recurrence might receive a second CS.

  17. Suppression of microRNA-31 increases sensitivity to 5-FU at an early stage, and affects cell migration and invasion in HCT-116 colon cancer cells

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    Sun Xiao-Feng

    2010-11-01

    Full Text Available Abstract Background MicroRNAs (miRNAs are endogenously expressed noncoding RNAs with important biological and pathological functions. Although several studies have shown that microRNA-31 (miR-31 is obviously up-regulated in colorectal cancer (CRC, there is no study on the functional roles of miR-31 in CRC. Methods Anti-miR™ miRNA 31 inhibitor (anti-miR-31 is a sequence-specific and chemically modified oligonucleotide to specifically target and knockdown miR-31 molecule. The effect of anti-miR-31 transfection was investigated by real-time PCR. HCT-116p53+/+ and HCT-116p53-/-colon cancer cells were treated by anti-miR-31 with or without 5-fluorouracil (5-FU, cell proliferation was determined by MTT assay; apoptosis was detected by DAPI staining; cell cycle was evaluated by flow cytometry; colony formation, migration and invasion assays were performed to investigate the effect of suppression of miR-31 on the cell lines. Results Real-time PCR results showed that anti-miR-31 was efficiently introduced into the cells and reduced miR-31 levels to 44.1% in HCT-116p53+/+ and 67.8% in HCT-116p53-/-cell line (p = 0.042 and 0.046. MTT results showed that anti-miR-31 alone had no effect on the proliferation of HCT-116p53+/+ or HCT-116p53-/-. However, when combined with 5-FU, anti-miR-31 inhibited the proliferation of the two cell lines as early as 24 h after exposure to 5-FU (p = 0.038 and 0.044. Suppression of miR-31 caused a reduction of the migratory cells by nearly 50% compared with the negative control in both HCT-116p53+/+ and HCT-116p53-/-(p = 0.040 and 0.001. The invasive ability of the cells were increased by 8-fold in HCT-116p53+/+ and 2-fold in HCT-116p53-/- (p = 0.045 and 0.009. Suppression of miR-31 had no effect on cell cycle and colony formation (p > 0.05. Conclusions Suppression of miR-31 increases sensitivity to 5-FU at an early stage, and affects cell migration and invasion in HCT-116 colon cancer cells.

  18. Stereotactic body radiation therapy for the treatment of early-stage minimally invasive adenocarcinoma or adenocarcnioma in situ (formerly bronchioloalveolar carcinoma: a patterns of failure analysis

    Directory of Open Access Journals (Sweden)

    Badiyan Shahed N

    2013-01-01

    Full Text Available Abstract Introduction Ongoing prospective trials exploring stereotactic body radiation therapy (SBRT for early stage non-small cell lung cancer (NSCLC often exclude minimally invasive adenocarcinoma or adenocarcnioma in situ, formerly bronchioloalveolar carcinoma (BAC, due to concerns for accurate target delineation on CT. We performed a patterns of failure analysis to compare outcomes between BAC and other NSCLC subtypes. Methods One hundred twenty patients with early stage NSCLC were treated with SBRT from 2004–2009. Pathologic confirmation of NSCLC was obtained in 97 patients. Radiotherapy was delivered according to RTOG guidelines. The log-rank test was used to compare outcomes between BAC and other NSCLC. Results Median follow-up was 29 months. The median SBRT dose was 5400 cGy. Thirteen patients had radiographically diagnosed BAC and five patients had biopsy confirmed BAC, of which two had both. The three-year local control was 100% for biopsy-proven or radiographically diagnosed BAC (n = 18 and 86% for all other NSCLC subtypes (n = 102 (p = 0.13. Likewise, no significant difference was detected between BAC and other NSCLC for 3-year regional failure (12% vs. 20%, p = 0.45, progression-free survival (57.6% vs. 53.5%, p = 0.84 or overall survival (35% vs. 47%, p = 0.66. There was a trend towards lower three-year rates of freedom from distant failure in patients with any diagnosis of BAC compared to those without (26% vs. 38%, p = 0.053. Conclusions Compared to other NSCLC subtypes, BAC appears to have similar patterns of failure and survival after treatment with SBRT, however there may be an increased risk of distant metastases with BAC. RTOG guideline-based target delineation provides encouraging local control rates for patients with BAC.

  19. Altered snowfall and soil disturbance influence the early life stage transitions and recruitment of a native and invasive grass in a cold desert.

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    Gornish, Elise S; Aanderud, Zachary T; Sheley, Roger L; Rinella, Mathew J; Svejcar, Tony; Englund, Suzanne D; James, Jeremy J

    2015-02-01

    Climate change effects on plants are expected to be primarily mediated through early life stage transitions. Snowfall variability, in particular, may have profound impacts on seedling recruitment, structuring plant populations and communities, especially in mid-latitude systems. These water-limited and frequently invaded environments experience tremendous variation in snowfall, and species in these systems must contend with harsh winter conditions and frequent disturbance. In this study, we examined the mechanisms driving the effects of snowpack depth and soil disturbance on the germination, emergence, and establishment of the native Pseudoroegnaria spicata and the invasive Bromus tectorum, two grass species that are widely distributed across the cold deserts of North America. The absence of snow in winter exposed seeds to an increased frequency and intensity of freeze-thaw cycles and greater fungal pathogen infection. A shallower snowpack promoted the formation of a frozen surface crust, reducing the emergence of both species (more so for P. spicata). Conversely, a deeper snowpack recharged the soil and improved seedling establishment of both species by creating higher and more stable levels of soil moisture availability following spring thaw. Across several snow treatments, experimental disturbance served to decrease the cumulative survival of both species. Furthermore, we observed that, regardless of snowpack treatment, most seed mortality (70-80%) occurred between seed germination and seedling emergence (November-March), suggesting that other wintertime factors or just winter conditions in general limited survival. Our results suggest that snowpack variation and legacy effects of the snowpack influence emergence and establishment but might not facilitate invasion of cold deserts.

  20. Assessment of early-stage optic nerve invasion in retinoblastoma using high-resolution 1.5 Tesla MRI with surface coils: a multicentre, prospective accuracy study with histopathological correlation

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    Brisse, Herve J. [Institut Curie, Department of Radiology, Paris (France); Institut CURIE, Imaging Department, Paris (France); Graaf, Pim de; Rodjan, Firazia; Jong, Marcus C. de; Castelijns, Jonas A. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Galluzzi, Paolo [Neuroimaging and Neurointerventional Unit (NINT) Azienda Ospedaliera e Universitaria Senese, Siena (Italy); Cosker, Kristel; Savignoni, Alexia [Institut Curie, Department of Biostatistics, Paris (France); Maeder, Philippe [Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Department of Radiology, Lausanne (Switzerland); Goericke, Sophia [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Aerts, Isabelle [Institut Curie, Department of Pediatric Oncology, Paris (France); Desjardins, Laurence [Institut Curie, Department of Ophthalmology, Paris (France); Moll, Annette C. [VU University Medical Center, Department of Ophthalmology, Amsterdam (Netherlands); Hadjistilianou, Theodora [Azienda Ospedaliera Universitaria Senese, Department of Ophthalmology, Siena (Italy); Toti, Paolo [University of Siena, Department of Medical Biotechnologies, Pathology Unit, Siena (Italy); Valk, Paul van der [VU University Medical Center, Department of Pathology, Amsterdam (Netherlands); Sastre-Garau, Xavier [Institut Curie, Department of Biopathology, Paris (France); Collaboration: European Retinoblastoma Imaging Collaboration (ERIC)

    2015-05-01

    To assess the accuracy of high-resolution (HR) magnetic resonance imaging (MRI) in diagnosing early-stage optic nerve (ON) invasion in a retinoblastoma cohort. This IRB-approved, prospective multicenter study included 95 patients (55 boys, 40 girls; mean age, 29 months). 1.5-T MRI was performed using surface coils before enucleation, including spin-echo unenhanced and contrast-enhanced (CE) T1-weighted sequences (slice thickness, 2 mm; pixel size <0.3 x 0.3 mm{sup 2}). Images were read by five neuroradiologists blinded to histopathologic findings. ROC curves were constructed with AUC assessment using a bootstrap method. Histopathology identified 41 eyes without ON invasion and 25 with prelaminar, 18 with intralaminar and 12 with postlaminar invasion. All but one were postoperatively classified as stage I by the International Retinoblastoma Staging System. The accuracy of CE-T1 sequences in identifying ON invasion was limited (AUC = 0.64; 95 % CI, 0.55 - 0.72) and not confirmed for postlaminar invasion diagnosis (AUC = 0.64; 95 % CI, 0.47 - 0.82); high specificities (range, 0.64 - 1) and negative predictive values (range, 0.81 - 0.97) were confirmed. HR-MRI with surface coils is recommended to appropriately select retinoblastoma patients eligible for primary enucleation without the risk of IRSS stage II but cannot substitute for pathology in differentiating the first degrees of ON invasion. (orig.)

  1. Prognostic impact of proliferation for resected early stage 'pure' invasive lobular breast cancer: Cut-off analysis of Ki67 according to histology and clinical validation.

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    Carbognin, Luisa; Sperduti, Isabella; Fabi, Alessandra; Dieci, Maria Vittoria; Kadrija, Dzenete; Griguolo, Gaia; Pilotto, Sara; Guarneri, Valentina; Zampiva, Ilaria; Brunelli, Matteo; Orvieto, Enrico; Nortilli, Rolando; Fiorio, Elena; Parolin, Veronica; Manfrin, Erminia; Caliò, Anna; Nisticò, Cecilia; Pellini, Francesca; Scarpa, Aldo; Pollini, Giovanni Paolo; Conte, Pierfranco; Tortora, Giampaolo; Bria, Emilio

    2017-10-01

    The intent of this analysis was to investigate and validate the prognostic potential of Ki67 in a multi-center series of patients affected by early stage 'pure' invasive lobular carcinoma (ILC). Clinical-pathological data of patients affected by ILC were correlated with overall survival and disease-free survival (OS/DFS); data from a parallel invasive ductal carcinoma (IDC) patients' cohort were gathered as well. The maximally selected Log-Rank statistics analysis was applied to Ki67 continuous variable to estimate the appropriate cut-off. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was performed as well. Data from overall 1097 (457/222 ILC: training/validation set; 418 IDC) patients were gathered. The identified optimal Ki67 cut-offs were 4% and 14% for DFS in ILC and IDC cohort, respectively. In ILC patients, the Ki67 cut-off was an independent OS predictor. Ten-years OS and DFS were 89.9% and 77.2% (p = 0.007) and 79.4% and 69.2% (p = 0.03) for patients with Ki67 ≤ 4% and >4%, respectively. In IDC patients, 10-years OS was 93.8% and 71.7%, p = 0.02, DFS was 84.0% and 52.6%, p = 0.0003, for patients with Ki67 ≤ 14% and >14%, respectively. In the validation set, the optimal Ki67 OS cut-off was 5%. The STEPP analysis showed that in the presence of low Ki67 values, IDC patients have a better DFS than ILC patients, while with the increase of values the prognosis tends to overlap. Despite the retrospective design of the study, the prognostic relevance of Ki67 (as well as its optimal cut-off) seems to significantly differ according to breast cancer histology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Chul; Kim, Jai Keun; Lee, Jei Hee [Ajou University School of Medicine, Department of Radiology, Suwon, Gyeonggi-do (Korea, Republic of); Kim, Myeong-Jin [Yonsei University Health system, Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Kim, Young Bae [Ajou University School of Medicine, Department of Pathology, Suwon (Korea, Republic of); Shin, Sung Jae [Ajou University School of Medicine, Department of Gastroenterology, Suwon (Korea, Republic of)

    2016-02-15

    To evaluate the feasibility of mesorectal vascular invasion (MVI) in predicting early distant metastasis developed within 1 year of diagnosis of T3 rectal cancer using magnetic resonance imaging (MRI) Sixty-five patients with T3 rectal cancer (early metastasis, n = 28; non-metastasis, n = 37) were enrolled in this study. Early distant metastases developed in 28 patients (liver, n = 15; lung, n = 9; both, n = 4). Logistic regression was used to determine the independent predictors for early distant metastasis. In univariate analysis, tumour location, carcinoembryonic antigen (CEA), lymphovascular invasion (LVI), MRI-detected MVI, and mesorectal fat infiltration (MFI) (odds ratio [OR], 4.533, 9.583, 5.539, 27.046, and 5.539, respectively) were associated with early distant metastasis. Multivariate analysis demonstrated that MVI (OR, 29.949; P < 0.002) and LVI (OR, 6.684; P = 0.033) were independent factors for early distant metastasis. Specificity and positive predictive value (PPV) of MVI (94.59 %, and 89.47 %, respectively) were significantly higher than those of LVI (64.86 %, and 61.76 %), but sensitivity and negative predictive value were not significantly different between MVI (60.71 %, and 76.09 %) and LVI (75.00 %, and 77.42 %). While sensitivity of MRI-detected MVI was equal to that of CEA in predicting early distant metastasis from T3 rectal cancer, specificity and PPV may be improved by assessing MVI. (orig.)

  3. Measuring ultra-weak photon emission as a non-invasive diagnostic tool for detecting early-stage type 2 diabetes: A step toward personalized medicine

    NARCIS (Netherlands)

    Sun, M.; Wijk, E. van; Koval, S.; Wijk, R. van; He, M.; Wang, M.; Hankemeier, T.; Greef, J. van der

    2017-01-01

    The global prevalence of type 2 diabetes is estimated to reach 4.4% by 2030, placing a significant burden on our healthcare system. Therefore, the ability to identify patients in early stages of the disease is essential for both prevention and effective management, and diagnostic methods based on

  4. Measuring ultra-weak photon emission as a non-invasive diagnostic tool for detecting early-stage type 2 diabetes: A step toward personalized medicine.

    Science.gov (United States)

    Sun, Mengmeng; Van Wijk, Eduard; Koval, Slavik; Van Wijk, Roeland; He, Min; Wang, Mei; Hankemeier, Thomas; van der Greef, Jan

    2017-01-01

    The global prevalence of type 2 diabetes is estimated to reach 4.4% by 2030, placing a significant burden on our healthcare system. Therefore, the ability to identify patients in early stages of the disease is essential for both prevention and effective management, and diagnostic methods based on traditional Chinese medicine (TCM) may be suitable for identifying patients with early-stage type 2 diabetes. Here, a panel of three physicians trained in TCM classified 44 pre-diabetic subjects into three syndrome subtypes using TCM-based diagnostics. In addition, ultra-weak photon emission (UPE) was measured at four anatomical sites in each subject. Ten properties encompassing 40 parameters were then extracted from the UPE time series. Statistical analyses, including multinomial logistic regression, were performed using the results of each parameter measured at the four sites. Sixteen UPE parameters were then selected and used to discriminate between the three subtypes of pre-diabetic subjects. Next, Spearman's correlation coefficient was used to quantify the correlation between the 16 UPE parameters and the TCM-based diagnoses. The resulting correlation networks accurately reflected the differences between the three syndrome subtypes. These results suggest that UPE is a suitable tool for detecting subtypes in early-stage type 2 diabetes. In addition, our results provide evidence that TCM may represent an important step toward personalized medicine. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Association of occult metastases in sentinel lymph nodes and bone marrow with survival of women with early-stage invasive breast cancer

    Science.gov (United States)

    Giuliano, Armando E.; Hawes, Debra; Ballman, Karla V.; Whitworth, Pat W.; Blumencranz, Peter W.; Reintgen, Douglas S.; Morrow, Monica; Leitch, A. Marilyn; Hunt, Kelly K.; McCall, Linda M.; Abati, Andrea; Cote, Richard

    2017-01-01

    Context Immunochemical staining of sentinel lymph nodes (SLNs) and bone marrow identifies breast cancer metastases not seen with routine pathologic or clinical examination. Objective To determine the association between survival and metastases detected by immunochemical staining of SLNs and bone marrow from patients with early-stage breast cancer. Design, Setting, and Patients From May 1999 to May 2003, 126 sites in the American College of Surgeons Oncology Group Z0010 trial enrolled women with clinical T1–T2, N0, M0 invasive breast carcinoma in a prospective observational study. Interventions All patients underwent breast-conserving surgery and SLN dissection; bone marrow aspiration at the time of operation was initially optional and subsequently mandatory (March 2001). SLN specimens (hematoxylin-eosin negative) and bone marrow specimens were sent to a central laboratory for immunochemical staining; treating clinicians were blinded to results. Main Outcome Measures Overall survival (primary end point) and disease-free survival (a secondary end point). Results Of 5119 (98.3%) SLN specimens, 3904 (76.3%) were tumor-negative by hematoxylin-eosin staining. Of 3326 SLN specimens examined by immunohistochemistry, 349 (10.5%) were tumor-positive. Of 3413 bone marrow specimens examined by immunocytochemistry, 104 (3.0%) were positive. At a median follow-up of 6.3 years (through April 2010), 435 patients had died and 376 had disease recurrence. Immunohistochemical evidence of SLN metastases was not significantly associated with overall survival (5-year rates: 95.7% (95% CI, 95.0%–96.5%) for immunohistochemical positive and 95.1% (95% CI, 92.7%–97.5% for immunohistochemical negative disease, P=0.64), unadjusted hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.59–1.39; P=.64). Bone marrow metastases were associated with decreased overall survival (5-year rates: 95.0% (95% CI, 94.3%–95.8%) and 90.1% (95% CI, 84.5%–96.1%), respectively (P=.01) (unadjusted

  6. Morphogenesis of early stage melanoma

    Science.gov (United States)

    Chatelain, Clément; Amar, Martine Ben

    2015-08-01

    Melanoma early detection is possible by simple skin examination and can insure a high survival probability when successful. However it requires efficient methods for identifying malignant lesions from common moles. This paper provides an overview first of the biological and physical mechanisms controlling melanoma early evolution, and then of the clinical tools available today for detecting melanoma in vivo at an early stage. It highlights the lack of diagnosis methods rationally linking macroscopic observables to the microscopic properties of the tissue, which define the malignancy of the tumor. The possible inputs of multiscale models for improving these methods are shortly discussed.

  7. Multiple early gastric cancer with duodenal invasion

    Directory of Open Access Journals (Sweden)

    Okino Tetsuya

    2007-10-01

    Full Text Available Abstract Background Early gastric cancers with duodenal invasion are rare, and no previous case of multiple early gastric cancer, one invading the duodenal bulb, has been reported. Case presentation A 79-year-old woman was investigated for upper abdominal discomfort. Endoscopic examination revealed an irregular nodulated lesion in the antrum area, and a reddish aggregated-type semi-circumferential nodulated lesion extending from the prepyloric area to the duodenal bulb through the normal mucosa with the antrum lesion. Biopsy revealed a tubular adenoma for the antrum lesion and a well-differentiated tubular adenocarcinoma for the prepyloric lesion. Distal gastrectomy with sufficient duodenal resection was performed. Microscopically, the antrum lesion appeared as a papillary adenocarcinoma, and the prepyloric lesion as a mainly papillary adenocarcinoma which partially invaded the submucosa without any sequential elongation for endoscopic findings. The lesion extended into the duodenal bulb, and was 12 mm in length from the oral end of Brunner's gland's area and limited within the duodenal mucosa. Conclusion Here, we present an unusual case of multiple early gastric cancer, one of which invaded the duodenum with relative wide mucosal spreading. This case illustrates that even early stage cancers located in the gastric antrum, particularly in the prepyloric area can invade the duodenum directly.

  8. Long-term prognostic performance of Ki67 rate in early stage, pT1-pT2, pN0, invasive breast carcinoma.

    Directory of Open Access Journals (Sweden)

    Fabien Reyal

    Full Text Available BACKGROUND: Molecular signatures may become of use in clinical practice to assess the prognosis of breast cancers. However, although international consensus conferences sustain the use of these new markers in the near future, concerns remain about their degree of discordance and cost-effectiveness in different international settings. The present study aims to validate Ki67 as prognostic factor in a large cohort of early-stage (pT1-pT2, pN0 breast cancer patients. METHODS: 456 patients treated in 1995-1996 were identified in the Institut Curie database. Ki67 (MIB1 was retrospectively assessed by immunohistochemistry for all cases. The prognostic value of this index was compared to that of histological grade (HG, Estrogen receptor (ER and HER2 status. Distant disease free interval, loco-regional recurrence, time-lapse from first metastatic diagnosis to death were analyzed. RESULTS: All 456 patients were treated by lumpectomy plus axillary dissection and radiotherapy. 27 patients (5.9% received systemic treatment. Tumors were classified as HG1 in 35%, HG2 in 42% and HG3 in 23% of cases. ER was expressed in 86% of the tumors, HER2 in 5% and 14% were triple negative. The median follow-up was 151 [5-191] months. Distant and loco-regional disease recurrences were observed in 16% and 18%, respectively. High (>20% Ki67 rate [HR = 3 (1.8-4.8, p<10e-06] and HG3 [HR = 4.4 (2.2-8.6, p = 0.00002] were associated with an increased rate of distant relapse. In multivariate analysis, the Ki67 remained the only significant prognostic factor in the subgroups of ER positive HER2 negative [HR = 2.6 (1.5-4.6, p = 0.0006] and ER positive HER2 negative HG2 tumors [HR = 2.2 (1.01-4.8, p = 0.04]. CONCLUSIONS: We validate the prognosis value of the Ki67 rate in small size node negative breast cancer. We conclude that Ki67 is a potential cost-effective decision marker for adjuvant therapy in early-stage HG2, pT1-pT2, pN0, breast cancers.

  9. Early diagnosis of early stage lung cancer

    Directory of Open Access Journals (Sweden)

    Andrej Debeljak

    2005-11-01

    Full Text Available Background: For the detection of premalignant changes of bronchial mucosa and early stages of lung cancer frequent chest X-ray, spiral low dose computed tomography, fluorescence bronchoscopy, sputum cytology (also with automated systems with genetic and molecular changes in the sputum cells and bronchial mucosa were used. These screening methods of the high-risk groups for lung cancer achieved: earlier diagnosis of lung cancer in lower stage, higher operability, longer 5-year survival, but without mortality reduction.Conclusions: In the clinical practice we can examine higher risk groups for lung cancer in randomised control trials with multimodality approach: frequent chest low-dose fast spiral computed tomography, sputum cytology with genetic and molecular examinations and fluorescence bronchoscopy. Smoking cessation remains the best means to achieve mortality reduction from lung cancer.

  10. Intestinal Cell Tight Junctions Limit Invasion of Candida albicans through Active Penetration and Endocytosis in the Early Stages of the Interaction of the Fungus with the Intestinal Barrier.

    Directory of Open Access Journals (Sweden)

    Marianne Goyer

    Full Text Available C. albicans is a commensal yeast of the mucous membranes in healthy humans that can also cause disseminated candidiasis, mainly originating from the digestive tract, in vulnerable patients. It is necessary to understand the cellular and molecular mechanisms of the interaction of C. albicans with enterocytes to better understand the basis of commensalism and pathogenicity of the yeast and to improve the management of disseminated candidiasis. In this study, we investigated the kinetics of tight junction (TJ formation in parallel with the invasion of C. albicans into the Caco-2 intestinal cell line. Using invasiveness assays on Caco-2 cells displaying pharmacologically altered TJ (i.e. differentiated epithelial cells treated with EGTA or patulin, we were able to demonstrate that TJ protect enterocytes against invasion of C. albicans. Moreover, treatment with a pharmacological inhibitor of endocytosis decreased invasion of the fungus into Caco-2 cells displaying altered TJ, suggesting that facilitating access of the yeast to the basolateral side of intestinal cells promotes endocytosis of C. albicans in its hyphal form. These data were supported by SEM observations of differentiated Caco-2 cells displaying altered TJ, which highlighted membrane protrusions engulfing C. albicans hyphae. We furthermore demonstrated that Als3, a hypha-specific C. albicans invasin, facilitates internalization of the fungus by active penetration and induced endocytosis by differentiated Caco-2 cells displaying altered TJ. However, our observations failed to demonstrate binding of Als3 to E-cadherin as the trigger mechanism of endocytosis of C. albicans into differentiated Caco-2 cells displaying altered TJ.

  11. Plant invasion across space and time: factors affecting nonindigenous species success during four stages of invasion.

    Science.gov (United States)

    Theoharides, Kathleen A; Dukes, Jeffrey S

    2007-01-01

    Invasive nonindigenous plant species (NIPS) threaten native diversity, alter ecosystem processes, and may interact with other components of global environmental change. Here, a general framework is outlined that attempts to connect patterns of plant invasion to processes underlying these patterns at four well-established spatio-temporal stages of the invasion process: transport, colonization, establishment, and landscape spread. At each stage we organize findings and ideas about the filters that limit NIPS success and the interaction of these filters with historical aspects of introduction events, NIPS traits, and ecosystem properties. While it remains difficult to draw conclusions about the risk of invasion across ecosystems, to delineate universal 'invader traits', or to predict large-scale extinctions following invasions, this review highlights the growing body of research that suggests that the success of invasive NIPS is controlled by a series of key processes or filters. These filters are common to all invasion events, and will interact throughout the stages of plant invasion, although the relative importance of a filter may be stage, species or location specific. It is suggested that both research and management programs may benefit from employing multiscale and stage approaches to studying and controlling invasion. We further use the framework to briefly examine potential interactions between climate change and filters that limit NIPS invasion.

  12. Non-invasive detection of genomic imbalances in Hodgkin/Reed-Sternberg cells in early and advanced stage Hodgkin's lymphoma by sequencing of circulating cell-free DNA: a technical proof-of-principle study.

    Science.gov (United States)

    Vandenberghe, Peter; Wlodarska, Iwona; Tousseyn, Thomas; Dehaspe, Luc; Dierickx, Daan; Verheecke, Magali; Uyttebroeck, Anne; Bechter, Oliver; Delforge, Michel; Vandecaveye, Vincent; Brison, Nathalie; Verhoef, Gregor E G; Legius, Eric; Amant, Frederic; Vermeesch, Joris R

    2015-02-01

    Hodgkin's lymphoma is one of the most common lymphoid neoplasms in young adults, but the low abundance of neoplastic Hodgkin/Reed-Sternberg cells in the tumour hampers the elucidation of its pathogenesis, biology, and diversity. After an incidental observation that genomic aberrations known to occur in Hodgkin's lymphoma were detectable in circulating cell-free DNA, this study was undertaken to investigate whether circulating cell-free DNA can be informative about genomic imbalances in Hodgkin's lymphoma. We applied massive parallel sequencing to circulating cell-free DNA in a prospective study of patients with biopsy proven nodular sclerosis Hodgkin's lymphoma. Genomic imbalances in Hodgkin/Reed-Sternberg cells were investigated by fluorescence in-situ hybridisation (FISH) on tumour specimens. By non-invasive prenatal testing, we observed several genomic imbalances in circulating cell-free DNA of a pregnant woman, who was subsequently diagnosed with early-stage nodular sclerosis Hodgkin's lymphoma stage IIA during gestation. FISH on tumour tissue confirmed corresponding genomic imbalances in Hodgkin/Reed-Sternberg cells. We prospectively studied circulating cell-free DNA of nine nodular sclerosis Hodgkin's lymphoma cases: eight at first diagnosis and one at first relapse. Seven patients had stage IIA disease and two had stage IVB disease. In eight, genomic imbalances were detected, including, among others, gain of chromosomes 2p and 9p, known to occur in Hodgkin's lymphoma. These gains and losses in circulating cell-free DNA were extensively validated by FISH on Hodgkin/Reed-Sternberg cells in biopsy samples. Initiation of chemotherapy induced normalisation of circulating cell-free DNA profiles within 2-6 weeks. The cell cycle indicator Ki67 and cleaved caspase-3 were detected in Hodgkin/Reed-Sternberg cells by immunohistochemistry, suggesting high turnover of Hodgkin/Reed-Sternberg cells. In early and advanced stage nodular sclerosis Hodgkin's lymphoma, genomic

  13. Invasion dynamics of competing species with stage-structure.

    Science.gov (United States)

    Bewick, Sharon; Wang, Guoqing; Younes, Hannah; Li, Bingtuan; Fagan, William F

    2017-08-03

    The spread of an invasive species often results in a decline and subsequent disappearance of native competitors. Several models, primarily based on spatially explicit Lotka-Volterra competition dynamics, have been developed to understand this phenomenon. In general, the goal of these models is to relate fundamental life history traits, for example dispersal ability and competition strength, to the rate of spread of the invasive species, which is also the rate at which the invasive species displaces its native competitor. Stage-structure is often an important determinant of population dynamics, but it has received little attention within the context of Lotka-Volterra invasion models. For many species, behaviors like dispersal and competition depend on life-stage. To describe the processes of invasion in these species, it is important to understand how behaviors that vary as a function of life-stage can impact spread rate. In this paper, we develop a spatially explicit, stage-structured Lotka-Volterra competition model. By comparing spread speed predictions from this model to spread speed predictions from an analogous single-stage model, we are able to determine when stage-structure is important and how stage-dependent behavior can alter the characteristics of an invasion. Copyright © 2017. Published by Elsevier Ltd.

  14. Dislocation generation during early stage sintering.

    Science.gov (United States)

    Sheehan, J. E.; Lenel, F. V.; Ansell, G. S.

    1973-01-01

    Discussion of the effects of capillarity-induced stresses on dislocations during early stage sintering. A special version of Hirth's (1963) theoretical calculation procedures modified to describe dislocation nucleation on planes meeting the sintering body's neck surface obliquely is shown to predict plastic flow at stress levels know to exist between micron size metal particles in the early stages of sintering.

  15. Mammographic detection and staging of invasive lobular carcinoma.

    NARCIS (Netherlands)

    Veltman, J.; Boetes, C.; Die, L. van; Bult, P.; Blickman, J.G.; Barentsz, J.O.

    2006-01-01

    The aim of the study was to evaluate mammography in detecting and staging of invasive lobular carcinoma (ILC) in order to assess the performance and impact of observer variability. Forty-two cases of ILC were retrospectively evaluated twice by two breast radiologists. Mammographic performance as wel

  16. Radiation Therapy for Early Stage Lung Cancer

    OpenAIRE

    Parashar, Bhupesh; Arora, Shruthi; Wernicke, A. Gabriella

    2013-01-01

    Radiation therapy for early stage lung cancer is a promising modality. It has been traditionally used in patients not considered candidates for standard surgical resection. However, its role has been changing rapidly since the introduction of new and advanced technology, especially in tumor tracking, image guidance, and radiation delivery. Stereotactic radiation therapy is one such advancement that has shown excellent local control rates and promising survival in early stage lung cancer. In a...

  17. Radiation Therapy for Early Stage Lung Cancer

    OpenAIRE

    Parashar, Bhupesh; Arora, Shruthi; Wernicke, A. Gabriella

    2013-01-01

    Radiation therapy for early stage lung cancer is a promising modality. It has been traditionally used in patients not considered candidates for standard surgical resection. However, its role has been changing rapidly since the introduction of new and advanced technology, especially in tumor tracking, image guidance, and radiation delivery. Stereotactic radiation therapy is one such advancement that has shown excellent local control rates and promising survival in early stage lung cancer. In a...

  18. [Treatment of early stage Hodgkin disease

    DEFF Research Database (Denmark)

    Specht, Lena; Carde, P.; Mauch, P.

    1993-01-01

    In early stage Hodgkin's disease the optimal choice of treatment is still an unresolved issue. Twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out world-wide. The preliminary results of a global meta-analysis of these trials...

  19. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L.; Carde, P.; Mauch, P.;

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a glob...

  20. CT perfusion at early stage of hepatic diffuse disease

    Institute of Scientific and Technical Information of China (English)

    Sheng Guan; Wei-Dong Zhao; Kang-Rong Zhou; Wei-Jun Peng; Jian Mao; Feng Tang

    2005-01-01

    AIM: To determine the validity of the non-invasive method of CT perfusion (CTP) in rat model of hepatic diffuse disease. METHODS: Twenty-eight Wistar rats were divided into two groups. Liver diffuse lesions were induced by dietthylnitrosamine in 14 rats of test group. Rats in control groupwere bred with pure water. From the 1st to 12th wk after the test group was intervened, both groups were studied every week with CTP. CTP parameters of liver parenchymain different periods and pathologic changes in two groups were compared and analyzed.RESULTS: The process of hepatic diffuse lesions in test groups was dassified into three stages or periods according to the pathologic alterations, namely hepattitis, hepatic fibrosis, and cirrhosis. During this period, hepatic artery flow (HAF)of control group declined slightly, mean transit time (MTT),blood flow (BF) and volume (BV) increased, but there wereno significant differences between different periods. Tntest group, HAF tended to increase gradually, MTT prolonged obviously, BV and BF decreased at the same time. The results of statistical analysis revealed that the difference in the HAF ratio of test group to control group was significant.The ratio of BV and BF in test group to control group in stageof hepatitis and hepatic cirrhosis, hepatic fibrosis and early stage of hepatic cirrhosis was significantly different, but there was no significant difference between hepatitis and hepatic fibrosis. The main pathological changes in stage of hepatitis were swelling of hepatic cells, while sinusoid capillarization and deposition of collagen aggravated gradually in the extravascular Disse's spaces in stage of fibrosis and early stage of cirrhosis.CONCLUSION: The technique could reflect some early changes of hepatic blood perfusion in rat with liver diffuse disease and is valuable for their early diagnosis.

  1. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L; Carde, P; Mauch, P;

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a global...... be kept at a minimum. Recently, trials have been carried out testing chemotherapy alone. The results of these trials are however conflicting. In order not to jeopardize the good results achieved with the standard treatments developed over the last three decades, newer treatment approaches should...... be carefully tested in large randomized trials before being implemented for general clinical use....

  2. Early Stage of Pulsed Discharge in Water

    Institute of Scientific and Technical Information of China (English)

    卢新培; 潘垣; 刘克富; 刘明海; 张寒虹

    2001-01-01

    The bubble radius at the early stage of discharge in water is investigated using high-speed photography. Some simulation results on the bubble radius are presented, which are in agreement with the experimental results, with a maximum difference of about 10%. The reasons why the peak pressure of the first shock wave is only related to the energy released in the bubble during the first half period are addressed. The energy released in the bubble after the first half period increases the bubble pulsation period, but it produces no more than 10% under the peak pressure of the second shock wave.

  3. Dupuytren contracture. Radiotherapy of early stages

    Energy Technology Data Exchange (ETDEWEB)

    Herbst, M.; Regler, G.

    1985-03-01

    Conventional radiotherapy is the treatment of choice for the early stages of theDupuytren contracture. The conventional semi-deep therapy is more favorable than the soft ray technique and the moulage technique. 62 patients have been treated at Erlangen; 33 out of them (46 irradiated hands) with a minimum observation time of 18 months have been evaluated. The pathologic process was stopped in 98% of the cases. 85% of the patients showed an improvement of troubles by regression of tubercules and cords, pains and sensation of pressure. A recurrence was obseved only in one patient at the edge of the irradiated volume.

  4. Predictors of recurrence in early stage oral tongue squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Chandrashekar Mani

    2015-01-01

    Full Text Available Introduction: Many histopathological parameters in oral tongue squamous cell carcinoma (OTSCC have been identified as predictive factors. Certain tumor-related factors increase the risk of nodal metastasis, and many pathological factors affect survival. Objective: The objective of this study is to identify that tumor-related histopathological prognostic factors that can predict recurrence and potentially influence the decision for adjuvant radiotherapy in early stage OTSCC. Materials and Methods: A total of 51 patients who underwent surgery for early stage OTSCC (stage I, II from 2007 to 2013 were selected. Demographic and clinical details were retrieved. Histopathological reports were reviewed for the following parameters-Margin status (close <5 mm, positive - Invasive squamous cell carcinoma [SCC], carcinoma in situ, marked dysplasia, microscopic depth of invasion, skeletal muscle infiltration (SMI, tumor differentiation, perineural invasion, lymphovascular invasion. Overall survival and recurrence-free survival (RFS were calculated using the Kaplan-Meier method. Predictors of recurrence were identified using Univariate analysis. Results: Median follow-up was 22 months (range, 5-89 months, the overall survival and RFS were 88% and 81% respectively. The recurrence rate was 19.5% during this time period. The only significant predictor of recurrence in pathologically early stage OTSCC was SMI (P = 0.003 on univariate analysis. Eighty-seven percentage of the recurrences in our study occurred within the 1 st year, with a disease specific mortality rate of 12.5%. Conclusion: In early stage OTSCC, Failure occurred predominantly in patients who had SMI.

  5. Subthalamic nucleus deep brain stimulation in early stage Parkinson's disease.

    Science.gov (United States)

    Charles, David; Konrad, Peter E; Neimat, Joseph S; Molinari, Anna L; Tramontana, Michael G; Finder, Stuart G; Gill, Chandler E; Bliton, Mark J; Kao, Chris; Phibbs, Fenna T; Hedera, Peter; Salomon, Ronald M; Cannard, Kevin R; Wang, Lily; Song, Yanna; Davis, Thomas L

    2014-07-01

    Deep brain stimulation (DBS) is an effective and approved therapy for advanced Parkinson's disease (PD), and a recent study suggests efficacy in mid-stage disease. This manuscript reports the results of a pilot trial investigating preliminary safety and tolerability of DBS in early PD. Thirty subjects with idiopathic PD (Hoehn & Yahr Stage II off medication), age 50-75, on medication ≥6 months but ≤4 years, and without motor fluctuations or dyskinesias were randomized to optimal drug therapy (ODT) (n = 15) or DBS + ODT (n = 15). Co-primary endpoints were the time to reach a 4-point worsening from baseline in the UPDRS-III off therapy and the change in levodopa equivalent daily dose from baseline to 24 months. As hypothesized, the mean UPDRS total and part III scores were not significantly different on or off therapy at 24 months. Medication requirements in the DBS + ODT group were lower at all time points with a maximal difference at 18 months. With a few exceptions, differences in neuropsychological functioning were not significant. Two subjects in the DBS + ODT group suffered serious adverse events; remaining adverse events were mild or transient. This study demonstrates that subjects with early stage PD will enroll in and complete trials testing invasive therapies and provides preliminary evidence that DBS is well tolerated in early PD. The results of this trial provide the data necessary to design a large, phase III, double-blind, multicenter trial investigating the safety and efficacy of DBS in early PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. CT-scan prediction of thyroid cartilage invasion for early laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Hartl, Dana M; Landry, Guillaume; Bidault, François; Hans, Stéphane; Julieron, Morbize; Mamelle, Gérard; Janot, François; Brasnu, Daniel F

    2013-01-01

    Treatment choice for laryngeal cancer may be influenced by the diagnosis of thyroid cartilage invasion on preoperative computed tomography (CT). Our objective was to determine the predictive value of CT for thyroid cartilage invasion in early- to mid-stage laryngeal cancer. Retrospective study (1992-2008) of laryngeal squamous cell carcinoma treated with open partial laryngectomy and resection of at least part of the thyroid cartilage. Previous laser surgery, radiation therapy, chemotherapy and second primaries were excluded. CT prediction of thyroid cartilage invasion was determined by specialized radiologists. Tumor characteristics and pathologic thyroid cartilage invasion were compared to the radiologic assessment. 236 patients were treated by vertical (20 %), supracricoid (67 %) or supraglottic partial laryngectomy (13 %) for tumors staged cT1 (26 %), cT2 (55 %), and cT3 (19 %). The thyroid cartilage was invaded on pathology in 19 cases (8 %). CT's sensitivity was 10.5 %, specificity 94 %, positive predictive value 13 %, and negative predictive value 92 %. CT correctly predicted thyroid cartilage invasion in only two cases for an overall accuracy of 87 %. Among the false-positive CT's, tumors involving the anterior commissure were significantly over-represented (61.5 % vs. 27 %, p = .004). Tumors with decreased vocal fold (VF) mobility were significantly over-represented in the group of false-negatives (41 vs. 13 %, p = .0035). Preoperative CT was not effective in predicting thyroid cartilage invasion in these early- to mid-stage lesions, overestimating cartilage invasion for AC lesions and underestimating invasion for lesions with decreased VF mobility.

  7. Safety of laparoscopy versus laparotomy in early-stage endometrial cancer : a randomised trial

    NARCIS (Netherlands)

    Mourits, M.J.E.; Bijen, C.B.; Arts, H.J.; Ter Brugge, H.G.; van der Sijde, R.; Paulsen, L.; Wijma, J.; Bongers, M.Y.; Post, W.J.; van der Zee, A.G.; de Bock, G.H.

    2010-01-01

    Background The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy, which is associated with substantial morbidity. Total laparoscopic hysterectomy (TLH) and bilateral salpingo-oophorectomy is less invasive and is assumed to b

  8. The surgical management of early-stage cervical cancer.

    Science.gov (United States)

    Salicrú, Sabina R; de la Torre, Javier F V; Gil-Moreno, Antonio

    2013-08-01

    The main objective is to update the literature data in the last year which may support a surgical approach to early cervical cancer [ECC; Stage International Federation of Gynecology and Obstetrics (FIGO) IA-IB1-IIA1]. Radical hysterectomy remains the gold standard by most international guidelines because surgical treatment has hardly changed in recent decades, except for stage IA1. Trends in clinical research in the past 12-18 months involve minimal invasive surgery (with laparoscopic surgery or robotic-assisted surgery), fertility preservation (in the initial stages and in the absence of bad prognostic factors), nerve-sparing and sentinel node techniques. Some institutions have published studies in specific groups such as older, obese or pregnant women. There is a growing trend to practice less aggressive surgery in order to preserve fertility in young women and avoid an excess of treatment in some selected patients. Therefore, nerve-sparing techniques can help to improve the quality of life. More studies are needed to demonstrate oncologic results of the sentinel node technique. Laparoscopic and robotic-assisted surgery can substitute open surgical treatment.

  9. Urinary biomarkers at early ADPKD disease stage.

    Directory of Open Access Journals (Sweden)

    Katja Petzold

    Full Text Available Autosomal dominant polycystic kidney disease (ADPKD is characterized by a decline in renal function at late disease stage when the majority of functional renal parenchyma is replaced by cystic tissue. Thus, kidney function, assessed by estimated glomerular filtration rate (eGFR does not well represent disease burden in early disease. Here, we investigated various urinary markers for tubular injury and their association with disease burden in ADPKD patients at early disease course.ADPKD patients between 18 and 40 years with an eGFR greater or equal to 70 ml per min per 1.73m2 were eligible for this cross-sectional study. Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL, Kidney Injury Molecule-1 (KIM-1, and Uromodulin (UMOD were investigated by Enzyme-Linked Immunosorbent Assay. Clara Cell Protein 16 (CC16 was investigated by Latex Immuno Assay. Cryoscopy was performed to assess urine osmolality and Urinary Albumin-to-Creatinine Ratio (UACR was calculated. The association and the predictive properties of the markers on eGFR and height adjusted total kidney volume (htTKV was evaluated using multiple regression analysis, incorporating different control variables for adjustment. Internal bootstrapping validated the obtained results.In 139 ADPKD patients (age 31 ±7 years, mean eGFR of 93 ± 19 ml per min per 1.73 m2 the total kidney volume was negatively correlated with eGFR and UMOD and positive associated with age, UACR, KIM-1 and urine osmolality after adjustment for possible confounders. Urine osmolality and htTKV were also associated with eGFR, whereas no association of CC16, NGAL and UMOD with eGFR or htTKV was found.UACR and urinary KIM-1 are independently associated with kidney size but not with renal function in our study population. Urine osmolality was associated with eGFR and kidney volume following adjustment for multiple confounders. Despite statistical significance, the clinical value of our results is not yet conceivable

  10. Limitations of Colposcopy in Early Invasive Cervical Cancer Detection

    OpenAIRE

    Grubišić, Goran

    2007-01-01

    Colposcopy is a key element in the diagnostic chain required to reduce cervical cancer mortality but it has limitations in the diagnosis of malignant disease. In the Republic of Croatia the Croatian Society for Colposcopy and Cervical Pathology started constructing guidelines for early detection, therapy and follow-up of patients with early invasive cervical cancer in order to achieve the best possible results in diagnosis, therapy and follow-up. From 2001 to 2006 Croatian society ...

  11. Non-invasive assessment of maternal hemodynamics in early pregnancy

    NARCIS (Netherlands)

    van der Graaf, Anne Marijn; Zeeman, Gerda G.; Groen, Henk; Roberts, Claire; Dekker, Gus A.

    2013-01-01

    Objectives: Non-invasive assessment of maternal hemodynamics in early pregnancy may be promising in evaluating maternal hemodynamic (mal)adaptation to pregnancy. We explored usage of applanation tonometry and Doppler ultrasound for assessment of cardiac output (CO), systemic vascular resistance (SVR

  12. Non-invasive brain stimulation in early rehabilitation after stroke.

    Science.gov (United States)

    Blesneag, A V; Popa, L; Stan, A D

    2015-01-01

    The new tendency in rehabilitation involves non-invasive tools that, if applied early after stroke, promote neurorecovery. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation may correct the disruption of cortical excitability and effectively contribute to the restoration of movement and speech. The present paper analyses the results of non-invasive brain stimulation (NIBS) trials, highlighting different aspects related to the repetitive transcranial magnetic stimulation frequency, transcranial direct current stimulation polarity, the period and stimulation places in acute and subacute ischemic strokes. The risk of adverse events, the association with motor or language recovery specific training, and the cumulative positive effect evaluation are also discussed.

  13. Production of Early Diploid Males by European Colonies of the Invasive Hornet Vespa velutina nigrithorax.

    Science.gov (United States)

    Darrouzet, Eric; Gévar, Jérémy; Guignard, Quentin; Aron, Serge

    2015-01-01

    The invasive yellow-legged hornet Vespa velutina nigrithorax was accidentally introduced in Europe in the early 2000s. As is the case in colonies of other wasp and hornet species, V. velutina colonies are known to produce sexuals (males and new queens) at the end of the summer. We show that early-stage colonies in French populations frequently produce males well before the usual reproductive period. The vast majority of the males produced are diploid, which is consistent with the loss of genetic diversity previously reported in introduced populations in France. Since males do not participate in colony activities, the production of early diploid males at the expense of workers is expected to hamper colony growth and, ultimately, decrease the expansion of the species in its invasive range in Europe.

  14. Production of Early Diploid Males by European Colonies of the Invasive Hornet Vespa velutina nigrithorax.

    Directory of Open Access Journals (Sweden)

    Eric Darrouzet

    Full Text Available The invasive yellow-legged hornet Vespa velutina nigrithorax was accidentally introduced in Europe in the early 2000s. As is the case in colonies of other wasp and hornet species, V. velutina colonies are known to produce sexuals (males and new queens at the end of the summer. We show that early-stage colonies in French populations frequently produce males well before the usual reproductive period. The vast majority of the males produced are diploid, which is consistent with the loss of genetic diversity previously reported in introduced populations in France. Since males do not participate in colony activities, the production of early diploid males at the expense of workers is expected to hamper colony growth and, ultimately, decrease the expansion of the species in its invasive range in Europe.

  15. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T;

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  16. An Analysis of Immunoreactive Signatures in Early Stage Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Yu Hong

    2015-05-01

    Interpretation: Tumor-associated autoimmune reactions may be triggered by early stage HCCs. Measurement of serum autoantibody to TAAs may be complementary to AFP measurements and improve diagnosis of early HCC.

  17. Early detection of invasive plants: principles and practices

    Science.gov (United States)

    Welch, Bradley A.; Geissler, Paul H.; Latham, Penelope

    2014-01-01

    Invasive plants infest an estimated 2.6 million acres of the 83 million acres managed by the National Park Service (NPS) in the United States. The consequences of these invasions present a significant challenge for the NPS to manage the agency’s natural resources “unimpaired for the enjoyment of future generations.” More NPS lands are infested daily despite diligent efforts to curtail the problem. Impacts from invasive species have been realized in most parks, resulting in an expressed need to control existing infestations and restore affected ecosystems. There is a growing urgency in the NPS and other resource management organizations to be proactive. The NPS I&M Program, in collaboration with the U.S. Geological Survey (USGS) Status and Trends Program, compiled this document to provide guidance and insight to parks and other natural areas engaged in developing early-detection monitoring protocols for invasive plants. While several rapid response frameworks exist, there is no consistent or comprehensive guidance informing the active detection of nonnative plants early in the invasion process. Early-detection was selected as a primary focus for invasive-species monitoring because, along with rapid response, it is a key strategy for successful management of invasive species. Eradication efforts are most successful on small infestations (that is less than 1 hectare) and become less successful as infestation size increases, to the point that eradication is unlikely for large (that is greater than 1,000 hectares) populations of invasive plants. This document provides guidance for natural resource managers wishing to detect invasive plants early through an active, directed monitoring program. It has a Quick-Start Guide to direct readers to specific chapters and text relevant to their needs. Decision trees and flow charts assist the reader in deciding what methods to choose and when to use them. This document is written in a modular format to accommodate use of

  18. Very early stages of massive stars

    Science.gov (United States)

    Vasyunina, Tatiana

    2010-12-01

    The goal of this thesis work is to investigate the initial conditions and the early phases of the formation of high-mass stars by means of dedicated observational studies. We consider two object classes: infrared dark clouds (IRDCs), and a subsequent stage characterized by the presence of young embedded (proto-)stellar clusters. First, we estimate masses and column densities for a completely new sample of southern IRDCs, utilizing our own millimeter continuum emission maps as well as Spitzer satellite data. The parameters we derive show that IRDCs from our sample have the potential to form not only low- and intermediate-mass stars, but can also be the birth places of massive stars. In particular, the comparison of our results with previously obtained data for low-mass starless cores shows a clear trend for IRDCs to have systematically higher column densities. The interpolated IRDC peak column densities exceed the threshold for the onset of massive star formation previously advocated by theoretical studies. We also critically evaluate the limitations of the applied emission and extinction methods. Second, we investigate the physical conditions and the chemical composition of the dense gas within the IRDCs of our sample by means of a multi-line molecular spectroscopy analysis. All the clouds have complex HCO+ line pro les, and we detect SiO emission in some clouds. These ndings mark the presence of infall and out ow motions in at least some parts of the IRDCs, and hence, ongoing star formation. In comparison with low-mass starless cores, the IRDCs have broader and more intense lines. Thus, they may be characterised by more turbulent conditions. Nevertheless, we nd a tendency for the IRDCs to have molecular abundances similar to the case of low-mass starless cores. This indicates similar chemical initial conditions for low- and high-mass star-forming regions. Finally, we study the stellar composition and environmental conditions in the young embedded cluster IRAS

  19. Long-term results of breast conserving surgery vs. mastectomy for early stage invasive breast cancer: 20-year follow-up of the Danish randomized DBCG-82TM protocol

    DEFF Research Database (Denmark)

    Blichert-Toft, M.; Nielsen, M.; During, M.;

    2008-01-01

    The main objective of the present study aims at comparing the long-term efficacy of breast conserving surgery (BCS) vs. mastectomy (M) based on a randomized design. The Danish Breast Cancer Cooperative Group (DBCG) conducted the trial (DBCG-82TM) from January 1983 to March 1989 recruiting 1154...... patients with invasive breast carcinoma. Follow-up time ended 1(st) May 2006 with a median follow-up time of 19.6 years (time span 17.1-23.3 years). Eligibility criteria included a one-sided, unifocal, primary operable breast carcinoma, patient age below 70 years, probability of satisfactory cosmetic......% of the complete series. 10-year recurrence free survival (RFS) and 20-year overall survival (OS) based on intent to treat did not reveal significant differences in outcome between breast conserving surgery vs. mastectomy, p=0.95 and p=0.10, respectively. Including the complete series comprising 1133 eligible...

  20. Subcompartmentalisation of proteins in the rhoptries correlates with ordered events of erythrocyte invasion by the blood stage malaria parasite.

    Directory of Open Access Journals (Sweden)

    Elizabeth S Zuccala

    Full Text Available Host cell infection by apicomplexan parasites plays an essential role in lifecycle progression for these obligate intracellular pathogens. For most species, including the etiological agents of malaria and toxoplasmosis, infection requires active host-cell invasion dependent on formation of a tight junction - the organising interface between parasite and host cell during entry. Formation of this structure is not, however, shared across all Apicomplexa or indeed all parasite lifecycle stages. Here, using an in silico integrative genomic search and endogenous gene-tagging strategy, we sought to characterise proteins that function specifically during junction-dependent invasion, a class of proteins we term invasins to distinguish them from adhesins that function in species specific host-cell recognition. High-definition imaging of tagged Plasmodium falciparum invasins localised proteins to multiple cellular compartments of the blood stage merozoite. This includes several that localise to distinct subcompartments within the rhoptries. While originating from the same organelle, however, each has very different dynamics during invasion. Apical Sushi Protein and Rhoptry Neck protein 2 release early, following the junction, whilst a novel rhoptry protein PFF0645c releases only after invasion is complete. This supports the idea that organisation of proteins within a secretory organelle determines the order and destination of protein secretion and provides a localisation-based classification strategy for predicting invasin function during apicomplexan parasite invasion.

  1. [Changes in radiotherapy indication for early-stage operated endometrial cancer. Revised staging, predictive factors. Conclusions from our own results].

    Science.gov (United States)

    Póti, Zsuzsa; Katona, Csilla; Szalai, Tibor; Mayer, Árpád

    2016-07-03

    Optimal postoperative radiotherapy indications for early-stage operated endometrial cancers have drastically changed with the new imaging generation (magnetic resonance imaging, positron emission tomography/computed tomography) and more detailed pathomorphology. The depth and growth of tumor invasion, presence or absence of the lymph node metastases, grading and lymphovascular invasion are the most important factors to predict the progression and to influence the prognosis. In 2016, on the basis of these, the European Gynecologist Oncology and Radiotherapy Society published a report in which they proposed unanimously indications for postoperative radio- and/or radiochemotherapy. The basis of their work was prospective multilevel randomized investigations which could avoid over- or undertreatment hazards. The results obtained by the authors of this article from 164 operated patients in early-stage endometrium carcinoma seem to be acceptable, in spite of the fact that their earlier radiotherapy indication was different and in the pathological description lymphovascular invasion was not included and the grading was not always applied.

  2. Pancreatic Perfusion CT in Early Stage of Severe Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Yoshihisa Tsuji

    2012-01-01

    Full Text Available Early intensive care for severe acute pancreatitis is essential for improving SAP mortality rates. However, intensive therapies for SAP are often delayed because there is no ideal way to accurately evaluate severity in the early stages. Currently, perfusion CT has been shown useful to predict prognosis of SAP in the early stage. In this presented paper, we would like to review the clinical usefulness and limitations of perfusion CT for evaluation of local and systemic complications in early stage of SAP.

  3. Patient Perspectives on Deep Brain Stimulation Clinical Research in Early Stage Parkinson's Disease.

    Science.gov (United States)

    Heusinkveld, Lauren; Hacker, Mallory; Turchan, Maxim; Bollig, Madelyn; Tamargo, Christina; Fisher, William; McLaughlin, Lauren; Martig, Adria; Charles, David

    2017-01-01

    The FDA has approved a multicenter, double-blind, Phase III, pivotal trial testing deep brain stimulation (DBS) in 280 people with very early stage Parkinson's disease (PD; IDE#G050016). In partnership with The Michael J. Fox Foundation for Parkinson's Research, we conducted a survey to investigate motivating factors, barriers, and gender differences among potentially eligible patients for participation in a trial testing DBS in early PD compared to standard medical treatment. The majority of survey respondents (72%) indicated they would consider learning more about participating. Early PD patients are therefore likely to consider enrolling in trials of invasive therapies that may slow symptom progression and help future patients.

  4. Parametrial involvement in women with low-risk, early-stage cervical cancer.

    Science.gov (United States)

    Vanichtantikul, A; Tantbirojn, P; Manchana, T

    2017-09-01

    This study identified the incidence of parametrial involvement in low risk, early-stage cervical cancer patients and evaluated the factors associated with parametrial involvement. All stage IA2-IB1 cervical cancer patients who underwent radical hysterectomy with pelvic lymphadenectomy were retrospectively reviewed. Patients with squamous cell carcinoma or adenocarcinoma grade 1-2, tumour size less than 2 cm, no lymphovascular space invasion (LVSI), negative pelvic nodes and depth of stromal invasion (DSI) less than 10 mm were identified as the low-risk group. A total of 243 patients were eligible. Squamous cell carcinomas were the most frequent histological cell type (65%). Most patients (81.5%) had tumour size less than 2 cm. Thirteen patients (5.3%) had parametrial involvement, 77 (31.7%) had DSI more than 10 mm, 121 (49.8%) had more than 50% invasion, 119 (49%) had LVSI and 19 (7.5%) had node metastasis. Ninety-five patients (39.1%) were defined as low risk. None of low-risk group had parametrial involvement. DSI more than 10 mm or more than 50% stromal invasion, presence of LVSI and pelvic node metastasis were significant factors associated with parametrial involvement. Parametrial involvement in low-risk, early-stage cervical cancer is extremely low. Less radical surgery may be an alternative treatment option. © 2016 John Wiley & Sons Ltd.

  5. Invasive species information networks: Collaboration at multiple scales for prevention, early detection, and rapid response to invasive alien species

    Science.gov (United States)

    Simpson, Annie; Jarnevich, Catherine S.; Madsen, John; Westbrooks, Randy G.; Fournier, Christine; Mehrhoff, Les; Browne, Michael; Graham, Jim; Sellers, Elizabeth A.

    2009-01-01

    Accurate analysis of present distributions and effective modeling of future distributions of invasive alien species (IAS) are both highly dependent on the availability and accessibility of occurrence data and natural history information about the species. Invasive alien species monitoring and detection networks (such as the Invasive Plant Atlas of New England and the Invasive Plant Atlas of the MidSouth) generate occurrence data at local and regional levels within the United States, which are shared through the US National Institute of Invasive Species Science. The Inter-American Biodiversity Information Network's Invasives Information Network (I3N), facilitates cooperation on sharing invasive species occurrence data throughout the Western Hemisphere. The I3N and other national and regional networks expose their data globally via the Global Invasive Species Information Network (GISIN). International and interdisciplinary cooperation on data sharing strengthens cooperation on strategies and responses to invasions. However, limitations to effective collaboration among invasive species networks leading to successful early detection and rapid response to invasive species include: lack of interoperability; data accessibility; funding; and technical expertise. This paper proposes various solutions to these obstacles at different geographic levels and briefly describes success stories from the invasive species information networks mentioned above. Using biological informatics to facilitate global information sharing is especially critical in invasive species science, as research has shown that one of the best indicators of the invasiveness of a species is whether it has been invasive elsewhere. Data must also be shared across disciplines because natural history information (e.g. diet, predators, habitat requirements, etc.) about a species in its native range is vital for effective prevention, detection, and rapid response to an invasion. Finally, it has been our

  6. Survey of transcripts expressed by the invasive juvenile stage of the liver fluke Fasciola hepatica

    Directory of Open Access Journals (Sweden)

    Alvarez-Valín Fernando

    2010-04-01

    Full Text Available Abstract Background The common liver fluke Fasciola hepatica is the agent of a zoonosis with significant economic consequences in livestock production worldwide, and increasing relevance to human health in developing countries. Although flukicidal drugs are available, re-infection and emerging resistance are demanding new efficient and inexpensive control strategies. Understanding the molecular mechanisms underlying the host-parasite interaction provide relevant clues in this search, while enlightening the physiological adaptations to parasitism. Genomics and transcriptomics are still in their infancy in F. hepatica, with very scarce information available from the invasive newly excysted juveniles (NEJ. Here we provide an initial glimpse to the transcriptomics of the NEJ, the first stage to interact with the mammalian host. Results We catalogued more than 500 clusters generated from the analysis of F. hepatica juvenile expressed sequence tags (EST, several of them not detected in the adult stage. A set of putative F. hepatica specific transcripts, and a group of sequences conserved exclusively in flatworms were identified. These novel sequences along with a set of parasite transcripts absent in the host genomes are putative new targets for future anti-parasitic drugs or vaccine development. Comparisons of the F. hepatica sequences with other metazoans genomes or EST databases were consistent with the basal positioning of flatworms in the bilaterian phylogeny. Notably, GC content, codon usage and amino acid frequencies are remarkably different in Schistosomes to F. hepatica and other trematodes. Functional annotation of predicted proteins showed a general representation of diverse biological functions. Besides proteases and antioxidant enzymes expected to participate in the early interaction with the host, various proteins involved in gene expression, protein synthesis, cell signaling and mitochondrial enzymes were identified. Differential

  7. Early effects of preoperative radiation therapy for invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Shigeo; Igarashi, Tatsuo; Ito, Haruo

    1983-10-01

    22 patients with high grade invasive bladder cancer were treated with preoperative radiation therapy (910 rad by fast neutron or 3000 rad by X ray during 2 weeks) followed by radical cystectomy and urinary diversion. 62.5 % of patients showed reduction in tumor size more than 50% evaluated by cystogram. Stage down was observed in 38% of patients compared between clinical and pathological stage. Histopathological effect of GII or GIII, according to the criteria described by Ohboshi, was noticed in 79 % of the patients. Better effect seemed to be obtained in fast neutron treated group than in X ray group. 19 patients received curative surgery, and 18 patients were alive without recurrence after 10 months (mean observed term). One died from lung metastasis 4.5 months after surgery. 50% of the patients complained of side effects of irradiation although they were tolerable, and 32% of the patients had major complications of surgery.

  8. An actuarial approach to comparing early stage and late stage lung cancer mortality and survival.

    Science.gov (United States)

    Goldberg, Sara W; Mulshine, James L; Hagstrom, Dale; Pyenson, Bruce S

    2010-02-01

    Comparing the mortality characteristics of different cohorts is an essential process in the life insurance industry. Pseudodisease, lead-time bias, and length bias, which are critical to determining the value of cancer screening, have close analogues in life insurance company management, including the temporal impact of underwriting. Ratios of all-cause mortality rates for cancer cohorts relative to standard population mortality rates can provide insights into early stage and late stage mortality differences, differences by age, sex, race, and histology, and allow modeling of biases associated with early stage detection or screening protocols. The Surveillance, Epidemiology and End Results (SEER) data set has characteristics that allow efficient application of actuarial techniques. We show the mortality burden associated with treated early stage lung cancer and that identifying all lung cancers at early stage could reduce US lung cancer deaths by over 70,000 per year.

  9. Phylogenetic ctDNA analysis depicts early stage lung cancer evolution

    OpenAIRE

    Wilson, Gareth A.; Constantin, Tudor; Quesne, John Le; Moore, David A.; Kirkizlar, Eser; Fraioli, Francesco; Bakir, Maise Al; Zambrana, Francisco; Endozo, Raymondo; Bi, Wenya Linda; Fennessy, Fiona M.; Forster, Martin D.; Hafez, Dina; Ganguly, Apratim; Kareht, Stephanie

    2017-01-01

    The early detection of relapse following primary surgery for non-small cell lung cancer and the characterization of emerging subclones seeding metastatic sites might offer new therapeutic approaches to limit tumor recurrence. The potential to non-invasively track tumor evolutionary dynamics in ctDNA of early-stage lung cancer is not established. Here we conduct a tumour-specific phylogenetic approach to ctDNA profiling in the first 100 TRACERx (TRAcking non-small cell lung Cancer Evolution th...

  10. A decade of aquatic invasive species (AIS) early detection ...

    Science.gov (United States)

    As an invasion prone location, the St. Louis River Estuary (SLRE) has been a case study for ongoing research to develop the framework for a practical Great Lakes monitoring network for early detection of aquatic invasive species (AIS). Early detection, however, necessitates finding new invaders before they are common. Here we outline our research (2005 present) approach and findings, including strategies to increase detection efficiency by optimizing specimen collection and identification methods. Initial surveys were designed to over-sample to amass data as the basis for numerical experiments to investigate to the effort required for a given detection probability. Later surveys tested the outcome of implementing these strategies, examined the potential benefits of sampling larval fish instead of adults and explored the prospect of using advanced DNA based methods as an alternative to traditional taxonomy. To date we have identified several previously undetected invertebrate invaders, developed survey design and gear recommendations and have refined the search strategy for systems beyond the SLRE. In addition, because we’ve accumulated such a large body of data we now have the basis to show spatial-temporal trends for native and non-native species in the SLRE. not applicable

  11. Collaboration with Pharma Will Introduce Nanotechnologies in Early Stage Drug Development | FNLCR Staging

    Science.gov (United States)

    The Frederick National Lab has begun to assist several major pharmaceutical companies in adopting nanotechnologies in early stage drug development, when the approach is most efficient and cost-effective. For some time, the national lab’s Nanotechno

  12. [Cognitive rehabilitation in early stage Alzheimer's disease].

    Science.gov (United States)

    Kasper, E; Thöne-Otto, A; Bürger, K; Schröder, S G; Hoffmann, W; Schneider, W; Teipel, S

    2016-07-01

    Dementia impairs the coping with routine daily tasks and social relationships due to an increasing degeneration of cognitive abilities. An appropriate treatment must adequately consider the effects of declined cognitive abilities on patients and their environment. Therefore, in recent times, integrative procedures for cognitive rehabilitation (CR) have become increasingly important for the therapy of patients with mild cognitive impairment (MCI) and mild dementia (MD). CR approaches provide compensatory possibilities for clearly defined routine challenges and the individual needs of those affected. This overview article in the form of a selective review elaborates factors for the effectiveness of CR on the basis of the currently available literature: 1) individuality - consideration of personal needs and targets, 2) compensation - mediation of skills and strategies to compensate for cognitive impairments, 3) interaction - inclusion of relatives and environmental conditions and 4) integration - integration of various therapeutic disciplines and methods. On the basis of this assessment with regards to the content, a critical analysis of the methods of short and long-term therapeutic effects on MCD and MD was carried out. Although the resulting factors were of high long-term relevance for the improvement of depression and quality of life, effects on cognition were more pronounced for MCI than for MD, which emphasizes the importance of beginning therapy as early as possible. The results show that future studies on effectiveness must employ endpoints relevant for routine daily life, and that the possibility of an implementation of therapeutic concepts in a healthcare system should be considered as an essential criterion.

  13. Short-term efficacy of the minimally invasive treatment with implantation of porous tantalum rod for femur head necrosis in the early stage%多孔钽棒植入微创治疗早期股骨头坏死的近期疗效

    Institute of Scientific and Technical Information of China (English)

    张劲松; 杨述华; 许伟华; 叶树楠; 雷鸣; 迮仁浩

    2011-01-01

    Objective To investigate the clinical efficacy of the minimally invasive treatment with implantation of porous tantalum rod for femur head necrosis in the early stage (ARCO Stage Ⅰ and ARCO Stage Ⅱ).Methods From February 2007 to September 2008, 31 patients (39 affected hips) with femur head necrosis in the early stage underwent treatment as below.A small incision was made 1.5 cm beneath the greater trochanter.Under the the perspective of C-arm, a tunnel from the femoral neck to the osteonecrosis zone of the femoral head was made.Through the tunnel,the porous tantalum rod was implanted into the osteonecrosis zone of the femoral head for about 5 mm beneath the subchondral bone.The pre-operative ARCO staging of the affected hips were Stage Ⅰ (n=l 6) and Stage Ⅱ (n=23).Among the 31 patients, 8 sustained lesion in both hips, and 23 in a single hip.Results A11 the patients were followed up within a period from 13 to 32 months, with 21.6 months on average.The final evaluation was made according to the last followup data.The efficacy of the surgery was evaluated according to the Harris hip score (HHS).The pre-operative excellent and good rate was 48.4% (1 5/3 1), while the post-operative one was 90.3% (28/3 1).Meanwhile, observations were made in order to know whether there were imaging developments, and whether further treatments were needed.Conclusions The minimally invasive treatment with implantation of porous tantalum rod for adult femur head necrosis in the early stage has the advantages of simple operations, small wound, short operation time, and less blood loss.The treatment can improve the function of the joint, efficiently prevent the collapse of the femoral head, and delay the development of the avascular necrosis of the adult femoral head.The short-term efficacy is good.%目的 探讨多孔钽金属棒植入微创治疗早期(ARCO I期、II期)股骨头坏死的临床疗效.方法 2007年2月至2008年9月治疗早期股骨头坏死31例(39

  14. Modified cervicopexy: a novel, less-invasive technique for Stages III and IV uterine prolapse.

    Science.gov (United States)

    Elsaman, Ali M; Salem, Hosam T; Amin, Magdy; Fetih, Ahmed N; Othman, Essam-Edin R; Zahran, Kamal M

    2014-12-01

    To evaluate modified anterior abdominal wall cervicopexy (AWC) as a less invasive (via 3-cm minilaparotomy) and more augmented (via securing posterior vaginal wall to uterosacral ligaments) technique. Case series of 30 women with Stages III and IV apical uterine prolapse assessed by the pelvic organ prolapse quantification system. The modified AWC procedure was performed successfully for 17 cases with Stage III uterovaginal prolapse and 13 cases with Stage IV uterovaginal prolapse. The procedure was conducted safely with no operative or postoperative complications, apart from two cases with postoperative urinary retention. Operative time ranged from 45 to 70min. Follow-up was available for 1-3 years. Overall, 27 cases were satisfied with the procedure, and three cases developed recurrence after caesarean section due to cutting the supporting sutures. The modified AWC procedure is less invasive, simple and effective for Stages III and IV uterine prolapse. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Minimally Invasive Molecular Staging (MIMS) RT-PCR Breast Cancer Study

    Science.gov (United States)

    2007-03-31

    31-03-2007 Final Report 19990426 - 20061231 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Minimally Invasive Molecular Staging (MIMS) N00014-99-1-0784 RT...carcinoma micrometastases in axillary lymph nodes by means of reverse-transcriptase Polymerase chain reaction: comparison between mucl mRNA and keratin-19

  16. Two-stage minimally invasive surgical management of colonic gallstone ileus.

    Science.gov (United States)

    Lujan, Henry J; Bisland, William B

    2010-08-01

    Colonic gallstone ileus is an unusual cause of colonic obstruction. Management of these patients is not standardized and can be challenging. As these patients are often ill and frail at presentation, surgical management needs to be individualized to decrease morbidity and mortality. We report a case that was managed by staged minimally invasive techniques with an excellent outcome.

  17. Functioning in early and late stages of schizophrenia

    Directory of Open Access Journals (Sweden)

    Leonardo Gazzi Costa

    2014-12-01

    Full Text Available INTRODUCTION: Schizophrenia is frequently associated with a debilitating course and prominent impairment in social and occupational functioning. Although the criteria for classification into stages have not been defined in the literature, illness duration and functioning seem to be good candidates.OBJECTIVE:To compare functioning of patients with schizophrenia at different stages of the disease (early vs. late and healthy sex- and age-matched controls.METHODS: This double-blinded, case-controlled study included 79 individuals: 23 patients with schizophrenia diagnosed up to 5 years earlier; 19 patients with schizophrenia diagnosed at least 20 years earlier; and healthy matched controls. Diagnoses were established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV Axis I Disorder. Functioning was assessed using the Functioning Assessment Short Test (FAST.RESULTS: Patients in the early stage had significantly higher scores than healthy controls in total FAST and in autonomy, occupational functioning, cognitive functioning and interpersonal relationships. Individuals in the late stage had significantly poorer functioning than controls in all domains. The comparison of functioning between the two groups of patients revealed no significant differences, except in occupational functioning, in which late stage patients had a poorer performance.CONCLUSION: Functioning impairment in schizophrenia tends to remain stable despite illness duration. Therefore, functioning should be effectively assessed at an early stage, as illness duration alone may not be the most reliable criterion to stage patients with schizophrenia.

  18. All-optical photoacoustic imaging and detection of early-stage dental caries

    Science.gov (United States)

    Sampathkumar, Ashwin; Hughes, David A.; Longbottom, Chris; Kirk, Katherine J.

    2015-02-01

    Dental caries remain one of the most common oral diseases in the world. Current detection methods, such as dental explorer and X-ray radiography, suffer from poor sensitivity and specificity at the earliest (and reversible) stages of the disease because of the small size (stage lesions. We have developed a fine-resolution (480 nm), ultra-broadband (1 GHz), all-optical photoacoustic imaging (AOPAI) system to image and detect early stages of tooth decay. This AOPAI system provides a non-contact, non-invasive and non-ionizing means of detecting early-stage dental caries. Ex-vivo teeth exhibiting early-stage, white-spot lesions were imaged using AOPAI. Experimental scans targeted each early-stage lesion and a reference healthy enamel region. Photoacoustic (PA) signals were generated in the tooth using a 532-nm pulsed laser and the light-induced broadband ultrasound signal was detected at the surface of the tooth with an optical path-stabilized Michelson interferometer operating at 532 nm. The measured time-domain signal was spatially resolved and back-projected to form 2D and 3D maps of the lesion using k-wave reconstruction methods. Experimental data collected from areas of healthy and diseased enamel indicate that the lesion generated a larger PA response compared to healthy enamel. The PA-signal amplitude alone was able to detect a lesion on the surface of the tooth. However, time- reversal reconstructions of the PA scans also quantitatively depicted the depth of the lesion. 3D PA reconstruction of the diseased tooth indicated a sub-surface lesion at a depth of 0.6 mm, in addition to the surface lesion. These results suggest that our AOPAI system is well suited for rapid clinical assessment of early-stage dental caries. An overview of the AOPAI system, fine-resolution PA and histology results of diseased and healthy teeth will be presented.

  19. Early Stage Software Reliability Estimation with Stochastic Reward Nets

    Institute of Scientific and Technical Information of China (English)

    ZHAO Jing; LIU Hong-wei; CUI Gang; YANG Xiao-zong

    2005-01-01

    This paper presents software reliability modeling issues at the early stage of a software development for fault tolerant software management system. Based on Stochastic Reward Nets, an effective model of hierarchical view for a fault tolerant software management system is put forward, and an approach that consists of system transient performance analysis is adopted. A quantitative approach for software reliability analysis is given. The results show its usefulness for the design and evaluation of the early-stage software reliability modeling when failure data is not available.

  20. Two-stage Hydrolysis of Invasive Algal Feedstock for Ethanol Fermentation

    Institute of Scientific and Technical Information of China (English)

    Xin Wang; Xianhua Liu; Guangyi Wang

    2011-01-01

    The overall goal of this work was to develop a saccharification method for the production of third generation biofuel(i.e.bioethanol) using feedstock of the invasive marine macroalga Gracilaria salicornia.Under optimum conditions(120℃ and 2% sulfuric acid for 30 min), dilute acid hydrolysis of the homogenized invasive plants yielded a low concentration of glucose(4.1mM or 4.3g glucose/kg fresh algal biomass). However, two-stage hydrolysis of the homogenates (combination of dilute acid hydrolysis with enzymatic hydrolysis) produced 13.8g of glucose from one kilogram of fresh algal feedstock. Batch fermentation analysis produced 79.1g EtOH from one kilogram of dried invasive algal feedstock using the ethanologenic strain Escherichia coli K011. Furthermore, ethanol production kinetics indicated that the invasive algal feedstock contained different types of sugar, including C5-sugar. This study represents the first report on third generation biofuel production from invasive macroalgae, suggesting that there is great potential for the production of renewable energy using marine invasive biomass.

  1. Radiation therapy planning for early-stage Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Maraldo, Maja V; Dabaja, Bouthaina S; Filippi, Andrea R

    2015-01-01

    PURPOSE: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements...

  2. Early Stages of the Evolution of Life: a Cybernetic Approach

    Science.gov (United States)

    Melkikh, Alexey V.; Seleznev, Vladimir D.

    2008-08-01

    Early stages of the evolution of life are considered in terms of control theory. A model is proposed for the transport of substances in a protocell possessing the property of robustness with regard to changes in the environmental concentration of a substance.

  3. Radiation Plus Chemotherapy in Early-Stage Hodgkin Lymphoma

    Science.gov (United States)

    Adding radiation therapy to chemotherapy may improve outcomes in patients with early-stage Hodgkin lymphoma, according to a paper published in the Cochrane Database of Systematic Reviews in February 2011, but the long-term effects of this regimen are not

  4. [Surgical treatment of breast neoplasms in early stages].

    Science.gov (United States)

    Cheshuk, Ie V; Drozdov, V M; Neĭman, A M; Zotov, O S; Zakhartseva, L M; Anikus'ko, M F; Zaĭchuk, V V; Sydorchuk, O I

    2002-01-01

    Analysis of literary data and own investigation results for the modern surgical methods of treatment of mammary gland cancer in early stages was performed. Indexes of patients survival after surgical removal of mammary gland (MG) and quadranthectomy did not differ. Preservation of MG constitutes great social and psycho-emotional significance for women-patients.

  5. Management of Early-stage Hodgkin Lymphoma: A Practice Guideline.

    Science.gov (United States)

    Herst, J; Crump, M; Baldassarre, F G; MacEachern, J; Sussman, J; Hodgson, D; Cheung, M C

    2017-01-01

    In the past, treatment for patients with early-stage Hodgkin lymphoma consisted mainly of radiotherapy. Now, chemotherapy alone and chemoradiotherapy are treatment options. These guidelines aim to provide recommendations on the optimal management of early-stage Hodgkin lymphoma. We conducted a systematic review searching MEDLINE, EMBASE, the Cochrane Library and other literature sources from 2003 to 2015, and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Two authors independently reviewed and selected studies, and appraised the evidence quality. The document underwent internal and external review by content, methodology experts, a patient representative and clinicians in Ontario. We have issued recommendations for patients with classical Hodgkin lymphoma and with nodular lymphocyte predominant Hodgkin lymphoma; with favourable and unfavourable prognosis; and for the use of positron emission tomography to direct treatment. We have provided our interpretation of the evidence and considerations for implementation. Examples of recommendations are: 'Patients with early-stage classical Hodgkin lymphoma should not be treated with radiotherapy alone'; 'chemotherapy plus radiotherapy or chemotherapy alone are recommended treatment options for patients with early-stage non-bulky Hodgkin lymphoma'; 'The Working Group does not recommend the use of a negative interim positron emission tomography scan alone to identify patients with early-stage Hodgkin lymphoma for whom radiotherapy can be omitted without a reduction in progression-free survival'. Through the use of GRADE, recommendations were geared towards patient important outcomes and their strength reflected the available evidence and its interpretation from the patients' point of view. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  6. Efficacy of 3-Dimensional Endorectal Ultrasound for Staging Early Extraperitoneal Rectal Neoplasms.

    Science.gov (United States)

    Pinto, Rodrigo Ambar; Corrêa Neto, Isaac José Felippe; Nahas, Sérgio Carlos; Rizkalah Nahas, Caio Sérgio; Sparapan Marques, Carlos Frederico; Ribeiro Junior, Ulysses; Kawaguti, Fábio Shiguehissa; Cecconello, Ivan

    2017-05-01

    Adequate oncologic staging of rectal neoplasia is important for treatment and prognostic evaluation of the disease. Diagnostic methods such as endorectal ultrasound can assess rectal wall invasion and lymph node involvement. The purpose of this study was to correlate findings of 3-dimensional endorectal ultrasound and pathologic diagnosis of extraperitoneal rectal tumors with regard to depth of rectal wall invasion, lymph node involvement, percentage of rectal circumference involvement, and tumor extension. Consecutive patients with extraperitoneal rectal tumors were prospectively assessed by 3-dimensional endorectal ultrasound blind to other staging methods and pathologic diagnosis. Patients who underwent endorectal ultrasound followed by surgery were included in the study. The study was conducted at a single academic institution. Sensitivity, specificity, positive and negative predictive values, area under curve, and κ coefficient between 3-dimensional endorectal ultrasound and pathologic diagnosis were determined. Intraclass correlation coefficient was calculated for tumor extension and percentage of rectal wall involvement. Forty-four patients (27 women; mean age = 63.5 years) were evaluated between September 2010 and June 2014. Most lesions were malignant (72.7%). For depth of submucosal invasion, 3-dimensional endorectal ultrasound showed sensitivity of 77.3%, specificity of 86.4%, positive predictive value of 85.0%, a negative predictive value of 79.2%, and an area under curve of 0.82. The weighted κ coefficient for depth of rectal wall invasion staging was 0.67, and there was no agreement between 3-dimensional endorectal ultrasound and pathologic diagnosis for lymph node involvement (κ = -0.164). Intraclass correlation coefficient for lesion extension and percentage of rectal circumference involvement were 0.45 and 0.66. A better correlation between 3-dimensional endorectal ultrasound and pathologic diagnosis was observed in tumors <5 cm and with <50

  7. Two-Stage Indicators to Assess Learning Curves for Minimally Invasive Ivor Lewis Esophagectomy.

    Science.gov (United States)

    Wang, Qi; Wu, Zixiang; Chen, Gang; Zhang, Sai; Shen, Gang; Wu, Ming

    2016-10-05

    Background Minimally invasive esophagectomy (MIE) Ivor Lewis has been increasingly performed over the last two decades. To guide the implementation of this technically demanding procedure, a comprehensive assessment of MIE-Ivor Lewis learning curves should include both the general competence to accomplish the procedure and the ability to generate oncological benefits. These objectives are believed to be associated with different phases of the learning curve. Methods A retrospective review of the first 109 patients who underwent MIE-Ivor Lewis by a single qualified surgeon was conducted. Relevant variables were collected and assessed by regression analysis to identify suitable indicators for patient stratification and learning curve assessment. Thereafter, the differential analysis was performed among groups to validate the learning curve model. Results Two variables, intrathoracic gastroesophageal anastomosis time and bilateral recurrent laryngeal nerve (RLN) lymphadenectomy number, which plateaued, respectively, after the 26th and 88th cases, were selected as meaningful indicators to identify different competence levels. Therefore, 109 patients were chronologically subcategorized into three groups (the first 26 MIEs as the early group, the next 62 cases as the middle group, and 21 most recent cases as the late group). Perioperative data were compared between groups with positive results to indicate a three-phase model for a learning curve for MIE-Ivor Lewis. Conclusions An MIE-Ivor Lewis learning curve should include three discrete phases that indicate, successively, unskilled operation (general competence to accomplish, less proficiency), surgical proficiency, and oncological efficacy. Intrathoracic anastomosis time and bilateral RLN lymphadenectomy were identified as suitable indicators delineate the different stages of an MIE-Ivor Lewis learning curve.

  8. Minimally Invasive Early Operative Treatment of Progressive Foot and Ankle Deformity Associated With Charcot-Marie-Tooth Disease.

    Science.gov (United States)

    Boffeli, Troy J; Tabatt, Jessica A

    2015-01-01

    Charcot-Marie-Tooth disease is a neuromuscular disorder that commonly results in a predictable pattern of progressive bilateral lower extremity weakness, numbness, contracture, and deformity, including drop foot, loss of ankle eversion strength, dislocated hammertoes, and severe cavus foot deformity. Late stage reconstructive surgery will be often necessary if the deformity becomes unbraceable or when neuropathic ulcers have developed. Reconstructive surgery for Charcot-Marie-Tooth deformity is generally extensive and sometimes staged. Traditional reconstructive surgery involves a combination of procedures, including tendon lengthening or transfer, osteotomy, and arthrodesis. The described technique highlights our early surgical approach, which involves limited intervention before the deformity becomes rigid, severe, or disabling. We present 2 cases to contrast our early minimally invasive technique with traditional late stage reconstruction. Charcot-Marie-Tooth disease affects different muscles at various stages of disease progression. As 1 muscle becomes weak, the antagonist will overpower it and cause progressive deformity. The focus of the early minimally invasive approach is to decrease the forces that cause progressive deformity yet maintain function, where possible. Our goal has been to maintain a functional and braceable foot and ankle, with the hope of avoiding or limiting the extent of future major reconstructive surgery. The presented cases highlight the patient selection criteria, the ideal timing of early surgical intervention, the procedure selection criteria, and operative pearls. The early minimally invasive approach includes plantar fasciotomy, Achilles tendon lengthening, transfer of the peroneus longus to the fifth metatarsal, Hibbs and Jones tendon transfer, and hammertoe repair of digits 1 to 5.

  9. Early invasion of brain parenchyma by African trypanosomes.

    Directory of Open Access Journals (Sweden)

    Ute Frevert

    Full Text Available Human African trypanosomiasis or sleeping sickness is a vector-borne parasitic disease that has a major impact on human health and welfare in sub-Saharan countries. Based mostly on data from animal models, it is currently thought that trypanosome entry into the brain occurs by initial infection of the choroid plexus and the circumventricular organs followed days to weeks later by entry into the brain parenchyma. However, Trypanosoma brucei bloodstream forms rapidly cross human brain microvascular endothelial cells in vitro and appear to be able to enter the murine brain without inflicting cerebral injury. Using a murine model and intravital brain imaging, we show that bloodstream forms of T. b. brucei and T. b. rhodesiense enter the brain parenchyma within hours, before a significant level of microvascular inflammation is detectable. Extravascular bloodstream forms were viable as indicated by motility and cell division, and remained detectable for at least 3 days post infection suggesting the potential for parasite survival in the brain parenchyma. Vascular inflammation, as reflected by leukocyte recruitment and emigration from cortical microvessels, became apparent only with increasing parasitemia at later stages of the infection, but was not associated with neurological signs. Extravascular trypanosomes were predominantly associated with postcapillary venules suggesting that early brain infection occurs by parasite passage across the neuroimmunological blood brain barrier. Thus, trypanosomes can invade the murine brain parenchyma during the early stages of the disease before meningoencephalitis is fully established. Whether individual trypanosomes can act alone or require the interaction from a quorum of parasites remains to be shown. The significance of these findings for disease development is now testable.

  10. An Analysis of Immunoreactive Signatures in Early Stage Hepatocellular Carcinoma

    Science.gov (United States)

    Hong, Yu; Long, Jiang; Li, Hai; Chen, Shuhong; Liu, Qiqi; Zhang, Bei; He, Xiaomin; Wang, Yan; Li, Hongyi; Li, Yimei; Zhang, Tao; Lu, Chenzhen; Yan, Hao; Zhang, Minli; Li, Qing; Cao, Bangwei; Bai, Zhigang; Wang, Jin; Zhang, Zhongtao; Zhu, Shengtao; Zheng, Jiasheng; Ou, Xiaojuan; Ma, Hong; Jia, Jidong; You, Hong; Wang, Shengqi; Huang, Jian

    2015-01-01

    Background Hepatocellular carcinoma (HCC) is prevalent worldwide and early diagnosis of HCC is critical for effective treatment and optimal prognosis. Methods Serum was screened first by immunoproteomic analysis for HCC-related tumor associated antigens (TAAs). Selected TAAs were clinically evaluated retrospectively in patients with HCC, liver cirrhosis, chronic hepatitis and healthy controls. Levels of autoantibody to the selected TAAs were measured by protein microarrays containing protein antigens of the candidate TAAs. Analyses were done by using receiver operating characteristics (ROC) to calculate diagnostic accuracy. Findings Twenty-two candidate TAAs were assessed by protein microarray analysis in 914 participants with serum α-fetoprotein (AFP) available. Twelve candidate TAAs were statistically different in signal intensity between HCC and controls. Among them, CENPF, HSP60 and IMP-2 showed AUC (area under the curve) values of 0.826, 0.764 and 0.796 respectively for early HCC. The highest prevalence of autoantibody positivity was observed in HCC cases with BCLC tumor stage A, well-differentiated histology and Child-Pugh grade C. Specifically, 73.6% or 79.3% cases of early HCC with negative AFP were positive for autoantibody to CENPF or HSP60. Interpretation Tumor-associated autoimmune reactions may be triggered by early stage HCCs. Measurement of serum autoantibody to TAAs may be complementary to AFP measurements and improve diagnosis of early HCC. PMID:26137588

  11. UWB based low-cost and non-invasive practical breast cancer early detection

    Science.gov (United States)

    Vijayasarveswari, V.; Khatun, S.; Fakir, M. M.; Jusoh, M.; Ali, S.

    2017-03-01

    Breast cancer is one of the main causes of women death worldwide. Breast tumor is an early stage of cancer that locates in cells of a human breast. As there is no remedy, early detection is crucial. Towards this, Ultra-Wideband (UWB) is a prominent candidate. It is a wireless communication technology which can achieve high bandwidth with low power utilization. UWB is suitable to be used for short range communication systems including breast cancer detection since it is secure, non-invasive and human health friendly. This paper presents the low-cost and non-invasive early breast cancer detection strategy using UWB sensor (or antenna). Emphasis is given here to detect breast tumor in 2D and 3D environments. The developed system consisted of hardware and software. Hardware included UWB transceiver and a pair of home-made directional sensor/antenna. The software included feed-forward back propagation Neural Network (NN) module to detect the tumor existence, size and location along with soft interface between software and hardware. Forward scattering technique was used by placing two sensors diagonally opposite sides of a breast phantom. UWB pulses were transmitted from one side of phantom and received from other side, controlled by the software interface in PC environment. Collected received signals were then fed into the NN module for training, testing and validation. The system exhibited detection efficiency on tumor existence, location (x, y, z), and size were approximately 100%, (78.17%, 70.66%, 92.46%), 85.86% respectively. The proposed UWB based early breast cancer detection system could be more practical with low-cost, user friendly and non-harmful features. This project may help users to monitor their breast health regularly at their home.

  12. Early morbidity after simultaneous and staged bilateral total knee arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer Calov; Husted, Henrik;

    2015-01-01

    PURPOSE: The aim of this nationwide study was to investigate the early morbidity after bilateral simultaneous and staged total knee arthroplasty (TKA) in order to clarify potential benefits of a well-established fast-track regime. METHODS: The Danish National Patient Registry was searched for all...... bilateral simultaneous and staged TKA procedures from 2010 to 2011. The staged procedures were defined as two separate procedures done within 0-6 months or within 7-18 months. RESULTS: A total of 157 patients had bilateral simultaneous TKA, 346 patients had bilateral staged TKA within 0-6 months and 292...... simultaneous TKA versus three deaths (0.9 and 1.0 %) in each of the bilateral staged groups within 90 days of surgery (n.s.). The total readmission rate within 30 days of surgery was lower after bilateral simultaneous TKA (7 %, CI 4.0-12.0) and bilateral staged TKA within 0-6 months (9 %, CI 6.4-12.4) compared...

  13. The early stages in the oxidation of Na

    Energy Technology Data Exchange (ETDEWEB)

    Shek, M.L. (25 Old Saddle Road, Ridge, New York 11961 (USA)); Hrbek, J. (Chemistry Department, Brookhaven National Laboratory, Upton, New York 11973 (USA)); Sham, T.K. (Department of Chemistry, University of Western Ontario, Ontario, NA6 5B7, Canada (CA)); Xu, G. (Chemistry Department, Brookhaven National Laboratory, Upton, New York 11973 (USA))

    1991-05-01

    We report soft x-ray photoemission results on the early stages of the oxidation of Na at {similar to}80 K. The first stage (up to {approx gt}0.5 L exposure) is characterized by a narrow O 2{ital p} level and a Na 2{ital p} surface core level shifted by {minus}0.55 eV with respect to the bulk core level. The Na 2{ital p} surface plasmon loss intensity shifts toward smaller energies, consistent with a decrease in surface conduction electron density. The second stage (starting from {similar to}1 L) is characterized by the emergence of di-oxygen'' valence levels and a Na 2{ital p} component shifted by {similar to}0.8 eV with respect to the bulk binding energy. The oxidation is strongly nonuniform, as suggested by the small oxygen doses needed for the onset of the second oxidation stage, and the continued presence of the bulk plasmon loss from metallic Na. The two new Na 2{ital p} binding energies are tentatively attributed to different final-state screening of metallic Na adjacent to dispersed oxygen atoms in the first stage, and of the Na atoms with mostly oxygen nearest neighbors in the second stage. Observations regarding large negative core level shifts upon large oxygen exposures are also summarized.

  14. Information processing theory in the early design stages

    DEFF Research Database (Denmark)

    Cash, Philip; Kreye, Melanie

    2014-01-01

    suggestions for improvements and support. One theory that may be particularly applicable to the early design stages is Information Processing Theory (IPT) as it is linked to the design process with regard to the key concepts considered. IPT states that designers search for information if they perceive......, the new knowledge is shared between the design team to reduce ambiguity with regards to its meaning and to build a shared understanding – reducing perceived uncertainty. Thus, we propose that Information-Processing Theory is suitable to describe designer activity in the early design stages......Developing appropriate theory is one of the main challenges facing engineering design (Cross, 2007). Theory helps to both explain design activity but also support greater research impact in the domain. It is useful for gaining a more comprehensive understanding of design activity and developing...

  15. Information processing theory in the early design stages

    DEFF Research Database (Denmark)

    Cash, Philip; Kreye, Melanie

    2014-01-01

    Developing appropriate theory is one of the main challenges facing engineering design (Cross, 2007). Theory helps to both explain design activity but also support greater research impact in the domain. It is useful for gaining a more comprehensive understanding of design activity and developing...... suggestions for improvements and support. One theory that may be particularly applicable to the early design stages is Information Processing Theory (IPT) as it is linked to the design process with regard to the key concepts considered. IPT states that designers search for information if they perceive...... uncertainty with regard to the knowledge necessary to solve a design challenge. They then process this information and compare if the new knowledge they have gained covers the previous knowledge gap. In engineering design, uncertainty plays a key role, particularly in the early design stages which has been...

  16. Adjuvant chemotherapy for early-stage cervical cancer.

    Science.gov (United States)

    Asano, Hiroshi; Todo, Yukiharu; Watari, Hidemichi

    2016-04-01

    The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone after radical surgery (RS) has not yet been established, and radiation therapy (RT) or concurrent chemoradiotherapy (CCRT) is recommended as the standard adjuvant therapy after RS for early-stage cervical cancer in various guidelines. The main purpose of adjuvant therapy after RS, however, should be to reduce extrapelvic recurrence rather than local recurrence, although adjuvant RT or CCRT has survival benefits for patients with intermediate- or high-risk factors for recurrence. Moreover, several studies reported that adjuvant therapies including RT were associated with a higher incidence of complications, such as lymphedema, bowel obstruction and urinary disturbance, and a lower grade of long-term quality of life (QOL) or sexual functioning than adjuvant chemotherapy alone. The effect of adjuvant chemotherapy alone for early-stage cervical cancer with intermediate- or high-risk factors for recurrence were not fully investigated in prospective studies, but several retrospective studies suggest that the adjuvant effects of chemotherapy alone are at least similar to that of RT or CCRT in terms of recurrence rate, disease-free survival, or overall survival (OS) with lower incidence of complications. Whereas cisplatin based combination regimens were used in these studies, paclitaxel/cisplatin (TP) regimen, which is currently recognized as a standard chemotherapy regimen for patients with metastatic, recurrent or persistent cervical cancer by Gynecologic Oncology Group (GOG), had also survival benefit as an adjuvant therapy. Therefore, it may be worth considering a prospective randomized controlled trial (RCT) of adjuvant chemotherapy alone using TP regimen versus adjuvant RT as an alternative adjuvant therapy. Because early-stage cervical cancer is a curable

  17. Effects of genistein on early-stage cutaneous wound healing

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eunkyo [Department of Home Economics Education, Chung-Ang University, Seoul 156-756 (Korea, Republic of); Lee, Seung Min [Research Institute of Health Sciences, Korea University, Seoul 136-701 (Korea, Republic of); Jung, In-Kyung [Department of Home Economics Education, Chung-Ang University, Seoul 156-756 (Korea, Republic of); Lim, Yunsook [Department of Foods and Nutrition, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Jung-Hyun, E-mail: jjhkim@cau.ac.kr [Department of Home Economics Education, Chung-Ang University, Seoul 156-756 (Korea, Republic of)

    2011-07-08

    Highlights: {yields} We examine the effect of genistein on cutaneous wound healing. {yields} Genistein enhanced wound closure during the early stage of wound healing. {yields} These genistein effects on wound closure were induced by reduction of oxidative stress through increasing antioxidant capacity and modulation of pro-inflammatory cytokine expression. -- Abstract: Wound healing occurs in three sequential phases: hemostasis and inflammation, proliferation, and remodeling. Inflammation, the earliest phase, is considered a critical period for wound healing because immune cells remove damaged tissues, foreign debris, and remaining dead tissue. Wound healing would be delayed without inflammation, and this phase is affected by antioxidation capacity. Therefore, we hypothesized that genistein, which has an antioxidant effect, might modulate the wound healing process by altering the inflammatory response. After three days of acclimation, mice were divided into three groups: control, 0.025% genistein, and 0.1% genistein. After two weeks of an experimental diet, skin wounds were induced. Wounded skin areas were imaged, and the healing rate calculated. To measure lipid peroxidation, antioxidant enzyme expression and activity, and pro-inflammatory cytokine expression, skin and liver tissues were harvested at 12, 24, 48, and 72 h. Genistein did not affect body weight. The rate of wound closure in mice fed genistein was significantly faster than in the control group during the early stage of wound healing, especially in first three days. Cu, Zn-SOD and Mn-SOD expression in wound skin tissue in the 0.1% genistein group was lower than in the control group. However, CAT expression did not differ among groups. We also found that genistein modulated NF-{kappa}B and TNF-{alpha} expression during the early stage of wound healing. The genistein group had significantly lower hepatic lipid peroxidation and higher SOD, CAT, and GPx activities than the control group. These results

  18. Awareness of memory deficits in early stage Huntington's disease.

    Directory of Open Access Journals (Sweden)

    Laurent Cleret de Langavant

    Full Text Available Patients with Huntington's disease (HD are often described as unaware of their motor symptoms, their behavioral disorders or their cognitive deficits, including memory. Nevertheless, because patients with Parkinson's disease (PD remain aware of their memory deficits despite striatal dysfunction, we hypothesize that early stage HD patients in whom degeneration predominates in the striatum can accurately judge their own memory disorders whereas more advanced patients cannot. In order to test our hypothesis, we compared subjective questionnaires of memory deficits (in HD patients and in their proxies and objective measures of memory dysfunction in patients. Forty-six patients with manifest HD attending the out-patient department of the French National Reference Center for HD and thirty-three proxies were enrolled. We found that HD patients at an early stage of the disease (Stage 1 were more accurate than their proxies at evaluating their own memory deficits, independently from their depression level. The proxies were more influenced by patients' functional decline rather than by patients' memory deficits. Patients with moderate disease (Stage 2 misestimated their memory deficits compared to their proxies, whose judgment was nonetheless influenced by the severity of both functional decline and depression. Contrasting subjective memory ratings from the patients and their objective memory performance, we demonstrate that although HD patients are often reported to be unaware of their neurological, cognitive and behavioral symptoms, it is not the case for memory deficits at an early stage. Loss of awareness of memory deficits in HD is associated with the severity of the disease in terms of CAG repeats, functional decline, motor dysfunction and cognitive impairment, including memory deficits and executive dysfunction.

  19. Early Contact Stage of Apoptosis: Its Morphological Features and Function

    Directory of Open Access Journals (Sweden)

    Etheri Mikadze

    2006-01-01

    Full Text Available Apoptosis has been a biological phenomenon of intense interest for 20 years, but the earlier morphological features of apoptosis have not been determined hitherto. Using the methods of semi- and ultrathin sections, the livers of intact embryos and young rats have been studied under the effect of cycloheximide to determine morphological features of an early stage of apoptosis. It is discovered that both in hepatoblasts and hepatocytes, apoptosis, besides the well-known stages, also includes an early contact stage, distinguishing features of which are agglutination of bound ribosomes (breaking of translation, elimination of the nucleolus, reduction of free polysomes (and in hepatocytes, reduction of cisterns of rough endoplasmic reticulum, formation of cytoplasmic excrescences, and cell shape changes. The early stage of apoptosis is characterized by close contact with neighboring cells. At a certain phase of the contact stage of apoptosis, the nucleolus reappears in the nucleus and the number of free polysomes in the cytoplasm increases, which suggests the renewal of synthesis of new RNA and proteins. Close contact of differentiating and mitotic hepatoblasts with apoptotic cells indicates a certain functional relationship between these cells that is realized not only by micropinocytosis, but through gap junctions as well. We assume that the apoptotic cell, besides proteolytic products, can contain newly synthesized, low-molecular substances, the relocation of which from apoptotic to neighboring cells may contribute to both functional activity and proliferation of adjacent hepatoblasts and, therefore, the function of apoptosis may not be limited only to the elimination of harmful, damaged, and unwanted cells.

  20. Phyllotactic pattern formation in early stages of cactus ontogeny

    Directory of Open Access Journals (Sweden)

    Edyta M. Gola

    2011-01-01

    Full Text Available Representatives of the family Cactaceae are characterized by a wide range of phyllotaxis. To assess the origin of this diversity, early stages of phyllotactic pattern formation were examined in seedlings. The analysis of the sequence of areole initiation revealed intertribal differences. In seedlings from the Trichocereeae (Gymnocalycium, Rebutia and Notocacteae (Parodia tribes, two opposite cotyledonal areoles developed as the first elements of a pattern. Usually, next pair of areoles was initiated perpendicularly to cotyledonal areoles, starting the decussate pattern. This pattern was subsequently transformed into bijugate or into simple spiral phyllotaxis. In seedlings from the Cacteae tribe (Mammillaria and Thelocactus, cotyledonal areoles were never observed and the first areoles always appeared in the space between cotyledons. It was either areole pair (mainly in Mammillaria, starting a decussate pattern, or a single areole (mainly in Thelocactus quickly followed by areoles spirally arranged, usually in accordance with the main Fibonacci phyllotaxis. Differences in the initial stages of pattern formation do not fully explain the phyllotaxis diversity in mature cacti. Only two, the most common phyllotactic patterns occurred in the early development of studied seedlings, i.e. the main Fibonacci and the decussate pattern. Discrepancy in the range of phyllotactic spectra in seedlings and in mature plants suggests that phyllotaxis diversity emerges during further plant growth. Initial phyllotactic transformations, occurring already in the very early stages, indicate great plasticity of cactus growth and seem to support the hypothesis of the ontogenetic increase of phyllotaxis diversity due to transformations.

  1. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie;

    2015-01-01

    INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine the incid......INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine...... the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications. METHODS: This was a retrospective, descriptive cohort....... CONCLUSION: The types and frequency of complications observed in this study resemble those reported in similar studies of RALH for malignant gynaecologic conditions. Health-care professionals treating and caring for women with early-stage endometrial cancer should know of the types and frequency of post...

  2. Requirement Defect Mitigation Technique: An Early Stage Implementation

    Directory of Open Access Journals (Sweden)

    Md. Rizwan Beg

    2012-09-01

    Full Text Available Requirement defect identification and mitigation at early stage of Software Development Life Cycle (SDLC is very cost effective than to later stages. The requirements analysis in requirement engineering process is critical and major foundation of requirement defect identification. A poor requirement analysis process may lead to software requirement specification (SRS full of defects akin to misplaced, ambiguous, incompatible, misinterpreted, and incomplete requirements. In this paper, requirement defects are being identified and properly mitigated as per its severity in the requirement phase to get rid of major rework by spending extra cost and effort at the later stages. Here, a Defect Mitigation Technique (DMT is proposed for mitigating the identified requirement defect and also the reliability of requirement is being assessed to deliver Reliable Requirement. The proposed algorithm is helping the DMT for its proper processing, defect mitigation and reliability assessment. The prime motive of this study is an effort to put off requirements stage defects from entering into later stages of SDLC.

  3. Stage-specific proteome signatures in early bovine embryo development.

    Science.gov (United States)

    Deutsch, Daniela R; Fröhlich, Thomas; Otte, Kathrin A; Beck, Andrea; Habermann, Felix A; Wolf, Eckhard; Arnold, Georg J

    2014-10-03

    Development of early embryonic stages before activation of the embryonic genome depends on sufficiently stored products of the maternal genome, adequate recruitment and degradation of mRNAs, as well as activation, deactivation, and relocation of proteins. By application of an isobaric tagging for relative and absolute quantification (iTRAQ)-based approach, the proteomes of bovine embryos at the zygote and 2-cell and 4-cell stage with MII oocytes as a reference were quantitatively analyzed. Of 1072 quantified proteins, 87 differed significantly in abundance between the four stages. The proteomes of 2-cell and 4-cell embryos differed most from the reference MII oocyte, and a considerable fraction of proteins continuously increased in abundance during the stages analyzed, despite a strongly attenuated rate of translation reported for this period. Bioinformatic analysis revealed particularly interesting proteins involved in the p53 pathway, lipid metabolism, and mitosis. Verification of iTRAQ results by targeted SRM (selected reaction monitoring) analysis revealed excellent agreement for all five proteins analyzed. By principal component analysis, SRM quantifications comprising a panel of only five proteins were shown to discriminate between all four developmental stages analyzed here. For future experiments, an expanded SRM protein panel will provide the potential to detect developmental disturbances with high sensitivity and enable first insights into the underlying molecular pathways.

  4. Clonal expansion and linear genome evolution through breast cancer progression from pre-invasive stages to asynchronous metastasis

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Larsen, Martin Jakob; Lænkholm, Anne Vibeke

    step. Our data, contrary to the proposed model of early dissemination of metastatic cells and parallel progression of primary tumors and metastases, provide evidence of linear progression of breast cancer with relatively late dissemination from the primary tumor. The genomic discordance between......Evolution of the breast cancer genome from pre-invasive stages to asynchronous metastasis is complex and mostly unexplored, but highly demanded as it may provide novel markers for and mechanistic insights in cancer progression. The increasing use of personalized therapy of breast cancer...... necessitates knowledge of the degree of genomic concordance between different steps of malignant progression as primary tumors often are used as surrogates of systemic disease. Based on exome sequencing we performed copy number profiling and point mutation detection on successive steps of breast cancer...

  5. Phylogenetic ctDNA analysis depicts early stage lung cancer evolution

    DEFF Research Database (Denmark)

    Abbosh, Christopher; Birkbak, Nicolai Juul; Wilson, Gareth A.

    2017-01-01

    of early-stage lung cancer is not established. Here we conduct a tumour-specific phylogenetic approach to ctDNA profiling in the first 100 TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy (Rx)) study participants, including one patient co-recruited to the PEACE (Posthumous Evaluation......The early detection of relapse following primary surgery for non-small cell lung cancer and the characterization of emerging subclones seeding metastatic sites might offer new therapeutic approaches to limit tumor recurrence. The potential to non-invasively track tumor evolutionary dynamics in ctDNA...... of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and perform tumor volume limit of detection analyses. Through blinded profiling of post-operative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients destined to experience...

  6. Early stages of bipolar disorder: characterization and strategies for early intervention

    Directory of Open Access Journals (Sweden)

    Adiel C. Rios

    2015-12-01

    Full Text Available Objective: To characterize the early stages of bipolar disorder (BD, defined as the clinical prodrome/subsyndromal stage and first-episode phase, and strategies for their respective treatment. Methods: A selective literature search of the PubMed, Embase, PsycINFO, and ISI databases from inception until March 2014 was performed. Included in this review were articles that a characterized prodromal and first-episode stages of BD or b detailed efficacy and safety/tolerability of interventions in patients considered prodromal for BD or those with only one episode of mania/hypomania. Results: As research has only recently focused on characterization of the early phase of BD, there is little evidence for the effectiveness of any treatment option in the early phase of BD. Case management; individual, group, and family therapy; supportive therapy; and group psychoeducation programs have been proposed. Most evidence-based treatment guidelines for BD do not address treatment specifically in the context of the early stages of illness. Evidence for pharmacotherapy is usually presented in relation to illness polarity (i.e., manic/mixed or depressed or treatment phase. Conclusions: Although early recognition and treatment are critical to preventing unfavorable outcomes, there is currently little evidence for interventions in these stages of BD.

  7. An Invasive Plant Inventory and Early Detection Prioritization Tool

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — In 2010-2013, Utah State University partnered with the U. S. Fish and Wildlife Service (USFWS) to conduct invasive plant prioritization workshops and inventories on...

  8. Spatiotemporal proteomic analyses during pancreas cancer progression identifies serine/threonine stress kinase 4 (STK4) as a novel candidate biomarker for early stage disease.

    Science.gov (United States)

    Mirus, Justin E; Zhang, Yuzheng; Hollingsworth, Michael A; Solan, Joell L; Lampe, Paul D; Hingorani, Sunil R

    2014-12-01

    Pancreas cancer, or pancreatic ductal adenocarcinoma, is the deadliest of solid tumors, with a five-year survival rate of disease improves survival rates, but access to tissue and other biospecimens that could be used to develop early detection markers is confounded by the insidious nature of pancreas cancer. Mouse models that accurately recapitulate the human condition allow disease tracking from inception to invasion and can therefore be useful for studying early disease stages in which surgical resection is possible. Using a highly faithful mouse model of pancreas cancer in conjunction with a high-density antibody microarray containing ∼2500 antibodies, we interrogated the pancreatic tissue proteome at preinvasive and invasive stages of disease. The goal was to discover early stage tissue markers of pancreas cancer and follow them through histologically defined stages of disease using cohorts of mice lacking overt clinical signs and symptoms and those with end-stage metastatic disease, respectively. A panel of seven up-regulated proteins distinguishing pancreas cancer from normal pancreas was validated, and their levels were assessed in tissues collected at preinvasive, early invasive, and moribund stages of disease. Six of the seven markers also differentiated pancreas cancer from an experimental model of chronic pancreatitis. The levels of serine/threonine stress kinase 4 (STK4) increased between preinvasive and invasive stages, suggesting its potential as a tissue biomarker, and perhaps its involvement in progression from precursor pancreatic intraepithelial neoplasia to pancreatic ductal adenocarcinoma. Immunohistochemistry of STK4 at different stages of disease revealed a dynamic expression pattern further implicating it in early tumorigenic events. Immunohistochemistry of a panel of human pancreas cancers confirmed that STK4 levels were increased in tumor epithelia relative to normal tissue. Overall, this integrated approach yielded several tissue

  9. Neural changes underlying early stages of L2 vocabulary acquisition.

    Science.gov (United States)

    Pu, He; Holcomb, Phillip J; Midgley, Katherine J

    2016-11-01

    Research has shown neural changes following second language (L2) acquisition after weeks or months of instruction. But are such changes detectable even earlier than previously shown? The present study examines the electrophysiological changes underlying the earliest stages of second language vocabulary acquisition by recording event-related potentials (ERPs) within the first week of learning. Adult native English speakers with no previous Spanish experience completed less than four hours of Spanish vocabulary training, with pre- and post-training ERPs recorded to a backward translation task. Results indicate that beginning L2 learners show rapid neural changes following learning, manifested in changes to the N400 - an ERP component sensitive to lexicosemantic processing and degree of L2 proficiency. Specifically, learners in early stages of L2 acquisition show growth in N400 amplitude to L2 words following learning as well as a backward translation N400 priming effect that was absent pre-training. These results were shown within days of minimal L2 training, suggesting that the neural changes captured during adult second language acquisition are more rapid than previously shown. Such findings are consistent with models of early stages of bilingualism in adult learners of L2 (e.g. Kroll and Stewart's RHM) and reinforce the use of ERP measures to assess L2 learning.

  10. The importance of adjuvant chemotherapy and pelvic radiotherapy in high-risk early stage endometrial carcinoma.

    Science.gov (United States)

    Jutzi, Leah; Hoskins, Paul; Lim, Peter; Aquino-Parsons, Christina; Tinker, Anna; Kwon, Janice S

    2013-12-01

    To determine the impact of a policy change in which women with high-risk early stage endometrioid endometrial cancer (EEC) received adjuvant chemoradiotherapy. This is a population-based retrospective cohort study of British Columbia Cancer Registry patients diagnosed from 2008 to 2012 with high-risk early stage EEC, who received adjuvant chemoradiotherapy after primary surgery. High-risk early stage was defined as the presence of two or more high-risk uterine factors: grade 3 tumor, more than 50% myometrial invasion, and/or cervical stromal involvement. Adjuvant therapy consisted of 3 or 4 cycles of carboplatin and paclitaxel chemotherapy, followed by pelvic radiotherapy. Sites and rate of recurrence were compared to a historical cohort diagnosed from 2005 to 2008 in which none of the patients received adjuvant chemoradiotherapy. Five-year progression-free and overall survival rates were calculated. The study includes 55 patients. All patients except for 2 received at least 3 cycles of chemotherapy. All patients received pelvic radiotherapy except for 2 who received brachytherapy only. Median follow-up was 27 months (7-56 months). Four patients (7.3%) recurred, including three with distant recurrence only and one with both a pelvic and paraaortic nodal recurrence. The historical cohort had a 29.4% recurrence rate, and therefore the hazard ratio for recurrence was 0.27 (95% CI 0.02-4.11). Five-year progression-free and overall survival rates were 88.6% and 97.3%, respectively. Patients with high-risk early stage endometrial carcinoma treated with adjuvant chemoradiotherapy have a low rate of recurrence compared to those not receiving such therapy. © 2013.

  11. Preoperative balloon occluded arterial infusion chemotherapy for locally invasive bladder cancer. Accurate staging for bladder preservation

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Norio; Arima, Kiminobu; Kawamura, Juichi [Mie Univ., Tsu (Japan). School of Medicine; Tochigi, Hiromi

    1999-02-01

    The possibility of bladder preservation by preoperative balloon occluded arterial infusion (BOAI) chemotherapy was studied in 111 patients with locally invasive bladder cancer. BOAI was performed by blocking the blood flow of the internal iliac artery and by performing intra-arterial infusion of adriamycin (50 mg/body) and cisplatin (100 mg/body). Before BOAI the clinical diagnosis was T2 in 36, T3a in 29, T3b in 27, T4 in 11 and after BOAI it was T0 in 1, T1 in 27, T2 in 25, T3a in 20, T3b in 20, and T4 in 10. Down staging was observed on diagnostic images in 46.6%. Thirty patients (27.0%) received transurethral resection of bladder tumor (TUR-Bt) and their bladder could be preserved. The 5-year cancer-specific survival rate was 100% in pT0 (n=9), 97.5% in pT1 (n=47), 79.9% in pT2 (n=21), 80.0% in pT3a (n=6), 39.9% in pT3b (n=18) and 51.9% in pT4 cases (n=9). For the bladder preservation, accurate staging diagnosis is required. Since 1992, endorectal magnetic resonance imaging (MRI) has been used in addition to imaging diagnosis for improving the accuracy of staging diagnosis. The accuracies of staging diagnosis with and without endorectal MRI were 62.5% and 44.0%, respectively. BOAI as a neoadjuvant chemotherapy has the possibility of bladder-preserving therapy in locally invasive bladder cancer. Also, the endorectal MRI can improve the accuracy of staging diagnosis, which is important for the bladder preservation. (author)

  12. MidColumbia - Early Detection, Monitoring and Mapping of Invasives with Volunteers

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Project will initiate a program for the early detection, monitoring and mapping of invasive species on McNary and Umatilla NWR's using Refuge volunteers. The initial...

  13. Invasion patterns in stage I endometrioid and mucinous ovarian carcinomas: a clinicopathologic analysis emphasizing favorable outcomes in carcinomas without destructive stromal invasion and the occasional malignant course of carcinomas with limited destructive stromal invasion.

    Science.gov (United States)

    Chen, Shirley; Leitao, Mario M; Tornos, Carmen; Soslow, Robert A

    2005-07-01

    Stage I, low-grade endometrioid and mucinous ovarian carcinomas have an excellent prognosis. Published data have suggested that destructive stromal invasion, a relatively uncommon finding in these tumors, is a poor prognostic factor. We investigated this by studying all FIGO stage I, grades 1 and 2 (of 3) endometrioid and mucinous ovarian carcinomas that were surgically staged at the Memorial Sloan-Kettering Cancer Center from 1980 to 2000. We undertook a careful review of all available slides using current diagnostic criteria and correlated histopathologic indices with clinical outcome data. Cases studied included 13 endometrioid ovarian carcinomas (stage IA, eight; stage IC, five) and six intestinal mucinous ovarian carcinomas (stage IA, three; stage IC, three). All of the tumors contained areas of expansile invasion, greater than that acceptable for microinvasion, and were thus diagnosed as carcinomas instead of borderline tumors. Nevertheless, nearly all demonstrated borderline tumor (noninvasive) components. Six tumors contained at least one focus of destructive stromal invasion (two endometrioid and four mucinous ovarian carcinomas). Four additional cases showed a focus suspicious for but not diagnostic of destructive invasion ('indeterminate for destructive invasion') (two endometrioid and two mucinous ovarian carcinomas). Follow-up data were available for 17 patients. The median follow-up was 81 months (range, 9-161 months). In all, 14 patients were alive with no evidence of disease (expansile invasion alone, eight; destructive stromal invasion, four; and indeterminate for destructive invasion, two). Three patients died of their disease (destructive stromal invasion, two; and indeterminate for destructive invasion, one). The size, number, and nuclear grade of destructive stromal invasion foci did not appear to have an impact on survival in this relatively limited number of patients. Outcome data in patients with stage I, low-grade endometrioid and mucinous

  14. Early stages of irradiation induced dislocations in urania

    Science.gov (United States)

    Chartier, A.; Onofri, C.; Van Brutzel, L.; Sabathier, C.; Dorosh, O.; Jagielski, J.

    2016-10-01

    The early stages of nucleation and growth of dislocations by irradiation in urania is clarified based on the combination of experiments and atomistic calculations. It is established that irradiation induced dislocations follow a five stage process: (i) point defects are first created by irradiation, (ii) they aggregate into clusters, (iii) from which nucleate Frank loops, (iv) which transform into unfaulted loops via Shockley that in turn grow, and (v) finally reorganize into forest dislocations. Stages (i)-(iii) participate in the lattice expansion while the onset of lattice contraction starts with stage (iv), i.e., when unfaulted loops nucleate. Irradiation induced dislocations operate in the spontaneous recombination regime, to be opposed to the thermal diffusion regime. Body of arguments collaborates to this statement, the main one is the comparison between characteristic distances estimated from the dose rate (Vat/(K0×τ ) ) 1/3 and from the diffusion coefficient (D×τ ) 1/2 . Such a comparison identifies materials under irradiation as belonging either into the recombination regime or not.

  15. Early stage design and analysis of biorefinery networks

    DEFF Research Database (Denmark)

    Sin, Gürkan

    2013-01-01

    Recent work regarding biorefineries resulted in many competing concepts and technologies for conversion of renewable bio-based feedstock into many promising products including fuels, chemicals, materials, etc. The design of a biorefinery process requires, at its earlier stages, the selection...... biorefinery concept for a lignocellulosic biorefinery. More specifically we highlight the required information management (management of various sources of data), the superstructure which is needed to represent the design space, generic but simple models covering all the processing steps of biorefineries...... of the process configuration which exhibits the best performances, for a given set of economical, technical and environmental criteria. To this end, we formulate a computer-aided framework as an enabling technology for early stage design and analysis of biorefineries. The tool represents different raw materials...

  16. [Ophthalmologic manifestations in early and late stages of AIDS].

    Science.gov (United States)

    Schnaudigel, O E; Gümbel, H; Richter, R; Subklew, R; Garweg, T

    1994-10-01

    In a prospective study of 101 patients with HIV infection and a medium CD4 lymphocyte cell count of 350 x 10(6)/l and a retrospective study of the records of 79 AIDS patients, we compared the first ocular symptoms in HIV-infected patients to the CD4 count. In Walter-Reed stages 2-4 (n = 101) we found sicca syndrome in 9.2%, in 52% lens opacities in the cortex and only in less than 1% HIV-related angiopathy of the retina. In Walter Reed stages 5-6 (n = 79), 26% of the AIDS patients developed CMV retinitis, 33% HIV angiopathy of the retina and only 1% retinal toxoplasmosis. The average CD4 lymphocyte cell count was never better than 100 x 10(6). Lens opacities in HIV-infected patients could be an early ophthalmological symptom of HIV infection.

  17. Effects of genistein on early-stage cutaneous wound healing.

    Science.gov (United States)

    Park, Eunkyo; Lee, Seung Min; Jung, In-Kyung; Lim, Yunsook; Kim, Jung-Hyun

    2011-07-08

    Wound healing occurs in three sequential phases: hemostasis and inflammation, proliferation, and remodeling. Inflammation, the earliest phase, is considered a critical period for wound healing because immune cells remove damaged tissues, foreign debris, and remaining dead tissue. Wound healing would be delayed without inflammation, and this phase is affected by antioxidation capacity. Therefore, we hypothesized that genistein, which has an antioxidant effect, might modulate the wound healing process by altering the inflammatory response. After three days of acclimation, mice were divided into three groups: control, 0.025% genistein, and 0.1% genistein. After two weeks of an experimental diet, skin wounds were induced. Wounded skin areas were imaged, and the healing rate calculated. To measure lipid peroxidation, antioxidant enzyme expression and activity, and pro-inflammatory cytokine expression, skin and liver tissues were harvested at 12, 24, 48, and 72 h. Genistein did not affect body weight. The rate of wound closure in mice fed genistein was significantly faster than in the control group during the early stage of wound healing, especially in first three days. Cu, Zn-SOD and Mn-SOD expression in wound skin tissue in the 0.1% genistein group was lower than in the control group. However, CAT expression did not differ among groups. We also found that genistein modulated NF-κB and TNF-α expression during the early stage of wound healing. The genistein group had significantly lower hepatic lipid peroxidation and higher SOD, CAT, and GPx activities than the control group. These results suggest that genistein supplementation reduces oxidative stress by increasing antioxidant capacity and modulating proinflammatory cytokine expression during the early stage of wound healing.

  18. USANS investigation of early stages of metal foam formation

    CERN Document Server

    Bellmann, D; Banhart, J

    2002-01-01

    Metallic foams are on the verge of being used in industrial applications. However, the mechanism of foam creation, especially the early stages, are still unexplored. Ultra small-angle neutron scattering (USANS), performed with the double-crystal diffractometer (DCD) at the Geesthacht Neutron Facility (GeNF), is a promising method for obtaining a three-dimensional average of a pore size distribution in a wide size range from about 100 nm to about 20 mu m. Analysis of the neutron scattering curves yielded pore size distributions which conformed with the results obtained by microscopy. (orig.)

  19. Histopathological diagnosis of acral lentiginous melanoma in early stages.

    Science.gov (United States)

    Fernandez-Flores, Angel; Cassarino, David S

    2017-02-01

    Acral lentiginous melanoma is a rare variant of melanoma that is associated with a relatively low survival rate. The latter is partly due to the advanced stage in which the tumor is usually diagnosed. The diagnostic delay is mainly due to difficulties in identifying the very early histopathological signs of acral melanoma. The current article is a review of diagnostic clues, concepts, and definitions from the literature, as well as illustrating examples from our own archives. We have sought to provide an article that can be easily consulted in difficult cases of acral lentiginous melanoma.

  20. In vivo research using early life stage models.

    Science.gov (United States)

    Seabra, Rita; Bhogal, Nirmala

    2010-01-01

    Scientists, for a variety of reasons, need to carry out in vivo research. Since experiments that require the use of adult animals pose various logistical, economical and ethical issues, the use of embryonic and larval forms of some organisms are potentially attractive alternatives. Early life stages are appealing because, in general, large numbers of individuals can be maintained in relatively simple housing, minimising costs, and their use involves fewer legal formalities. With this succinct review, we aim to provide an overview of different biological issues that have been successfully explored with the help of eggs, embryos and larvae from the frog, zebrafish and chicken.

  1. The studies of nodular graphite cast iron early stages austempering

    OpenAIRE

    A. Krzyńska; M. Kaczorowski

    2008-01-01

    The results of early stage of ductile cast iron austempering are presented. The aim of the investigations was to look closer into the structure – mechanical properties relationships of this very attractive cast material. The experiment was carried out with enriched with Cu EN-GJS-500-7 grade ductile iron. The specimens were first solution heat treated 1 hour in 910oC and then isothermally quenched for different time in molten tin at the temperature 275oC. The mechanical properties of as cast ...

  2. Nontrivial dynamics in the early stages of inflation

    CERN Document Server

    Calzetta, E A

    1995-01-01

    Abstract: Inflationary cosmologies, regarded as dynamical systems, have rather simple asymptotic behavior, insofar as the cosmic baldness principle holds. Nevertheless, in the early stages of an inflationary process, the dynamical behavior may be very complex. In this paper, we show how even a simple inflationary scenario, based on Linde's ``chaotic inflation'' proposal, manifests nontrivial dynamical effects such as the breakup of invariant tori, formation of cantori and Arnol'd's diffusion. The relevance of such effects is highlighted by the fact that even the occurrence or not of inflation in a given Universe is dependent upon them.

  3. Emerging Literature on Cognitive Intervention Techniques for Early Stage Dementia

    Directory of Open Access Journals (Sweden)

    John W Den Boer

    2016-10-01

    Full Text Available Dementia is a growing world-wide phenomenon, impacting more than six million people in the United States. Despite its high projected prevalence, it is a significantly under-represented phenomena, with (underestimate ranging from 15-25% of the general population. The effect of the aging of the population and significant increase in life expectancy has combined to catapult dementia into the range of one of most alarming healthcare problems. Diverse and emerging literature in the area of cognitive prevention/intervention for mild cognitive impairment (MCI/early stage dementia will be reviewed. Additionally, future research and clinical directions will be explored.

  4. Reproductive and early life stages pathology - Histopathology workshop report

    Science.gov (United States)

    Bruno, D.W.; Nowak, B.; Elliott, D.G.

    2006-01-01

    Pathology occurring during reproduction and larval development represents an important part of the life cycle of fish, and the diseases that affect eggs and larvae often result in significant losses. However, mortality during this period is frequently ignored or poorly researched as the temptation is to replace the losses rather than investigate the causes. A histopathology workshop organised at the newly refurnished laboratory within the Danish Veterinary School was an opportunity to discuss the pathology of selected diseases associated with Reproductive and Early Life Stages Pathology. Several people also kindly provided reference slides.

  5. Two stage enucleation and deflation of a large unicystic ameloblastoma with mural invasion in mandible.

    Science.gov (United States)

    Sasaki, Ryo; Watanabe, Yorikatsu; Ando, Tomohiro; Akizuki, Tanetaka

    2014-06-01

    A treatment for strategy of unicystic ameloblastoma (UA) should be decided by its pathology type including luminal or mural type. Luminal type of UA can be treated only by enucleation alone, but UA with mural invasion should be treated aggressively like conventional ameloblastomas. However, it is difficult to diagnose the subtype of UA by an initial biopsy. There is a possibility that the lesion is an ordinary cyst or keratocystic odontogenic tumor, leading to a possible overtreatment. Therefore, this study performed the enucleation of the cyst wall and deflation at first, and the pathological finding confirmed mural invasion into the cystic wall, leading to the second surgery. The second surgery enucleated scar tissue, bone curettage, and deflation, and was able to contribute to the reduction of the recurrence rate by removing tumor nest in scar tissue or new bone, enhancing new bone formation, and shrinking the mandibular expanding by fenestration. In this study, a large UA with mural invasion including condyle was treated by "two-stage enucleation and deflation" in a 20-year-old patient.

  6. Early outcome of minimally invasive mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Shawky Fareed

    2016-08-01

    Conclusion: Right anterolateral mini-thoracotomy minimally invasive technique provides excellent exposure of the mitral valve, even with a small atrium and offers a better cosmetic lateral scar which is less prone to keloid formation. In addition, minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. It should be used as an initial approach for mitral valve surgery. Furthermore, it was believed that less spreading of the incision, no interference with the diaphragm and less tissue dissection might improve outcomes, particularly respiratory function.

  7. A patient with medulloblastoma in its early developmental stage.

    Science.gov (United States)

    Shinojima, Naoki; Nakamura, Hideo; Tasaki, Masayoshi; Kameno, Kouki; Anai, Shigeo; Iyama, Ken-ichi; Ando, Yukio; Seto, Hiroshi; Kuratsu, Jun-Ichi

    2014-12-01

    Medulloblastoma is the most frequent malignant brain tumor of the posterior fossa in children and is considered an embryonal tumor. It has been suggested that medulloblastomas be categorized into 4 distinct molecular subgroups- WNT (DKK1), SHH (SFRP1), Group 3 (NPR3), or Group 4 (KCNA1)-since each subgroup is distinct and there is no overlap. The authors report on a 13-year-old boy with medulloblastoma. He presented with sudden-onset nausea and vomiting due to intratumoral hemorrhage. The medulloblastoma was thought to be in an early developmental stage because the tumor volume was extremely small. Immunohistochemical analysis showed that the tumor was mainly composed of DKK1- and NPR3-positive areas. The individual areas of the tumor stained only for DKK1 or NPR3, with no overlap-that is, DKK1 and NPR3 expression were mutually exclusive. Samples obtained by laser microdissection of individual areas and subjected to mass spectrometry confirmed that the expression patterns of proteins were different. Fluorescence in situ hybridization for chromosome 6 showed there were 2 distinct types of cells that exhibited monosomy or disomy of chromosome 6. These results demonstrated that distinct subtypes of medulloblastoma may be present within a single tumor, an observation that has not been previously reported. Our findings in this case indicate that early-stage medulloblastoma may include more than 1 distinct subtype and hint at factors involved in the origin and development of medulloblastomas.

  8. On Branching Processes and the Early Stages of the Spread of an Epidemic

    Institute of Scientific and Technical Information of China (English)

    Ahmed E; Yassen M T

    1998-01-01

    Branching process (BP) is used to model the early stages of the spread of a sexually transmitted disease. The early stages of AIDS spread which is transmitted both homosexually and heterosexually are studied as a BP.

  9. The effects of blocking angiotensin receptors on early stages of diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Alaleh Gheissari

    2012-01-01

    Conclusion: Angiotensin receptor blockers may reduce VCAM-1 and microalbuminuria and may increase NO levels in early stages of DN. Thus administration of ARBs might be considered even in early stages of DN.

  10. Spectral Discrimination of the Invasive Plant Spartina alterniflora at Multiple Phenological Stages in a Saltmarsh Wetland.

    Directory of Open Access Journals (Sweden)

    Zu-Tao Ouyang

    Full Text Available Spartina alterniflora has widely invaded the saltmarshes of the Yangtze River Estuary and brought negative effects to the ecosystem. Remote sensing technique has recently been used to monitor its distribution, but the similar morphology and canopy structure among S. alterniflora and its neighbor species make it difficult even with high-resolution images. Nevertheless, these species have divergence on phenological stages throughout the year, which cause distinguishing spectral characteristics among them and provide opportunities for discrimination. The field spectra of the S. alterniflora community as well as its major victims, native Phragmites australis and Scirpus mariqueter, were measured in 2009 and 2010 at multi-phenological stages in the Yangtze River Estuary, aiming to find the most appropriate periods for mapping S. alterniflora. Collected spectral data were analyzed separately for every stage firstly by re-sampling reflectance curves into continued 5-nm-wide hyper-spectral bands and then by re-sampling into broad multi-spectral bands - the same as the band ranges of the TM sensor, as well as calculating commonly used vegetation indices. The results showed that differences among saltmarsh communities' spectral characteristics were affected by their phenological stages. The germination and early vegetative growth stage and the flowering stage were probably the best timings to identify S. alterniflora. Vegetation indices like NDVI, ANVI, VNVI, and RVI are likely to enhance spectral separability and also make it possible to discriminate S. alterniflora at its withering stage.

  11. Conservative surgery and radiation for early-stage breast cancer.

    Science.gov (United States)

    Fowble, B L; Orel, S G; Jardines, L

    1993-07-01

    In selected patients with early-stage breast cancer, conservative surgery and radiation represent an alternative equal to mastectomy in terms of local recurrence, distant metastasis, survival, and long-term complications. Patients with early-stage breast cancer who are candidates for conservative surgery and radiation include those whose primary tumor is less than 4 to 5 cm in size without evidence of gross multicentricity or diffuse microcalcifications. Patients with an extensive intraductal component may be appropriate candidates provided that margins of resection are negative. Young age is not a contraindication to the conservative treatment. A preexisting history of collagen vascular disease or prior mantle irradiation for Hodgkin's or non-Hodgkin's lymphoma represents a contraindication to conservative surgery and radiation because of the potential for severe complications. An additional contraindication is the pregnant woman in whom delivery cannot be accomplished before the initiation of radiation. Mammography is essential in the pretreatment evaluation and posttreatment follow-up of the conservatively treated patient. The goal of the pretreatment mammogram is to assess the extent of disease in the ipsilateral breast as well as to evaluate the contralateral breast. In patients who present with microcalcifications, a postbiopsy mammogram before radiation is essential to document complete removal of all malignant-appearing microcalcifications. Mammography is an essential part of the follow-up program in order to detect a recurrence in the treated breast as well as a cancer in the contralateral breast cancer. The optimal interval for follow-up mammography has not been determined, although programs employing mammography on a yearly basis after treatment have been associated with the detection of early recurrences and excellent survival after salvage mastectomy for these recurrences.

  12. Early stage health technology assessment (HTA) of biomedical devices: the MATCH experience

    OpenAIRE

    Pecchia, Leandro; Craven, Michael P

    2013-01-01

    Early stage Health Technology Assessment (HTA) of biomedical devices requires different methods than those usually employed for pharmaceuticals. This paper reviews widely used methods for HTA, discusses their limits for early stage evaluation of biomedical devices and presents two methods for early stage HTA being developed in the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) project: Analytic Hierarchy Process (AHP) to elicit user needs; and early stage economic ev...

  13. Early stage health technology assessment (HTA) of biomedical devices: the MATCH experience

    OpenAIRE

    Pecchia, Leandro; Craven, Michael P

    2013-01-01

    Early stage Health Technology Assessment (HTA) of biomedical devices requires different methods than those usually employed for pharmaceuticals. This paper reviews widely used methods for HTA, discusses their limits for early stage evaluation of biomedical devices and presents two methods for early stage HTA being developed in the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) project: Analytic Hierarchy Process (AHP) to elicit user needs; and early stage economic e...

  14. Association of code status discussion with invasive procedures among advanced-stage cancer and noncancer patients

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    Sasaki A

    2017-07-01

    Full Text Available Akinori Sasaki,1 Eiji Hiraoka,1 Yosuke Homma,2 Osamu Takahashi,3 Yasuhiro Norisue,4 Koji Kawai,5 Shigeki Fujitani4 1Department of Internal Medicine, 2Department of Emergency Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu City, Chiba, 3Department of Internal Medicine, St. Luke’s International Hospital, Chuo-ku, Tokyo, 4Department of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu City, Chiba, 5Department of Gastroenterology, Ito Municipal Hospital, Ito City, Shizuoka, Japan Background: Code status discussion is associated with a decrease in invasive procedures among terminally ill cancer patients. We investigated the association between code status discussion on admission and incidence of invasive procedures, cardiopulmonary resuscitation (CPR, and opioid use among inpatients with advanced stages of cancer and noncancer diseases. Methods: We performed a retrospective cohort study in a single center, Ito Municipal Hospital, Japan. Participants were patients who were admitted to the Department of Internal Medicine between October 1, 2013 and August 30, 2015, with advanced-stage cancer and noncancer. We collected demographic data and inquired the presence or absence of code status discussion within 24 hours of admission and whether invasive procedures, including central venous catheter placement, intubation with mechanical ventilation, and CPR for cardiac arrest, and opioid treatment were performed. We investigated the factors associated with CPR events by using multivariate logistic regression analysis. Results: Among the total 232 patients, code status was discussed with 115 patients on admission, of which 114 (99.1% patients had do-not-resuscitate (DNR orders. The code status was not discussed with the remaining 117 patients on admission, of which 69 (59% patients had subsequent code status discussion with resultant DNR orders. Code status discussion on admission decreased the incidence of central venous

  15. Primary Treatment Options for High-Risk/Medically Inoperable Early Stage NSCLC Patients.

    Science.gov (United States)

    Jones, Guy C; Kehrer, Jason D; Kahn, Jenna; Koneru, Bobby N; Narayan, Ram; Thomas, Tarita O; Camphausen, Kevin; Mehta, Minesh P; Kaushal, Aradhana

    2015-11-01

    Lung cancer is among the most common cancers worldwide and is the leading cause of cancer death in both men and women. For patients with early stage (American Joint Committee on Cancer T1-2, N0) non-small-cell lung cancer, the current standard of care is lobectomy with systematic lymph node evaluation. Unfortunately, patients with lung cancer often have medical comorbities, which may preclude the option of surgical resection. In such cases, a number of minimally invasive to noninvasive treatment options have gained popularity in the treatment of these high-risk patients. These modalities provide significant advantages, including patient convenience, treatment in an outpatient setting, and acceptable toxicities, including reduced impact on lung function and a modest risk of postprocedure chest wall pain. We provide a comprehensive review of the literature, including reported outcomes, complications, and limitations of sublobar resection with or without intraoperative brachytherapy, radiofrequency ablation, microwave ablation, percutaneous cryoablation, photodynamic therapy, and stereotactic body radiotherapy.

  16. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie

    2015-01-01

    INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine...... the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications. METHODS: This was a retrospective, descriptive cohort...... study of 235 women with endometrial cancer or atypical complex hyperplasia who had RALH. Surgeries were stratified into two groups: with or without pelvic lymphadenectomy. RESULTS: A total of 6% developed a grade 3 or higher complication with no significant difference (p = 0.24) between the groups...

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

    Science.gov (United States)

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

    2016-01-01

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

  18. SBRT in operable early stage lung cancer patients.

    Science.gov (United States)

    Roesch, Johannes; Andratschke, Nicolaus; Guckenberger, Matthias

    2014-08-01

    Since decades the gold standard for treatment of early stage non-small cell lung cancer (NSCLC) is surgical lobectomy plus mediastinal lymph node dissection. Patients in worse health status are treated with sublobar resection or radiation treatment. With development of stereotactic-body-radiotherapy (SBRT), outcome of patients treated with radiation was substantially improved. Comparison of SBRT and surgical techniques is difficult due to the lack of randomized trials. However, all available evidence in form of case control studies of population based studies show equivalence between sublobar resection and SBRT indicating that SBRT-when performed by a trained and experienced team-should be offered to all high-risk surgical patients. For patients not willing to take the risk of lobectomy and therefore refusing surgery, SBRT is an excellent treatment option.

  19. Early Stage Disease Diagnosis System Using Human Nail Image Processing

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    Trupti S. Indi

    2016-07-01

    Full Text Available Human’s hand nail is analyzed to identify many diseases at early stage of diagnosis. Study of person hand nail color helps in identification of particular disease in healthcare domain. The proposed system guides in such scenario to take decision in disease diagnosis. The input to the proposed system is person nail image. The system will process an image of nail and extract features of nail which is used for disease diagnosis. Human nail consist of various features, out of which proposed system uses nail color changes for disease diagnosis. Here, first training set data is prepared using Weka tool from nail images of patients of specific diseases. A feature extracted from input nail image is compared with the training data set to get result. In this experiment we found that using color feature of nail image average 65% results are correctly matched with training set data during three tests conducted.

  20. Infrared coagulation versus rubber band ligation in early stage hemorrhoids

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    P.J. Gupta

    2003-10-01

    Full Text Available The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54 or infrared coagulation (N = 46. Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years. The mean duration of disease was 17.5 months (range 12 to 34 months. The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale. Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059. The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03, but also had a higher recurrence or failure rate (P = 0.03. Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

  1. Locomotor function in the early stage of Parkinson's disease.

    Science.gov (United States)

    Carpinella, Ilaria; Crenna, Paolo; Calabrese, Elena; Rabuffetti, Marco; Mazzoleni, Paolo; Nemni, Raffaello; Ferrarin, Maurizio

    2007-12-01

    The cardinal motor symptoms of Parkinson's disease (PD) have been widely investigated with particular reference to abnormalities of steady-state walking. The great majority of studies, however are related to severe forms of PD patients (phases > = 3 of Hoehn and Yahr scale), where locomotor abnormalities are clearly manifested. Goal of the present study was to quantitatively describe locomotor symptoms in subjects with mild PD. Accordingly, a multitask protocol involving instrumental analysis of steady-state linear walking, initiation of gait, and turning while walking was applied to a group of patients with idiopathic PD in their early clinical stage (phases 1 and 2 of Hoehn and Yahr scale), as well as in age-matched elderly controls. Kinematic, kinetic, and myoelectric measures were obtained by optoelectronic motion analysis, force platform, and telemetric electromyography. Results in PD patients showed a tendency to bradykinetic gait, with reduction of walking speed and cadence. Impairments of gait initiation consisted in reduction of the backward shift of the center of pressure (CoP) and prolongation of the stepping phase. Alterations of the turning task were more consistent and included delayed reorientation of the head toward the new direction, altered head-upper trunk rotational strategy, and adoption of a greater number of steps to complete the turning. It is concluded that patients in the early stage of PD reveal mild alterations of steady-state linear walking and more significant anomalies in the transitional conditions, especially during changes in the travel direction. Quantitative analysis of nonstationary locomotor tasks might be a potentially useful starting point for further studies on the pathophysiology of PD.

  2. Paranasal Manifestations of Early Stage Chronic Lymphocytic Leukemia

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    Ceren Günel

    2015-04-01

    Full Text Available OBJECTIVE: Chronic lymphocytic leukemia (CLL is the most common adult leukemia. A few studies have been reported about the relationship between CLL and paranasal sinuses. We aimed to investigate the paranasal manifestations of CLL and to determine the expression of nuclear factor-ĸB (NF-kB and tumor necrosis factor (TNF-α in the nasal mucosa in patients with CLL. MATERIALS AND METHODS: This study was a clinical trial that involved 40 patients. Group CLL (n=20 consisted of patients with early-stage CLL who were followed-up at the hematology clinic and who did not receive any treatment. The control group (n=20 consisted of patients who had undergone concha surgery because of nasal obstruction. Paranasal sinus computer tomography scans of all patients were taken, they were scored on the basis of the Lund–Mackay system, and sinusitis findings were recorded. The biopsy material taken from the inferior concha head of all patients was immunohistochemically stained with primary antibodies against NF-kB and TNF-α. RESULTS: There were no statistically significant differences between the two groups with respect to NF-κB (p=0.716 and TNF-α staining scores (p=1.000. The Lund–Mackay scores were significantly higher in the CLL group than in the control group (p=0.004. Fourteen patients had sinusitis at different locations, while the most common diagnosis was maxillary sinusitis (n=8 in the CLL group. CONCLUSION: This study showed that patients with early-stage CLL tend to have rhinosinusitis. However, NF-kB and TNF-α may not have a role in the inflammatory process involving the paranasal sinuses in patients with CLL.

  3. Compromised margins following mastectomy for stage I-III invasive breast cancer.

    Science.gov (United States)

    Yu, Jennifer; Al Mushawah, Fatema; Taylor, Marie E; Cyr, Amy E; Gillanders, William E; Aft, Rebecca L; Eberlein, Timothy J; Gao, Feng; Margenthaler, Julie A

    2012-09-01

    We investigated factors associated with positive margins following mastectomy and the impact on outcomes. We identified 240 patients with stage I-III invasive breast cancer who underwent mastectomy from 1999 to 2009. Data included patient and tumor characteristics, pathologic margin assessment, and outcomes. Margin positivity was defined as the presence of in situ or invasive malignancy at any margin. Descriptive statistics were used for data summary and were compared using χ(2). Of the 240 patients, 132 (55%) had a simple mastectomy with sentinel lymph node biopsy and 108 (45%) had a modified radical mastectomy. Overall, 21 patients (9%) had positive margins, including 12 (57%) with one positive margin, 3 (14%) with two positive margins, and 6 (29%) with three or more positive margins. The most commonly affected margin was the deep margin (48% of patients). Eight of the 21 patients (38%) received adjuvant chest wall irradiation. There were no differences between patients who had a positive margin and those who did not with respect to patient age, race, percentage of in situ component, tumor size, tumor grade, lymphovascular invasion, or immunostain profile (P > 0.05 for all). None of the patients with positive margins experienced a local recurrence. Positive margins following mastectomy occurred in nearly 10% of our patients. No specific patient or tumor characteristics predicted a risk for having a positive margin. Despite the finding that only approximately 40% of patients received adjuvant radiation in the setting of a positive margin, no local recurrences have been observed. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Longitudinal trajectories of awareness in early-stage dementia.

    Science.gov (United States)

    Clare, Linda; Nelis, Sharon M; Martyr, Anthony; Whitaker, Christopher J; Marková, Ivana S; Roth, Ilona; Woods, Robert T; Morris, Robin G

    2012-01-01

    Although it is often assumed that awareness decreases as dementia severity increases, there is limited evidence regarding changes in awareness over time. We examined awareness in 101 individuals with early-stage dementia (PwD) and their carers; 66 were reassessed after 12 months and 51 were seen again at 20 months. Awareness was assessed in relation to memory, everyday activities, and socio-emotional functioning using discrepancies between PwD and carer ratings on parallel questionnaires. PwD completed neuropsychological tests and measures of mood and quality of life. Carers completed measures of mood and stress. At initial assessment, discrepancies were greatest for activities of daily living, moderate for memory, and least pronounced for socio-emotional functioning. Discrepancy scores did not change over time. PwD self-ratings indicated perceived poorer functioning in everyday activities over time, but no change for memory and socio-emotional functioning. Carer ratings indicated perceived decline in everyday activities and socio-emotional functioning, but no change for memory. PwD declined in neuropsychological functioning, but self-ratings of depression, anxiety, and quality of life remained stable over time. Carer mood and stress levels also remained stable. At least in the earlier stages of dementia, it should not be assumed that awareness will inevitably decrease as dementia progresses.

  5. Prognostic Gene-Expression Signature for Patients with Hepatitis C-Related Early-Stage Cirrhosis

    Science.gov (United States)

    Hoshida, Yujin; Villanueva, Augusto; Sangiovanni, Angelo; Sole, Manel; Hur, Chin; Andersson, Karin L.; Chung, Raymond T; Gould, Joshua; Kojima, Kensuke; Gupta, Supriya; Taylor, Bradley; Crenshaw, Andrew; Gabriel, Stacey; Minguez, Beatriz; Iavarone, Massimo; Friedman, Scott L.; Colombo, Massimo; Llovet, Josep M.; Golub, Todd R.

    2013-01-01

    Background & Aims Liver cirrhosis affects 1%–2% of population and is the major risk factor of hepatocellular carcinoma (HCC). Hepatitis C cirrhosis-related HCC is the most rapidly increasing cause of cancer death in the US. Non-invasive methods have been developed to identify patients with asymptomatic, early-stage cirrhosis, increasing the burden of HCC surveillance, but biomarkers are needed to identify patients with cirrhosis who are most in need of surveillance. We investigated whether a liver-derived 186-gene signature previously associated with outcomes of patients with HCC is prognostic for patients newly diagnosed with cirrhosis but without HCC. Methods We performed gene expression profile analysis of formalin-fixed needle biopsies from the livers of 216 patients with hepatitis C-related early-stage (Child-Pugh class A) cirrhosis who were prospectively followed for a median of 10 years at an Italian center. We evaluated whether the 186-gene signature was associated with death, progression of cirrhosis, and development of HCC. Results Fifty-five (25%), 101 (47%), and 60 (28%) patients were classified as having poor-, intermediate-, and good-prognosis signatures, respectively. In multivariable Cox regression modeling, the poor-prognosis signature was significantly associated with death (P=.004), progression to advanced cirrhosis (P<.001), and development of HCC (P=.009). The 10-year rates of survival were 63%, 74%, and 85% and the annual incidences of HCC were 5.8%, 2.2%, and 1.5% for patients with poor-, intermediate-, and good-prognosis signatures, respectively. Conclusions A 186-gene signature used to predict outcomes of patients with HCC is also associated with outcomes of patients with hepatitis C-related early-stage cirrhosis. This signature might be used to identify patients with cirrhosis in most need of surveillance and strategies to prevent their development of HCC. PMID:23333348

  6. Modeling TGF-β in early stages of cancer tissue dynamics.

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    Gianluca Ascolani

    Full Text Available Recent works have highlighted a double role for the Transforming Growth Factor β (TGF-β: it inhibits cancer in healthy cells and potentiates tumor progression during late stage of tumorigenicity, respectively; therefore it has been termed the "Jekyll and Hyde" of cancer or, alternatively, an "excellent servant but a bad master". It remains unclear how this molecule could have the two opposite behaviours. In this work, we propose a TGF-β multi scale mathematical model at molecular, cellular and tissue scales. The multi scalar behaviours of the TGF-β are described by three coupled models built up together which can approximatively be related to distinct microscopic, mesoscopic, and macroscopic scales, respectively. We first model the dynamics of TGF-β at the single-cell level by taking into account the intracellular and extracellular balance and the autocrine and paracrine behaviour of TGF-β. Then we use the average estimates of the TGF-β from the first model to understand its dynamics in a model of duct breast tissue. Although the cellular model and the tissue model describe phenomena at different time scales, their cumulative dynamics explain the changes in the role of TGF-β in the progression from healthy to pre-tumoral to cancer. We estimate various parameters by using available gene expression datasets. Despite the fact that our model does not describe an explicit tissue geometry, it provides quantitative inference on the stage and progression of breast cancer tissue invasion that could be compared with epidemiological data in literature. Finally in the last model, we investigated the invasion of breast cancer cells in the bone niches and the subsequent disregulation of bone remodeling processes. The bone model provides an effective description of the bone dynamics in healthy and early stages cancer conditions and offers an evolutionary ecological perspective of the dynamics of the competition between cancer and healthy cells.

  7. Effectiveness of an Early Versus Conservative Invasive Treatment Strategy in Acute Coronary Syndromes

    DEFF Research Database (Denmark)

    Hansen, Kim Wadt; Sorensen, Rikke; Madsen, Mette;

    2015-01-01

    Background: Randomized clinical trials have found that early invasive strategies reduce mortality, myocardial infarction (MI), and rehospitalization compared with a conservative invasive approach in acute coronary syndromes (ACSs), but the effectiveness of such strategies in real-world settings...... is unknown. Objective: To investigate adverse cardiovascular outcomes of an early versus conservative invasive strategy in a national cohort of patients with ACSs. Design: Retrospective cohort study. Setting: Administrative health care data on hospitalizations, procedures, and outcomes abstracted from...... the Danish national registries and covering all acute invasive procedures in patients presenting with an ACS. Patients: 19 704 propensity score-matched patients hospitalized with a first ACS between 1 January 2005 and 31 December 2011. Measurements: Risk for cardiac death or rehospitalization for MI within...

  8. Early-Stage Breast Cancer in the Octogenarian: Tumor Characteristics, Treatment Choices, and Clinical Outcomes

    Science.gov (United States)

    Mamtani, Anita; Gonzalez, Julie J.; Neo, Dayna; Slanetz, Priscilla J.; Houlihan, Mary Jane; Herold, Christina I.; Recht, Abram; Hacker, Michele R.; Sharma, Ranjna

    2016-01-01

    Background Nodal staging with sentinel node biopsy (SLNB), post-lumpectomy radiotherapy (RT), and endocrine therapy (ET) for estrogen receptor-positive (ER+) tumors is valuable in the treatment of early-stage (stages 1 or 2) breast cancer but used less often for elderly women. Methods This retrospective study investigated women referred for surgical evaluation of biopsy-proven primary early-stage invasive breast cancer from January 2001 to December 2010. Clinicopathologic features, treatment course, and outcomes for women ages 80–89 years and 50–59 years were compared. Results The study identified 178 eligible women ages 80–89 years and 169 women ages 50–59 years. The elderly women more often had grade 1 or 2 disease (p = 0.003) and ER+ tumors (p = 0.007) and less frequently had undergone adjuvant therapies (all p ≤ 0.001). Lumpectomy was performed more commonly for the elderly (92 vs. 83 %, p = 0.02), and axillary surgery was less commonly performed (46 vs. 96 %; p < 0.001). Fewer elderly women had undergone post-lumpectomy RT (42 vs. 89 %; p < 0.001) and ET for ER+ tumors (72 vs. 95 %; p < 0.001). During the median follow-up period of 56 months for the 80- to 89-year old group and 98 months for the 50- to 59-year-old group, death from breast cancer was similar (4 vs. 5 %; p = 0.5). The two groups respectively experienced 7 versus 6 locoregional recurrences and 11 versus 13 distant recurrences. Conclusions The octogenarians had disease survivorship similar to that of the younger women despite less frequent use of adjuvant therapies, likely reflecting lower-risk disease features. Whether increased use of axillary surgery, post-lumpectomy RT, and/or ET for ER+ tumors would further improve outcomes is an important area for further study, but treatment should not be deferred solely on the basis of age. PMID:27364507

  9. HPV16 variant lineage, clinical stage, and survival in women with invasive cervical cancer

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    Zuna Rosemary E

    2011-10-01

    Full Text Available Abstract Background HPV16 variants are associated with different risks for development of CIN3 and invasive cancer, although all are carcinogenic. The relationship of HPV 16 variants to cancer survival has not been studied. Methods 155 HPV16-positive cervical cancers were categorized according to European and non-European variant patterns by DNA sequencing of the E6 open reading frame. Clinico-pathologic parameters and clinical outcome were collected by chart review and death registry data. Results Of the 155 women (mean age 44.7 years; median follow-up 26.7 months, 85.2% harbored European variants while 14.8% had non-European sequences. HPV16 variants differed by histologic cell type (p = 0.03 and stage (1 vs. 2+; p = 0.03. Overall, 107 women (68.0% were alive with no evidence of cancer, 42 (27.1% died from cervical cancer, 2 (1.3% were alive with cervical cancer, and 4 (2.6% died of other causes. Death due to cervical cancer was associated with European variant status (p Conclusions Overall, invasive cervical cancers with non-European variants showed a less aggressive behavior than those with European variants. These findings should be replicated in a population with more non-European cases.

  10. Treatment of early-stage Hodgkin lymphoma.

    Science.gov (United States)

    Engert, Andreas; Raemaekers, John

    2016-07-01

    Hodgkin lymphoma (HL) has become one of the best curable malignancies today. This is particularly true for patients with early-stage disease. Today, most patients in this risk group are treated with a combination of chemotherapy followed by small-field radiotherapy. More recent clinical trials such as the German Hodgkin Study Group (GHSG) HD10 study demonstrated, that even two cycles of ABVD followed by 20 Gy involved-field radiation therapy (IF-RT) are sufficient and result in more than 90% of patients being cured. The current treatment for early unfavorable patients is either four cycles of ABVD plus 30 Gy IF-RT or two cycles of BEACOPPbaseline followed by two cycles of ABVD plus IF-RT. Here, the European Organization for Research and Treatment of Cancer (EORTC) demonstrated that in positron emission tomography (PET)-positive patients after two cycles of ABVD, treatment switched to two cycles of BEACOPPbaseline plus radiotherapy results in significantly improved outcomes. Other aspects including attempts to further reduce intensity of treatment will be discussed.

  11. Has lymphography a role in early stage testicular germ cell tumours?

    Energy Technology Data Exchange (ETDEWEB)

    Stephenson, N.J.H. [Royal Melbourne Hospital, Parkville, VIC (Australia). Dept. of Nuclear Medicine; Sandeman, T.F.; McKenzie, A.F. [Peter MacCallum Cancer Inst., Melbourne, VIC (Australia). Depts. of Radiation Oncology and Diagnostic Imaging

    1995-02-01

    A retrospective study was performed of 183 newly diagnosed seminoma cases and 73 newly diagnosed non-seminomatous germ cell tumours (NSGCT) presenting from 1985 to 1989 to a tertiary referral cancer hospital. The purpose was to assess the contribution of bipedal lymphography (LG) to the management of these patients. As the main value of LG is in detecting small retroperitoneal lymph node (LN) metastases, analysis concentrated upon early stage disease, specifically N{sub 0} and N{sub 1a} LN disease. Comparison between LG results, abdominopelvic computed tomography (APCT), final clinical stage and treatment outcome was performed. We found that with the LG and APCT criteria used (filling defects > 2 mm and LN diameter >20 mm, respectively), LG was much more sensitive in disease detection. However, with modern techniques APCT can reliably detect disease 10 mm or greater. In addition, tumour marker status, primary tumour vascular invasion status and initial clinical examination were each more important in staging NSGCT disease than LG alone. Thus, LG is now rarely used in our institution but we will have to monitor our excellent survival data to confirm that this change in policy is warranted. 14 refs., 5 tabs., 2 figs.

  12. Influence of Spartina alterniflora invasion stages on macrobenthic communities on a tidal flat in Wenzhou Bay, China

    Directory of Open Access Journals (Sweden)

    Bao-Ming Ge

    2012-09-01

    Full Text Available Many coastal habitats in eastern China are being substantially altered by the invasion of Spartina alterniflora. The species richness, density, Margalef's diversity index (R and Shannon's diversity index (H' of macrobenthic communities on a tidal flat in Wenzhou Bay, China, were analyzed with the factors of invasion stage and season, in 2007. A significant effect of invasion stage, season, and the interaction between them on communities was detected. The macrobenthic community was more complex in the patch of initial S. alterniflora invasion than in the patches of some other invasion stages. Macrobenthic communities were classified by cluster and ordination in accordance with the habitat character of the S. alterniflora invasion stage. Our research demonstrated that the S. alterniflora invasion stage affected the macrobenthic communities significantly. The results indicated that biodiversity increased in the initial stage of invasion (invasion age 1-2 years and then decreased in the stage of invasion underway (invasion age 3-4 years and in the stage of invasion completed (invasion age 5-6 years; this phenomenon was related to the change in the S. alterniflora canopy which accompanied the invasion stages.Muitos habitats costeiros vêm sendo alterados substancialmente pela invasão de Spartina alterniflora no leste da China. Em 2007, em uma planície de maré situada em Wenzhou Bay, foram analisadas riqueza de espécies, densidade e diversidade da macrofauna bêntica em relação a diferentes estágios da invasão da gramínea e à estação do ano. Para as medidas de diversidade foram usados os índices de Margalef (R e de Shannon (H'. Foram detectados efeitos significativos do estágio de invasão e época do ano sobre a macrofauna. As comunidades macrofaunais foram mais complexas nas manchas onde a invasão de S. alterniflora estava no seu início, quando considerados os locais onde as manchas estavam em estágios mais avançados. Através das

  13. Large Conization and Laparoendoscopic Single-Port Pelvic Lymphadenectomy in Early-Stage Cervical Cancer for Fertility Preservation

    Directory of Open Access Journals (Sweden)

    Polat Dursun

    2013-01-01

    Full Text Available Fertility preservation in early-stage cervical cancer is a hot topic in gynecologic oncology. Although radical vaginal trachelectomy (RVT is suggested as a fertility preserving approach, there are some serious concerns like cervical stenosis, second trimester loss, preterm delivery in survivors, and lack of residual tumor in the majority of the surgical specimens. Therefore, less radical surgical operations have been proposed in early-stage cervical carcinomas. On the other hand, single-incision laparoscopic surgery (SILS is an evolving endoscopic approach for minimal access surgery. In this report, we present a case with early-stage cervical cancer who wishes to preserve fertility. We successfully performed single-port pelvic lymphadenectomy and large conization to preserve fertility potential of the patient. We think that combination of less radical approach like conization and single-port pelvic lymphadenectomy might be less minimally invasive and is still an effective surgical approach in well-selected cases with cervical carcinomas. Incorporation of single-port laparoscopy into the minimally invasive fertility sparing management of the cervical cancer will improve patients outcome with less complications and better cosmesis. Further studies are needed to reach a clear conclusion.

  14. The influence of the level of lamina propria invasion and the prevalence of p53 nuclear accumulation on survival in stage T1 transitional cell bladder cancer

    DEFF Research Database (Denmark)

    Hermann, G G; Horn, T; Steven, K

    1998-01-01

    related to age, level of lamina propria invasion and presence of p53 nuclear accumulation. For this subpopulation overall survival was 67%, and 79% for stage T1a, 70% for stage T1b and 57% for stage T1c (p positive (61......PURPOSE: We assessed the influence of the level of lamina propria invasion and the prevalence of p53 nuclear immunoreactivity on the survival of patients with stage T1 transitional cell bladder cancer. MATERIALS AND METHODS: All patients presenting with stage T1 bladder cancer were prospectively...... and routinely grouped according to the level of lamina propria invasion. Invasion of the tumor stalk was defined as stage T1a, invasion of the lamina propria proper superficial to the level of muscularis mucosa as stage T1b and into or deeper than the muscularis mucosa as stage T1c. The p53 nuclear...

  15. Longitudinal correlation of 3D OCT to detect early stage erosion in bovine enamel.

    Science.gov (United States)

    Aden, Abdirahman; Anderson, Paul; Burnett, Gary R; Lynch, Richard J M; Tomlins, Peter H

    2017-02-01

    Erosive tissue-loss in dental enamel is of significant clinical concern because the net loss of enamel is irreversible, however, initial erosion is reversible. Micro-hardness testing is a standard method for measuring initial erosion, but its invasive nature has led to the investigation of alternative measurement techniques. Optical coherence tomography (OCT) is an attractive alternative because of its ability to non-invasively image three-dimensional volumes. In this study, a four-dimensional OCT system is used to longitudinally measure bovine enamel undergoing a continuous erosive challenge. A new method of analyzing 3D OCT volumes is introduced that compares intensity projections of the specimen surface by calculating the slope of a linear regression line between corresponding pixel intensities and the associated correlation coefficient. The OCT correlation measurements are compared to micro-hardness data and found to exhibit a linear relationship. The results show that this method is a sensitive technique for the investigation of the formation of early stage erosive lesions.

  16. Longitudinal correlation of 3D OCT to detect early stage erosion in bovine enamel

    Science.gov (United States)

    Aden, Abdirahman; Anderson, Paul; Burnett, Gary R.; Lynch, Richard J. M.; Tomlins, Peter H.

    2017-01-01

    Erosive tissue-loss in dental enamel is of significant clinical concern because the net loss of enamel is irreversible, however, initial erosion is reversible. Micro-hardness testing is a standard method for measuring initial erosion, but its invasive nature has led to the investigation of alternative measurement techniques. Optical coherence tomography (OCT) is an attractive alternative because of its ability to non-invasively image three-dimensional volumes. In this study, a four-dimensional OCT system is used to longitudinally measure bovine enamel undergoing a continuous erosive challenge. A new method of analyzing 3D OCT volumes is introduced that compares intensity projections of the specimen surface by calculating the slope of a linear regression line between corresponding pixel intensities and the associated correlation coefficient. The OCT correlation measurements are compared to micro-hardness data and found to exhibit a linear relationship. The results show that this method is a sensitive technique for the investigation of the formation of early stage erosive lesions.

  17. Exome sequencing identifies early gastric carcinoma as an early stage of advanced gastric cancer.

    Science.gov (United States)

    Kang, Guhyun; Hwang, Woo Cheol; Do, In-Gu; Wang, Kai; Kang, So Young; Lee, Jeeyun; Park, Se Hoon; Park, Joon Oh; Kang, Won Ki; Jang, Jiryeon; Choi, Min-Gew; Lee, Jun Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung; Kim, Min Ji; Kim, Seonwoo; Park, Cheol Keun; Kim, Kyoung-Mee

    2013-01-01

    Gastric carcinoma is one of the major causes of cancer-related mortality worldwide. Early detection and treatment leads to an excellent prognosis in patients with early gastric cancer (EGC), whereas the prognosis of patients with advanced gastric cancer (AGC) remains poor. It is unclear whether EGCs and AGCs are distinct entities or whether EGCs are the beginning stages of AGCs. We performed whole exome sequencing of four samples from patients with EGC and compared the results with those from AGCs. In both EGCs and AGCs, a total of 268 genes were commonly mutated and independent mutations were additionally found in EGCs (516 genes) and AGCs (3104 genes). A higher frequency of C>G transitions was observed in intestinal-type compared to diffuse-type carcinomas (P = 0.010). The DYRK3, GPR116, MCM10, PCDH17, PCDHB1, RDH5 and UNC5C genes are recurrently mutated in EGCs and may be involved in early carcinogenesis.

  18. Radiation therapy for early stages of Morbus Ledderhose

    Energy Technology Data Exchange (ETDEWEB)

    Heyd, Reinhard [Dept. of Radiotherapy, Klinikum Offenbach (Germany); Dorn, Anne Pia; Mueller-Schimpfle, Marcus [Central Inst. of Radiology, Municipal Hospitals, Frankfurt/Main-Hoechst (Germany); Herkstroeter, Markus [Radiotherapeutic Practice at the Municipal Hospitals, Frankfurt/Main-Hoechst (Germany); Roedel, Claus; Fraunholz, Ingeborg [Dept. of Radiotherapy and Oncology, Univ. Hospital Frankfurt/Main (Germany)

    2010-01-15

    Purpose: To evaluate the efficacy of radiation therapy (RT) in the treatment of early stages of benign plantar fibromatosis (Morbus Ledderhose [ML]). Patients and Methods: From 2003 to 2008, 24 patients (33 sites) with a mean age of 52 years received RT for symptomatic ML. Prior to RT, 19 patients complained of pain and 15 had walking difficulties. 21 patients (28 sites) were irradiated with orthovolt-age X-rays and three (five sites) received electron-beam irradiation. The RT protocol consisted of five weekly fractions of 3.0 Gy (15 Gy), repeated after 6 weeks to a total dose of 30 Gy in 20 patients (28 sites). In four patients (five sites), two single fractions of 4.0 Gy were applied, repeated at intervals of 4 weeks to total doses of 24-32 Gy. Primary study endpoints were the prevention of disease progression and the avoidance of a surgical intervention. Secondary endpoints were pain relief, improvement of gait, and patients' subjective satisfaction measured with a linear analog scale (LAS). Results: After a median follow-up of 22.5 months, none of the patients experienced a progression of number and size of the lesions or the clinical symptoms. In eleven sites (33.3%) complete remission of cords or nodules occurred, in 18 (54.5%) a reduced number or size was noted, and four sites (12.1%) were unchanged. Pain relief was achieved in 13/19 patients (68.4%), and an improvement of gait abnormalities was noted in 11/15 patients (73.3%). The patients' subjective satisfaction measured by means of the LAS revealed a median improvement of 3.5 points in 22/24 patients (91.6%). Skin or soft tissues toxicities RTOG grade > 2 were not noted. Conclusion: RT is effective for treatment of the early stages of ML and may obviate the need for a surgical intervention. Long-term follow-up studies including a larger number of patients are required to define the role of RT in the management of this disorder. (orig.)

  19. Native language change during early stages of second language learning.

    Science.gov (United States)

    Bice, Kinsey; Kroll, Judith F

    2015-11-11

    Research on proficient bilinguals has demonstrated that both languages are always active, even when only one is required. The coactivation of the two languages creates both competition and convergence, facilitating the processing of cognate words, but slowing lexical access when there is a requirement to engage control mechanisms to select the target language. Critically, these consequences are evident in the native language (L1) as well as in the second language (L2). The present study questioned whether L1 changes can be detected at early stages of L2 learning and how they are modulated by L2 proficiency. Native English speakers learning Spanish performed an English (L1) lexical decision task that included cognates while event-related potentials were recorded. They also performed verbal fluency, working memory, and inhibitory control tasks. A group of matched monolinguals performed the same tasks in English only. The results revealed that intermediate learners demonstrate a reduced N400 for cognates compared with noncognates in English (L1), and an emerging effect is visually present in beginning learners as well; however, no behavioral cognate effect was present for either group. In addition, slower reaction times in English (L1) are related to a larger cognate N400 magnitude in English (L1) and Spanish (L2), and to better inhibitory control for learners but not for monolinguals. The results suggest that contrary to the claim that L2 affects L1 only when L2 speakers are highly proficient, L2 learning begins to impact L1 early in the development of the L2 skill.

  20. Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion.

    Science.gov (United States)

    Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

    2016-05-28

    To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the

  1. Efficiency of teaching patients with early-stage rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Evgenia Vladislavovna Orlova

    2014-01-01

    Full Text Available Education programs are an important part of the management of patients with rheumatoid arthritis (RA.Objective: to develop a unified model of an education program for RA patients and to evaluate its efficiency at the early stage of the disease.Material and methods. A group education program was worked out with the support of the All-Russian public organization of the disabled “The Russian rheumatology organization “Nadezhda” (Hope” and encompassed 4 daily classes lasting 90 min. All information was presented by a multidisciplinary team of specialists (rheumatologists, a cardiologist, a psychologist, a physiotherapist, and a physical trainer. The study included 55 patients with early RA (89.1% of women aged 18 to 62 years; the duration of the disease was 2 to 22 months; of them 25 were taught using the education program (a study group; 30 received drug therapy only (a control group. Following 3 and 6 months, the number of tender and swollen joints, erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and pain were determined applying a 100-ml VAS, DAS28, HAQ, and RAPID3. Adherence to non-drug treatments was assessed employing a special patient questionnaire.Results. Three and six months after being taught, two patient groups showed increases in adherence to joint protection methods by 13 and 10 times (p<0.01, regular physical training by 4 and 3.25 times (p<0.01, uses of orthoses for the wrist joint by 2 times and 75% (p<0.01 and knee orthoses by 33.3 and 50.0% (p<0.01, and orthopedic insoles by 71.4 and 57.1% (p<0.01, respectively. Following 6 months, there were statistically significant differences between the two groups in most parameters (p<0.05, except for ESR, CRP, and DAS28 (p>0.05. Further more, a good response to treatment was significantly more common in these periods, as shown by the EULAR response criteria (DAS28: 56.3% versus 40% in the control group (p<0.05.Conclusion. The education program decreases the intensity

  2. Silicon: The key element in early stages of biocalcification.

    Science.gov (United States)

    Matsko, Nadejda B; Znidaršič, Nada; Letofsky-Papst, Ilse; Dittrich, Maria; Grogger, Werner; Strus, Jasna; Hofer, Ferdinand

    2011-04-01

    Biocalcification is a widespread process of forming hard tissues like bone and teeth in vertebrates. It is also a topic connecting life sciences and earth sciences: calcified skeletons and shells deposited as sediments represent the earth's fossil record and are of paramount interest for biogeochemists trying to get an insight into the past of our planet. This study reports on the role of silicon in the early biocalcification steps, where silicon and calcium were detected on the surface of cyanobacteria (initial stage of lacustrine calcite precipitation) and in crustacean cuticles. By using innovative methodological approaches of correlative microscopy (AFM in combination with analytical TEM: EFTEM, EELS) the chemical form of silicon in biocalcifying matrices and organic-inorganic particles is determined. Previously, silicon was reported to be localized in active growth areas in the young bone of vertebrates. We have found evidence that biocalcification in evolutionarily distant organisms involves very similar initial phases with silicon as a key element at the organic-inorganic interface.

  3. Cytonuclear incompatibility contributes to the early stages of speciation.

    Science.gov (United States)

    Barnard-Kubow, Karen B; So, Nina; Galloway, Laura F

    2016-12-01

    Genetic incompatibility is a hallmark of speciation. Cytonuclear incompatibilities are proposed to be among the first genetic barriers to arise during speciation. Accordingly, reproductive isolation (RI) within species should be heavily influenced by interactions between the organelle and nuclear genomes. However, there are few clear examples of cytonuclear incompatibility within a species. Here, we show substantial postzygotic RI in first-generation hybrids between differentiated populations of an herbaceous plant (up to 92% reduction in fitness). RI was primarily due to germination and survival, with moderate RI for pollen viability. RI for survival was asymmetric and caused by cytonuclear incompatibility, with the strength of incompatibility linearly related to chloroplast genetic distance. This cytonuclear incompatibility may be the result of a rapidly evolving plastid genome. Substantial asymmetric RI was also found for germination, but was not associated with cytonuclear incompatibility, indicating endosperm or maternal-zygote incompatibilities. These results demonstrate that cytonuclear incompatibility contributes to RI within species, suggesting that initial rates of speciation could be influenced by rates of organelle evolution. However, other genetic incompatibilities are equally important, indicating that even at early stages, speciation can be a complex process involving multiple genes and incompatibilities.

  4. Affective motives for smoking among early stage smokers.

    Science.gov (United States)

    Mathew, Amanda R; Wahlquist, Amy E; Garrett-Mayer, Elizabeth; Gray, Kevin M; Saladin, Michael E; Carpenter, Matthew J

    2014-10-01

    As most smokers initiate smoking during adolescence, assessment of smoking motives that underlie trajectories of dependence is critical for both prevention and cessation efforts. In the current study, we expected participants with higher nicotine dependence would smoke (a) less for positive reinforcement (PR) and (b) more for negative reinforcement (NR) motives. We secondarily assessed the relative contribution of PR to NR motives across levels of dependence. Data were drawn from a study on cue-elicited craving among occasional versus daily adolescent smokers aged 16-20 years (N = 111). Smoking motives were assessed in relation to 3 commonly used measures of nicotine dependence: (a) Fagerström Test for Nicotine Dependence (FTND), (b) Autonomy over Smoking Scale (AUTOS), and (c) Nicotine Dependence Syndrome Scale (NDSS). Compared to occasional smokers, daily smokers had significantly higher scores on each dependence measure and endorsed more prominent NR smoking motives. Each measure of nicotine dependence was strongly associated with NR motives for smoking, although measures differed in their association with PR motives. As expected, the FTND, AUTOS, and NDSS each significantly predicted smoking motive difference score (PR - NR), such that higher dependence was associated with more prominent NR motives for smoking. Results are consistent with our understanding of dependence and provide further support for 3 common measures of nicotine dependence among early stage smokers. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Early stages of diamond BEN-HFCVD on iridium

    Energy Technology Data Exchange (ETDEWEB)

    Arnault, J.C.; Faerber, J. [Groupe Surfaces-Interfaces, Institut de Physique et Chimie de Strasbourg, IPCMS-GSI, UMR 7504, BP 43, 23, rue du Loess, 67034 Strasbourg Cedex 2 (France); Vonau, F. [Laboratoire de Physique et Spectroscopie Electronique, 4, rue des Freres Lumiere, 68093 Mulhouse Cedex (France); Arabski, J.; Schmerber, G. [Groupe des Materiaux Metalliques, IPCMS-GEMM, 91404 Orsay (France); Wyczisk, F.; Legagneux, P. [Thales R and T, Domaine de Corbeville, 91404 Orsay Cedex (France)

    2003-09-01

    This study attempts to better understand the BEN effects on diamond nucleation on iridium buffer layers investigated by in situ electron spectroscopies (XPS, AES). The surface morphology is further characterised by AFM and SEM FEG. Nano-Auger experiments provide information about the chemical nature of the crystals. During the early stages of BEN, nano-Auger observations revealed a significant carbon sp{sup 3} contribution within the bright crystals whereas the surrounding areas are mainly sp{sup 2}. This emphasizes the BEN effect on the diamond nucleation. Moreover, AES experiments reveal the formation of graphite. The equivalent thickness of the graphite layer is estimated from XPS data, it is close to a monolayer. The graphite formation is not a proper effect of BEN because it is also obtained under CVD environment according to our study. Anisotrope crystals arranged along left angle 110 right angle directions have been characterized by HR-SEM and AFM. (copyright 2003 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  6. The studies of nodular graphite cast iron early stages austempering

    Directory of Open Access Journals (Sweden)

    A. Krzyńska

    2008-12-01

    Full Text Available The results of early stage of ductile cast iron austempering are presented. The aim of the investigations was to look closer into the structure – mechanical properties relationships of this very attractive cast material. The experiment was carried out with enriched with Cu EN-GJS-500-7 grade ductile iron. The specimens were first solution heat treated 1 hour in 910oC and then isothermally quenched for different time in molten tin at the temperature 275oC. The mechanical properties of as cast and heat treated specimens were tested to evaluate tensile Rm and yield strength R p, 0.2 and elongation A5. Additionally hardness measurements were carried out using Brinell-Rockwell method. Structure of the specimens both as cast and after austempering was studied using conventional light microscopy. Moreover, scanning electron microscopy (SEM was applied for fracture surface observations. It was concluded that short time low temperature austempering lead to formation martensitic microstructure characterized by very high hardness with almost zero ductility. The lack of ductility make the material very sensitive to any structure defects which work as a stress concentrators which strongly influence the strength of heat treated ductile iron specimens.

  7. Cognitive Stimulation for Apathy in Probable Early-Stage Alzheimer's

    Directory of Open Access Journals (Sweden)

    Linda L. Buettner

    2011-01-01

    Full Text Available We studied changes in apathy among 77 community-dwelling older persons with mild memory loss in a randomized clinical trial comparing two nonpharmacological interventions over four weeks. The study used a pre-post design with randomization by site to avoid contamination and diffusion of effect. Interventions were offered twice weekly after baseline evaluations were completed. The treatment group received classroom style mentally stimulating activities (MSAs while the control group received a structured early-stage social support (SS group. The results showed that the MSA group had significantly lower levels of apathy (P<.001 and significantly lower symptoms of depression (P<.001. While both groups improved on quality of life, the MSA group was significantly better (P=.02 than the SS group. Executive function was not significantly different for the two groups at four weeks, but general cognition improved for the MSA group and declined slightly for the SS group which produced a significant posttest difference (P<.001. Recruitment and retention of SS group members was difficult in this project, especially in senior center locations, while this was not the case for the MSA group. The examination of the data at this four-week time point shows promising results that the MSA intervention may provide a much needed method of reducing apathy and depressive symptoms, while motivating participation and increasing quality of life.

  8. Metformin inhibits early stage diethylnitrosamine‑induced hepatocarcinogenesis in rats.

    Science.gov (United States)

    Jo, Woori; Yu, Eun-Sil; Chang, Minsun; Park, Hyun-Kyu; Choi, Hyun-Ji; Ryu, Jae-Eun; Jang, Sungwoong; Lee, Hyo-Ju; Jang, Ja-June; Son, Woo-Chan

    2016-01-01

    Antitumor effects of metformin have recently emerged despite its original use for type II diabetes. In the present study, the effects of metformin on the development and recurrence of hepatocellular carcinoma (HCC) were investigated using the diethylnitrosamine (DEN)‑induced rat model of HCC. Tumor foci were characterized by gross examination and by histopathological characteristics, including proliferation, hepatic progenitor cell content and the expression of hepatocarcinoma‑specific molecular markers. Potential target molecules of metformin were investigated to determine the molecular mechanism underlying the inhibitory effects of metformin on chemically induced liver tumorigenesis. The antitumor effects of metformin were increased by the reduction of surface nodules and decreased the incidence of altered hepatocellular foci, hepatocellular adenoma and carcinoma. Also, decreased expression levels of glutathione S‑transferase placental form, proliferating cell nuclear antigen and cytokeratin 8 described the inhibitory effects of metformin on HCC. In the present study, Wistar rats receiving treatment with DEN were administered metformin for 16 weeks. In addition, metformin suppressed liver tumorigenesis via an AMPK‑dependent pathway. These results suggested that metformin has promising effects on the early stage of HCC in rats. Therefore, metformin may be used for the prevention of HCC recurrence following primary chemotherapy for HCC and/or for high‑risk patients, including chronic hepatitis and cirrhosis.

  9. Building performance simulation in the early design stage: An introduction to integrated dynamic models

    DEFF Research Database (Denmark)

    Negendahl, Kristoffer

    2015-01-01

    Designing with building performance simulation feedback in the early design stage has existed since the early days of computational modeling. However, as a consequence of a fragmented building industry building performance simulations (BPSs) in the early design stage are closely related to who is...

  10. Clonal expansion and linear genome evolution through breast cancer progression from pre-invasive stages to asynchronous metastasis

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Larsen, Martin Jakob; Lænkholm, Anne-Vibeke

    2015-01-01

    Evolution of the breast cancer genome from pre-invasive stages to asynchronous metastasis is complex and mostly unexplored, but highly demanded as it may provide novel markers for and mechanistic insights in cancer progression. The increasing use of personalized therapy of breast cancer necessita...

  11. A novel fully-humanised 3D skin equivalent to model early melanoma invasion

    Science.gov (United States)

    Hill, David S; Robinson, Neil D P; Caley, Matthew P; Chen, Mei; O’Toole, Edel A; Armstrong, Jane L; Przyborski, Stefan; Lovat, Penny E

    2015-01-01

    Metastatic melanoma remains incurable, emphasising the acute need for improved research models to investigate the underlying biological mechanisms mediating tumour invasion and metastasis, and to develop more effective targeted therapies to improve clinical outcome. Available animal models of melanoma do not accurately reflect human disease and current in vitro human skin equivalent models incorporating melanoma cells are not fully representative of the human skin microenvironment. We have developed a robust and reproducible, fully-humanised 3D skin equivalent comprising a stratified, terminally differentiated epidermis and a dermal compartment consisting of fibroblast-generated extracellular matrix. Melanoma cells incorporated into the epidermis were able to invade through the basement membrane and into the dermis, mirroring early tumour invasion in vivo. Comparison of our novel 3D melanoma skin equivalent with melanoma in situ and metastatic melanoma indicates this model accurately recreates features of disease pathology, making it a physiologically representative model of early radial and vertical growth phase melanoma invasion. PMID:26330548

  12. Staged minimally invasive plate osteosynthesis of proximal tibial fractures with acute compartment syndrome.

    Science.gov (United States)

    Kim, Joon-Woo; Oh, Chang-Wug; Oh, Jong-Keon; Kyung, Hee-Soo; Park, Kyeong-Hyeon; Kim, Hee-June; Jung, Jae-Wook; Jung, Young-Soo

    2017-06-01

    High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome. Twenty-eight patients with proximal tibial fractures accompanied by acute compartment syndrome who underwent staged MIPO and had a minimum of 12 months follow-up were enrolled. According to the AO/OTA classification, 6 were 41-A, 15 were 41-C, 2 were 42-A and 5 were 42-C fractures; this included 6 cases of open fractures. Immediate fasciotomy was performed once compartment syndrome was diagnosed and stabilization of the fracture followed using external fixation. After the soft tissue condition normalized, internal conversion with MIPO was done on an average of 37 days (range, 9-158) after index trauma. At the time of internal conversion, the external fixator pin site grades were 0 in 3 cases, 1 in 12 cases, 2 in 10 cases and 3 in 3 cases, as described by Dahl. Radiographic assessment of bony union and alignment and a functional assessment using the Knee Society Score and American Orthopedic Foot and Ankle Society (AOFAS) score were carried out. Twenty-six cases achieved primary bony union at an average of 18.5 weeks. Two cases of nonunion healed after autogenous bone grafting. The mean Knee Society Score and the AOFAS score were 95 and 95.3 respectively, at last follow-up. Complications included 1 case of osteomyelitis in a patient with a grade IIIC open fracture and 1 case of malunion caused by delayed MIPO due to poor wound conditions. Duration of external fixation and the external fixator pin site grade were not related to the

  13. Sampling design for aquatic invasive species early detection in Great Lakes ports

    Science.gov (United States)

    From 2006-2012, we evaluated a pilot aquatic invasive species (AIS) early detection monitoring program in Lake Superior that was designed to detect newly introduced fishes. We established survey protocols for three major ports (Duluth-Superior, Sault Ste. Marie, Thunder Bay) and ...

  14. Sampling design for early detection of aquatic invasive species in Great Lakes ports

    Science.gov (United States)

    We evaluated a pilot adaptive monitoring program for aquatic invasive species (AIS) early detection in Lake Superior. The monitoring program is designed to detect newly-introduced fishes, and encompasses the lake’s three major ports (Duluth-Superior, Sault Ste. Marie, Thund...

  15. Identification of cellular infiltrates during early stages of brain inflammation with magnetic resonance microscopy.

    Directory of Open Access Journals (Sweden)

    Helmar Waiczies

    Full Text Available A comprehensive view of brain inflammation during the pathogenesis of autoimmune encephalomyelitis can be achieved with the aid of high resolution non-invasive imaging techniques such as microscopic magnetic resonance imaging (μMRI. In this study we demonstrate the benefits of cryogenically-cooled RF coils to produce μMRI in vivo, with sufficient detail to reveal brain pathology in the experimental autoimmune encephalomyelitis (EAE model. We could visualize inflammatory infiltrates in detail within various regions of the brain, already at an early phase of EAE. Importantly, this pathology could be seen clearly even without the use of contrast agents, and showed excellent correspondence with conventional histology. The cryogenically-cooled coil enabled the acquisition of high resolution images within short scan times: an important practical consideration in conducting animal experiments. The detail of the cellular infiltrates visualized by in vivo μMRI allows the opportunity to follow neuroinflammatory processes even during the early stages of disease progression. Thus μMRI will not only complement conventional histological examination but will also enable longitudinal studies on the kinetics and dynamics of immune cell infiltration.

  16. Dream features in the early stages of Parkinson's disease.

    Science.gov (United States)

    Bugalho, Paulo; Paiva, Teresa

    2011-11-01

    Few studies have investigated the relation between dream features and cognition in Parkinson's disease (PD), although vivid dreams, hallucinations and cognitive decline have been proposed as successive steps of a pathological continuum. Our objectives were therefore to characterize the dreams of early stage PD and to study the relation between dream characteristics, cognitive function, motor status, depression, dopaminergic treatment, and the presence of REM sleep behaviour disorder (RBD) and hallucinations. Dreams of 19 male PD patients and 21 matched control subjects were classified according to Hall and van de Castle system. h statistics was used to compare the dream content between patients and controls. We tested the relation between patients' dreams characteristics and cognitive function (Frontal assessment battery (FAB) and Mini-Mental State Examination tests) depression (Beck depression inventory), motor function (UPDRS), dopaminergic treatment, the presence of RBD (according to clinical criteria) and hallucinations, using general linear model statistics. Patients and controls differed only on FAB scores. Relevant differences in the Hall and van de Castle scale were found between patient's dreams and those of the control group, regarding animals, aggression/friendliness, physical aggression, befriender (higher in the patient group) and aggressor and bodily misfortunes (lower in the patient group) features. Cognitive and particularly frontal dysfunction had a significant influence on the frequency of physical aggression and animal related features, while dopaminergic doses, depressive symptoms, hallucinations and RBD did not. We found a pattern of dream alteration characterized by heightened aggressiveness and the presence of animals. These were related to more severe frontal dysfunction, which could be the origin of such changes.

  17. Early Stage of Hypertensive Retinopathy; Is It Really Important?

    Directory of Open Access Journals (Sweden)

    Murat KARAMAN

    2014-09-01

    Full Text Available OBJECTIVE: To investigate the relationship between early stage hypertensive retinopathy (HTRP and endothelial dysfunction (ED in atherogenesis. MATERIAL and METHODS: A total of 99 subjects consisting of 73 patients diagnosed with Essential Hypertension (HT and 26 healthy subjects were included to the study. Flow mediated dilatation (FMD was performed to detect ED. Asymmetric dimethylarginine-ADMA was measured as a marker of ED and the hsCRP and sTWEAK levels were measured for microvascular inflammation. All patients were screened for retinopathy. RESULTS: The mean blood pressure of the hypertensive patients and the control subjects was 140.1±13.7/86.1±10.7 and 107.12±10.0/65.38±10.2 respectively. HTRP was positive in 60.3% (n=44 and negative in 39.7% (n=29 of the patients with hypertension. There was grade 1 retinopathy in 52.1% and grade 2 retinopathy in 8.2% of hypertensive patients. The hsCRP, sTWEAK and ADMA levels were significantly higher in hypertensive patients than in the control group (respectively, p=0,011, p=0,001, p=0,001. FMD levels were lower in the hypertensive group, as expected. FMD levels were lower in the retinopathy group when the hypertensive group with and without retinopathy and the control group compared. hsCRP, sTWEAK and ADMA levels were significantly higher in subjects with retinopathy. hsCRP, sTWEAK and ADMA levels were also significantly higher in subjects with retinopathy (p=0.039, p=0.001, p=0.001. CONCLUSION: ED is thought to play a role in HT etiology and is also important in the development of HT complications. It would be appropriate to evaluate hypertensive patients more carefully and perform the necessary laboratory tests to detect ED so that the proper treatment can be started (ACEI, exercise, lifestyle changes.

  18. Protein dynamics modulated electron transfer kinetics in early stage photosynthesis.

    Science.gov (United States)

    Kundu, Prasanta; Dua, Arti

    2013-01-28

    A recent experiment has probed the electron transfer kinetics in the early stage of photosynthesis in Rhodobacter sphaeroides for the reaction center of wild type and different mutants [Science 316, 747 (2007)]. By monitoring the changes in the transient absorption of the donor-acceptor pair at 280 and 930 nm, both of which show non-exponential temporal decay, the experiment has provided a strong evidence that the initial electron transfer kinetics is modulated by the dynamics of protein backbone. In this work, we present a model where the electron transfer kinetics of the donor-acceptor pair is described along the reaction coordinate associated with the distance fluctuations in a protein backbone. The stochastic evolution of the reaction coordinate is described in terms of a non-Markovian generalized Langevin equation with a memory kernel and Gaussian colored noise, both of which are completely described in terms of the microscopics of the protein normal modes. This model provides excellent fits to the transient absorption signals at 280 and 930 nm associated with protein distance fluctuations and protein dynamics modulated electron transfer reaction, respectively. In contrast to previous models, the present work explains the microscopic origins of the non-exponential decay of the transient absorption curve at 280 nm in terms of multiple time scales of relaxation of the protein normal modes. Dynamic disorder in the reaction pathway due to protein conformational fluctuations which occur on time scales slower than or comparable to the electron transfer kinetics explains the microscopic origin of the non-exponential nature of the transient absorption decay at 930 nm. The theoretical estimates for the relative driving force for five different mutants are in close agreement with the experimental estimates obtained using electrochemical measurements.

  19. A decade of aquatic invasive species (AIS) early detection method development in the St. Louis River estuary

    Science.gov (United States)

    As an invasion prone location, the St. Louis River Estuary (SLRE) has been a case study for ongoing research to develop the framework for a practical Great Lakes monitoring network for early detection of aquatic invasive species (AIS). Early detection, however, necessitates findi...

  20. Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

    Science.gov (United States)

    Ramirez, Pedro T.; Pareja, Rene; Rendón, Gabriel J.; Millan, Carlos; Frumovitz, Michael; Schmeler, Kathleen M.

    2014-01-01

    The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies have explored less radical surgical options for early-stage cervical cancer, including simple hysterectomy, simple trachelectomy, and cervical conization with or without sentinel lymph node biopsy and pelvic lymph node dissection. Such options may be available for patients with low-risk early-stage cervical cancer. Criteria that define this low-risk group include: squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumor size <2 cm, stromal invasion <10mm, and no lymph-vascular space invasion. In this report, we provide a review of the existing literature on the conservative management of cervical cancer and describe ongoing multi-institutional trials evaluating the role of conservative surgery in selected patients with early-stage cervical cancer. PMID:24041877

  1. A proposal for a TNM staging system for extramammary Paget disease: Retrospective analysis of 301 patients with invasive primary tumors.

    Science.gov (United States)

    Ohara, Kuniaki; Fujisawa, Yasuhiro; Yoshino, Koji; Kiyohara, Yoshio; Kadono, Takafumi; Murata, Yozo; Uhara, Hisashi; Hatta, Naohito; Uchi, Hiroshi; Matsushita, Shigeto; Takenouchi, Tatsuya; Hayashi, Toshihiko; Yoshimura, Kenichi; Fujimoto, Manabu

    2016-09-01

    Although extramammary Paget disease (EMPD) usually appears as carcinoma in situ, it sometimes becomes invasive (iEMPD) and fatal. However, a TNM staging system for iEMPD has yet to be established. The aim of this study was to establish a TNM staging system for iEMPD. We retrospectively collected iEMPD patients treated at 12 institutes in Japan. Factors reported to be associated with survival such as distant metastasis, lymph node (LN) metastasis, and primary tumor status were evaluated using the log-rank test. We enrolled 301 iEMPD patients, of whom 114 had remote metastases (49 had both distant and LN metastasis; 2, distant metastasis only; and 63, LN metastasis only) and the remaining 187 patients had no remote metastasis. Distant metastasis (M1) showed worse survival (PTNM staging system: stage I, T1N0M0; stage II, T2N0M0; stage IIIa, anyTN1M0; stage IIIb, anyTN2M0; stage IV, anyTanyNM1. Other than stages II and IIIa, each stage had a statistically distinct survival curve. We propose a TNM staging system for EMPD using simple factors for classification that could provide important prognostic information in managing EMPD. However, accumulation of more patient data and further revision of the system are required. Copyright © 2016 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  2. The Use of Frozen Section in the Early Diagnosis of Acute Invasive Fungal Sinusitis.

    Science.gov (United States)

    Melancon, C Claire; Clinger, John D

    2017-08-01

    Objectives Acute invasive fungal sinusitis (AIFS) remains a significant cause of morbidity and mortality in the immunocompromised patient population. Early diagnosis is key to improving patient outcomes. Frozen section biopsies have been shown to decrease time to diagnosis when compared with permanent pathology. However, its accuracy has not been adequately described in the literature, specifically in regard to AIFS. The aim of this study is to evaluate the statistical diagnostic accuracy of frozen sections and to review the etiology, clinical presentation, and current diagnostic protocols in management of AIFS. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods Retrospective review included 67 pathologic records in Co-Path, with search criteria including invasive fungal, clinical history, frozen section, and final diagnosis between the dates of 2006 and 2015. Results Sixty-seven cases were reviewed per the search criteria in Co-Path. Of these, 31 met further criteria of having had frozen section analysis. Variables such as sensitivity, specificity, positive predictive value, and negative predictive value were assessed. All 21 positive frozen sections correlated with positive permanent pathology, giving a positive predictive value of 100%. Frozen section biopsies were 87.5% sensitive and 100% specific. Conclusion Early diagnosis of AIFS has been shown to decrease morbidity and mortality. Frozen section biopsies remain key in obtaining an early diagnosis among patients with a high clinical suspicion for invasive fungal sinusitis. Frozen section biopsies positive for invasive fungal pathology were universally consistent with definitive diagnosis.

  3. Exome sequencing identifies early gastric carcinoma as an early stage of advanced gastric cancer.

    Directory of Open Access Journals (Sweden)

    Guhyun Kang

    Full Text Available Gastric carcinoma is one of the major causes of cancer-related mortality worldwide. Early detection and treatment leads to an excellent prognosis in patients with early gastric cancer (EGC, whereas the prognosis of patients with advanced gastric cancer (AGC remains poor. It is unclear whether EGCs and AGCs are distinct entities or whether EGCs are the beginning stages of AGCs. We performed whole exome sequencing of four samples from patients with EGC and compared the results with those from AGCs. In both EGCs and AGCs, a total of 268 genes were commonly mutated and independent mutations were additionally found in EGCs (516 genes and AGCs (3104 genes. A higher frequency of C>G transitions was observed in intestinal-type compared to diffuse-type carcinomas (P = 0.010. The DYRK3, GPR116, MCM10, PCDH17, PCDHB1, RDH5 and UNC5C genes are recurrently mutated in EGCs and may be involved in early carcinogenesis.

  4. Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer*

    Science.gov (United States)

    Rocha, Rafael Dahmer; Girardi, André Ricardo; Pinto, Renata Reis; de Freitas, Viviane Aguilera Rolim

    2015-01-01

    Objective To propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer. Materials and Methods Prospective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA. Results The overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases. Conclusion Axillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy. PMID:26811550

  5. Diagnosis of Late Stage, Early Onset, Small Fiber Polyneuropathy

    Science.gov (United States)

    2016-10-01

    additionally discovered SFPN that affects adolescents and adults [2]. This early-onset SFPN usually begins in adolescence or early adulthood but can...promote early diagnosis. What was the impact on other disciplines? Nothing to report. What was the impact on technology transfer? Nothing to report...What was the impact on society beyond science and technology ? As described above, Veterans’ health and, by extension, public health will be

  6. Upgrading the definition of early gastric cancer: better staging means more appropriate treatment.

    Science.gov (United States)

    Saragoni, Luca

    2015-12-01

    Since Murakami defined early gastric cancer (EGC) as a "carcinoma limited to the gastric mucosa and/or submucosa regardless of the lymph node status", several authors have focused on the most influential histopathological parameters for predicting the development of lymph node metastases by considering the lymph node status as an important prognostic factor. A few authors have also considered the depth of invasion as one of the keys to explaining the existence of subgroups of patients affected by EGC with poor prognoses. In any case, EGC is still considered an initial phase of tumor progression with good prognosis. The introduction of modern endoscopic devices has allowed a precise diagnosis of early lesions, which can lead to improved definitions of tumors that can be radically treated with endoscopic mucosal resection or endoscopic submucosal dissection (ESD). Given the widespread use of these techniques, the Japanese Gastric Cancer Association (JGCA) identified in 2011 the standard criteria that should exclude the presence of lymph node metastases. At that time, EGCs with nodal involvement should have been asserted as no longer fitting the definition of an early tumor. Some authors have also demonstrated that the morphological growth pattern of a tumor, according to Kodama's classification, is one of the most important prognostic factors, thereby suggesting the need to report it in histopathological drafts. Notwithstanding the acquired knowledge regarding the clinical behavior of EGC, Murakami's definition is still being used. This definition needs to be upgraded according to the modern staging of the disease so that the appropriate treatment would be selected.

  7. Biomarkers for early and late stage chronic allograft nephropathy by proteogenomic profiling of peripheral blood.

    Directory of Open Access Journals (Sweden)

    Sunil M Kurian

    Full Text Available BACKGROUND: Despite significant improvements in life expectancy of kidney transplant patients due to advances in surgery and immunosuppression, Chronic Allograft Nephropathy (CAN remains a daunting problem. A complex network of cellular mechanisms in both graft and peripheral immune compartments complicates the non-invasive diagnosis of CAN, which still requires biopsy histology. This is compounded by non-immunological factors contributing to graft injury. There is a pressing need to identify and validate minimally invasive biomarkers for CAN to serve as early predictors of graft loss and as metrics for managing long-term immunosuppression. METHODS: We used DNA microarrays, tandem mass spectroscopy proteomics and bioinformatics to identify genomic and proteomic markers of mild and moderate/severe CAN in peripheral blood of two distinct cohorts (n = 77 total of kidney transplant patients with biopsy-documented histology. FINDINGS: Gene expression profiles reveal over 2400 genes for mild CAN, and over 700 for moderate/severe CAN. A consensus analysis reveals 393 (mild and 63 (moderate/severe final candidates as CAN markers with predictive accuracy of 80% (mild and 92% (moderate/severe. Proteomic profiles show over 500 candidates each, for both stages of CAN including 302 proteins unique to mild and 509 unique to moderate/severe CAN. CONCLUSIONS: This study identifies several unique signatures of transcript and protein biomarkers with high predictive accuracies for mild and moderate/severe CAN, the most common cause of late allograft failure. These biomarkers are the necessary first step to a proteogenomic classification of CAN based on peripheral blood profiling and will be the targets of a prospective clinical validation study.

  8. Molecular characterization of an early invasive Staphylococcus epidermidis prosthetic joint infection.

    Science.gov (United States)

    Rosenthal, Marnie E; Dever, Lisa L; Moucha, Calin S; Chavda, Kalyan D; Otto, Michael; Kreiswirth, Barry N

    2011-09-01

    Historically regarded as a skin commensal, Staphylococcus epidermidis has been increasingly implicated in invasive foreign body infections such as catheter-related bloodstream infections, indwelling device infections, and prosthetic joint infections. We report a case of an aggressive, difficult-to-eradicate, invasive prosthetic hip infection occurring early after hardware implant and associated with a high-grade bacteremia and assess its salient molecular characteristics. The clinical and molecular characteristics of this isolate mirror the pathogenesis and persistence commonly seen with invasive methicillin-resistant S. aureus and may be attributed to the combination of resistance genes (SCCmec type IV), putative virulence factors (arcA and opp3a), cytolytic peptide production (α-type phenol-soluble modulins), and biofilm adhesion, interaction, and maturation (bhp, aap, and β-type phenol-soluble modulins).

  9. Approaches to the Treatment of Early Stage of Gallstone Disease in Children

    Directory of Open Access Journals (Sweden)

    O.G. Shadrin

    2013-11-01

    Conclusions. Diagnosis and treatment of GSD at the early stage make it possible to increase the efficacy of therapy in whole. It was noted that ursodeoxycholic acid (Ukrliv suspension possesses high efficiency and safety in the treatment of early GSD stage in children.

  10. Targeted labeling of early-​stage tumor spheroid in chorioallantoic membrane model with upconversion nanoparticles

    NARCIS (Netherlands)

    K. Liu; J.A. Holz; Y. Ding; X. Liu; Y. Zhang; L. Tu; X. Kong; B. Priem; A. Nadort; S.A.G. Lambrechts; M.C.G. Aalders; W.J. Buma; Y. Liu; H. Zhang

    2015-01-01

    In vivo detection of cancer at early-​stage, i.e. smaller than 2 mm, is a challenge in biomedicine. In this work target labeling of early-​stage tumor spheroid (∼500 μm) is realized for the first time in chick embryo chorioallantoic membrane (CAM) model with monoclonal antibody functionalized upconv

  11. 76 FR 76907 - Small Business Investment Companies-Early Stage SBICs

    Science.gov (United States)

    2011-12-09

    ... comments, identified by RIN 3245-AG32, by any of the following methods: Federal eRulemaking Portal: http..., particularly those without the necessary assets or cash flow for traditional bank funding. Although the venture... the ``Early Stage SBIC'' definition. Third, an Early Stage SBIC must invest at least 50 percent of its...

  12. Possible roles for folic acid in the regulation of trophoblast invasion and placental development in normal early human pregnancy.

    Science.gov (United States)

    Williams, Paula J; Bulmer, Judith N; Innes, Barbara A; Broughton Pipkin, Fiona

    2011-06-01

    In addition to its role in the prevention of neural tube defects, folic acid has many other physiological functions, including cell proliferation, DNA replication, and antioxidant protection. The aim of this study was to determine the role that folic acid has in regulating placental trophoblast development. Placental explants from placentae at gestational age 7 wk (n = 3) were cultured in folic acid at concentrations of 10(-6) M, 10(-8) M, and 10(-10) M. Extravillous trophoblast (EVT) invasion was assessed following 6-day culture, and explants were used for immunohistochemical evaluation of proliferation (MKI67) and apoptosis (active caspase 3). In addition, an array was performed on cell culture supernatants to examine a range of matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs). Folic acid increased the invasion of EVT cells in this explant model by between 83% and 19% (P = 0.005), and this was associated with increased MKI67 positivity and decreased active caspase 3 positivity; this effect was concentration dependent and showed a biphasic response. In addition, culture in folic acid increased vascular density, as determined by anti-CD31 immunostaining (P = 0.05). The increase in EVT invasion correlated with increased placental explant secretion of MMP2 (P = 0.01), MMP3 (P = 0.01), and MMP9 (P = 0.02). This study demonstrates that folic acid is potentially important in a number of crucial early stages of placental development, including EVT invasion, angiogenesis, and secretion of MMPs, and highlights the need for further studies to address the benefit of longer-term folic acid supplementation throughout pregnancy to prevent pregnancy disorders associated with deficient placental development, including preeclampsia.

  13. Oxidative stress tolerance of early stage diabetic endothelial progenitor cell

    Directory of Open Access Journals (Sweden)

    Dewi Sukmawati

    2015-06-01

    Conclusions: Primitive BM-EPCs showed vasculogenic dysfunction in early diabetes. However the oxidative stress is not denoted as the major initiating factor of its cause. Our results suggest that primitive BM-KSL cell has the ability to compensate oxidative stress levels in early diabetes by increasing the expression of anti-oxidative enzymes.

  14. Predictive factors for lymph node metastasis in early gastric cancer with lymphatic invasion after endoscopic resection.

    Science.gov (United States)

    Park, Ji Won; Ahn, Sangjeong; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Rhee, Poong-Lyul; Kim, Kyoung-Mee; Kim, Jae J

    2017-04-04

    Lymph node (LN) metastasis is found in only about 5-10% of the patients who undergo additional surgery after non-curative endoscopic resection. Lymphatic invasion after endoscopic submucosal dissection (ESD) is regarded as non-curative resection due to risk of reginal LN metastasis. This study was aimed to identify clinicopathologic predictive factors for LN metastasis in early gastric cancer (EGC) with lymphatic invasion after endoscopic resection. Among a total of 2036 patients who underwent endoscopic resection for EGC at Samsung Medical Center from April 2000 to May 2011, 146 patients were diagnosed with lymphatic invasion. And 123 patients who had gastrectomy with LN dissection due to presence of lymphatic invasion as one of the non-curative factors were included in this study. Demographics, endoscopic tumor findings, histological findings, surgical findings with pathologic reports, and follow-up data were collected from the patient's medical records. Pathological re-evaluation of resected specimens was performed. Among a total of 123 patients, LN metastases were found in seven patients (5.7%). The univariate analysis revealed that the LN metastasis was significantly more frequent in patients with certain morphology of lymphatic invasion that shows adhesion to endothelium of lymphatic tumor emboli (p = 0.016), higher number of lymphatic tumor emboli in whole section (p < 0.001) and papillary adenocarcinoma component (p = 0.024). In multivariate analysis, the number of lymphatic tumor emboli [OR 93.5, 95% CI (2.62-3330.81)] and the presence of papillary adenocarcinoma component [OR 552.5, 95% CI (1.20-254871.81)] were identified as independent predictors of LN metastasis in patients with lymphatic invasion after endoscopic resection. The number of lymphatic tumor emboli and the presence of papillary adenocarcinoma component were significant predictors for LN metastasis in patients with lymphatic invasion after endoscopic resection.

  15. De novo Transcriptome Analysis of Rhizoctonia solani AG1 IA Strain Early Invasion in Zoysia japonica Root.

    Science.gov (United States)

    Zhu, Chen; Ai, Lin; Wang, Li; Yin, Pingping; Liu, Chenglan; Li, Shanshan; Zeng, Huiming

    2016-01-01

    Zoysia japonica brown spot was caused by necrotrophic fungus Rhizoctonia solani invasion, which led to severe financial loss in city lawn and golf ground maintenance. However, little was known about the molecular mechanism of R. solani pathogenicity in Z. japonica. In this study we examined early stage interaction between R. solani AG1 IA strain and Z. japonica cultivar "Zenith" root by cell ultra-structure analysis, pathogenesis-related proteins assay and transcriptome analysis to explore molecular clues for AG1 IA strain pathogenicity in Z. japonica. No obvious cell structure damage was found in infected roots and most pathogenesis-related protein activities showedg a downward trend especially in 36 h post inoculation, which exhibits AG1 IA strain stealthy invasion characteristic. According to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) database classification, most DEGs in infected "Zenith" roots dynamically changed especially in three aspects, signal transduction, gene translation, and protein synthesis. Total 3422 unigenes of "Zenith" root were predicted into 14 kinds of resistance (R) gene class. Potential fungal resistance related unigenes of "Zenith" root were involved in ligin biosynthesis, phytoalexin synthesis, oxidative burst, wax biosynthesis, while two down-regulated unigenes encoding leucine-rich repeat receptor protein kinase and subtilisin-like protease might be important for host-derived signal perception to AG1 IA strain invasion. According to Pathogen Host Interaction (PHI) database annotation, 1508 unigenes of AG1 IA strain were predicted and classified into 37 known pathogen species, in addition, unigenes encoding virulence, signaling, host stress tolerance, and potential effector were also predicted. This research uncovered transcriptional profiling during the early phase interaction between R. solani AG1 IA strain and Z. japonica, and will greatly help identify key pathogenicity of AG1 IA strain.

  16. Early Outcomes of Minimally Invasive Anterior Longitudinal Ligament Release for Correction of Sagittal Imbalance in Patients with Adult Spinal Deformity

    Directory of Open Access Journals (Sweden)

    Armen R. Deukmedjian

    2012-01-01

    Full Text Available The object of this study was to evaluate a novel surgical technique in the treatment of adult degenerative scoliosis and present our early experience with the minimally invasive lateral approach for anterior longitudinal ligament release to provide lumbar lordosis and examine its impact on sagittal balance. Methods. All patients with adult spinal deformity (ASD treated with the minimally invasive lateral retroperitoneal transpsoas interbody fusion (MIS LIF for release of the anterior longitudinal ligament were examined. Patient demographics, clinical data, spinopelvic parameters, and outcome measures were recorded. Results. Seven patients underwent release of the anterior longitudinal ligament (ALR to improve sagittal imbalance. All cases were split into anterior and posterior stages, with mean estimated blood loss of 125 cc and 530 cc, respectively. Average hospital stay was 8.3 days, and mean follow-up time was 9.1 months. Comparing pre- and postoperative 36′′ standing X-rays, the authors discovered a mean increase in global lumbar lordosis of 24 degrees, increase in segmental lumbar lordosis of 17 degrees per level of ALL released, decrease in pelvic tilt of 7 degrees, and decrease in sagittal vertical axis of 4.9 cm. At the last followup, there was a mean improvement in VAS and ODI scores of 26.2% and 18.3%. Conclusions. In the authors’ early experience, release of the anterior longitudinal ligament using the minimally invasive lateral retroperitoneal transpsoas approach may be a feasible alternative in correcting sagittal deformity.

  17. De novo Transcriptome Analysis of Rhizoctonia solani AG1 IA Strain Early Invasion in Zoysia japonica Root

    Science.gov (United States)

    Zhu, Chen; Ai, Lin; Wang, Li; Yin, Pingping; Liu, Chenglan; Li, Shanshan; Zeng, Huiming

    2016-01-01

    Zoysia japonica brown spot was caused by necrotrophic fungus Rhizoctonia solani invasion, which led to severe financial loss in city lawn and golf ground maintenance. However, little was known about the molecular mechanism of R. solani pathogenicity in Z. japonica. In this study we examined early stage interaction between R. solani AG1 IA strain and Z. japonica cultivar “Zenith” root by cell ultra-structure analysis, pathogenesis-related proteins assay and transcriptome analysis to explore molecular clues for AG1 IA strain pathogenicity in Z. japonica. No obvious cell structure damage was found in infected roots and most pathogenesis-related protein activities showedg a downward trend especially in 36 h post inoculation, which exhibits AG1 IA strain stealthy invasion characteristic. According to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) database classification, most DEGs in infected “Zenith” roots dynamically changed especially in three aspects, signal transduction, gene translation, and protein synthesis. Total 3422 unigenes of “Zenith” root were predicted into 14 kinds of resistance (R) gene class. Potential fungal resistance related unigenes of “Zenith” root were involved in ligin biosynthesis, phytoalexin synthesis, oxidative burst, wax biosynthesis, while two down-regulated unigenes encoding leucine-rich repeat receptor protein kinase and subtilisin-like protease might be important for host-derived signal perception to AG1 IA strain invasion. According to Pathogen Host Interaction (PHI) database annotation, 1508 unigenes of AG1 IA strain were predicted and classified into 37 known pathogen species, in addition, unigenes encoding virulence, signaling, host stress tolerance, and potential effector were also predicted. This research uncovered transcriptional profiling during the early phase interaction between R. solani AG1 IA strain and Z. japonica, and will greatly help identify key pathogenicity of AG1 IA strain

  18. Efficient and rapid isolation of early-stage embryos from Arabidopsis thaliana seeds

    OpenAIRE

    Raissig, Michael T; Gagliardini, Valeria; Jaenisch, Johan; Grossniklaus, Ueli; Baroux, Célia

    2013-01-01

    In flowering plants, the embryo develops within a nourishing tissue - the endosperm - surrounded by the maternal seed integuments (or seed coat). As a consequence, the isolation of plant embryos at early stages (1 cell to globular stage) is technically challenging due to their relative inaccessibility. Efficient manual dissection at early stages is strongly impaired by the small size of young Arabidopsis seeds and the adhesiveness of the embryo to the surrounding tissues. Here, we describe a ...

  19. Clonal expansion and linear genome evolution through breast cancer progression from pre-invasive stages to asynchronous metastasis

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Larsen, Martin Jakob; Lænkholm, Anne Vibeke;

    2015-01-01

    Evolution of the breast cancer genome from pre-invasive stages to asynchronous metastasis is complex and mostly unexplored, but highly demanded as it may provide novel markers for and mechanistic insights in cancer progression. The increasing use of personalized therapy of breast cancer necessita......Evolution of the breast cancer genome from pre-invasive stages to asynchronous metastasis is complex and mostly unexplored, but highly demanded as it may provide novel markers for and mechanistic insights in cancer progression. The increasing use of personalized therapy of breast cancer...... progression from one breast cancer patient, including two different regions of Ductal Carcinoma In Situ (DCIS), primary tumor and an asynchronous metastasis. We identify a remarkable landscape of somatic mutations, retained throughout breast cancer progression and with new mutational events emerging at each...

  20. Fertility-Sparing Surgery for Early-Stage Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Adelaide Fernanda Ribeiro Cubal

    2012-01-01

    Full Text Available Nowadays cervical cancer is diagnosed in many women who still want to have children. This led to the need to provide fertility-sparing treatments. The main goal is to maintain reproductive ability without decreasing overall and recurrence-free survival. In this article, we review data on procedures for fertility preservation, namely, vaginal and abdominal trachelectomy, less invasive surgery and neoadjuvant chemotherapy. For each one, oncological and obstetrical outcomes are analyzed. Comparing to traditionally offered radical hysterectomy, the overall oncologic safety is good, with promising obstetrical outcomes.

  1. Primary treatment options for high risk/medically inoperable early stage NSCLC patients

    Science.gov (United States)

    Jones, Guy C.; Kehrer, Jason D.; Kahn, Jenna; Koneru, Bobby N.; Narayan, Ram; Thomas, Tarita O.; Camphausen, Kevin; Mehta, Minesh P; Kaushal, Aradhana

    2015-01-01

    Lung cancer is among the most common cancers worldwide, and the leading cause of cancer death in both men and women. For patients with early stage (AJCC T1-2, N0) non-small cell lung cancer the current standard of care is lobectomy with systematic lymph node evaluation. Unfortunately, medical comorbities often present in patients with lung cancer, may preclude the option of surgical resection . In such cases, a number of minimal to non-invasive treatment options have gained popularity in the treatment of these high-risk patients. These modalities provide significant advantages including patient convenience, treatment in an outpatient setting, and acceptable toxicities including reduced impact on lung function and a modest risk of post-procedure chest wall pain. This manuscript seeks to provide a comprehensive review of the literature including reported outcomes, complications and limitations of sublobar resection with or without intraoperative brachytherapy, radiofrequency ablation, microwave ablation, percutaneous cryoablation, photodynamic therapy and stereotactic body radiation therapy. PMID:26027433

  2. The effect on esophagus after different radiotherapy techniques for early stage Hodgkin's lymphoma

    DEFF Research Database (Denmark)

    Jørgensen, Anni; Maraldo, M.; Brodin, Nils Patrik

    2013-01-01

    The cure rate of early stage Hodgkin's lymphoma (HL) is excellent; investigating the late effects of treatment is thus important. Esophageal toxicity is a known side effect in patients receiving radiotherapy (RT) to the mediastinum, although little is known of this in HL survivors. This study inv...... investigates the dose to the esophagus in the treatment of early stage HL using different RT techniques. Estimated risks of early esophagitis, esophageal stricture and cancer are compared between treatments....

  3. Original Paper Early stage leucocytosis in Nigerian pigs ...

    African Journals Online (AJOL)

    Sequential leukocyte changes associated with early phase of Trypanosoma brucei infection were investigated in ... members of the T. brucei sub group, human infective, T. brucei ..... trypanosome antigens to the bone marrow and generation of ...

  4. Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Masakatsu; Fukuzawa; Yutaka; Saito; Takahisa; Matsuda; Toshio; Uraoka; Takao; Itoi; Fuminori; Moriyasu

    2010-01-01

    AIM: To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis. METHODS: We studied 112 ECC lesions [mucosal/ submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] ≥ 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnifi- cation colonosc...

  5. Using Motivational Interviewing within the Early Stages of Group Development

    Science.gov (United States)

    Young, Tabitha L.

    2013-01-01

    This article presents developmentally appropriate applications of Motivational Interviewing (MI; Miller & Rollnick, 2002) for use in preparing group members for the working stages of group. Practical strategies are offered for using MI to facilitate an atmosphere of trust, recognize member readiness for change, identify and resolve members'…

  6. Perception of affective prosody in patients at an early stage of relapsing-remitting multiple sclerosis.

    Science.gov (United States)

    Kraemer, Markus; Herold, Michele; Uekermann, Jennifer; Kis, Bernhard; Daum, Irene; Wiltfang, Jens; Berlit, Peter; Diehl, Rolf R; Abdel-Hamid, Mona

    2013-03-01

    Cognitive dysfunction is well known in patients suffering from multiple sclerosis (MS) and has been described for many years. Cognitive impairment, memory, and attention deficits seem to be features of advanced MS stages, whereas depression and emotional instability already occur in early stages of the disease. However, little is known about processing of affective prosody in patients in early stages of relapsing-remitting MS (RRMS). In this study, tests assessing attention, memory, and processing of affective prosody were administered to 25 adult patients with a diagnosis of RRMS at an early stage and to 25 healthy controls (HC). Early stages of the disease were defined as being diagnosed with RRMS in the last 2 years and having an Expanded Disability Status Scale (EDSS) of 2 or lower. Patients and HC were comparable in intelligence quotient (IQ), educational level, age, handedness, and gender. Patients with early stages of RRMS performed below the control group with respect to the subtests 'discrimination of affective prosody' and 'matching of affective prosody to facial expression' for the emotion 'angry' of the 'Tübingen Affect Battery'. These deficits were not related to executive performance. Our findings suggest that emotional prosody comprehension is deficient in young patients with early stages of RRMS. Deficits in discriminating affective prosody early in the disease may make misunderstandings and poor communication more likely. This might negatively influence interpersonal relationships and quality of life in patients with RRMS.

  7. Swimming speed alteration in the early developmental stages of Paracentrotus lividus sea urchin as ecotoxicological endpoint.

    Science.gov (United States)

    Morgana, Silvia; Gambardella, Chiara; Falugi, Carla; Pronzato, Roberto; Garaventa, Francesca; Faimali, Marco

    2016-04-01

    Behavioral endpoints have been used for decades to assess chemical impacts at concentrations unlikely to cause mortality. With recently developed techniques, it is possible to investigate the swimming behavior of several organisms under laboratory conditions. The aims of this study were: i) assessing for the first time the feasibility of swimming speed analysis of the early developmental stage sea urchin Paracentrotus lividus by an automatic recording system ii) investigating any Swimming Speed Alteration (SSA) on P. lividus early stages exposed to a chemical reference; iii) identifying the most suitable stage for SSA test. Results show that the swimming speed of all the developmental stages was easily recorded. The swimming speed was inhibited as a function of toxicant concentration. Pluteus were the most appropriate stage for evaluating SSA in P. lividus as ecotoxicological endpoint. Finally, swimming of sea urchin early stages represents a sensitive endpoint to be considered in ecotoxicological investigations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. WE-EF-210-07: Development of a Minimally Invasive Photo Acoustic Imaging System for Early Prostate Cancer Detection

    Energy Technology Data Exchange (ETDEWEB)

    Sano, M; Yousefi, S; Xing, L [Stanford University School of Medicine, Stanford, CA (United States)

    2015-06-15

    Purpose: The objective of this work is to design, implement and characterize a catheter-based ultrasound/photoacoustic imaging probe for early-diagnosis of prostate cancer and to aid in image-guided radiation therapy. Methods: The need to image across 6–10cm of tissue to image the whole prostate gland limits the resolution achievable with a transrectal ultrasound approach. In contrast, the urethra bisects the prostate gland, providing a minimally invasive pathway for deploying a high resolution ultrasound transducer. Utilizing a high-frequency (20MHz) ultrasound/photoacoustic probe, high-resolution structural and molecular imaging of the prostate tissue is possible. A custom 3D printed probe containing a high-frequency single-element ultrasound transducer is utilized. The diameter of the probe is designed to fit inside a Foley catheter and the probe is rotated around the central axis to achieve a circular B-scan. A custom ultrasound amplifier and receiver was set up to trigger the ultrasound pulse transmission and record the reflected signal. The reconstructed images were compared to images generated by traditional 5 MHz ultrasound transducers. Results: The preliminary results using the high-frequency ultrasound probe show that it is possible to resolve finely detailed information in a prostate tissue phantom that was not achievable with previous low-frequency ultrasound systems. Preliminary ultrasound imaging was performed on tissue mimicking phantom and sensitivity and signal-to-noise ratio of the catheter was measured. Conclusion: In order to achieve non-invasive, high-resolution, structural and molecular imaging for early-diagnosis and image-guided radiation therapy of the prostate tissue, a transurethral catheter was designed. Structural/molecular imaging using ultrasound/photoacoustic of the prostate tissue will allow for localization of hyper vascularized areas for early-stage prostate cancer diagnosis.

  9. Skin-sparing mastectomy and immediate reconstruction: oncologic risks and aesthetic results in patients with early-stage breast cancer.

    Science.gov (United States)

    Slavin, S A; Schnitt, S J; Duda, R B; Houlihan, M J; Koufman, C N; Morris, D J; Troyan, S L; Goldwyn, R M

    1998-07-01

    Skin-sparing mastectomy has been advocated as an oncologically safe approach for the management of patients with early-stage breast cancer that minimizes deformity and improves cosmesis through preservation of the skin envelope of the breast. Because chest wall skin is the most frequent site of local failure after mastectomy, concerns have been raised that inadequate skin excision could result in an increased risk of local recurrence. Precise borders of the skin resection have not been well established, and long-term local recurrence rates after skin-sparing mastectomy are not known. The purpose of this study was to evaluate the oncologic safety and aesthetic results for skin-sparing mastectomy and immediate breast reconstruction with a latissimus dorsi myocutaneous flap and saline breast prosthesis. Fifty-one patients with early-stage breast cancer (26 with ductal carcinoma in situ and 25 with invasive carcinoma) undergoing primary mastectomy and immediate reconstruction with a latissimus flap were studied from 1991 through 1994. For 32 consecutive patients, skin-sparing mastectomy was defined as a 5-mm margin of skin designed around the border of the nipple-areolar complex. After the mastectomy, biopsies were obtained from the remaining native skin flap edges. Patients were followed for 44.8 months. Histologic examination of 114 native skin flap biopsy specimens failed to demonstrate breast ducts in the dermis of any of the 32 consecutive patients studied. One of 26 patients with ductal carcinoma in situ had metastases to the skin of the lateral chest wall and back. Four other patients, one with stage I disease and three with stage II-B disease, had recurrent breast carcinoma. The stage I patient had a local recurrence in the subcutaneous tissues near the mastectomy specimen. Two patients suffered axillary relapse, and one had distant metastases to the spine. The findings of this study support the technique of skin-sparing mastectomy as an oncologically safe one

  10. CTNNB1 (beta-catenin) mutation identifies low grade, early stage endometrial cancer patients at increased risk of recurrence.

    Science.gov (United States)

    Kurnit, Katherine C; Kim, Grace N; Fellman, Bryan M; Urbauer, Diana L; Mills, Gordon B; Zhang, Wei; Broaddus, Russell R

    2017-03-10

    Although the majority of low grade, early stage endometrial cancer patients will have good survival outcomes with surgery alone, those patients who do recur tend to do poorly. Optimal identification of the subset of patients who are at high risk of recurrence and would benefit from adjuvant treatment has been difficult. The purpose of this study was to evaluate the impact of somatic tumor mutation on survival outcomes in this patient population. For this study, low grade was defined as endometrioid FIGO grades 1 or 2, while early stage was defined as endometrioid stages I or II (disease confined to the uterus). Next-generation sequencing was performed using panels comprised of 46-200 genes. Recurrence-free and overall survival was compared across gene mutational status in both univariate and multivariate analyses. In all, 342 patients were identified, 245 of which had endometrioid histology. For grades 1-2, stages I-II endometrioid endometrial cancer patients, age (HR 1.07, 95% CI 1.03-1.10), CTNNB1 mutation (HR 5.97, 95% CI 2.69-13.21), and TP53 mutation (HR 4.07, 95% CI 1.57-10.54) were associated with worse recurrence-free survival on multivariate analysis. When considering endometrioid tumors of all grades and stages, CTNNB1 mutant tumors were associated with significantly higher rates of grades 1-2 disease, lower rates of deep myometrial invasion, and lower rates of lymphatic/vascular space invasion. When both TP53 and CTNNB1 mutations were considered, presence of either TP53 mutation or CTNNB1 mutation remained a statistically significant predictor of recurrence-free survival on multivariate analysis and was associated with a more precise confidence interval (HR 4.69, 95% CI 2.38-9.24). Thus, mutational analysis of a 2 gene panel of CTNNB1 and TP53 can help to identify a subset of low grade, early stage endometrial cancer patients who are at high risk of recurrence.Modern Pathology advance online publication, 10 March 2017; doi:10.1038/modpathol.2017.15.

  11. Factors significantly increasing or inhibiting early stages of malignant melanoma (M.M.) and non-invasive evaluation of new treatment by ingestion and external application of optimal doses of the most effective anti-M.M. substances: haritaki, cilantro, vitamin D3, nori, EPA with DHA, & application of special (+) solar energy stored paper, which reduced the M.M. active area & asbestos rapidly.

    Science.gov (United States)

    Omura, Yoshiaki; Jones, Marilyn; Duvvi, Harsha; Paluch, Kamila; Shimotsuura, Yasuhiro; Ohki, Motomu

    2013-01-01

    Sterilizing the pre-cancer skin of malignant melanoma (M.M.) with 70% Isopropyl alcohol intensified malignancy & the malignant response extended to surrounding normal looking skin, while sterilizing with 80% (vodka) or 12% (plum wine) ethyl alcohol completely inhibited M.M. in the area (both effects lasted for about 90 minutes initially). Burnt food (bread, vegetables, meat, and fish), a variety of smoked & non-smoked fish-skin, many animal's skin, pepper, Vitamin C over 75 mg, mango, pineapple, coconut, almond, sugars, Saccharine & Aspartame, garlic, onion, etc & Electromagnetic field from cellular phones worsened M.M. & induced abnormal M.M. response of surrounding skin. We found the following factors inhibit early stage of M.M. significantly: 1) Increasing normal cell telomere, by taking 500 mg Haritaki, often reached between 400-1150 ng& gradually diminished, but the M.M. response was completely inhibited until normal cell telomeres are reduced to 150 ng, which takes 6-8 hours. More than 70 mg Vitamin C, Orange Juice, & other high Vitamin C containing substances shouldn't be taken because they completely inhibit the effects of Haritaki. 2) We found Chrysotile asbestos & Tremolite asbestos (% of the Chrysotile amount) coexist. A special Cilantro tablet was used to remove asbestos & some toxic metals. 3) Vitamin D3 400 I.U. has a maximum inhibiting effect on M.M. but 800 I.U. or higher promotes malignancy. 4) Noricontaining Iodine, etc., was used. 5) EPA 180 mm with DHA 120 mg was most effectively used after metastasis to the surrounding skin was eliminated. When we combined 1 Cilantro tablet & Vitamin D3 400 I.U. withsmall Nori pieces & EPA with DHA, the effect of complete inhibition of M.M. lasted 9-11 hours. When these anti-M.M.substances (Haritaki, Vitamin D3, Cilantro, Nori, EPA. with DHA) were taken together, the effect lasted 12-14 hoursand M.M. involvement in surrounding normal-looking skin disappeared rapidly & original dark brown or black are as

  12. Systemic immune markers characterizing early stages of rheumatoid arthritis

    NARCIS (Netherlands)

    Chalan, Paulina Luiza

    2016-01-01

    Rheumatoid arthritis is a chronic autoimmune disease occurring in ~1% of the world population. The main feature of the disease is ongoing joint inflammation, caused by immune cells and their soluble factors, leading to irreversible bone erosions and cartilage damage. Early treatment can halt progres

  13. Inhibition of Host Cell Lysosome Spreading by Trypanosoma cruzi Metacyclic Stage-Specific Surface Molecule gp90 Downregulates Parasite Invasion.

    Science.gov (United States)

    Rodrigues, João Paulo Ferreira; Sant'ana, Guilherme Hideki Takahashi; Juliano, Maria Aparecida; Yoshida, Nobuko

    2017-09-01

    Successful infection by Trypanosoma cruzi, the agent of Chagas' disease, is critically dependent on host cell invasion by metacyclic trypomastigote (MT) forms. Two main metacyclic stage-specific surface molecules, gp82 and gp90, play determinant roles in target cell invasion in vitro and in oral T. cruzi infection in mice. The structure and properties of gp82, which is highly conserved among T. cruzi strains, are well known. Information on gp90 is still rather sparse. Here, we attempted to fill that gap. gp90, purified from poorly invasive G strain MT and expressing gp90 at high levels, inhibited HeLa cell lysosome spreading and the gp82-mediated internalization of a highly invasive CL strain MT expressing low levels of a diverse gp90 molecule. A recombinant protein containing the conserved C-terminal domain of gp90 exhibited the same properties as the native G strain gp90: it counteracted the host cell lysosome spreading induced by recombinant gp82 and exhibited an inhibitory effect on HeLa cell invasion by CL strain MT. Assays to identify the gp90 sequence associated with the property of downregulating MT invasion, using synthetic peptides spanning the gp90 C-terminal domain, revealed the sequence GVLYTADKEW. These data, plus the findings that lysosome spreading was induced upon HeLa cell interaction with CL strain MT, but not with G strain MT, and that in mixed infection CL strain MT internalization was inhibited by G strain MT, suggest that the inhibition of target cell lysosome spreading is the mechanism by which the gp90 molecule exerts its downregulatory role. Copyright © 2017 Rodrigues et al.

  14. Detection of gene expression pattern in the early stage after spinal cord injury by gene chip

    Institute of Scientific and Technical Information of China (English)

    刘成龙; 靳安民; 童斌辉

    2003-01-01

    Objective: To study the changes of the gene expression pattern of spinal cord tissues in the early stage after injury by DNA microarray (gene chip). Methods: The contusion model of rat spinal cord was established according to Allen's falling strike method and the gene expression patterns of normal and injured spinal cord tissues were studied by gene chip. Results: The expression of 45 genes was significantly changed in the early stage after spinal cord injury, in which 22 genes up-regulated and 23 genes down-regulated. Conclusions: The expression of some genes changes significantly in the early stage after spinal cord injury, which indicates the complexity of secondary spinal cord injury.

  15. Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

    Institute of Scientific and Technical Information of China (English)

    刘心; 张梅; 刘陕西; 祈光裕; 刘亚民

    2003-01-01

    Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.

  16. Early Invasive Versus Selective Strategy for Non-ST-Segment Elevation Acute Coronary Syndrome: The ICTUS Trial.

    Science.gov (United States)

    Hoedemaker, Niels P G; Damman, Peter; Woudstra, Pier; Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G P; de Winter, Robbert J

    2017-04-18

    The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and an elevated cardiac troponin T. No long-term benefit of an early invasive strategy was found at 1 and 5 years. The aim of this study was to determine the 10-year clinical outcomes of an early invasive strategy versus a selective invasive strategy in patients with NSTE-ACS and an elevated cardiac troponin T. The ICTUS trial was a multicenter, randomized controlled clinical trial that included 1,200 patients with NSTE-ACS and an elevated cardiac troponin T. Enrollment was from July 2001 to August 2003. We collected 10-year follow-up of death, myocardial infarction (MI), and revascularization through the Dutch population registry, patient phone calls, general practitioners, and hospital records. The primary outcome was the 10-year composite of death or spontaneous MI. Additional outcomes included the composite of death or MI, death, MI (spontaneous and procedure-related), and revascularization. Ten-year death or spontaneous MI was not statistically different between the 2 groups (33.8% vs. 29.0%, hazard ratio [HR]: 1.12; 95% confidence interval [CI]: 0.97 to 1.46; p = 0.11). Revascularization occurred in 82.6% of the early invasive group and 60.5% in the selective invasive group. There were no differences in additional outcomes, except for a higher rate of death or MI in the early invasive group compared with the rates for the selective invasive group (37.6% vs. 30.5%; HR: 1.30; 95% CI: 1.07 to 1.58; p = 0.009), driven by a higher rate of procedure-related MI in the early invasive group (6.5% vs. 2.4%; HR: 2.82; 95% CI: 1.53 to 5.20; p = 0.001). In patients with NSTE-ACS and elevated cardiac troponin T levels, an early invasive strategy has no benefit over a selective invasive strategy in reducing the 10-year composite outcome of

  17. A human xenograft model for testing early events of epithelial neoplastic invasion

    Science.gov (United States)

    McCANDLESS, JOHN R.; CRESS, ANNE E.; RABINOVITZ, ISAAC; PAYNE, CLAIRE M.; BOWDEN, G. TIM; KNOX, J. DAVID; NAGLE, RAY B.

    2017-01-01

    We report on a model of human prostate tumor cell invasion using the SCID (severe combined immunodeficient) mouse diaphragm. Tumor cells were injected into SCID mice intraperitoneally and the diaphragms harvested three to five weeks later. Electron microscopy showed tumor cell penetration of the mesothelial cell layer and adhesion to the underlying basement membrane on the inferior surface of the mouse diaphragm, where colonies developed. Immunohistochemistry showed invasion by tumor cells through the basement membrane into the muscle of the diaphragm, presence of human tumor cells among the muscle cells and the presence of selected proteins on the invasion front of the tumor cells. Digital image analysis enabled quantitative comparison of events in the metastatic cascade by variants of the tumor cell line and evaluation of the effectiveness of a putative tumor inhibitor. Results suggest that the SCID mouse diaphragm model is a convenient, effective, easily oriented and reproducible in vivo model of the early events associated with human prostate tumor cell invasion. PMID:21533373

  18. Nisqually - Early Detection Rapid Response, Monitoring and Mapping of High Priority Invasives with Refuge Weed Warriors 2006

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This project plan was to initiate a program for early detection and response, monitoring and mapping of invasive species on Grays Harbor NWR and continued current...

  19. Nisqually - Early Detection Rapid Response, Monitoring and Mapping of High Priority Invasive Species with Nisqually NWRC Weed Warriors 2007

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This project continues a successful program of early detection and rapid response, monitoring and mapping of invasive species on Nisqually NWRC (NNWRC) by Weed...

  20. Nisqually - Early Detection Rapid Response, Monitoring and Mapping of High Priority Invasive Species with Nisqually NWRC Weed Warriors 2008

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This project will continue a successful program of early detection and rapid response, monitoring and mapping of invasive species on Nisqually NWRC by Weed Warrior...

  1. [Anxiety-phobic disorders in the early childhood stage].

    Science.gov (United States)

    Volkova, O M; Kozlovskaia, G V; Proselkova, M O

    2012-01-01

    The complex of such phenomena as anxiety and fear in children of the early age and their relationship with risk factors for psychic pathology were investigated. Eighty cases of anxiety-phobic disorders in children of the first five years of life were studied. The types of behavioral and somatic reactions that allowed to reveal not only the clinically expressed phenomena of anxiety and fear but the higher readiness to them were described. The first anxiety-phobic reactions appeared at the age when emotional functions were not completely formed and might be considered as the presentations of emotional dysontogenesis. The authors assume that characteristics of fear expression in the early age allow to suspect a mental disease which might be timely diagnosed in case of its manifestation. The conclusions made in the paper may be useful for clinical practice of pediatricians, children neurologists, psychologists and psychiatrists.

  2. Signs of Early-stage Disk Growth Revealed with ALMA

    Science.gov (United States)

    Yen, Hsi-Wei; Koch, Patrick M.; Takakuwa, Shigehisa; Krasnopolsky, Ruben; Ohashi, Nagayoshi; Aso, Yusuke

    2017-01-01

    We present ALMA 1.3 mm continuum, 12CO, C18O, and SO data for the Class 0 protostars Lupus 3 MMS, IRAS 15398‑3559, and IRAS 16253‑2429 at resolutions of ∼100 au. By measuring a rotational profile in C18O, a 100 au Keplerian disk around a 0.3 M⊙ protostar is observed in Lupus 3 MMS. No 100 au Keplerian disks are observed in IRAS 15398‑3559 and IRAS 16253‑2429. Nevertheless, embedded compact (<30 au) continuum components are detected. The C18O emission in IRAS 15398‑3559 shows signatures of infall with a constant angular momentum. IRAS 16253‑2429 exhibits signatures of infall and rotation, but its rotational profile is unresolved. By fitting the C18O data with our kinematic models, the protostellar masses and the disk radii are inferred to be 0.01 M⊙ and 20 au in IRAS 15398‑3559, and 0.03 M⊙ and 6 au in IRAS 16253‑2429. By comparing the specific angular momentum profiles from 10,000 au to 100 au in eight Class 0 and I protostars, we find that the evolution of envelope rotation can be described with conventional inside-out collapse models. In comparison with a sample of 18 protostars with known disk radii, our results reveal signs of disk growth, with the disk radius increasing as {{M}* }0.8+/- 0.14 or {t}1.09+/- 0.37 in the Class 0 stage, where M* is the protostellar mass and t is the age. The disk growth rate slows down in the Class I stage. In addition, we find a hint that the mass accretion rate declines as {t}-0.26+/- 0.04 from the Class 0 to the Class I stages.

  3. Altered Synapse Stability in the Early Stages of Tauopathy

    Directory of Open Access Journals (Sweden)

    Johanna S. Jackson

    2017-03-01

    Full Text Available Synapse loss is a key feature of dementia, but it is unclear whether synaptic dysfunction precedes degenerative phases of the disease. Here, we show that even before any decrease in synapse density, there is abnormal turnover of cortical axonal boutons and dendritic spines in a mouse model of tauopathy-associated dementia. Strikingly, tauopathy drives a mismatch in synapse turnover; postsynaptic spines turn over more rapidly, whereas presynaptic boutons are stabilized. This imbalance between pre- and post-synaptic stability coincides with reduced synaptically driven neuronal activity in pre-degenerative stages of the disease.

  4. Estramustine phosphate reversibly inhibits an early stage during adenovirus replication.

    Science.gov (United States)

    Everitt, E; Ekstrand, H; Boberg, B; Hartley-Asp, B

    1990-01-01

    Estramustine phosphate, an estradiol-mustard conjugate, was shown to reversibly inhibit a stage during the first hour of productive adenovirus 2 infection of HeLa cells. This drug, employed in the therapy of advanced prostatic cancer, specifically interacts with microtubule-associated proteins (MAPs) of the cytoskeleton. The results obtained under physiological conditions in vivo suggest a MAPs-interference with the microtubule-mediated vectorial migration of the virus inoculum to the nucleus. Virus attachment, uncoating kinetics and the appearance of established uncoating intermediates were not affected.

  5. Screening of early antigen genes of adult-stage Trichinella spiralis using pig serum from different stages of early infection

    Science.gov (United States)

    The goal of this work was to identify novel, early antigens present in Trichinella spiralis. To this end, a cDNA library generated from 3-day old adult worms (Ad3) was immunologically screened using serum from a pig infected with 20,000 muscle larvae. The serum was obtained from multiple, time cours...

  6. New NIA Booklet By and For People With Early-Stage Alzheimer's Disease

    Science.gov (United States)

    ... Booklet By and For People With Early-Stage Alzheimer's Disease Past Issues / Fall 2007 Table of Contents For ... you have a family member or friends with Alzheimer's disease? Are you wondering what they're going through ...

  7. Effect of crude oil extracts on early stages of African catfish ...

    African Journals Online (AJOL)

    Effect of crude oil extracts on early stages of African catfish Heterobranchus ... carried out in the Institute of Oceanography Fish Farm, University of Calabar, Nigeria. Petroleum hydrocarbon was extracted from the two oils in separate 30litre ...

  8. Early-stage visual processing abnormalities in high-functioning autism spectrum disorder (ASD).

    Science.gov (United States)

    Baruth, Joshua M; Casanova, Manuel F; Sears, Lonnie; Sokhadze, Estate

    2010-06-01

    It has been reported that individuals with autism spectrum disorder (ASD) have abnormal responses to the sensory environment. For these individuals sensory overload can impair functioning, raise physiological stress, and adversely affect social interaction. Early-stage (i.e. within 200ms of stimulus onset) auditory processing abnormalities have been widely examined in ASD using event-related potentials (ERP), while ERP studies investigating early-stage visual processing in ASD are less frequent. We wanted to test the hypothesis of early-stage visual processing abnormalities in ASD by investigating ERPs elicited in a visual oddball task using illusory figures. Our results indicate that individuals with ASD have abnormally large cortical responses to task irrelevant stimuli over both parieto-occipital and frontal regions-of-interest (ROI) during early stages of visual processing compared to the control group. Furthermore, ASD patients showed signs of an overall disruption in stimulus discrimination, and had a significantly higher rate of motor response errors.

  9. Collaboration with Pharma Will Introduce Nanotechnologies in Early Stage Drug Development | Poster

    Science.gov (United States)

    The Frederick National Lab has begun to assist several major pharmaceutical companies in adopting nanotechnologies in early stage drug development, when the approach is most efficient and cost-effective.

  10. Collaboration with Pharma Will Introduce Nanotechnologies in Early Stage Drug Development | Poster

    Science.gov (United States)

    The Frederick National Lab has begun to assist several major pharmaceutical companies in adopting nanotechnologies in early stage drug development, when the approach is most efficient and cost-effective.

  11. Early interactions of Edwardsiella ictaluri, with Pangasianodon catfish and its invasive ability in cell lines.

    Science.gov (United States)

    Dung, T T; Chiers, K; Tuan, N A; Sorgeloos, P; Haesebrouck, F; Decostere, A

    2012-06-01

    Commercial Pangasianodon catfish production is heavily impacted by Bacillary Necrosis of Pangasius (BNP) caused by Edwardsiella ictaluri. This study aimed to investigate the early bacterium-host interactions following immersion challenge and to compare the retrieved data with the invasion ability of the used isolates in fish cell lines. Firstly, Pangasianodon hypophthalmus fingerlings were challenged via immersion using E. ictaluri isolate HO2 or 223. At different times post inoculation, fish were sacrificed and gill and internal organ samples were taken for bacteriological, histological and immunohistochemical evaluation. The bacterial load was higher for fish inoculated with isolate HO2 compared with 223. Histological and immunohistochemical analysis revealed multifocal necrotic areas in kidney, spleen and liver of HO2 inoculated fish at 72 h post inoculation with short rod-shaped immunoperoxidase positive bacteria clustered inside cells respectively. Bacteria especially were present in the gills and intestinal tract of HO2 inoculated fish, suggesting the gastrointestinal tract and gills act as portals of entry. Following, the ability of HO2, 223 and four additional isolates to invade a Chinook salmon embryo cell line, a fat head minnow cell line and a rainbow trout liver cell line was tested. All E. ictaluri isolates were invasive in all cell lines albeit at different degrees. Isolate HO2 was highly invasive in all cell lines with a significantly higher invasion capacity than isolate 223 in the Chinook salmon embryo cell line. A correlation between in vivo virulence and in vitro invasiveness hence is suggested although further studies are needed to confirm this hypothesis.

  12. XIAP as a prognostic marker of early recurrence of nonmuscular invasive bladder cancer

    Institute of Scientific and Technical Information of China (English)

    LI Ming; SONG Tao; YIN Zhen-fei; NA Yan-qun

    2007-01-01

    Background Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis (XIAP) might predict early recurrence in patients with non-muscular invasive bladder cancer.Methods The cohort comprised 176 consecutive patients with primary superficial bladder cancer treated with transurethral resection. Immunohistochemical staining using the standard avidin-biotin-peroxidase technique and RT-PCR were used to detect XIAP protein and mRNA expressions in cancer tissues. The relationship between XIAP expression and clinicopathological characteristics, cancer recurrence were analyzed.Results XIAP expression was observed in 108 cases (61.4%) and no expression in 68. There was no correlation between XIAP expression rate and the tumor pathological grade, but was an apparent trend toward the increased XIAP levels from well (G1) to poor (G3) differentiated cancer. Eighty-two (46.6%) patients experienced tumor recurrence at a mean of 28.6 months of the follow-up; 66 of them expressed XIAP (61.1%) and 16 were XIAP negative (23.5%). Twelve patients presented with invasive disease at the time of relapse and all of them expressed XIAP. Patients without XIAP expression or with low tumor grades had significantly higher recurrence-free survival than those with XIAP expression(log rank test P=0.0015) or high tumor grades (log rank test P<0.001). Multivariate analysis revealed that XIAP expression, tumor grade, and tumor number were independent predictors for the recurrence of non-muscular invasive bladder cancer (P=-0.004, 0.016, and 0.043, respectively).Conclusions XIAP may be considered as a new independent prognostic marker for early recurrence of non-muscular invasive bladder cancer.

  13. Chemotherapy alone versus chemotherapy plus radiotherapy for early stage Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Herbst, Christine; Rehan, Fareed Ahmed; Skoetz, Nicole

    2011-01-01

    BACKGROUND: Combined modality treatment (CMT) consisting of chemotherapy followed by localised radiotherapy is standard treatment for patients with early stage Hodgkin lymphoma (HL). However, due to long term adverse effects such as secondary malignancies, the role of radiotherapy has been...... questioned recently and some clinical study groups advocate chemotherapy only for this indication. OBJECTIVES: We performed a systematic review with meta-analysis of randomised controlled trials (RCTs) comparing chemotherapy alone with CMT in patients with early stage Hodgkin lymphoma with respect...

  14. Is surgery still the best management option for early stage NSCLC?

    OpenAIRE

    Ottlakan, Aurel; Martucci, Nicola; Rocco, Gaetano

    2014-01-01

    Under the formidable thrust of alternative management options for early stage lung cancer, the role of surgery in this disease subset has been questioned. Stereotactic body radiotherapy (SBRT) has been advocated as an ideal substitute for surgery not only in high risk patients or for the ones who refuse surgery but also in lieu of sublobar resection in otherwise fit patients. The therapeutic modalities for early stage NSCLC were compared as to warranting local control, enabling adequate tissu...

  15. Quality of life of Lithuanian women with early stage breast cancer

    OpenAIRE

    Ostapenko Valerijus; Veseliunas Jonas; Bulotiene Giedre

    2007-01-01

    Abstract Background In the last decades, there have been no studies carried out in Lithuania on the quality of life of breast cancer patients. The aim of the present study was to evaluate changes in the quality of life of Lithuanian women with the early stage of breast cancer nine months after surgery and its dependence on surgical strategy, adjuvant chemotherapy and the social and demographic status of the patients. Methods Seventy-seven patients with early stage breast cancer filled in the ...

  16. Liver breath tests non-invasively predict higher stages of non-alcoholic steatohepatitis

    NARCIS (Netherlands)

    Portincasa, Piero; Grattagliano, Ignazio; Lauterburg, Bernhard H.; Palmieri, Vincenzo O.; Palasciano, Giuseppe; Stellaard, Frans

    2006-01-01

    Effectively assessing subtle hepatic metabolic functions by novel non-invasive tests might be of clinical utility in scoring NAFLD (non-alcoholic fatty liver disease) and in identifying altered metabolic pathways. The present study was conducted on 39 (20 lean and 19 obese) hypertransaminasemic pati

  17. Liver breath tests non-invasively predict higher stages of non-alcoholic steatohepatitis

    NARCIS (Netherlands)

    Portincasa, Piero; Grattagliano, Ignazio; Lauterburg, Bernhard H.; Palmieri, Vincenzo O.; Palasciano, Giuseppe; Stellaard, Frans

    Effectively assessing subtle hepatic metabolic functions by novel non-invasive tests might be of clinical utility in scoring NAFLD (non-alcoholic fatty liver disease) and in identifying altered metabolic pathways. The present study was conducted on 39 (20 lean and 19 obese) hypertransaminasemic

  18. [Prospect and guideline update of sentinel lymph node biopsy for patients with early-stage breast carcinoma].

    Science.gov (United States)

    Zhou, Mei-qi; Chen, Hai-long; Hu, Yue; Deng, Yong-chuan; Zheng, Shu

    2014-07-01

    Axillary lymph nodes are the most common and initial site of metastasis of breast carcinoma. Precise axillary staging of breast carcinoma before initial treatment is crucial as it allows efficient identification for local and systemic treatment options, and provides prognostic information. Sentinel lymph node biopsy (SLNB) is an accurate minimally invasive technology for axillary staging. Although top evidence of high-quality clinical trials showed that SLNB could safely and effectively replace axillary lymph node dissection (ALND) for axillary negative patients with decrease in complications and improvement in quality of life, there are specific indications and contraindications for SLNB. Clinicians should balance the compliance of guideline and native clinical practice, especially for the circumstance of multifocal/multicentric lesion, breast biopsy history, and neoadjuvant chemotherapy. With the accumulation of clinical practice and new results of clinical trials, axillary therapy has changed from unique surgery to patient-tailored multi-disciplinary intervention, although ALND should be recommended traditionally if SLNB is positive. Intensive and accurate preoperative axillary staging is gradually valued by clinicians. Development of imaging modality especially ultrasonography and ultrasound-guided biopsy can identify some extra lymph node positive patients directly to ALND with avoidance of unnecessary SLNB. Thus, the positive rate of SLNB will decline significantly. It seems possible that axillary management will step into a noninvasive era abandoning SLNB in some patients with small breast cancer. In this article we review the prospect and guideline update of SLNB for patients with early-stage breast cancer.

  19. Developmental rate and behavior of early life stages of bighead carp and silver carp

    Science.gov (United States)

    Chapman, Duane C.; George, Amy E.

    2011-01-01

    The early life stages of Asian carp are well described by Yi and others (1988), but since these descriptions are represented by line drawings based only on live individuals and lacked temperature controls, further information on developmental time and stages is of use to expand understanding of early life stages of these species. Bighead carp and silver carp were cultured under two different temperature treatments to the one-chamber gas bladder stage, and a photographic guide is provided for bighead carp and silver carp embryonic and larval development, including notes about egg morphology and larval swimming behavior. Preliminary information on developmental time and hourly thermal units for each stage is also provided. Both carp species developed faster under warmer conditions. Developmental stages and behaviors are generally consistent with earlier works with the exception that strong vertical swimming immediately after hatching was documented in this report.

  20. Socioeconomic position and surgery for early-stage non-small-cell lung cancer

    DEFF Research Database (Denmark)

    Kærgaard Starr, Laila; Osler, Merete; Steding-Jessen, Marianne

    2013-01-01

    AIM: To examine possible associations between socioeconomic position and surgical treatment of patients with early-stage non-small-cell lung cancer (NSCLC). METHODS: In a register-based clinical cohort study, patients with early-stage (stages I-IIIa) NSCLC were identified in the Danish Lung Cancer...... in a health care system with free, equal access to health services, disadvantaged groups are less likely to receive surgery for lung cancer....... was associated with greater odds for no surgery in stage I and stage II patients as was living alone for stage I patients. Comorbidity, a short diagnostic interval and small diagnostic volume were all associated with higher odds for not undergoing surgery; but these factors did not appear to explain...

  1. Effect of Early Intervention Applied to Patients with Chronic Obstructive Pulmonary Disease at Different Stages

    Directory of Open Access Journals (Sweden)

    W Lei

    2014-04-01

    Full Text Available Objective: Early intervention in chronic obstructive pulmonary disease (COPD includes health education, smoking cessation, pulmonary rehabilitation and enhancing immunity (administration of influenza vaccine and polysaccharide nucleic acid fraction of bacillus Calmette-Guerin [BCG-PSN]. The effect of early intervention was investigated systematically in patients with COPD at different stages. Methods: We enrolled 422 patients with COPD at different stages without symptoms and then randomly assigned them to intervention and control groups. The intervention group was provided with early intervention and usual care while the control group was only provided with usual care. One year of follow-up was performed to observe forced expiratory volume in one second (FEV1, FEV1/forced vital capacity (FVC, and the ratio of patients with acute exacerbation (number of patients with acute exacerbation/total of patients. Results: The values of decline in FEV1 and FEV1/FVC were significantly lower in the intervention groups of stage I and II than control groups (all p 0.05. The ratios of patients with acute exacerbation were lower in the intervention groups of all the stages than the control groups (p < 0.05. Conclusion: Early intervention could slow the decline of FEV1 and FEV1/FVC in patients with COPD in stages I and II, but not in stages III and IV. Early intervention could also prevent patients with COPD from getting acute exacerbation and improve their quality of life in all the stages of the disease.

  2. Analyses of the early stages of star formation

    Science.gov (United States)

    Lintott, Christopher John

    This thesis presents a study of the physical and chemical properties of star forming regions, both in the Milky Way and in the distant Universe, building on the existing astrochem- ical models developed by the group at UCL. Observations of the nearby star-forming region, L134A, which were carried out with the James Clark Maxwell Telescope (JCMT) in Hawai'i are compared to the predictions of a model of star formation from gas rich in atomic (rather than molecular) hydrogen. A similar model is used to investigate the effect of non-equilibrium chemistry on the derivation of the cosmic-ray ionization rate, an important parameter in controlling both the chemistry and the physics of star forming clumps. A collapse faster than free-fall is proposed as an explanation for differences be tween the distribution of CS and N2H+ in such regions. Moving beyond the Milky Way, JCMT observations of sulphur-bearing species in the nearby starburst galaxy, M82, are presented and compared with existing molecular observations of similar systems. M82 is a local anlogue for star forming systems in the early Universe, many of which have star formation rates several thousand times that of the Milky Way. A model which treats the molecular gas in such systems as an assembly of 'hot cores' (protostellar cores which have a distinctive chemical signature) has been developed, and is used to predict the abundance of many species. An application of this model is used to explain the observed deviation in the early Universe from the otherwise tight relation between infrared and HCN luminosity via relatively recent star formation from near-primordial gas. Many of the stars formed in the early Universe must now be in massive elliptical systems, and work on the structure of these systems is presented. Data from the Sloan Digital Sky Survey is analysed to show that such galaxies have cores dominated by baryons rather than dark matter, and the dark matter profile is constrained by adiabatic contraction.

  3. The Serum Glycome to Discriminate between Early-Stage Epithelial Ovarian Cancer and Benign Ovarian Diseases

    Directory of Open Access Journals (Sweden)

    Karina Biskup

    2014-01-01

    Full Text Available Epithelial ovarian cancer (EOC is the sixth most common cause of cancer deaths in women because the diagnosis occurs mostly when the disease is in its late-stage. Current diagnostic methods of EOC show only a moderate sensitivity, especially at an early-stage of the disease; hence, novel biomarkers are needed to improve the diagnosis. We recently reported that serum glycome modifications observed in late-stage EOC patients by MALDI-TOF-MS could be combined as a glycan score named GLYCOV that was calculated from the relative areas of the 11 N-glycan structures that were significantly modulated. Here, we evaluated the ability of GLYCOV to recognize early-stage EOC in a cohort of 73 individuals comprised of 20 early-stage primary serous EOC, 20 benign ovarian diseases (BOD, and 33 age-matched healthy controls. GLYCOV was able to recognize stage I EOC whereas CA125 values were statistically significant only for stage II EOC patients. In addition, GLYCOV was more sensitive and specific compared to CA125 in distinguishing early-stage EOC from BOD patients, which is of high relevance to clinicians as it is difficult for them to diagnose malignancy prior to operation.

  4. The fourfold Democritus on the stage of early modern science.

    Science.gov (United States)

    Lüthy, C

    2000-09-01

    The renewed success of ancient atomism in the seventeenth century has baffled historians not only because of the lack of empirical evidence in its favor but also because of the exotic heterogeneity of the models that were proposed under its name. This essay argues that one of the more intriguing reasons for the motley appearance of early modern atomism is that Democritus, with whose name this doctrine was most commonly associated, was a figure of similar incoherence. There existed in fact no fewer than four quite different Democriti of Abdera and as many literary traditions: the atomist, the "laughing philosopher," the moralizing anatomist, and the alchemist. Around the year 1600 the doctrines of these literary figures, three of whom had no tangible connection with atomism, began to merge into further hybrid personae, some of whom possessed notable scientific potential. This essay offers the story of how these Democriti contributed to the rise of incompatible "atomisms."

  5. Modelling early stages of relativistic heavy-ion collisions

    Directory of Open Access Journals (Sweden)

    Ruggieri M.

    2016-01-01

    Full Text Available In this study we model early time dynamics of relativistic heavy ion collisions by an initial color-electric field which then decays to a plasma by the Schwinger mechanism. The dynamics of the many particles system produced by the decay is described by relativistic kinetic theory, taking into account the backreaction on the color field by solving self-consistently the kinetic and the field equations. Our main results concern isotropization and thermalization for a 1+1D expanding geometry. In case of small η/s (η/s ≲ 0.3 we find τisotropization ≈ 0.8 fm/c and τthermalization ≈ 1 fm/c in agreement with the common lore of hydrodynamics.

  6. Hydrogenation of iron in the early stage of Earth's evolution

    Science.gov (United States)

    Iizuka-Oku, Riko; Yagi, Takehiko; Gotou, Hirotada; Okuchi, Takuo; Hattori, Takanori; Sano-Furukawa, Asami

    2017-01-01

    Density of the Earth's core is lower than that of pure iron and the light element(s) in the core is a long-standing problem. Hydrogen is the most abundant element in the solar system and thus one of the important candidates. However, the dissolution process of hydrogen into iron remained unclear. Here we carry out high-pressure and high-temperature in situ neutron diffraction experiments and clarify that when the mixture of iron and hydrous minerals are heated, iron is hydrogenized soon after the hydrous mineral is dehydrated. This implies that early in the Earth's evolution, as the accumulated primordial material became hotter, the dissolution of hydrogen into iron occurred before any other materials melted. This suggests that hydrogen is likely the first light element dissolved into iron during the Earth's evolution and it may affect the behaviour of the other light elements in the later processes.

  7. Complete blood counts, liver function tests, and chest x-rays as routine screening in early-stage breast cancer: value added or just cost?

    Science.gov (United States)

    Louie, Raphael J; Tonneson, Jennifer E; Gowarty, Minda; Goodney, Philip P; Barth, Richard J; Rosenkranz, Kari M

    2015-11-01

    Current National Comprehensive Cancer Network guidelines for breast cancer staging include pre-treatment complete blood count (CBC) and liver function tests (LFT) to screen for occult metastatic disease. To date, the relevance of these tests in detecting metastatic disease in asymptomatic women with early-stage breast cancer (Stage I/II) has not been demonstrated. Although chest x-rays are no longer recommended in the NCCN guidelines, many centers continue to include this imaging as part of their screening process. We aim to determine the clinical and financial impact of these labs and x-rays in the evaluation of early-stage breast cancer patients. A single institution IRB-approved retrospective chart review was conducted of patients with biopsy-proven invasive breast cancer treated from January 1, 2005–December 31, 2009. We collected patient demographics, clinical and pathologic staging, chest x-ray, CBC, and LFT results at the time of referral. Patients were stratified according to radiographic stage at the time of diagnosis. We obtained Medicare reimbursement fees for cost analysis. From 2005 to 2009, 1609 patients with biopsy-proven invasive breast cancer were treated at our institution. Of the 1082 patients with radiographic stage I/II disease, 27.3 % of patients had abnormal CBCs. No additional testing was performed to evaluate these abnormalities. In the early-stage population, 24.7 % of patients had elevated LFTs, resulting in 84 additional imaging studies. No metastatic disease was detected. The cost of CBC, LFTs and chest x-rays was $110.20 per patient, totaling $106,410.99. Additional tests prompted by abnormal results cost $58,143.30 over the five-year period. We found that pre-treatment CBCs, LFTs, and chest x-rays did not improve detection of occult metastatic disease but resulted in additional financial costs. Avoiding routine ordering of these tests would save the US healthcare system $25.7 million annually.

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

    LENUS (Irish Health Repository)

    Hayes, Brian D

    2012-02-01

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

  9. CT characteristics and pathological implications of early stage (T1N0M0) lung adenocarcinoma with pure ground-glass opacity

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Xin; Zhao, Shao-hong; Wu, Jian; Wu, Chong-chong; Chang, Rui-ping; Ju, Hai-yue [Chinese PLA General Hospital, Department of Radiology, Beijing (China); Gao, Jie; Wang, Dian-jun [Chinese PLA General Hospital, Department of Pathology, Beijing (China)

    2015-09-15

    To analyze the CT characteristics and pathological classification of early lung adenocarcinoma (T1N0M0) with pure ground-glass opacity (pGGO). Ninety-four lesions with pGGO on CT in 88 patients with T1N0M0 lung adenocarcinoma were selected from January 2010 to December 2012. All lesions were confirmed by pathology. CT appearances were analyzed including lesion location, size, density, uniformity, shape, margin, tumour-lung interface, internal and surrounding malignant signs. Lesion size and density were compared using analysis of variance, lesion size also assessed using ROC curves. Gender of patients, lesion location and CT appearances were compared using χ2-test. There were no significant differences in gender, lesion location and density with histological invasiveness (P > 0.05). The ROC curve showed that the possibility of invasive lesion was 88.73 % when diameter of lesion was more than 10.5 mm. There was a significant difference between lesion uniformity and histological invasiveness (P = 0.01). There were significant differences in margin, tumour-lung interface, air bronchogram with histological invasiveness (P = 0.02,P = 0.00,P = 0.048). The correlation index of lesion size and uniformity was r = 0.45 (P = 0.00). The lesion size and uniformity, tumour-lung interface and the air bronchogram can help predict invasive extent of early stage lung adenocarcinoma with pGGO. (orig.)

  10. Addressing Challenges in Future Surveillance After Surgery for Early-Stage Cervical Cancer

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Petersen, Lone Kjeld; Blaakaer, Jan

    2015-01-01

    OBJECTIVE: This study examines surveillance after early-stage cervical cancer surgery. Since the 1980s, the value of surveillance has been discussed continuously. The main question explored is whether surveillance serves the purpose of ensuring early diagnosis of recurrence. MATERIALS AND METHODS...

  11. The Early Stages of Heart Development: Insights from Chicken Embryos

    Directory of Open Access Journals (Sweden)

    Johannes G. Wittig

    2016-04-01

    Full Text Available The heart is the first functioning organ in the developing embryo and a detailed understanding of the molecular and cellular mechanisms involved in its formation provides insights into congenital malformations affecting its function and therefore the survival of the organism. Because many developmental mechanisms are highly conserved, it is possible to extrapolate from observations made in invertebrate and vertebrate model organisms to humans. This review will highlight the contributions made through studying heart development in avian embryos, particularly the chicken. The major advantage of chick embryos is their accessibility for surgical manipulation and functional interference approaches, both gain- and loss-of-function. In addition to experiments performed in ovo, the dissection of tissues for ex vivo culture, genomic, or biochemical approaches is straightforward. Furthermore, embryos can be cultured for time-lapse imaging, which enables tracking of fluorescently labeled cells and detailed analysis of tissue morphogenesis. Owing to these features, investigations in chick embryos have led to important discoveries, often complementing genetic studies in mice and zebrafish. As well as including some historical aspects, we cover here some of the crucial advances made in understanding early heart development using the chicken model.

  12. Cortical gyrification and sulcal spans in early stage Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Tao Liu

    Full Text Available Alzheimer's disease (AD is characterized by an insidious onset of progressive cerebral atrophy and cognitive decline. Previous research suggests that cortical folding and sulcal width are associated with cognitive function in elderly individuals, and the aim of the present study was to investigate these morphological measures in patients with AD. The sample contained 161 participants, comprising 80 normal controls, 57 patients with very mild AD, and 24 patients with mild AD. From 3D T1-weighted brain scans, automated methods were used to calculate an index of global cortex gyrification and the width of five individual sulci: superior frontal, intra-parietal, superior temporal, central, and Sylvian fissure. We found that global cortex gyrification decreased with increasing severity of AD, and that the width of all individual sulci investigated other than the intra-parietal sulcus was greater in patients with mild AD than in controls. We also found that cognitive functioning, as assessed by Mini-Mental State Examination (MMSE scores, decreased as global cortex gyrification decreased. MMSE scores also decreased in association with a widening of all individual sulci investigated other than the intra-parietal sulcus. The results suggest that abnormalities of global cortex gyrification and regional sulcal span are characteristic of patients with even very mild AD, and could thus facilitate the early diagnosis of this condition.

  13. [Small partial laryngectomy for early-stage glottic carcinoma].

    Science.gov (United States)

    Song, Xicheng; Pan, Xinliang; Luan, Xinyong; Xu, Fenglei; Lei, Dapeng; Zhang, Liqiang; Liu, Dayu; Zhang, Qingquan

    2004-06-01

    To explore the surgery way for T1, T2 glottic carcinoma. Small partial laryngectomy were performed to 112 patients with T1, T2 (T1 N0 M0, T2 N0 M0) glottic carcinoma. The surgery method, effect and treatment advantage was summarized and compared with laser therapy and radiotherapy, the dynamic follow-up of arytaenoidea cartilage movement, glottidis rimae conformation and voice change was analyzed. The preoperative and postoperative voice quality was compared with the software of Dr. speech system for windows. All incisions were healed one stage in 6 or 7 days, the mean time in hospital is 9.76 days; all patients took food with mouth after 2 or 3 days, all trachea cannula was removed successfully during in hospital, the mean time with cannula is 7.32 days and the rate of removing cannula 100%. Arytaenoidea cartilago movement of 47 cases 1 week after surgery weakened and gradually improved, glottidis rimae conformation is close to be normal after 2 months. There is no significant difference of Shimmer and NNE between preoperative and postoperative 1 week (P > 0.05), but there is a significant difference between preoperative and postoperative 2 months, half a year, and also is between postoperative 1 week and 2 months, half a year (P < 0.01). All 76 cases survive during 3 years' follow-up, 35 of 36 cases in 5 years' follow-up survive (1 case died without definite cause), and there is 2 cases for recurrence. Small partial laryngectomy can provide large operative view, resect the tumor completely, make diet and speech recover in shorter time and improve the voice quality, so the surgery is available.

  14. Detecting early stage pressure ulcer on dark skin using multispectral imager

    Science.gov (United States)

    Yi, Dingrong; Kong, Linghua; Sprigle, Stephen; Wang, Fengtao; Wang, Chao; Liu, Fuhan; Adibi, Ali; Tummala, Rao

    2010-02-01

    We are developing a handheld multispectral imaging device to non-invasively inspect stage I pressure ulcers in dark pigmented skins without the need of touching the patient's skin. This paper reports some preliminary test results of using a proof-of-concept prototype. It also talks about the innovation's impact to traditional multispectral imaging technologies and the fields that will potentially benefit from it.

  15. 生物入侵预警研究%Early warning of biological invasion

    Institute of Scientific and Technical Information of China (English)

    马瑞俊

    2011-01-01

    This article describes the growing biological invasion in China, has become a threat to our biodiversity and ecological importance of environmental factors. Biological invasions caused a disappearance of local species diversity and species extinction as well as huge economic losses. The prevention of biological invasions in China should pay attention to monitoring and management system construction, intensify supervision and early warning studies.%生物入侵在我国不断加剧,已经成为威胁我国生物多样性与生态环境的重要因素。生物入侵造成了本地物种多样性消失和物种的灭绝以及巨大经济损失。我国对生物入侵的预防应重视监测与管理体系的建设,加大监管力度和预警的研究。

  16. Good daily habits during the early stages of life determine success throughout life

    Directory of Open Access Journals (Sweden)

    Jun Kohyama

    2016-07-01

    Full Text Available This paper assesses hypothesis that sufficient sleep duration and proper circadian rhythms during the early stages of life are indispensable to a successful life. Successful life was defined according to the famous cohort studies of Mischel's and Dunedin. To assess the hypothesis, neuronal elements presumably affecting early daily habits and successful life are reviewed. The effect of sufficient sleep duration and proper circadian rhythms during early stages of life on the development of the prefrontal cortex has been found to be the key issue to verify the hypothesis. Socioeconomic status is found to be another issue to be studied.

  17. Genomic alterations associated with early stages of breast tumor metastasis.

    Science.gov (United States)

    Ellsworth, Rachel E; Ellsworth, Darrell L; Patney, Heather L; Deyarmin, Brenda; Hooke, Jeffrey A; Love, Brad; Shriver, Craig D

    2008-07-01

    Molecular studies suggest that acquisition of metastatic potential occurs early in the development of breast cancer; mechanisms by which cells disseminate from the primary carcinomas and successfully colonize foreign tissues are, however, largely unknown. Thus, we examined levels and patterns of chromosomal alterations in primary breast tumors from node-negative (n = 114) and node-positive (n = 115) patients to determine whether specific genomic changes are associated with tumor metastasis. Fifty-two genetic markers representing 26 chromosomal regions commonly altered in breast cancer were examined in laser microdissected tumor samples to assess levels and patterns of allelic imbalance (AI). Real time-PCR (RT-PCR) was performed to determine expression levels of candidate genes. Data was analyzed using exact unconditional and Student's t-tests with significance values of P .05 and P .002 used for the clinicopathological and genomic analyses, respectively. Overall levels of AI in primary breast tumors from node-negative (20.8%) and node-positive (21.9%) patients did not differ significantly (P = 0.291). When data were examined by chromosomal region, only chromosome 8q24 showed significantly higher levels (P .0005) of AI in node-positive primary tumors (23%) versus node-negative samples (6%). c-MYC showed significantly higher levels of gene expression in primary breast tumors from patients with lymph node metastasis. Higher frequencies of AI at chromosome 8q24 in patients with positive lymph nodes suggest that genetic changes in this region are important to the process of metastasis. Because overexpression of c-MYC has been associated with cellular dissemination as well as development of the premetastatic niche, alterations of the 8q24 region, including c-MYC, may be key determinants in the development of lymph node metastasis.

  18. [An unexpected stage of alkalosis in the dynamics of the early posthemorrhagic period].

    Science.gov (United States)

    Beliaev, A V

    2000-01-01

    A study was made on acid-base metabolism in early posthemorrhagic period as exemplified by examination of patients presenting with gastrointestinal hemorrhage. It has been ascertained that hemorrhage is accompanied by a mixed variant of the acid-base state (ABS) deviation, namely metabolic lactate-acidosis and respiratory alkalosis. In the time-related course of posthemorrhagic period such deviations persist in patients with lethal outcome; with the disease running a favourable course the above deviations are found to return to normal quite soon. The development of complications leads to staging in ABC, its stages being as follows: stage I--the initial stage, stage II--persisting metabolic acidosis and respiratory alkalosis, stage III--alkalosis, stage IV--normalization, with stage III of ABS being encouraged by hypocapnia caused by function disorders of the lungs in early posthemorrhagic period, normalization of cell metabolism, increase in the rate of urination as a reflection of the third earlier identified stage of water metabolism, with the H+ excretion in the urine at the previous level. The identified ABS stage III threatens coming trouble, being accompanied by metabolic deviations together with a risk of function disorder of the myocardium.

  19. [Working memory for music in patients with mild cognitive impairment and early stage Alzheimer's disease].

    Science.gov (United States)

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2013-01-01

    A variety of studies demonstrated that some forms of memory for music are spared in dementia, but only few studies have investigated patients with early stages of dementia. In this pilot-study we tested working memory for music in patients with mild cognitive impairment (MCI) and early stage Alzheimer's disease (AD) with a newly created test. The test probed working memory using 7 gradually elongated tone-lines and 6 chords which were each followed by 3 similar items and 1 identical item. The participants of the study, namely 10 patients with MCI, 10 patients with early stage AD and 23 healthy subjects were instructed to select the identical tone-line or chord. Subjects with MCI and early AD showed significantly reduced performance than controls in most of the presented tasks. In recognizing chords MCI- participants surprisingly showed an unimpaired performance. The gradual increase of the impairment during the preclinical phase of AD seems to spare this special ability in MCI.

  20. In vivo CNS infection model of Acanthamoeba genotype T4: the early stages of infection lack presence of host inflammatory response and are a slow and contact-dependent process.

    Science.gov (United States)

    Omaña-Molina, Maritza; Hernandez-Martinez, Dolores; Sanchez-Rocha, Raquel; Cardenas-Lemus, Ulises; Salinas-Lara, Citlaltepetl; Mendez-Cruz, Adolfo Rene; Colin-Barenque, Laura; Aley-Medina, Patricia; Espinosa-Villanueva, Jesus; Moreno-Fierros, Leticia; Lorenzo-Morales, Jacob

    2017-02-01

    This study was developed in order to describe the early morphological events observed during the invasion of two pathogenic strains of Acanthamoeba (genotype T4); A. castellanii and A. culbertsoni, at the olfactory meatus and cerebral, pulmonary, renal, hepatic and splenic tissues levels, an in vivo invasion study. Histological and immunohistochemical description of the events at 24, 48, 72, and 96 h postintranasal inoculations of BALB/c mice was performed. A. castellanii showed a higher invasion rate than A. culbertsoni, which was only able to reach lung and brain tissue in the in vivo model. The current study supports previous evidence of lack of inflammatory response during the early stages of infection. Acanthamoeba invasion of the CNS and other organs is a slow and contact-dependent process. The early morphological events during the invasion of amoebae include the penetration of trophozoites into different epithelia: olfactory, respiratory, alveolar space, and renal tubule, which resemble the process of amoebae invasion described in corneal tissue. The data suggest that after reaching the nasal epithelium, trophozoites continued invasion, separating and lifting the most superficial cells, then migrating and penetrating between the cell junctions without causing a cytolytic effect on adjacent cells. These results reaffirm the idea that contact-dependent mechanisms are relevant for amoebae of Acanthamoeba genus regardless of the invasion site.

  1. Six1 overexpression at early stages of HPV16-mediated transformation of human keratinocytes promotes differentiation resistance and EMT

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Hanwen [Department of Drug Discovery and Biomedical Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC 29208 (United States); Pirisi, Lucia [Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, University of South Carolina, Columbia, SC 29208 (United States); Creek, Kim E., E-mail: creekk@sccp.sc.edu [Department of Drug Discovery and Biomedical Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC 29208 (United States)

    2015-01-01

    Previous studies in our laboratory discovered that SIX1 mRNA expression increased during in vitro progression of HPV16-immortalized human keratinocytes (HKc/HPV16) toward a differentiation-resistant (HKc/DR) phenotype. In this study, we explored the role of Six1 at early stages of HPV16-mediated transformation by overexpressing Six1 in HKc/HPV16. We found that Six1 overexpression in HKc/HPV16 increased cell proliferation and promoted cell migration and invasion by inducing epithelial–mesenchymal transition (EMT). Moreover, the overexpression of Six1 in HKc/HPV16 resulted in resistance to serum and calcium-induced differentiation, which is the hallmark of the HKc/DR phenotype. Activation of MAPK in HKc/HPV16 overexpressing Six1 is linked to resistance to calcium-induced differentiation. In conclusion, this study determined that Six1 overexpression resulted in differentiation resistance and promoted EMT at early stages of HPV16-mediated transformation of human keratinocytes. - Highlights: • Six1 expression increases during HPV16-mediated transformation. • Six1 overexpression causes differentiation resistance in HPV16-immortalized cells. • Six1 overexpression in HPV16-immortalized keratinocytes activates MAPK. • Activation of MAPK promotes EMT and differentiation resistance. • Six1 overexpression reduces Smad-dependent TGF-β signaling.

  2. Prognostic implication of the primary tumor location in early-stage breast cancer: focus on lower inner zone.

    Science.gov (United States)

    Yang, Jiqiao; Tang, Shenli; Zhou, Yuting; Qiu, Juanjuan; Zhang, Juying; Zhu, Sui; Lv, Qing

    2017-08-18

    The aim of this study was to investigate the prognostic significance of tumor location of lower inner zone (LIZ) on the survival of patients with early-stage breast cancer. We retrospectively identified 961 breast cancer patients from Jan 2000 to Apr 2016 from hospital database. We evaluated overall survival (OS) and disease-free survival (DFS) in patients with tumors in and outside LIZ. Subgroup analyses were performed according to clinicopathological characteristics and treatment strategies. A total of 838 cases were finally included. Patients with tumor location of LIZ showed significantly lower survival rates than tumors in other sites in terms of DFS (p = 0.028) but not OS (p = 0.106). When stratified into subgroups, tumors in LIZ retained a significant worse prognosis in DFS in patients with HER-2-negative, high ki-67 expression breast cancers, those who received neoadjuvant chemotherapy, axillary nodal negative patients, and patients with lymphovascular invasion. Univariate and multivariate analyses suggested that tumor location of LIZ was an independent prognostic factor for DFS (p = 0.022). Our results suggested that tumor location of LIZ was an independent adverse prognostic factor for DFS in patients with early-stage breast cancer. Multicenter studies with larger sample size are needed to confirm the conclusion and anatomical experiments are desired to elaborate the mechanism.

  3. {sup 1}H NMR-based spectroscopy detects metabolic alterations in serum of patients with early-stage ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ying; Lin, Lianjie [Second Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang 110004 (China); Xu, Yanbin [Wanlei Life Sciences (Shenyang) Co., Ltd., Shenyang 110179 (China); Lin, Yan; Jin, Yu [Second Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang 110004 (China); Zheng, Changqing, E-mail: changqing_zheng@126.com [Second Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang 110004 (China)

    2013-04-19

    Highlights: •Twenty ulcerative colitis patients and nineteen healthy controls were enrolled. •Increased 3-hydroxybutyrate, glucose, phenylalanine, and decreased lipid were found. •We report early stage diagnosis of ulcerative colitis using NMR-based metabolomics. -- Abstract: Ulcerative colitis (UC) has seriously impaired the health of citizens. Accurate diagnosis of UC at an early stage is crucial to improve the efficiency of treatment and prognosis. In this study, proton nuclear magnetic resonance ({sup 1}H NMR)-based metabolomic analysis was performed on serum samples collected from active UC patients (n = 20) and healthy controls (n = 19), respectively. The obtained spectral profiles were subjected to multivariate data analysis. Our results showed that consistent metabolic alterations were present between the two groups. Compared to healthy controls, UC patients displayed increased 3-hydroxybutyrate, β-glucose, α-glucose, and phenylalanine, but decreased lipid in serum. These findings highlight the possibilities of NMR-based metabolomics as a non-invasive diagnostic tool for UC.

  4. Transmissible Plasmid Containing Salmonella enterica Heidelberg Isolates Modulate Cytokine Production During Early Stage of Interaction with Intestinal Epithelial Cells.

    Science.gov (United States)

    Gokulan, Kuppan; Khare, Sangeeta; Williams, Katherine; Foley, Steven L

    2016-08-01

    The variation in cytokine production during bacterial invasion of human intestinal epithelial cells (IECs) is a contributing factor for progression of the infection. A few Salmonella enterica Heidelberg strains isolated from poultry products harbor transmissible plasmids (TPs), including those that encode a type-IV secretion system. Earlier, we showed that these TPs are responsible for increased virulence during infection. This study examines the potential role of these TPs in cytokine production in IECs. This study showed that S. Heidelberg strains containing TPs (we refer as virulent strains) caused decreased interleukin (IL)-10 production in IECs after 1 h infection. The virulent strains induced a high level of tumor necrosis factor-α production under identical conditions. The virulent strains of S. Heidelberg also altered the production of IL-2, IL-17, and granulocyte macrophage colony-stimulating factor compared to an avirulent strain. As a part of infection, bacteria cross the epithelial barrier and encounter intestinal macrophages. Hence, we examined the cytotoxic mechanism of strains of S. Heidelberg in macrophages. Scanning electron microscopy showed cell necrosis occurs during the early stage of infection. In conclusion, virulent S. Heidelberg strains were able to modify the host cytokine profile during the early stages of infection and also caused necrosis in macrophages.

  5. Critical Dysphagia is Common in Parkinson Disease and Occurs Even in Early Stages: A Prospective Cohort Study.

    Science.gov (United States)

    Pflug, Christina; Bihler, Moritz; Emich, Katharina; Niessen, Almut; Nienstedt, Julie Cläre; Flügel, Till; Koseki, Jana-Christiane; Plaetke, Rosemarie; Hidding, Ute; Gerloff, Christian; Buhmann, Carsten

    2017-08-21

    To assess the prevalence of dysphagia and its typical findings in unselected "real-world" Parkinson patients using an objective gold-standard method. This was a prospective, controlled, cross-sectional study conducted in 119 consecutive Parkinson patients of all stages independent of subjective dysphagia. Patients and 32 controls were clinically and endoscopically examined by flexible endoscopic evaluation of swallowing (FEES) to evaluate the deglutition with regard to three consistencies (water, biscuit, and bread). Typical findings of dysphagia like penetration and aspiration, residues, and leakage were assessed. Dysphagia was common in Parkinson patients and occurred in all, even early, disease stages. Only 5% (6/119) of patients showed a completely unremarkable deglutition. Aspiration was seen in 25% (30/119) of patients and always related to water. Residues occurred in 93% (111/119), most commonly for bread. Leakage was much less frequent and was found in only 3-18%, depending on consistency. In a significant fraction of patients, objective dysphagia was not subjectively perceived. A total of 16% of asymptomatic patients suffered from critical aspiration. Significant swallowing deficiencies already occurred in early disease. Aspiration was found in 4 of 20 (20%) patients with disease duration of less than 2 years. Seven of 57 patients (12%) with Hoehn and Yahr stage 2 suffered from severe aspiration. Given the high frequency of critical aspiration in Parkinson disease, these patients should be evaluated early for dysphagia to avoid complications and recommend an adequate therapy. FEES is a simple, cost efficient, minimally invasive method that is ideally suited for this purpose.

  6. Abnormal plasma DNA profiles in early ovarian cancer using a non-invasive prenatal testing platform: implications for cancer screening.

    Science.gov (United States)

    Cohen, Paul A; Flowers, Nicola; Tong, Stephen; Hannan, Natalie; Pertile, Mark D; Hui, Lisa

    2016-08-24

    Non-invasive prenatal testing (NIPT) identifies fetal aneuploidy by sequencing cell-free DNA in the maternal plasma. Pre-symptomatic maternal malignancies have been incidentally detected during NIPT based on abnormal genomic profiles. This low coverage sequencing approach could have potential for ovarian cancer screening in the non-pregnant population. Our objective was to investigate whether plasma DNA sequencing with a clinical whole genome NIPT platform can detect early- and late-stage high-grade serous ovarian carcinomas (HGSOC). This is a case control study of prospectively-collected biobank samples comprising preoperative plasma from 32 women with HGSOC (16 'early cancer' (FIGO I-II) and 16 'advanced cancer' (FIGO III-IV)) and 32 benign controls. Plasma DNA from cases and controls were sequenced using a commercial NIPT platform and chromosome dosage measured. Sequencing data were blindly analyzed with two methods: (1) Subchromosomal changes were called using an open source algorithm WISECONDOR (WIthin-SamplE COpy Number aberration DetectOR). Genomic gains or losses ≥ 15 Mb were prespecified as "screen positive" calls, and mapped to recurrent copy number variations reported in an ovarian cancer genome atlas. (2) Selected whole chromosome gains or losses were reported using the routine NIPT pipeline for fetal aneuploidy. We detected 13/32 cancer cases using the subchromosomal analysis (sensitivity 40.6 %, 95 % CI, 23.7-59.4 %), including 6/16 early and 7/16 advanced HGSOC cases. Two of 32 benign controls had subchromosomal gains ≥ 15 Mb (specificity 93.8 %, 95 % CI, 79.2-99.2 %). Twelve of the 13 true positive cancer cases exhibited specific recurrent changes reported in HGSOC tumors. The NIPT pipeline resulted in one "monosomy 18" call from the cancer group, and two "monosomy X" calls in the controls. Low coverage plasma DNA sequencing used for prenatal testing detected 40.6 % of all HGSOC, including 38 % of early stage cases. Our

  7. Minimally Invasive Methods for Staging in Lung Cancer: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Gonzalo Labarca

    2016-01-01

    Full Text Available Introduction. Endobronchial ultrasound (EBUS is a procedure that provides access to the mediastinal staging; however, EBUS cannot be used to stage all of the nodes in the mediastinum. In these cases, endoscopic ultrasound (EUS is used for complete staging. Objective. To provide a synthesis of the evidence on the diagnostic performance of EBUS + EUS in patients undergoing mediastinal staging. Methods. Systematic review and meta-analysis to evaluate the diagnostic yield of EBUS + EUS compared with surgical staging. Two researchers performed the literature search, quality assessments, data extractions, and analyses. We produced a meta-analysis including sensitivity, specificity, and likelihood ratio analysis. Results. Twelve primary studies (1515 patients were included; two were randomized controlled trials (RCTs and ten were prospective trials. The pooled sensitivity for combined EBUS + EUS was 87% (CI 84–89% and the specificity was 99% (CI 98–100%. For EBUS + EUS performed with a single bronchoscope group, the sensitivity improved to 88% (CI 83.1–91.4% and specificity improved to 100% (CI 99-100%. Conclusion. EBUS + EUS is a highly accurate and safe procedure. The combined procedure should be considered in selected patients with lymphadenopathy noted at stations that are not traditionally accessible with conventional EBUS.

  8. Structural neuroimaging across early-stage psychosis: Aberrations in neurobiological trajectories and implications for the staging model.

    Science.gov (United States)

    Bartholomeusz, Cali F; Cropley, Vanessa L; Wannan, Cassandra; Di Biase, Maria; McGorry, Patrick D; Pantelis, Christos

    2017-05-01

    This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model. In general, grey matter (and, to a lesser extent, white matter) declines across multiple frontal, temporal (especially superior regions), insular and parietal regions during the first episode of psychosis, which has a steeper trajectory than that of age-matched healthy counterparts. Although the ultra-high-risk of psychosis literature is considerably mixed, evidence indicates that certain volumetric structural aberrations predate psychotic illness onset (e.g. prefrontal cortex thinning), while other abnormalities present in ultra-high-risk of psychosis populations are potentially non-psychosis-specific (e.g. hippocampal volume reductions). We highlight the advantages of longitudinal designs, discuss the implications such studies have on clinical staging and provide directions for future research.

  9. The influence of number of high risk factors on clinical outcomes in patients with early-stage cervical cancer after radical hysterectomy and adjuvant chemoradiation

    Science.gov (United States)

    Lim, Soyi; Lee, Seok-Ho; Park, Chan-Yong

    2016-01-01

    Objective The purpose of this study was to evaluate the prognosis according to the number of high risk factors in patients with high risk factors after radical hysterectomy and adjuvant chemoradiation therapy for early stage cervical cancer. Methods Clinicopathological variables and clinical outcomes of patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IIA cervical cancer who had one or more high risk factors after radical hysterectomy and adjuvant chemoradiation therapy were retrospectively analyzed. Patients were divided into two groups according to the number of high risk factors (group 1, single high risk factor; group 2, two or more high risk factors). Results A total of 93 patients were enrolled in the present study. Forty nine out of 93 (52.7%) patients had a single high risk factor, and 44 (47.3%) had two or more high risk factors. Statistically significant differences in stage and stromal invasion were observed between group 1 and group 2. However, age, histology, tumor size, and lymphovascular space invasion did not differ significantly between the groups. Distant recurrence occurred more frequently in group 2, and the probability of recurrence and death was higher in group 2. Conclusion Patients with two or more high risk factors had worse prognosis in early stage cervical cancer. For these patients, consideration of new strategies to improve survival may be worthwhile. Conduct of further clinical trials is warranted for development of adjuvant treatment strategies individualized to each risk group. PMID:27200308

  10. Inherited DOCK2 Deficiency in Patients with Early-Onset Invasive Infections.

    Science.gov (United States)

    Dobbs, Kerry; Domínguez Conde, Cecilia; Zhang, Shen-Ying; Parolini, Silvia; Audry, Magali; Chou, Janet; Haapaniemi, Emma; Keles, Sevgi; Bilic, Ivan; Okada, Satoshi; Massaad, Michel J; Rounioja, Samuli; Alwahadneh, Adel M; Serwas, Nina K; Capuder, Kelly; Çiftçi, Ergin; Felgentreff, Kerstin; Ohsumi, Toshiro K; Pedergnana, Vincent; Boisson, Bertrand; Haskoloğlu, Şule; Ensari, Arzu; Schuster, Michael; Moretta, Alessandro; Itan, Yuval; Patrizi, Ornella; Rozenberg, Flore; Lebon, Pierre; Saarela, Janna; Knip, Mikael; Petrovski, Slavé; Goldstein, David B; Parrott, Roberta E; Savas, Berna; Schambach, Axel; Tabellini, Giovanna; Bock, Christoph; Chatila, Talal A; Comeau, Anne Marie; Geha, Raif S; Abel, Laurent; Buckley, Rebecca H; İkincioğulları, Aydan; Al-Herz, Waleed; Helminen, Merja; Doğu, Figen; Casanova, Jean-Laurent; Boztuğ, Kaan; Notarangelo, Luigi D

    2015-06-18

    Background Combined immunodeficiencies are marked by inborn errors of T-cell immunity in which the T cells that are present are quantitatively or functionally deficient. Impaired humoral immunity is also common. Patients have severe infections, autoimmunity, or both. The specific molecular, cellular, and clinical features of many types of combined immunodeficiencies remain unknown. Methods We performed genetic and cellular immunologic studies involving five unrelated children with early-onset invasive bacterial and viral infections, lymphopenia, and defective T-cell, B-cell, and natural killer (NK)-cell responses. Two patients died early in childhood; after allogeneic hematopoietic stem-cell transplantation, the other three had normalization of T-cell function and clinical improvement. Results We identified biallelic mutations in the dedicator of cytokinesis 2 gene (DOCK2) in these five patients. RAC1 activation was impaired in the T cells. Chemokine-induced migration and actin polymerization were defective in the T cells, B cells, and NK cells. NK-cell degranulation was also affected. Interferon-α and interferon-λ production by peripheral-blood mononuclear cells was diminished after viral infection. Moreover, in DOCK2-deficient fibroblasts, viral replication was increased and virus-induced cell death was enhanced; these conditions were normalized by treatment with interferon alfa-2b or after expression of wild-type DOCK2. Conclusions Autosomal recessive DOCK2 deficiency is a new mendelian disorder with pleiotropic defects of hematopoietic and nonhematopoietic immunity. Children with clinical features of combined immunodeficiencies, especially with early-onset, invasive infections, may have this condition. (Supported by the National Institutes of Health and others.).

  11. Building energy optimization in the early design stages: A simplified method

    DEFF Research Database (Denmark)

    Negendahl, Kristoffer; Nielsen, Toke Rammer

    2015-01-01

    This paper presents the application of multi-objective genetic algorithms for holistic building design that considers multiple criteria; building energy use, capital cost, daylight distribution and thermal indoor environment. The optimization focus is related to building envelope parameters....... It is concluded, that quasi-steady-state methods implemented as part of integrated dynamic models are fast and flexible enough to support building energy-, indoor environment- and cost-optimization the early design stages........ To obtain relevant feedback from multi-objective optimizations in early design stages, evaluation speed is a key concern. The paper presents a fast evaluation method fit for the early design stages. It uses a combination of two different quasi-steady-state methods for energy and indoor environment...

  12. Urticaria as the initial presentation of early stage Bronchioloalveolar carcinoma: a case report

    Institute of Scientific and Technical Information of China (English)

    HU Hui-hui; YING Ke-jing; WU Xiao-hong; CHAI Ying

    2012-01-01

    Bronchioloalveolar carcinoma is a subtype of the lung adenocarcinoma.Early stage bronchioloalveolar carcinoma is usually asymptomatic,especially in the peripheral lung.Rarely,urticaria has been described occurring with lung cancer,usually small-cell lung cancer,but no case has been reported of the bronchioloalveolar carcinoma yet.We report here a unique and initial urticaria on a patient,lasting for 6 months,who finally was diagnosed as early stage bronchioloalveolar carcinoma (T1aNOMo).After treatment of surgery,the symptom of urticaria disappeared and did not recur.Therefore,we consider that utricaria is a oossibly clinical manifestation in early stage bronchioloalveolar carcinoma.

  13. Nurses' experiences using a nursing information system: early stage of technology implementation.

    Science.gov (United States)

    Lee, Ting-Ting

    2007-01-01

    Adoption of information technology in nursing practice has become a trend in healthcare. The impact of this technology on users has been widely studied, but little attention has been given to its influence at the beginning stage of implementation. Knowing the barriers to adopting technology could shorten this transition stage and minimize its negative influences. The purpose of this study was to explore nurses' experiences in the early stage of implementing a nursing information system. Focus groups were used to collect data at a medical center in Taiwan. The results showed that nurses had problems with the system's content design, had insufficient training, were concerned about data security, were stressed by added work, and experienced poor interdisciplinary cooperation. To smooth this beginning stage, the author recommends involving nurses early in the system design, providing sufficient training in keyboard entry skills, redesigning workflow, and improving interdisciplinary communication.

  14. Identification of Early-Stage Alzheimer's Disease Using Sulcal Morphology and Other Common Neuroimaging Indices

    Science.gov (United States)

    Cai, Kunpeng; Xu, Hong; Guan, Hao; Zhu, Wanlin; Jiang, Jiyang; Cui, Yue; Zhang, Jicong; Liu, Tao; Wen, Wei

    2017-01-01

    Identifying Alzheimer’s disease (AD) at its early stage is of major interest in AD research. Previous studies have suggested that abnormalities in regional sulcal width and global sulcal index (g-SI) are characteristics of patients with early-stage AD. In this study, we investigated sulcal width and three other common neuroimaging morphological measures (cortical thickness, cortical volume, and subcortical volume) to identify early-stage AD. These measures were evaluated in 150 participants, including 75 normal controls (NC) and 75 patients with early-stage AD. The global sulcal index (g-SI) and the width of five individual sulci (the superior frontal, intra-parietal, superior temporal, central, and Sylvian fissure) were extracted from 3D T1-weighted images. The discriminative performances of the other three traditional neuroimaging morphological measures were also examined. Information Gain (IG) was used to select a subset of features to provide significant information for separating NC and early-stage AD subjects. Based on the four modalities of the individual measures, i.e., sulcal measures, cortical thickness, cortical volume, subcortical volume, and combinations of these individual measures, three types of classifiers (Naïve Bayes, Logistic Regression and Support Vector Machine) were applied to compare the classification performances. We observed that sulcal measures were either superior than or equal to the other measures used for classification. Specifically, the g-SI and the width of the Sylvian fissure were two of the most sensitive sulcal measures and could be useful neuroanatomical markers for detecting early-stage AD. There were no significant differences between the three classifiers that we tested when using the same neuroanatomical features. PMID:28129351

  15. Involving patient in the early stages of health technology assessment (HTA): a study protocol

    OpenAIRE

    Gagnon, Marie-Pierre; Candas, Bernard; Desmartis, Marie; Gagnon, Johanne; Roche, Daniel La; Rhainds, Marc; Coulombe, Martin; Dipankui, Mylène Tantchou; Légaré, France

    2014-01-01

    Background Public and patient involvement in the different stages of the health technology assessment (HTA) process is increasingly encouraged. The selection of topics for assessment, which includes identifying and prioritizing HTA questions, is a constant challenge for HTA agencies because the number of technologies requiring an assessment exceeds the resources available. Public and patient involvement in these early stages of HTA could make assessments more relevant and acceptable to them. ...

  16. Treatment outcome in patients with triple negative early stage breast cancers compared with other molecular subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Chang, Sei Kyung; Lee, Bo Mi; Shin, Hyun Soo [Dept. of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of); Park, Heily [Dept. of Radiation Oncology, Presbyterian Hospital, Jeonju (Korea, Republic of)

    2012-09-15

    To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.

  17. Charcot stage 0: A review and consideratons for making the correct diagnosis early.

    Science.gov (United States)

    Holmes, Crystal; Schmidt, Brian; Munson, Michael; Wrobel, James S

    2015-01-01

    Charcot neuropathic osteoarthropathy (CN) is a rare disease (NIDDK, NIH Summary Report Charcot Workshop, 2008) that causes significant morbidity and mortality for affected patients. The disease can result in severe deformities of the foot and ankle that contribute to the development of ulcerations and amputations. Medical advances have failed to find ways to stop the progression of the disease. However, it is known that early detection of the CN has a substantial impact on patient outcomes. CN in the earliest stage is very difficult to recognize and differentiate from other similar presenting diseases. We intend to outline clinical considerations practitioners can use when evaluating a patient with early stage suspected CN.

  18. Recovery in eastern Baltic cod: is increased recruitment caused by decreased predation on early life stages?

    DEFF Research Database (Denmark)

    Neumann, Viola; Köster, Fritz; Schaber, M.

    2014-01-01

    Cod (Gadus morhua) recruitment in the eastern Baltic Sea is influenced by predation on early life stages by sprat (Sprattus sprattus) and herring (Clupea harengus), which is considered as one of the mechanisms preventing cod recovery in the 1990s. In the light of improved cod recruitment in the s......Cod (Gadus morhua) recruitment in the eastern Baltic Sea is influenced by predation on early life stages by sprat (Sprattus sprattus) and herring (Clupea harengus), which is considered as one of the mechanisms preventing cod recovery in the 1990s. In the light of improved cod recruitment...

  19. Quality of life of Lithuanian women with early stage breast cancer

    OpenAIRE

    Bulotiene, Giedre; Veseliunas, Jonas; Ostapenko, Valerijus

    2007-01-01

    Background In the last decades, there have been no studies carried out in Lithuania on the quality of life of breast cancer patients. The aim of the present study was to evaluate changes in the quality of life of Lithuanian women with the early stage of breast cancer nine months after surgery and its dependence on surgical strategy, adjuvant chemotherapy and the social and demographic status of the patients. Methods Seventy-seven patients with early stage breast cancer filled in the FACT-An q...

  20. The role of magnetic resonance imaging in determining the proximal extension of early stage cervical cancer to the internal os

    Energy Technology Data Exchange (ETDEWEB)

    Bipat, Shandra, E-mail: s.bipat@amc.uva.nl [Department of Radiology, G1-231, Academic Medical Centre, University of Amsterdam, Meibergdreef 1105 AZ (Netherlands); Berg, Ryan A. van den [Department of Radiology, G1-231, Academic Medical Centre, University of Amsterdam, Meibergdreef 1105 AZ (Netherlands); Velden, Jacobus van der [Department of Gynecology and Obstetrics, Academic Medical Centre, University Amsterdam (Netherlands); Stoker, Jaap; Spijkerboer, Anje M. [Department of Radiology, G1-231, Academic Medical Centre, University of Amsterdam, Meibergdreef 1105 AZ (Netherlands)

    2011-04-15

    Purpose: To study the interobserver variability of MRI for visualization of the internal os and measuring the distance between tumor and the internal os in patients with early cervical carcinoma and to compare the distance between tumor and the internal os measured on MRI with invasion of the internal os determined by histopathology. Materials and methods: All T2-weighed MRI examinations between January 2003 and December 2007 of patients who underwent hysterectomy, of {<=}40 years, with clinical stage IB1 cervix carcinoma and tumor size {<=}2 cm were retrieved. 27 patients fulfilled these criteria. Two radiologists retrospectively reviewed the images for visualization of the internal os and the distance between tumor and the internal os; agreement and intraclass correlation coefficients (ICCs) were calculated to determine interobserver variability. The distance between tumor and the internal os measured on MRI was compared with invasion of the internal os determined by histopathology. Results: In 26 patients, visualization of the internal was rated as good or moderate by both radiologists (agreement 96%). In 15 patients, both radiologists observed a tumor and the ICC for the distance between tumor and the internal os was 0.752 (95%CI: 0.406-0.909). Assuming 5 mm distance between tumor and the internal os on MRI as criterion for invasion of the internal os, 1 true-positive, 2 false-positives and none false-negatives were observed. Assuming 1 cm as criterion increases the number of false-positives, respectively 3 and 5 by radiologist 1 and radiologist 2. Conclusion: MRI has high interobserver values for visualization of the internal os and no false-negatives for involvement of the internal os.

  1. Value of diffusion-weighted imaging in predicting parametrial invasion in stage IA2-IIA cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jung Jae; Kim, Chan Kyo; Park, Sung Yoon; Park, Byung Kwan [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Bohyun [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States)

    2014-05-15

    To investigate the value of diffusion-weighted imaging (DWI) in evaluating parametrial invasion (PMI) in stage IA2-IIA cervical cancer. A total of 117 patients with stage IA2-IIA cervical cancer who underwent preoperative MRI and radical hysterectomy were included in this study. Preoperative clinical variables and MRI variables were analysed and compared between the groups with and without pathologically proven PMI. All variables except age were significantly different between patients with and without pathologic PMI (P < 0.05). All variables except squamous cell carcinoma (SCC) antigen were also significantly correlated with pathologic PMI on univariate analysis (P < 0.05). Multivariate analysis indicated that PMI on MRI (P < 0.001) and tumour apparent diffusion coefficient (ADC) (P = 0.029) were independent predictors of pathologic PMI. Area under the curve of PMI on MRI increased significantly from 0.793 to 0.872 when combined with tumour ADC (P = 0.002). When PMI on MRI was further stratified by tumour ADC, the false negative rate was 2.0 % (1/49). In stage IA2-IIA cervical cancer, tumour ADC and PMI on MRI seem to be independent predictors of pathologic PMI. Combining the two predictors improved the diagnostic performance of identifying patients at low risk of pathologic PMI. (orig.)

  2. Illness representations and coping processes of Taiwanese patients with early-stage chronic kidney disease.

    Science.gov (United States)

    Lin, Chiu-Chu; Chen, Mei-Chun; Hsieh, Hsiu-Fang; Chang, Shu-Chen

    2013-06-01

    Chronic kidney disease (CKD) is a public health problem worldwide with an increasing incidence and prevalence and high cost. The role of illness perceptions in understanding health-related behavior has received little attention in patients with early-stage CKD. This qualitative study aimed to describe the illness representation and coping process experience of patients with early-stage CKD in Taiwan. A qualitative content analysis approach was used to analyze semistructured, open-ended, one-on-one interviews with 15 patients with early-stage CKD. Purposive sampling was used to recruit patients diagnosed with early-stage CKD from the nephrology departments of two medical centers in Taiwan. Trustworthiness of the study was evaluated using four criteria suggested by Lincoln and Guba. Six themes emerged from the analysis: experiencing early symptoms, self-interpreting the causes of having CKD, realizing CKD as a long-term disease, believing CKD could be controlled by following doctors' orders, anticipating the consequences of having CKD, and adopting coping strategies to delay the progress of CKD. Findings from this study compared with previous studies reveal that education can effectively change patient illness representations as an approach to improve coping behavior. This finding offers healthcare professionals insight into the health education necessary to assess patient illness representation to provide culturally sensitive interventions.

  3. Effects of cigarette smoke exposure on early stage embryos in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Tachi, Norihide; Aoyama, Mitsuko (Nagoya City Univ. Medical School (Japan))

    1989-09-01

    It is well recognized that cigarette smoking in pregnant women exerts many deleterious effects on their progenies; intrauterine growth retardation, and increases in perinatal mortality and premature births. The fetal growth retardation also has been reported in animals exposed to cigarette smoke. The authors previously demonstrated that cigarette smoke exposure in pregnant rats retarded the growth of fetuses from mid to late stages of pregnancy. In addition, the weight of uteri containing embryos in animals inhaling the smoke was smaller, although not significant, than that in the control on day 7 of pregnancy. Based on these findings, it was suggested that the growth of embryos in early stage seemed to be harmfully affected as well as during mid and late stages of pregnancy. However, since the uterine weight in early pregnancy was measured in the previous study instead of the direct observation of early stage embryos, it remained unclear whether the early development of embryos was really influenced by cigarette smoke exposure or not. The present study was designed to observe the effects of cigarette smoke inhalation by pregnant rats on early development of embryos from fertilization to implantation.

  4. Muscularis mucosae in desmoplastic stroma formation of early invasive rectal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Shinichi Ban; Michio Shimizu

    2009-01-01

    The origin of myofibroblasts or myofibroblastic cells in the desmoplastic stroma associated with carcinoma invasion has been controversial. In the early invasive area of a rectal adenocarcinoma reported here, an obvious transition between the muscularis mucosa and the bundles of eosinophilic stromal cells observed in the carcinomatous stroma was demonstrated both in morphology and in their cytoskeletal phenotype, which conceivably suggests that the smooth muscle cells of the muscularis mucosa could convert to the eosinophilic stromal cells, namely myofibroblasts.Moreover, type Ⅰ procollagen was demonstrated in both protein and mRNA levels in the areas of eosinophilic stromal cells with a lesser degree of differentiated smooth muscle phenotype that showed a transition from the muscularis mucosa, implying that the myofibroblastic cells converted from smooth muscle cells of the muscularis mucosa could be responsible for type Ⅰ collagen production. These findings suggest that the muscularis mucosae may not be a passive barrier through which colorectal carcinomas infiltrate into the submucosa, but may play an active role in the formation and remodeling of tumor stroma.

  5. Neuroendocrine tumors (carcinoids of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures

    Directory of Open Access Journals (Sweden)

    Kuryk O.G.

    2014-03-01

    Full Text Available Background. Neuroendocrine tumors of the stomach and intestines are rare diseases. Increasing incidence and complexity of diagnosis of these diseases cause acuteness of the problem. Objective. To evaluate the effectiveness of morphological examination of endoscopic biopsy material for diagnostics of neuroendocrine tumors and for evaluation of completeness of minimally invasive endoscopic surgical interventions (endoscopic mucosal resection and endoscopic submucosal dissection at neuroendocrine tumors. Methods. On the basis of Medical center "Oberig" in 2009 - 2013 in eight cases neuroendocrine tumors were diagnosed: 2 (25 % in the stomach, 2 (25% – in the duodenum, 2 (25% - in the small intestine, 1 (12.5 % - in the ascending colon, 1 (12.5% - in the rectum. Neuroendocrine tumors of stomach and ileum were removed by endoscopic mucosal resection, duodenal bulb and rectum neuroendocrine tumors – by endoscopic submucosal dissection, papillary duodenum, colon and jejunum neuroendocrine tumors – by surgical resection. Results. It was shown, that morphological evaluation of endoscopic mucosal biopsies is effective way to diagnose the neuroendocrine tumors. Conclusion. Endoscopic mucosal resection and endoscopic submucosal dissection allows to get advanced material for morphological diagnosis of neuroendocrine tumors and an adequate method of their removing Citation: Kuryk OG, Yakovenko VO, Bazdyrev VV, Bodnar LV. [Neuroendocrine tumors (carcinoids of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures]. Morphologia. 2014;8(1:58-64. Ukrainian.

  6. [Treatment of non-small cell lung carcinoma in early stages].

    Science.gov (United States)

    Meneses, José Carlos; Avila Martínez, Régulo J; Ponce, Santiago; Zuluaga, Mauricio; Bartolomé, Adela; Gámez, Pablo

    2013-12-01

    Treatment of lung carcinoma is multidisciplinary. There are different therapeutic strategies available, although surgery shows the best results in those patients with lung carcinoma in early stages. Other options such as stereotactic radiation therapy are relegated to patients with small tumors and poor cardiopulmonary reserve or to those who reject surgery. Adjuvant chemotherapy is not justified in patients with stage i of the disease and so double adjuvant chemotherapy should be considered. This adjuvant chemotherapy should be based on cisplatin after surgery in those patients with stages ii and IIIA.

  7. Early diagnosis of incipient caries based on non-invasive lasers

    Science.gov (United States)

    Velescu, A.; Todea, C.; Vitez, B.

    2016-03-01

    AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

  8. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

  9. A quantification model for apoptosis in mouse embryos in the early stage of fetation

    Institute of Scientific and Technical Information of China (English)

    WANG PengFei; FU JianHua; MA WanYun; CHEN DieYan; Lü DanYu; BAI WenJia

    2009-01-01

    Apoptosis is the most important inducement and modulator for embryos in the early stage of fetation, i.e. after the 8-cell stage, mostly the morula and blastula stage, to proceed to the stage of nonlinear development. Using a two-photon laser scanning microscopy (TPLSM) system, we obtained 3-dimensional (3D) fluorescent images of preimplantation mouse embryos. A model for quantification was established. The statistical results for the spatial location of apoptosis bodies in embryos was obtained following image processing, as well as investigation of the kinetics of apoptosis. It was found that most (70%) apoptosis occurred in the trophectoderm, and the departure between the centroid and geometric center of embryos had a step transition when embryos developed into the 32-cell stage,which was consistent with the theoretical prediction that the blastocele would induce a symmetry break of the distribution of cells in embryos.

  10. A quantification model for apoptosis in mouse embryos in the early stage of fetation

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Apoptosis is the most important inducement and modulator for embryos in the early stage of fetation, i.e. after the 8-cell stage, mostly the morula and blastula stage, to proceed to the stage of nonlinear development. Using a two-photon laser scanning microscopy (TPLSM) system, we obtained 3-dimensional (3D) fluorescent images of preimplantation mouse embryos. A model for quantification was established. The statistical results for the spatial location of apoptosis bodies in embryos was obtained following image processing, as well as investigation of the kinetics of apoptosis. It was found that most (70%) apoptosis occurred in the trophectoderm, and the departure between the centroid and geometric center of embryos had a step transition when embryos developed into the 32-cell stage, which was consistent with the theoretical prediction that the blastocele would induce a symmetry break of the distribution of cells in embryos.

  11. Reduced fractional anisotropy in early-stage cerebellar variant of multiple system atrophy.

    Science.gov (United States)

    Oishi, Kenichi; Konishi, Junya; Mori, Susumu; Ishihara, Hiroyuki; Kawamitsu, Hideaki; Fujii, Masahiko; Kanda, Fumio

    2009-04-01

    In patients with the cerebellar variant of multiple system atrophy (MSA-C), reduced fractional anisotropy (FA) has been reported in several brain areas. However, since previous studies have employed predetermined regions of interest (ROI), the brain areas showing the earliest alterations in FA are unknown. The sensitivity of detecting early-stage MSA-C and the time course of the FA reduction are also unknown. The purpose was to address these issues to determine the diagnostic value of FA for early diagnosis. Twenty-one patients with MSA-C were investigated. Voxel-based FA analysis and morphometry were used to detect the differences between early-stage MSA-C and normal controls. An ROI-based FA analysis was also used to clarify the temporal profile. From the early-stage, MSA-C patients exhibited reduced FA and white matter atrophy in the middle cerebellar peduncle, the inferior cerebellar peduncle, and the ventral pons. The FA of these areas decreased rapidly during the first few years after onset, after which a rather gradual reduction occurred. The receiver operating characteristics analysis revealed a high sensitivity and specificity for discriminating early MSA-C from normal controls. FA measurement could potentially be used to make an early diagnosis and monitor progression in MSA-C patients.

  12. Detailed stratification of TNM stage III rectal cancer based on the presence/absence of extracapsular invasion of the metastatic lymph nodes.

    Science.gov (United States)

    Komori, Koji; Kanemitsu, Yukihide; Kimura, Kenya; Sano, Tsuyoshi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Shimizu, Yasuhiro

    2013-06-01

    The presence/absence of extracapsular invasion in metastatic lymph nodes has been reported as being significantly correlated with the prognosis in a wide variety of cancers. However, the influence of extracapsular invasion in the metastatic lymph nodes on the prognosis in patients with stage III rectal cancer has not yet been investigated. We investigated the presence/absence of extracapsular invasion in the metastatic nodes of the relevant main/lateral lymph node group in patients with rectal cancer to determine the usefulness of this parameter for stratifying the prognosis of patients with stage III rectal cancer. This was a single-institution study. This study was conducted at a single institution. We enrolled 101 consecutive patients with stage III rectal cancer who had undergone curative surgery with extended lymph node dissection and investigated the presence/absence of extracapsular invasion in the regional metastatic lymph nodes to determine the usefulness of such stratification for a more precise prediction of the patient prognosis. The main outcomes measured were the disease-free and overall survival rates. Univariate analysis revealed a significantly poorer prognosis, in terms of both the disease-free survival rate (p = 0.003) and overall survival rate (p = 0.008), of the pN3-extracapsular invasion-positive cases in comparison with the pN3-extracapsular invasion-negative cases. Multivariate analysis revealed the presence/absence of extracapsular invasion in the metastatic lymph nodes as the only variable that was statistically significantly associated with the disease-free survival rate (p = 0.011). This was a retrospective study in a small number of patients from a single institution. There were no comparator groups. Detailed stratification of pN3 cases based on the presence/absence of extracapsular invasion in metastatic lymph nodes has the potential to contribute significantly to more available prediction of the prognosis of patients with stage III

  13. The spread of Impatiens parviflora DC. in Central European oak forests – another stage of invasion?

    Directory of Open Access Journals (Sweden)

    Kamila Reczyńska

    2015-12-01

    Full Text Available In this study, we examine the pattern of occurrence of Impatiens parviflora in Central European oak forests over time and its ecological requirements within these types of communities. Research was based on phytosociological data collected in 3776 relevés. A modified TWINSPAN algorithm were used to distinguish the groups of oak forests. The ecological preferences of the I. parviflora and studied communities as well as differences between invaded and non-invaded vegetation plots were analyzed using mean weighted Ellenberg indicator values (EIVs. Finally, both the temporal pattern of I. parviflora participation and changes in its coverage in the studied communities were analyzed. Our study confirmed a high adaptability of this species with respect to temperature, moisture, soil reaction and nutrients and determined its broad ecological optimum in oak forests. However, it also revealed both a greater sensitivity of some communities within Central European oak forests to the invasion of I. parviflora and differences in habitat conditions between invaded and non-invaded vegetation plots. This suggests that the habitat niche of I. parviflora within oak forests is not accidental. The analysis of temporal changes in the frequency of I. parviflora confirmed a 20% increase in relevés over the last 50 years. However, we did not identify any statistically significant rise in the coverage of I. parviflora in oak forests specifically during the studied period.

  14. Sequence of Tissue Responses in the Early Stages of Experimental Allergic Encephalomyelitis (EAE): Immunohistochemical, Light Microscopic, and Ultrastructural Observations in the Spinal Cord

    Science.gov (United States)

    DAmelio, Fernando E.; Smith, Marion E.; Eng, Lawrence F.

    1990-01-01

    Experimental allergic encephalomyelitis (EAE) was induced in adult Lewis rats with purified guinea pig CNS myelin and Freund's adjuvant. As soon as the very earliest clinical signs appeared the animals were perfused with fixatives and the spinal cord analyzed by electron microscopy, silver methods, and immunocytochemistry. Our findings suggest that in the early stages of EAE a sequence of events can be traced, although these events frequently overlap. The earliest morphological change appears to be astrocytic edema in both the cell body and processes. Increased amounts of glycogen particles and dispersion of glial filaments are prominent. These changes seem to occur just prior to the time when inflammatory cells begin to penetrate the capillary walls. Invasion of the neuropil mainly by macrophages and lymphocytes closely follows. Both macrophages and microglia seem to participate in phagocytosis of oligodendrocytes and myelin. Demyelination, however, is not a prominent feature at this early stage.

  15. Strategies of Individual Surgical Treatment for Early Stage Non-small Cell Lung Cancer and the Guidance of Intraoperative Frozen Pathology

    Directory of Open Access Journals (Sweden)

    Bin HU

    2016-06-01

    Full Text Available Early stage non-small cell lung cancer patients, especially those who presented small GGO on image, are increasing in Asia population. Retrospective clinical data indicated that the efficacy of sub-lobectomy for these patients may be non-inferior to that of lobectomy. Meanwhile, sub-lobectomy could preserve more pulmonary function for the patients. Researches have demonstrated that careful evaluation for the image manifestation is essential before sub-lobectomy and those who diagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma may be more appropriate for this procedure. Precise diagnosis of Intraoperative frozen section is an effective method toward personalization of surgical care for early-stage non-smallcell lung cancer.

  16. Sensitivity of early life stages of white sturgeon, rainbow trout, and fathead minnow to copper.

    Science.gov (United States)

    Vardy, David W; Oellers, Johanna; Doering, Jon A; Hollert, Henner; Giesy, John P; Hecker, Markus

    2013-01-01

    Populations of white sturgeon (WS; Acipenser transmontanus) are in decline in several parts of the United States and Canada, attributed primarily to poor recruitment caused by degradation of habitats, including pollution with contaminants such as metals. Little is known about sensitivity of WS to contaminants or metals such as copper (Cu). Here, acute (96 h) mortalities of WS early life stages due to exposure to Cu under laboratory conditions are reported. Two standard test species, rainbow trout (Oncorhynchus mykiss) and fathead minnow (Pimephales promelas), were exposed in parallel to determine relative sensitivity among species. Swim-up larvae [15 days post-hatch (dph)] and early juveniles (40-45 dph) of WS were more sensitive to Cu (LC(50) = 10 and 9-17 μg/L, respectively) than were yolksac larvae (8 dph; LC(50) = 22 μg/L) and the later juvenile life stage (100 dph; LC(50) = 54 μg/L). WS were more sensitive to Cu than rainbow trout and fathead minnow at all comparable life stages tested. Yolksac larvae of rainbow trout and fathead minnow were 1.8 and 4.6 times, respectively, more tolerant than WS, while swim-up and juvenile life stages of rainbow trout were between 1.4- and 2.4-times more tolerant than WS. When plotted in a species sensitivity distribution with other fishes, the mean acute toxicity value for early life stage WS was ranked between the 1st and 2nd centile. The WS life stage of greatest Cu sensitivity coincides with the beginning of active feeding and close association with sediment, possibly increasing risk. WS early life stages are sensitive to aqueous copper exposure and site-specific water quality guidelines and criteria should be evaluated closely to ensure adequate protection.

  17. Role of early minimal-invasive spine fixation in acute thoracic and lumbar spine trauma

    Directory of Open Access Journals (Sweden)

    Schmidt Oliver

    2007-01-01

    Full Text Available Polytraumatized patients following a severe trauma suffer from substantial disturbances of the immune system. Secondary organ dysfunction syndromes due to early hyperinflammation and late immunparalysis contribute to adverse outcome. Consequently the principle of damage control surgery / orthopedics developed in the last two decades to limit secondary iatrogenic insult in these patients. New percutaneous internal fixators provide implants for a damage control approach of spinal trauma in polytraumatized patients. The goal of this study is to evaluate the feasibility of minimal-invasive instrumentation in the setting of minor and major trauma and to discuss the potential benefits and drawbacks of this procedure. Materials and Methods: The present study is a prospective analysis of 76 consecutive patients (mean age 53.3 years with thoracolumbar spine fractures following major or minor trauma from August 2003 to January 2007 who were subjected to minimal-invasive dorsal instrumentation using CD Horizon ® Sextant TM Rod Insertion System and Longitude TM Rod Insertion System (Medtronic ® Sofamor Danek. Perioperative and postoperative outcome measures including e.g. local and systemic complications were assessed and discussed. Results: Forty-nine patients (64.5% suffered from minor trauma (Injury Severity Score < 16. Polytraumatized patients (n=27; 35.5% had associated chest (n=20 and traumatic brain injuries (n=22. For mono- and bisegmental dorsal instrumentation the Sextant TM was used in 60 patients, whereas in 16 longer ranging instrumentations the (prototype Longitude TM system was implanted. Operation time was substantially lower than in conventional approach at minimum 22.5 min for Sextant and 36.2 min for Longitude TM , respectively. Geriatric patients with high perioperative risk according to ASA classification benefited from the less invasive approach and lack of approach-related complications including no substantial blood loss

  18. Towards non-invasive diagnostic techniques for early detection of acute renal transplant rejection: A review

    Directory of Open Access Journals (Sweden)

    Elizabeth Hollis

    2017-03-01

    Full Text Available The kidney is a very important complicated filtering organ of the body. When the kidney reaches stage 5 chronic kidney disease, end stage renal failure, the preeminent therapy is renal transplantation. Although it is the best form of treatment, lack of kidney donors is still challenging. Therefore, all efforts should be employed to prolong the survival rate of the transplanted kidney. However, graft dysfunction (e.g., acute rejection is one of the serious barriers to long term kidney transplant survival. Currently, graft dysfunction’s gold standard of diagnosis is renal biopsy. Although renal biopsy is helpful, it is not preferred due to its invasive nature, high morbidity rates, and expensiveness. Therefore, noninvasive imaging techniques have become the subject of extensive research and interest, giving a strong promise to replace, or at least to decrease, biopsy usage in diagnosing graft dysfunction. This survey will discuss not only the current diagnosis and treatment of graft dysfunction but also the state-of-the-art imaging techniques in detecting acute renal transplant rejection.

  19. Potential role of blood microRNAs as non-invasive biomarkers for early detection of asymptomatic coronary atherosclerosis in obese children with metabolic syndrome.

    Science.gov (United States)

    Omran, Ahmed; Elimam, Dalia; He, Fang; Peng, Jing; Yin, Fei

    2012-12-01

    The pandemic of the childhood obesity represent a major public health problem all over the world. This leads to detection of many health conditions that were previously considered an adulthood diseases. The rise in the prevalence of the obesity and overweight among children means that the world will face an explosion in the prevalence of the metabolic syndrome (MS), which increases the risk of atherosclerotic disease and death in adulthood. The atherosclerotic process has proved to develop silently for decades during childhood and adolescence before the cardiovascular complications such as myocardial infarction and stroke occur. This means that obese children especially with MS could have heart attacks and suffer from heart disease in an age when they should be very healthy, but most of these data either derived from autopsy findings or studies that confirmed the presence of peripheral atherosclerosis. Very early detection of coronary atherosclerosis in obese children with metabolic syndrome through a non invasive method will be of great importance, allowing for early therapeutic intervention. The discovery of microRNAs (miRNAs) is considered a major scientific breakthrough in the last years; recent studies have suggested a potentially important role of miRNAs in the control of diversity aspects of cardiac functions in health and disease including coronary atherosclerosis. Moreover, circulating miRNAs profiles recently used as a non-invasive biomarker for diagnosis of multiple cardiovascular diseases. The identification of distinct circulating miRNA profiles may impact the development of specific miRNAs as biomarkers in pediatric cardiovascular diseases. Therefore, we postulate that some of these circulating miRNAs may be a potential biomarker for early non-invasive diagnosis of coronary atherosclerosis in very early asymptomatic stage in obese children with metabolic syndrome, giving an excellent chance to fight against the first killer in the adult population in

  20. Prognosis and staging of superficial endobronchial lung cancer: the impact of invasion depth, tumor diameter, and coexistent pneumonitis or atelectasis

    Institute of Scientific and Technical Information of China (English)

    CHEN Chang; ZHENG Hui; GAO Wen; ZHOU Ying; JIANG Sen; SUEN Hon-chi

    2010-01-01

    Background There are few reports discussing the surgical pathological characteristics of superficial endobronchial lung cancer (SELC) defined as cancer growth limited to the bronchial wall. Its prognosis and corresponding TNM staging have not been fully clarified. Little is known as to whether T status is impacted by the existence of associated atelectasis or pneumonia (which might be controversial, indicating either T1 or T2), and circumstantial invasion depth.Methods Between 1988 and 2007, 81 out of 8817 surgically treated patients met SELC criteria; there was no detectable invasion beyond the bronchial wall. A retrospective review was performed and follow-up information was collected.Results The overall five-year survival rate of 81 patients was 85.6%; for NOM0 (n=67), N1M0 (n=7) and N2M0 (n=7)patients, they were 89.3%, 75.0% and 60.0%, respectively. Intraluminal tumor size measured from 0.4 to 3.0 cm;obstructive atelectasis or pneumonia was noted in 14 patients. The presence of tumor-associated obstructive atelectasis or pneumonia did not have a significant impact upon prognosis (P=0.96), nor did the greatest diameter of the tumor (P=0.70). Histology showed carcinoma in situ (level one) in 13 cases; invasion of the submucosal layer (level two) in 12,involvement of the muscular layer (level three) in 20, invasion into the space between the muscular layer and cartilage (level four) in 21, and bronchial cartilage infiltration in 15 (level five). In cases without lymphnode metastases, five-year survival was 100% for the first three levels and 84.0% and 61.3% for the level four and level five.Conclusions Relative to TNM-based prognostic data, superficial endobronchial lung cancer exhibits increased five-year survival rates, and therefore should be placed at the forefront among tumors in the T1 class, regardless of tumor size or the presence of secondary obstructive atelectasis or pneumonia. Lymphnode metastasis is associated with a worse prognosis. Survival is

  1. Bmi-1 promotes invasion and metastasis, and its elevated expression is correlated with an advanced stage of breast cancer

    Directory of Open Access Journals (Sweden)

    Kung Hsiang-Fu

    2011-01-01

    Full Text Available Abstract Background B-lymphoma Moloney murine leukemia virus insertion region-1 (Bmi-1 acts as an oncogene in various tumors, and its overexpression correlates with a poor outcome in several human cancers. Ectopic expression of Bmi-1 can induce epithelial-mesenchymal transition (EMT and enhance the motility and invasiveness of human nasopharyngeal epithelial cells (NPECs, whereas silencing endogenous Bmi-1 expression can reverse EMT and reduce the metastatic potential of nasopharyngeal cancer cells (NPCs. Mouse xenograft studies indicate that coexpression of Bmi-1 and H-Ras in breast cancer cells can induce an aggressive and metastatic phenotype with an unusual occurrence of brain metastasis; although, Bmi-1 overexpression did not result in oncogenic transformation of MCF-10A cells. However, the underlying molecular mechanism of Bmi-1-mediated progression and the metastasis of breast cancer are not fully elucidated at this time. Results Bmi-1 expression is more pronouncedly increased in primary cancer tissues compared to matched adjacent non-cancerous tissues. High Bmi-1 expression is correlated with advanced clinicopathologic classifications (T, N, and M and clinical stages. Furthermore, a high level of Bmi-1 indicates an unfavorable overall survival and serves as a high risk marker for breast cancer. In addition, inverse transcriptional expression levels of Bmi-1 and E-cadherin are detected between the primary cancer tissues and the matched adjacent non-cancerous tissues. Higher Bmi-1 levels are found in the cancer tissue, whereas the paired adjacent non-cancer tissue shows higher E-cadherin levels. Overexpression of Bmi-1 increases the motility and invasive properties of immortalized human mammary epithelial cells, which is concurrent with the increased expression of mesenchymal markers, the decreased expression of epithelial markers, the stabilization of Snail and the dysregulation of the Akt/GSK3β pathway. Consistent with these

  2. Risk factors for early invasive fungal disease in critically ill patients

    Science.gov (United States)

    Singh, Gurmeet; Pitoyo, Ceva Wicaksono; Aditianingsih, Dita; Rumende, Cleopas Martin

    2016-01-01

    Background: The incidence of invasive fungal disease (IFD) is increasing worldwide in the past two to three decades. Critically ill patients in Intensive Care Units are more vulnerable to fungal infection. Early detection and treatment are important to decrease morbidity and mortality in critically ill patients. Objective: Our study aimed to assess factors associated with early IFD in critically ill patients. Materials and Methods: This prospective cohort study was conducted in critically ill patients, from March to September 2015. Total number of patients (74) in this study was drawn based on one of the risk factors (human immunodeficiency virus). Specimens were collected on day 5–7 of hospitalization. Multivariate analysis with logistic regression was performed for factors, with P < 0.25 in bivariate analysis. Results: Two hundred and six patients were enrolled in this study. Seventy-four patients were with IFD, majority were males (52.7%), mean age was 58 years (range 18–79), mean Leon's score was 3 (score range 2–5), majority group was nonsurgical/nontrauma (72.9%), and mean fungal isolation was positive on day 5. Candida sp. (92.2%) is the most frquently isolated fungal infection. Urine culture yielded the highest number of fungal isolates (70.1%). Mortality rate in this study was 50%. In multivariate analysis, diabetes mellitus (DM) (P = 0.018, odds ratio 2.078, 95% confidence interval 1.135–3.803) was found as an independent factor associated with early IFD critically ill patients. Conclusion: DM is a significant factor for the incidence of early IFD in critically ill patients. PMID:27994377

  3. Risk factors for early invasive fungal disease in critically ill patients

    Directory of Open Access Journals (Sweden)

    Gurmeet Singh

    2016-01-01

    Full Text Available Background: The incidence of invasive fungal disease (IFD is increasing worldwide in the past two to three decades. Critically ill patients in Intensive Care Units are more vulnerable to fungal infection. Early detection and treatment are important to decrease morbidity and mortality in critically ill patients. Objective: Our study aimed to assess factors associated with early IFD in critically ill patients. Materials and Methods: This prospective cohort study was conducted in critically ill patients, from March to September 2015. Total number of patients (74 in this study was drawn based on one of the risk factors (human immunodeficiency virus. Specimens were collected on day 5–7 of hospitalization. Multivariate analysis with logistic regression was performed for factors, with P< 0.25 in bivariate analysis. Results: Two hundred and six patients were enrolled in this study. Seventy-four patients were with IFD, majority were males (52.7%, mean age was 58 years (range 18–79, mean Leon's score was 3 (score range 2–5, majority group was nonsurgical/nontrauma (72.9%, and mean fungal isolation was positive on day 5. Candida sp. (92.2% is the most frquently isolated fungal infection. Urine culture yielded the highest number of fungal isolates (70.1%. Mortality rate in this study was 50%. In multivariate analysis, diabetes mellitus (DM (P = 0.018, odds ratio 2.078, 95% confidence interval 1.135–3.803 was found as an independent factor associated with early IFD critically ill patients. Conclusion: DM is a significant factor for the incidence of early IFD in critically ill patients.

  4. Sydney, Australia Community Meets Classroom: Celebrating Families and Difference in the Early Stages of Primary Education

    Science.gov (United States)

    Burns, Kellie

    2006-01-01

    Teachers and teacher educators are often hard pressed to find resources that creatively integrate lesbian, gay, bisexual, transgender (LGBT), and intersex issues into the early stages of primary education. While there is a growing number of academics who stress the importance of addressing topics of sexual and gender diversity during the early…

  5. Creating Socionas: Building creative understanding of people's experiences in the early stages of new product development

    NARCIS (Netherlands)

    Postma, C.E.

    2012-01-01

    This work presents the research into Creating Socionas, a step-by-step approach to building creative understanding of user experience in the early stages of new product development (NPD). Creative understanding is the combination of a rich, cognitive and affective understanding of the other, and the

  6. Patterns of recurrence and survival after surgery or stereotactic radiotherapy for early stage NSCLC

    NARCIS (Netherlands)

    van den Berg, Liseth L.; Klinkenberg, Theo J.; Groen, Harry J. M.; Widder, Joachim

    Introduction: Surgery is the standard treatment for early stage non-small-cell lung cancer (NSCLC). For medically inoperable patients, stereotactic ablative radiotherapy (SABR) has emerged as widely used standard treatment. The aim of this study was to analyze survival and patterns of tumor

  7. Cognitive impairment in early-stage non-demented Parkinson's disease patients

    DEFF Research Database (Denmark)

    Pfeiffer, Helle Cecilie Viekilde; Løkkegaard, A; Zoetmulder, Marielle

    2013-01-01

    In Parkinson's disease (PD), Parkinson's disease dementia (PDD) and Parkinson's disease-mild cognitive impairment (PD-MCI) are common. PD-MCI is a risk factor for developing PDD. Knowledge of cognition in early-stages PD is essential in understanding and predicting the dementia process....

  8. 77 FR 25775 - Small Business Investment Companies-Early Stage SBICs

    Science.gov (United States)

    2012-05-01

    ... diversification criteria. Section V of this notice describes the criteria by which SBA will evaluate applicants... work with SBA leverage and make appropriate suggestions to manage risk. Risk mitigation strategies... Diversification Rights. Per Sec. 107.320, SBA reserves the right to maintain diversification among Early Stage...

  9. Concurrent Data Elicitation Procedures, Processes, and the Early Stages of L2 Learning: A Critical Overview

    Science.gov (United States)

    Leow, Ronald P.; Grey, Sarah; Marijuan, Silvia; Moorman, Colleen

    2014-01-01

    Given the current methodological interest in eliciting direct data on the cognitive processes L2 learners employ as they interact with L2 data during the early stages of the learning process, this article takes a critical and comparative look at three concurrent data elicitation procedures currently employed in the SLA literature: Think aloud (TA)…

  10. Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer

    NARCIS (Netherlands)

    Langius, Jacqueline A. E.; Doornaert, Patricia; Spreeuwenberg, Marieke D.; Langendijk, Johannes A.; Leemans, C. Rene; van Bokhorst-de van der Schueren, Marian A. E.

    2010-01-01

    Background and purpose: Although patients with early stage (T1/T2) laryngeal cancer (LC) are thought to have a low incidence of malnutrition, severe weight loss is observed in a subgroup of these patients during radiotherapy (RI). The objective of this study was to evaluate weight loss and nutrition

  11. Target volume delineation variation in radiotherapy for early stage rectal cancer in the Netherlands

    NARCIS (Netherlands)

    Nijkamp, Jasper; de Haas-Kock, Danielle F. M.; Beukema, Jannet C.; Neelis, Karen J.; Woutersen, Dankert; Ceha, Heleen; Rozema, Tom; Slot, Annerie; Vos-Westerman, Hanneke; Intven, Martijn; Spruit, Patty H.; van der Linden, Yvette; Geijsen, Debby; Verschueren, Karijn; van Herk, Marcel B.; Marijnen, Corrie A. M.

    2012-01-01

    Purpose: The aim of this study was to measure and improve the quality of target volume delineation by means of national consensus on target volume definition in early-stage rectal cancer. Methods and materials: The CTV's for eight patients were delineated by 11 radiation oncologists in 10 institutes

  12. "It's the Bread and Butter of Our Practice": Experiencing the Early Years Foundation Stage

    Science.gov (United States)

    Roberts-Holmes, Guy

    2012-01-01

    This article presents the experiences of nursery and primary head teachers (n = 12) on the English Early Years Foundation Stage (EYFS) after its first year of implementation in 2010. Findings are drawn from a subset of data (head teachers of primary and nursery schools) which forms part of a larger Department for Children, Schools and Families…

  13. Creating Socionas: Building creative understanding of people's experiences in the early stages of new product development

    NARCIS (Netherlands)

    Postma, C.E.

    2012-01-01

    This work presents the research into Creating Socionas, a step-by-step approach to building creative understanding of user experience in the early stages of new product development (NPD). Creative understanding is the combination of a rich, cognitive and affective understanding of the other, and the

  14. Clinical Practice of Adjuvant Chemotherapy in Patients with Early-Stage Epithelial Ovarian Cancer

    NARCIS (Netherlands)

    Frielink, L.M.; Pijlman, B.M.; Ezendam, N.P.; Pijnenborg, J.M.A.

    2016-01-01

    BACKGROUND: Adjuvant platinum-based chemotherapy improves survival in women with early-stage epithelial ovarian cancer (EOC). Yet, there is a wide variety in clinical practice. METHODS: All patients diagnosed with FIGO I and IIa EOC (2006-2010) in the south of the Netherlands were analyzed. The perc

  15. 77 FR 25042 - Small Business Investment Companies-Early Stage SBICs

    Science.gov (United States)

    2012-04-27

    ....1830. Section 107.1181--Interest reserve requirements for Early Stage SBICs. Two commenters addressed... provided an exception to the interest reserve requirement for leverage in the form of a discounted... reserve requirements. SBA clearly stated its intention to do so in the preamble to the proposed rule....

  16. Concurrent Data Elicitation Procedures, Processes, and the Early Stages of L2 Learning: A Critical Overview

    Science.gov (United States)

    Leow, Ronald P.; Grey, Sarah; Marijuan, Silvia; Moorman, Colleen

    2014-01-01

    Given the current methodological interest in eliciting direct data on the cognitive processes L2 learners employ as they interact with L2 data during the early stages of the learning process, this article takes a critical and comparative look at three concurrent data elicitation procedures currently employed in the SLA literature: Think aloud (TA)…

  17. Evaluation of hypothesized adverse outcome pathway linking thyroid peroxidase inhibition to fish early life stage toxicity

    Science.gov (United States)

    There is an interest in developing alternatives to the fish early-life stage (FELS) test (OECD test guideline 210), for predicting adverse outcomes (e.g., impacts on growth and survival) using less resource-intensive methods. Development and characterization of adverse outcome pa...

  18. Patterns of recurrence and survival after surgery or stereotactic radiotherapy for early stage NSCLC

    NARCIS (Netherlands)

    van den Berg, Liseth L.; Klinkenberg, Theo J.; Groen, Harry J. M.; Widder, Joachim

    2015-01-01

    Introduction: Surgery is the standard treatment for early stage non-small-cell lung cancer (NSCLC). For medically inoperable patients, stereotactic ablative radiotherapy (SABR) has emerged as widely used standard treatment. The aim of this study was to analyze survival and patterns of tumor recurren

  19. "It's the Bread and Butter of Our Practice": Experiencing the Early Years Foundation Stage

    Science.gov (United States)

    Roberts-Holmes, Guy

    2012-01-01

    This article presents the experiences of nursery and primary head teachers (n = 12) on the English Early Years Foundation Stage (EYFS) after its first year of implementation in 2010. Findings are drawn from a subset of data (head teachers of primary and nursery schools) which forms part of a larger Department for Children, Schools and Families…

  20. Memory Club: A Group Intervention for People with Early-Stage Dementia and Their Care Partners

    Science.gov (United States)

    Zarit, Steven H.; Femia, Elia E.; Watson, Jennifer; Rice-Oeschger, Laura; Kakos, Bernadette

    2004-01-01

    Purpose: Diagnosis of dementia in its early stages presents a window of opportunity for examining the immediate and long-term consequences of the illness at a point when the individual with memory loss can still participate in decision making. Design and Methods: Memory Club is a l0-session group program designed to provide information about…

  1. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients

    NARCIS (Netherlands)

    B. karakullukcu (Baris); K. Oudenaarde (Kim); M.P. Copper (Marcel); W.M.C. Klop; R. van Veen (Robert); M. Wildeman (Maarten); I. Bing Tan

    2010-01-01

    textabstractThe indications of photodynamic therapy (PDT) of oral cavity and oropharynx neoplasms are not well defined. The main reason is that the success rates are not well established. The current paper analyzes our institutional experience of early stage oral cavity and oropharynx neoplasms (Tis

  2. Interobserver delineation uncertainty in involved-node radiation therapy (INRT) for early-stage Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Aznar, Marianne C; Girinsky, Theodore; Berthelsen, Anne Kiil

    2017-01-01

    BACKGROUND AND PURPOSE: In early-stage classical Hodgkin lymphoma (HL) the target volume nowadays consists of the volume of the originally involved nodes. Delineation of this volume on a post-chemotherapy CT-scan is challenging. We report on the interobserver variability in target volume definiti...

  3. Effective Packet Number for 5G IM WeChat Application at Early Stage Traffic Classification

    Directory of Open Access Journals (Sweden)

    Muhammad Shafiq

    2017-01-01

    Full Text Available Accurate network traffic classification at early stage is very important for 5G network applications. During the last few years, researchers endeavored hard to propose effective machine learning model for classification of Internet traffic applications at early stage with few packets. Nevertheless, this essential problem still needs to be studied profoundly to find out effective packet number as well as effective machine learning (ML model. In this paper, we tried to solve the above-mentioned problem. For this purpose, five Internet traffic datasets are utilized. Initially, we extract packet size of 20 packets and then mutual information analysis is carried out to find out the mutual information of each packet on n flow type. Thereafter, we execute 10 well-known machine learning algorithms using crossover classification method. Two statistical analysis tests, Friedman and Wilcoxon pairwise tests, are applied for the experimental results. Moreover, we also apply the statistical tests for classifiers to find out effective ML classifier. Our experimental results show that 13–19 packets are the effective packet numbers for 5G IM WeChat application at early stage network traffic classification. We also find out effective ML classifier, where Random Forest ML classifier is effective classifier at early stage Internet traffic classification.

  4. Do we need an early unfavorable (intermediate) stage of Hodgkin's lymphoma?

    DEFF Research Database (Denmark)

    Specht, Lena; Raemaekers, John

    2007-01-01

    The outcome of patients who have early unfavorable or intermediate-stage Hodgkin's lymphoma has greatly improved. The increasing efficacy of chemotherapy and late toxic effects of wide-field radiotherapy justify the careful testing of the new involved-node radiotherapy principle in the combined-m...

  5. 76 FR 81430 - Small Business Investment Companies-Early Stage SBICs; Public Webinars

    Science.gov (United States)

    2011-12-28

    ...- creating startups and small firms, accelerate research, and address barriers to success for entrepreneurs... From the Federal Register Online via the Government Publishing Office ] SMALL BUSINESS ADMINISTRATION 13 CFR Part 107 Small Business Investment Companies--Early Stage SBICs; Public Webinars AGENCY:...

  6. Prolonged Exposure Therapy for a Vietnam Veteran with PTSD and Early-Stage Dementia

    Science.gov (United States)

    Duax, Jeanne M.; Waldron-Perrine, Brigid; Rauch, Sheila A. M.; Adams, Kenneth M.

    2013-01-01

    Although prolonged exposure therapy (PE) is considered an evidence-based treatment for PTSD, there has been little published about the use of this treatment for older adults with comorbid early-stage dementia. As the number of older adults in the United States continues to grow, so will their unique mental health needs. The present article…

  7. MUC4 and MUC1 expression in adenocarcinoma of the stomach correlates with vessel invasion and lymph node metastasis: an immunohistochemical study of early gastric cancer.

    Directory of Open Access Journals (Sweden)

    Yukihiro Tamura

    Full Text Available We have previously reported that MUC4 expression is a poor prognostic factor in various carcinomas. Our previous study also showed that MUC1 expression in gastric cancers, including the early and advanced stages is a poor prognostic factor. In the present study, the expression profiles of MUC4 and MUC1 were examined by immunohistochemistry (IHC using two anti-MUC4 monoclonal antibodies (MAbs, 8G7 and 1G8, and anti-MUC1 MAb DF3 in 104 gastrectomy specimens of early gastric adenocarcinoma with submucosal invasion (pT1b2, including 197 histological subtype lesions. Before the IHC study of the human specimens, we evaluated the specificity of the two MAbs by Western blotting and IHC of two MUC4 mRNA expressing gastric cancer cell lines. MAb 8G7 reacted clearly, whereas MAb 1G8 did not show any reactivity, in either Western blotting or IHC. In the IHC of the gastric cancers, the expression rates of MUC4/8G7 detected by MAb 8G7, MUC4/1G8 detected by MAb 1G8 and MUC1/DF3 detected by MAb DF3 in well differentiated types (70%, 38/54; 67%, 36/54; 52%, 28/54 were significantly higher than those in poorly differentiated types (18%, 10/55; 36%, 20/55; 13%, 7/55 (P<0.0001; P = 0.0021; P<0.0001, respectively. The MUC4/8G7 expression was related with lymphatic invasion (r = 0.304, P = 0.033. On the other hand, the MUC4/1G8 expression was related with lymphatic invasion (r = 0.395, P = 0.001 and lymph node metastasis (r = 0.296, P = 0.045. The MUC1/DF3 expression was related with lymphatic invasion (r = 0.357, P = 0.032 and venous invasion (r = 0.377, P = 0.024. In conclusion, the expression of MUC4 as well as MUC1 in early gastric cancers is a useful marker to predict poor prognostic factors related with vessel invasion.

  8. Reproductive biology and early establishment of Pinus elliottii var. elliottii in Brazilian sandy coastal plain vegetation: implications for biological invasion

    Directory of Open Access Journals (Sweden)

    Fernando Campanhã Bechara

    2013-04-01

    Full Text Available Pinus is the most invasive woody taxon, exceeded only by herbaceous plants. This study reports the reproductive biology and early establishment of Pinus elliottii Engelm. var. elliottii, describing its invasive properties in a protected natural area of the Brazilian coastal sandy plains. We evaluated the seed germination and rain, longevity of seed viability and the initial dynamics of the seedlings of Pinus elliottii var elliottii through field and laboratory experiments. We recorded a continuous seed rain of about 204.0 viable seeds m- 2 per year, with a 90 % germination rate. The seeds exhibited a low longevity of viability in the soil and a dense, permanent seedling bank that may explain the high levels of pine invasion. The environmental impact caused by the pine's biological invasion suggests the recommendation for its immediate eradication, together with a restoration plan to restitute the native biodiversity gradually.

  9. Single-Stage Minimally Invasive Surgery for Synchronous Primary Pulmonary Adenocarcinoma and Left Atrial Myxoma.

    Science.gov (United States)

    van der Merwe, Johan; Beelen, Roel; Martens, Sebastiaan; Van Praet, Frank

    2015-12-01

    We report the first successful short-term outcome of single-stage combined video-assisted thoracoscopic surgery lobectomy and port access surgery in a patient with operable primary right lower lobe adenocarcinoma and a synchronous cardiac myxoma. The video-assisted thoracic surgery right lower lobectomy with systematic lymph node dissection was performed first, followed by myxoma excision by port access surgery through the same working port incision. The histopathologic analysis confirmed a pT2a N0 M0 R0 (TNM 7th edition) primary poorly differentiated pulmonary adenocarcinoma and a completely excised cardiac myxoma. Postoperative recovery was uneventful, and follow-up at 6 weeks confirmed an excellent surgical and oncologic outcome.

  10. A robust prognostic gene expression signature for early stage lung adenocarcinoma

    DEFF Research Database (Denmark)

    Krzystanek, Marcin; Moldvay, Judit; Szüts, David;

    2016-01-01

    Stage I lung adenocarcinoma is usually not treated with adjuvant chemotherapy; however, around half of these patients do not survive 5 years. Therefore, a reliable prognostic biomarker for early stage patients would be critical to identify those most likely to benefit from early additional treatm...... not given adjuvant therapy. Seven genes consistently obtained statistical significance in Cox regression for overall survival. The combined signature has a weighted mean hazard ratio of 3.2 in all cohorts and 3.0 (C.I. 1.3-7.4, p ...... treatments. Several studies have searched for gene expression prognostic biomarkers for lung adenocarcinoma, but these have not yielded a widely accepted prognosticator. We analyzed gene expression from seven published lung adenocarcinoma cohorts for which we included only stage I and II patients who were...

  11. Extent of pelvic lymphadenectomy and use of adjuvant vaginal brachytherapy for early-stage endometrial cancer.

    Science.gov (United States)

    Matsuo, Koji; Machida, Hiroko; Ragab, Omar M; Takiuchi, Tsuyoshi; Pham, Huyen Q; Roman, Lynda D

    2017-03-01

    To examine trends of adjuvant radiotherapy choice and to examine associations between pelvic lymphadenectomy and radiotherapy choice for women with early-stage endometrial cancer. The Surveillance, Epidemiology, and End Results Program was used to identify surgically treated stage I-II endometrial cancer between 1983 and 2012 (type 1 n=79,474, and type 2 n=25,020). Piecewise linear regression models were used to examine temporal trends of intracavitary brachytherapy (ICBT) and whole pelvic radiotherapy (WPRT) use, pelvic lymphadenectomy rate, and sampled node counts. Multivariable binary logistic regression models were used to identify independent predictors for ICBT use. There was a significant increase in ICBT use and decrease in WPRT use during the study period. ICBT use exceeded WPRT use in 2003 for type 1 stage IA, and in 2007 for type 1 stage IB and type 2 stage IA diseases. In addition, number of sampled pelvic nodes significantly increased over time in type 1-2 stage I-II diseases (mean, 7.0-12.7 in 1988 to 15.2-17.6 in 2012, all Pcancer: adjusted-odds ratios for 1-10 and >10 nodes versus no lymphadenectomy in stage IA (1.38/2.40), IB (2.75/6.32), and II (1.36/2.91) diseases. Similar trends were observed for type 2 cancer: adjusted-odds ratios for stage IA (1.69/3.73), IB (2.25/5.65), and II (1.36/2.19) diseases. Our results suggest that surgeons and radiation oncologists are evaluating the extent of pelvic lymphadenectomy when counseling women with early-stage endometrial cancer for adjuvant radiotherapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Early-Stage Pilot Study on Using Fractional-Order Calculus-Based Filtering for the Purpose of Analysis of Electroencephalography Signals

    Directory of Open Access Journals (Sweden)

    Kawala-Janik Aleksandra

    2016-12-01

    Full Text Available Analysis of Electroencephalography (EEG signals has recently awoken the increased interest of numerous researchers all around the world with regard to rapid development of Brain-Computer Interaction-related research areas and because EEG signals are implemented in most of the non-invasive BCI systems, as they provide necessary information regarding activity of the brain. In this paper, a very early stage pilot study on implementation of filtering based on fractional-order calculus (Bi-Fractional Filters – BFF for the purpose of EEG signal classification is presented in brief.

  13. Patient-Reported Outcomes and Early Discontinuation in Aromatase Inhibitor-Treated Postmenopausal Women With Early Stage Breast Cancer

    Science.gov (United States)

    Kadakia, Kunal C.; Snyder, Claire F.; Kidwell, Kelley M.; Seewald, Nicholas J.; Flockhart, David A.; Skaar, Todd C.; Desta, Zereunesay; Rae, James M.; Otte, Julie L.; Carpenter, Janet S.; Storniolo, Anna M.; Hayes, Daniel F.; Stearns, Vered

    2016-01-01

    Background. Early discontinuation of aromatase inhibitors (AIs) is common and leads to poor outcomes but is challenging to predict. In the Exemestane and Letrozole Pharmacogenetics trial, a high rate of early discontinuation due to intolerance was observed. We hypothesized that early changes in patient-reported outcomes (PROs) predict AI discontinuation and that biochemical factors are associated with changes in PROs. Patients and Methods. Postmenopausal women with early-stage breast cancer enrolled in a prospective randomized trial of exemestane versus letrozole completed questionnaires at baseline and serially over 24 months to assess overall quality of life (EuroQOL Visual Analog Scale [VAS]); mood; and multiple symptoms, including a musculoskeletal symptom cluster. A joint mixed-effects/survival model was used to estimate the effect of the change in PROs on AI discontinuation. Associations between biochemical factors and change in PROs were examined. Results. A total of 490 patients were analyzed. Worsening of EuroQOL VAS and the musculoskeletal cluster were associated with the highest risk for early discontinuation (hazard ratio [HR], 2.77 [95% confidence interval (CI), 2.72–2.81; p = .015]; HR, 4.39 [95% CI, 2.40–8.02; p < .0001], respectively). Pharmacokinetics and estrogen metabolism were not consistently associated with change in PRO measures. No clinically significant differences in any PRO between AIs were observed. Conclusion. Changes in PROs early during AI therapy were associated with treatment discontinuation. Identification of these changes could be used to target interventions in patients at high risk for early discontinuation. Implications for Practice: Early changes in patient-reported outcomes (PROs) can predict nonpersistence to aromatase inhibitor therapy. If used in clinical practice, PROs might identify women at highest risk for early discontinuation and allow for interventions to improve tolerance before significant toxicities develop

  14. The Final Stage of Mongol Invasion of Europe: A Military Force and Secret Diplomacy (1 »

    Directory of Open Access Journals (Sweden)

    A.V. Maiorov

    2015-01-01

    Full Text Available The paper analyzes the sources of information on the direct contact of the Emperor Frederick II with the Mongols before the attack of the latter on Europe, the persistent rumors of his collusion with the invaders, who came to blow mainly to the enemies of Frederick, the refusal of the Emperor of an armed clash with the Tatars, the refusal to participate in the Crusade prepared by the German prelates against the Tatars, but instead – a withdrawal of the imperial troops in Italy and the siege of Rome in order to force the pope to recognize the supremacy of the Emperor, the sudden retreat of the Tartars themselves from the German border and the abandonment of the original plans for the conquest of Germany, unexpected counteraction against Frederick of the German prelates who had been previously loyal to the Emperor and who accused him of a serious crime against the Church and the whole of Christianity. The author concludes that the Emperor Frederick and the leaders of the Western Mongol campaign were associated with secret mutual obligations. Many of his contemporaries were aware of the Emperor’s secret contacts with the Tartars (Albert von Beheim, Matthew Paris, and others.. The author analyzes the information and is trying to separate the elements of political propaganda from the established facts. The Emperor’s conspiracy with the Tatar leaders is indicated both by direct evidence and numerous indirect information analyzed in the article. On the one hand, the Emperor did everything possible to avoid a direct military confrontation with the Tatars and disrupt plans of his supporters in Germany to combat the invaders. On the other hand, the Tatar impact in Europe fell entirely on the Friedrich’s enemies who took the side of the pope in the latter’s conflict with Emperor. As a result of the Tatar invasion of Europe position of the Emperor in his confrontation with the Roman church greatly strengthened. This change in the balance of power

  15. The Final Stage of Mongol Invasion of Europe: A Military Force and Secret Diplomacy (2 »

    Directory of Open Access Journals (Sweden)

    A.V. Mayorov

    2015-01-01

    Full Text Available The paper analyzes the sources of information on the direct contact of the Emperor Frederick II with the Mongols before the attack of the latter on Europe, the persistent rumors of his collusion with the invaders, who came to blow mainly to the enemies of Frederick, the refusal of the Emperor of an armed clash with the Tatars, the refusal to participate in the Crusade prepared by the German prelates against the Tatars, but instead – a withdrawal of the imperial troops in Italy and the siege of Rome in order to force the pope to recognize the supremacy of the Emperor, the sudden retreat of the Tartars themselves from the German border and the abandonment of the original plans for the conquest of Germany, unexpected counteraction against Frederick of the German prelates who had been previously loyal to the Emperor and who accused him of a serious crime against the Church and the whole of Christianity. The author concludes that the Emperor Frederick and the leaders of the Western Mongol campaign were associated with secret mutual obligations. Many of his contemporaries were aware of the Emperor’s secret contacts with the Tartars (Albert von Beheim, Matthew Paris, and others.. The author analyzes the information and is trying to separate the elements of political propaganda from the established facts. The Emperor’s conspiracy with the Tatar leaders is indicated both by direct evidence and numerous indirect information analyzed in the article. On the one hand, the Emperor did everything possible to avoid a direct military confrontation with the Tatars and disrupt plans of his supporters in Germany to combat the invaders. On the other hand, the Tatar impact in Europe fell entirely on the Frederick’s enemies who took the side of the pope in the latter’s conflict with Emperor. As a result of the Tatar invasion of Europe position of the Emperor in his confrontation with the Roman church greatly strengthened. This change in the balance of power

  16. Strong correlation between early stage atherosclerosis and electromechanical coupling of aorta

    Science.gov (United States)

    Liu, X. Y.; Yan, F.; Niu, L. L.; Chen, Q. N.; Zheng, H. R.; Li, J. Y.

    2016-03-01

    Atherosclerosis is the underlying cause of cardiovascular diseases that are responsible for many deaths in the world, and the early diagnosis of atherosclerosis is highly desirable. The existing imaging methods, however, are not capable of detecting the early stage of atherosclerosis development due to their limited spatial resolution. Using piezoresponse force microscopy (PFM), we show that the piezoelectric response of an aortic wall increases as atherosclerosis advances, while the stiffness of the aorta shows a less evident correlation with atherosclerosis. Furthermore, we show that there is strong correlation between the coercive electric field necessary to switch the polarity of the artery and the development of atherosclerosis. Thus by measuring the electromechanical coupling of the aortic wall, it is possible to probe atherosclerosis at the early stage of its development, not only improving the spatial resolution by orders of magnitude, but also providing comprehensive quantitative information on the biomechanical properties of the artery.

  17. Sustainability Evaluation of Retrofitting and Renovation of Buildings in Early Stages

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Maslesa, Esmir; Gohardani, Navid

    2013-01-01

    Research on the barriers for building renovation in Denmark has revealed that an important obstacle is a lack of simple and holistic tools that can assist stakeholders in decision-making during the early stages of projects (pre-project phases). The purpose of this paper is to present preliminary...... research results and ideas for the development of a tool, which can be used as decision support for renovation projects in early stages. The research is part of the Eracobuild project ACES – “A concept for promotion of sustainable retrofitting and renovation in early stages” with participants from Denmark......, Sweden and Cyprus. This paper is mainly based on a work package concerning benefits of restoration. The approach has been - after a literature review - to start by conducting a needs and stakeholder analysis with 10 interviews. Based on this initial analysis a requirement specification for the decision...

  18. The value of business incubation services for early stage start-ups

    DEFF Research Database (Denmark)

    Jakobsen, Brian; Tanev, Stoyan; Jensen, Søren

    2017-01-01

    that they could create value for the different stakeholders involved in their business ecosystem. The second issue is the need to categorize the various types of business incubators before examining the way they create value for early start-ups. In most national or regional entrepreneurial ecosystems...... there are different types of business incubators that do not necessarily offer the same types of services neither share a common vision about the way they should create value for their client companies. At the same time, early stage start-ups rely on the services provided by incubators and accelerators and need...... of the benefits from engaging in specific incubation programs. The objective of this paper is to investigate the value dimensions of specific types of business incubation services for early-stage start-ups in a way that may help such newly created firms to maximize the benefits from their participation...

  19. [Application of peloidotherapy at the early stage of rehabilitation after cerebral ischemic stroke].

    Science.gov (United States)

    Gorbunov, F E; Penionzhkevich, D Iu; Kotenko, E P

    2010-01-01

    The objective of the present study was to evaluate clinical efficiency of peloidotherapy in the early reconvalescence period following cerebral ischemic stroke. A rationale for the application of peloidotherapy is presented based on the results of follow-up of 60 patients (26 men and 34 women) aged from 43 to 70 years at the early stage of recovery (within 10 weeks and more after stroke). Special attention was given to clinical dynamics of the post-stroke condition and the influence of peloidotherapy on the mechanisms underlying formation of cerebral hemodynamic effects, adaptive changes in the functional systems of hemostasis and microcirculation, and development of pathophysiological cascade of metabolic processes in the brain. All therapeutic procedures were fairly well tolerated by the patients. Neither allergic reactions nor other adverse effects of the treatment were documented which testifies to the safety of peloidotherapy at the early stage of rehabilitation after cerebral ischemic stroke.

  20. Performance of serum biomarkers for the early detection of invasive aspergillosis in febrile, neutropenic patients: a multi-state model.

    Directory of Open Access Journals (Sweden)

    Michaël Schwarzinger

    Full Text Available BACKGROUND: The performance of serum biomarkers for the early detection of invasive aspergillosis expectedly depends on the timing of test results relative to the empirical administration of antifungal therapy during neutropenia, although a dynamic evaluation framework is lacking. METHODS: We developed a multi-state model describing simultaneously the likelihood of empirical antifungal therapy and the risk of invasive aspergillosis during neutropenia. We evaluated whether the first positive test result with a biomarker is an independent predictor of invasive aspergillosis when both diagnostic information used to treat and risk factors of developing invasive aspergillosis are taken into account over time. We applied the multi-state model to a homogeneous cohort of 185 high-risk patients with acute myeloid leukemia. Patients were prospectively screened for galactomannan antigenemia twice a week for immediate treatment decision; 2,214 serum samples were collected on the same days and blindly assessed for (1->3- β-D-glucan antigenemia and a quantitative PCR assay targeting a mitochondrial locus. RESULTS: The usual evaluation framework of biomarker performance was unable to distinguish clinical benefits of β-glucan or PCR assays. The multi-state model evidenced that the risk of invasive aspergillosis is a complex time function of neutropenia duration and risk management. The quantitative PCR assay accelerated the early detection of invasive aspergillosis (P = .010, independently of other diagnostic information used to treat, while β-glucan assay did not (P = .53. CONCLUSIONS: The performance of serum biomarkers for the early detection of invasive aspergillosis is better apprehended by the evaluation of time-varying predictors in a multi-state model. Our results provide strong rationale for prospective studies testing a preemptive antifungal therapy, guided by clinical, radiological, and bi-weekly blood screening with galactomannan

  1. Minimally Invasive Anal Fistula Treatment (MAFT)-An Appraisal of Early Results in 416 Patients.

    Science.gov (United States)

    Chowbey, P K; Khullar, R; Sharma, A; Soni, V; Najma, K; Baijal, M

    2015-12-01

    Minimally invasive anal fistula treatment (MAFT) was introduced to minimize early postoperative morbidity, preserve sphincter continence, and reduce recurrence. We report our early experience with MAFT in 416 patients. Preoperative MRI was performed in 150 patients initially and subsequently thereafter. The technique involves fistuloscope-aided localization of internal fistula opening, examination and fulguration of all fistula tracks, and secure stapled closure of internal fistula opening within anal canal/rectum. MAFT was performed as day-care procedure in 391 patients (93.9 %). During surgery, internal fistula opening could not be located in 100 patients (24 %). Seven patients required readmission to hospital. Mean visual analog scale scores for pain on discharge and at 1 week were 3.1 (1-6) and 1.6 (0-3), respectively. Mean duration for return to normal activity was 3.2 days (2-11 days). Fistula recurrence was observed in 35/134 patients (26.1 %) at 1 year follow-up. MAFT may be performed as day-care procedure with benefits of less pain, absence of perianal wounds, faster recovery, and preservation of sphincter continence. However, long-term results from more centers are needed especially for recurrence.

  2. Early rehabilitation following less invasive surgical stabilisation plate fixation for distal femoral fractures.

    Science.gov (United States)

    Smith, T O; Hedges, C; MacNair, R; Schankat, K

    2009-06-01

    The less invasive surgical stabilisation (LISS) plate fixation method is an orthopaedic procedure for the fixation of distal femoral fractures. Early physiotherapy treatments of motion and mobilisation have been advocated following this procedure. This article critically appraises the evidence base assessing the early rehabilitation of patients following LISS fixation for distal femoral fractures. A review of EMBASE, Medline, CINAHL and AMED, and a hand search were undertaken. Two independent reviewers identified all eligible articles. Two reviewers extracted the data, which were verified by a third reviewer. All included articles were critically appraised by two independent reviewers using the Critical Appraisal Skills Programme tool. Seventeen case series assessing 508 patients with 535 fractures were reviewed. No clinical trials comparing physiotherapy programmes were identified. The review identified that following LISS fixation for distal femoral fractures, patients begin range-of-motion exercises immediately and are initially required to restrict weight-bearing following surgery. It remains unclear whether casts, braces or immobilisation aids are applied during the initial postoperative period. The efficacy of different physiotherapy protocols following LISS fixation for distal femoral fractures remains unclear. Further well-designed randomised controlled trials are required to compare different postoperative physiotherapy rehabilitation programmes for patients following LISS fixation of distal femoral fractures in order to determine the optimal postoperative management for this complex patient group.

  3. [Minimally invasive endoscopic thyroidectomy via an anterior chest approach for early papillary thyroid cancer].

    Science.gov (United States)

    Huang, Xiao-ming; Sun, Wei; Hong, Yun; Cai, Qian; Liang, Fa-ya; Han, Ping

    2012-07-01

    To evaluate the feasibility and safety of endoscopic thyroidectomy via anterior chest approach for early papillary thyroid cancer (T1N0M0). From July 2004 to December 2010, 91 patients with early papillary thyroid cancer underwent minimally invasive endoscopic thyroidectomy via anterior chest approach. The clinical and pathologic characteristics of patients, operation types, operative time, postoperative hospital stay time, and postoperative complications were analyzed retrospectively. All 91 operations were successfully performed endoscopically. There was no case conversed to open surgery. The mean tumor size was (0.96 ± 0.71) cm. The operation types included unilateral lobectomy (41 cases), unilateral subtotal lobectomy (3 cases), ipsilateral lobectomy and contralateral subtotal lobectomy (42 cases), and bilateral total thyroidectomy (5 cases). Central compartment node dissection was carried out in 39 cases with the tumor diameter less than 1.0 cm and in 29 cases with the tumor diameter of 1.0 - 2.0 cm. The mean operating time was (99 ± 17) min, the mean bleeding volume was (18 ± 12) ml, and the mean post-operative hospital stay time was (3 ± 1) days. Temporary recurrent laryngeal nerve (RLN), paresis occurred in 2 cases and recovered within 1 to 2 months after the surgery. One patient showed permanent RLN paralysis. Two patients showed temporary hypoparathyroidism. No patient showed post-operative seroma and tracheal injury. There was no case with injury to the superior laryngeal nerve. No further complications, such as irritating cough, tetany, and emphysema developed after the operation. With the anterior chest wall approach, all patients had no surgical scar on the neck and thus they were satisfied with the cosmetic outcomes. All patients were disease free by follow-up of 7 to 85 (58.4 ± 17.2) months. Minimally invasive endoscopic thyroid surgery through anterior chest approach is a feasible and safe method for the treatment of early papillary thyroid

  4. The relationship between clinical phenotype and early staged bilateral deep brain stimulation in Parkinson disease.

    Science.gov (United States)

    Sung, Victor W; Watts, Ray L; Schrandt, Christian J; Guthrie, Stephanie; Wang, Deli; Amara, Amy W; Guthrie, Barton L; Walker, Harrison C

    2013-12-01

    While many centers place bilateral deep brain stimulation (DBS) systems simultaneously, unilateral subthalamic nucleus (STN) DBS followed by a staged contralateral procedure has emerged as a treatment option for many patients. However, little is known about whether the preoperative phenotype predicts when staged placement of a DBS electrode in the opposite STN will be required. The authors aimed to determine whether preoperative clinical phenotype predicts early staged placement of a second STN DBS electrode in patients who undergo unilateral STN DBS for Parkinson disease (PD). Eighty-two consecutive patients with advanced PD underwent unilateral STN DBS contralateral to the most affected hemibody and had at least 2 years of follow-up. Multivariate logistic regression analysis determined preoperative characteristics that predicted staged placement of a second electrode in the opposite STN. Preoperative measurements included aspects of the Unified Parkinson's Disease Rating Scale (UPDRS), motor asymmetry index, and body weight. At 2-year follow-up, 28 (34%) of the 82 patients had undergone staged placement of a contralateral electrode while the remainder chose to continue with unilateral stimulation. Statistically significant improvements in UPDRS total and Part 3 scores were retained at the end of the 2-year follow-up period in both subsets of patients. Multivariate logistic regression analysis showed that the most important predictors for early staged placement of a second subthalamic stimulator were low asymmetry index (OR 13.4, 95% CI 2.8-64.9), high tremor subscore (OR 7.2, CI 1.5-35.0), and low body weight (OR 5.5, 95% CI 1.4-22.3). This single-center study provides evidence that elements of the preoperative PD phenotype predict whether patients will require early staged bilateral STN DBS. These data may aid in the management of patients with advanced PD who undergo STN DBS.

  5. Early developmental stages of Ascaris lumbricoides featured by high-resolution mass spectrometry.

    Science.gov (United States)

    Melo, Carlos Fernando Odir Rodrigues; Esteves, Cibele Zanardi; de Oliveira, Rosimeire Nunes; Guerreiro, Tatiane Melina; de Oliveira, Diogo Noin; Lima, Estela de Oliveira; Miné, Júlio César; Allegretti, Silmara Marques; Catharino, Rodrigo Ramos

    2016-11-01

    Ascaris lumbricoides is responsible for a highly disseminated helminth parasitic disease, ascariosis, a relevant parasitosis that responds for great financial burden on the public health system of developing countries. In this work, metabolic fingerprinting using high-resolution mass spectrometry (HRMS) was employed to identify marker molecules from A. lumbricoides in different development stages. We have identified nine biomarkers, such as pheromones and steroidal prohormones in early stages, among other molecules in late development stages, making up four molecules for fertilized eggs, four marker molecules for first larvae (L1) and one marker molecule for third larvae (L3). Therefore, our findings indicate that this approach is suitable for biochemical characterization of A. lumbricoides development stages. Moreover, the straightforward analytical method employed, with almost no sample preparation from a complex matrix (feces) using high-resolution mass spectrometry, suggests that it is possible to seek for an easier and faster way to study animal molding processes.

  6. A role for E2-2 at the DN3 stage of early thymopoiesis

    DEFF Research Database (Denmark)

    Wikström, Ingela; Forssell, Johan; Penha-Goncalves, Mario N;

    2008-01-01

    proteins, Id2 displayed a prominent expression exclusively in DN1, whereas Id3 showed some expression in DN1, followed by a down regulation and then a prominent induction, peaking in the DP stage. E2-2 was expressed during the DN stages, as well as in the DP stage, suggesting that E2-2 operates in concert...... with the other E-proteins during early thymocyte development. We found that E2-2 null thymocytes displayed a partial block at the DN3 stage of development, as well as a reduced expression of pre-T alpha, known to be regulated also by E2A and HEB. The fact that E2-2 deficient thymocytes develop without gross...

  7. Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jin [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Han, Seungbong [Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Kim, Young Seok, E-mail: ysk@amc.seoul.kr [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Nam, Joo-Hyun [Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Kim, Hak Jae [Department of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Jae Weon [Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Won [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Byoung-Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Cha, Soon Do [Department of Obstetrics and Gynecology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Kim, Juree [Department of Radiation Oncology, Cheil General Hospital and Women' s Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Lee, Ki-Heon [Department of Obstetrics and Gynecology, Cheil General Hospital and Women' s Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Yoon, Mee Sun [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of); and others

    2013-11-15

    Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer. Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve. Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54). Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis.

  8. Magnetic Resonance Imaging as a Valuable Tool for Predicting Parametrial Invasion in Stage IB1 to IIA2 Cervical Cancer.

    Science.gov (United States)

    Kim, Miseon; Suh, Dong Hoon; Kim, Kidong; Lee, Hak Jong; Kim, Yong Beom; No, Jae Hong

    2017-02-01

    The aims of study were to determine the predictive value of preoperative magnetic resonance imaging (MRI) for parametrial invasion (PMI) and to develop a predictive model for PMI in patients with stage IB1 to IIA2 cervical cancer. We retrospectively analyzed patients with stage IB1 to IIA2 cervical cancer (n = 215) who underwent radical hysterectomy between 2003 and 2014. The presence of PMI from postoperative pathological reports and its association with preoperative MRI findings were evaluated. We developed a predictive model for PMI using independent predictive factors identified by logistic regression and estimated its predictive performance. Thirty patients (14.0%) had PMI from postoperative pathological reports. Among the preoperative MRI findings, a greater tumor diameter (4.2 vs 2.0 cm; P PMI (53.3% vs 8.6%; P PMI. Multivariate analysis identified tumor volume (odds ratio, 7.0; 95% confidence interval, 2.63-18.53; P PMI (odds ratio, 6.1; 95% confidence interval, 2.31-15.97; P PMI. Our predictive model demonstrates that the presence of PMI or a tumor volume of greater than 18.0 cm has a higher sensitivity (86.7% vs 53.3%) and lower specificity (74.6% vs 91.4%) than the presence of PMI alone. Specifically, the model's negative predictive value was superior to that of PMI only (97.2% vs 92.3%). In the low-risk group, defined as preoperative MRI findings suggesting no PMI and a tumor volume of 18.0 cm or less, the proportion of false negative cases was just 2.8%. When tumor volume with findings suggesting that PMI is considered, preoperative MRI is useful in excluding PMI. A predictive model based on preoperative MRI findings seems to be valuable in identifying potential candidates for less radical surgery in stage IB1 to IIA2 cervical cancer.

  9. Peritoneal elastic lamina invasion: limitations in its use as a prognostic marker in stage II colorectal cancer.

    Science.gov (United States)

    Grin, Andrea; Messenger, David E; Cook, Megan; O'Connor, Brenda I; Hafezi, Sara; El-Zimaity, Hala; Kirsch, Richard

    2013-12-01

    Peritoneal involvement in colorectal cancer (CRC) is an adverse prognostic feature, which may prompt consideration of adjuvant chemotherapy in stage II disease. Controversies and challenges surrounding its assessment have led to consideration of peritoneal elastic lamina invasion (ELI) as an alternative marker of advanced local spread. The objectives of this study were (1) to evaluate the prognostic significance of peritoneal ELI in stage II CRC and (2) to determine the feasibility of ELI assessment in routine practice with the use of an elastic stain. Two hundred seventeen patients with stage II CRC (186, pT3; 31, pT4) were assessed for ELI and other established adverse histologic features. Of the pT3 tumors, 31 (16.7%) were ELI positive, 121 (65%) were ELI negative, and 34 (18.3%) lacked an identifiable elastic lamina. There were no significant differences in disease-free survival between pT3 ELI-negative and ELI-positive tumors (P = .517). The disease-free survival of pT4 tumors was significantly lower than that of pT3 ELI-negative tumors (P = .024) and pT3 ELI-positive tumors (P = .026), respectively. The elastic lamina was detected less frequently in right-sided pT3 tumors compared with left-sided tumors (65/91 [71.4%] versus 87/95 [91.6%], P ELI was not an adverse prognostic factor in this study. The frequent absence of an identifiable elastic lamina, particularly in right-sided tumors, may limit the use of ELI as a prognostic marker in CRC.

  10. Early detection of potentially invasive invertebrate species in Mytilus galloprovincialis Lamarck, 1819 dominated communities in harbours

    Science.gov (United States)

    Preda, Cristina; Memedemin, Daniyar; Skolka, Marius; Cogălniceanu, Dan

    2012-12-01

    Constanţa harbour is a major port on the western coast of the semi-enclosed Black Sea. Its brackish waters and low species richness make it vulnerable to invasions. The intensive maritime traffic through Constanţa harbour facilitates the arrival of alien species. We investigated the species composition of the mussel beds on vertical artificial concrete substrate inside the harbour. We selected this habitat for study because it is frequently affected by fluctuating levels of temperature, salinity and dissolved oxygen, and by accidental pollution episodes. The shallow communities inhabiting it are thus unstable and often restructured, prone to accept alien species. Monthly samples were collected from three locations from the upper layer of hard artificial substrata (maximum depth 2 m) during two consecutive years. Ten alien macro-invertebrate species were inventoried, representing 13.5% of the total number of species. Two of these alien species were sampled starting the end of summer 2010, following a period of high temperatures that triggered hypoxia, causing mass mortalities of benthic organisms. Based on the species accumulation curve, we estimated that we have detected all benthic alien species on artificial substrate from Constanţa harbour, but additional effort is required to detect all the native species. Our results suggest that monitoring of benthic communities at small depths in harbours is a simple and useful tool in early detection of potentially invasive alien species. The selected habitat is easily accessible, the method is low-cost, and the samples represent reliable indicators of alien species establishment.

  11. Invasive pulmonary aspergillosis: role of early diagnosis and surgical treatment in patients with acute leukemia

    Directory of Open Access Journals (Sweden)

    Ursavas Ahmet

    2006-07-01

    Full Text Available Abstract Background Aspergillus is a ubiquitous soil-dwelling fungus known to cause significant pulmonary infection in immunocompromised patients. The incidence of aspergillosis has increased during the past two decades and is a frequently lethal complication of acute leukemia patients that occurs following both chemotherapy and bone marrow transplantation. The diagnosis of invasive pulmonary aspergillosis (IPA according to the criteria that are established by European Organization for the Research and Treatment of Cancer and Mycoses Study Group raise difficulties in severely ill patients. Despite established improvements in field of diagnosis (galactomannan antigen, quantitative PCR, real-time PCR for Aspergillus spp., and findings of computed tomography and treatment with new antifungals, it is still a major problem in patients with acute leukemia. However, prompt and effective treatment of IPA is crucial because most patients will need subsequent chemotherapy for underlying hematologic disease as soon as possible. Case presentation We report a 33-year-old male patient with acute promyelocytic leukemia diagnosed in 1993 that developed invasive pulmonary aspergillosis due to A. flavus at relapse in 2003. The patient was successfully treated with liposomal amphotericin B and underwent surgical pulmonary resection. The operative course was uneventful. Conclusion This report emphasizes the clinical picture, applicability of recent advances in diagnostic and therapeutic approaches for IPA. For early identification of a patient infected with IPA, a high index of suspicion and careful clinical and radiological examinations with serial screening for galactomannan should be established. If aspergillosis is suspected, anti-aspergillosis drug should be administered immediately, and if a unique pulmonary lesion remains, surgical resection should be considered to prevent reactivation during consecutive chemotherapy courses and to improve the outcome.

  12. Plausibility in Early Stages of Architectural Design: A New Tool for High-Rise Residential Buildings

    Institute of Scientific and Technical Information of China (English)

    Dirk Donath; Danny Lobos

    2009-01-01

    This paper analyzes the problem of the design of envelopes for high-rise isolated residential build-ings. The phenomenon of envelope creation appears in the early stages of the architectural design. Vari-ables that influence the final shape and size of such envelopes are then identified. This paper presents the state-of-the-art tools for the current solutions at the commercial and academic/scientific level. The variables identified in this research are the client's needs, the urban code and architectural practice, and their specific components for the final creation of a new decision support system tool based on the building information modeling (BIM) software platform, to facilitate the work in the project development and drawing production stages. This tool generates several options for building envelopes according to the parameters required by the city Zoning Planning Commission. These options then lead to deliver reliable data and a geometry that can be analyzed in a timely fashion by the engineers, builders, architects, government, and clients in the early stages of the building's design. The results show that use of specific information and communication technologies (ICT) tools in the early stages of a building design helps reduce the working time, increases confidence in the generated solution, and contributes to the exploration of altematives in a short period of time.

  13. Bacterial communities associated with white shrimp (Litopenaeus vannamei larvae at early developmental stages

    Directory of Open Access Journals (Sweden)

    ANTONIUS SUWANTO

    2010-04-01

    Full Text Available Bacterial communities associated with white shrimp (Litopenaeus vannamei larvae at early developmental stages. Biodiversitas 11 (2: 65-68.Terminal Restriction Fragment Length Polymorphism (T-RFLP was used to monitor the dynamics of the bacterial communities associated with early developmental stages of white shrimp (Litopenaeus vannamei larvae. Samples for analysis were egg, hatching nauplii, 24 hours old nauplii, and 48 hours old nauplii which were collected from one cycle of production at commercial hatchery. T-RFLP results indicated that the bacterial community associated with early stages of shrimp development might be transferred vertically from broodstock via egg. There was no significant difference between bacterial communities investigated, except the bacterial community of 48 hours old nauplii. Diversity analyses showed that the bacterial community of egg had the highest diversity and evenness, meanwhile the bacterial community of 48 hours old nauplii had the lowest diversity. Nine phylotypes were found at all stages with high abundance. Those TRFs were identified as γ- proteobacteria, α-proteobacteria, and bacteroidetes group.

  14. Identification and comparison of the 3 early stages of resynthesis for the lichen Cladonia rangiferina.

    Science.gov (United States)

    Athukorala, Sarangi N P; Huebner, Erwin; Piercey-Normore, Michele D

    2014-01-01

    A lichen is an association between a biotrophic fungal partner and a green algal and (or) cyanobacterial partner, which may be considered a "controlled" parasitic interaction. While controlled parasitism implies benefit to both interacting partners, a parasitism that is not controlled implies that one partner benefits to the detriment of the other partner. The objective of this study was to compare morphological development of the interaction between Cladonia rangiferina with its compatible algal partner (Asterochloris glomerata/irregularis) and incompatible algae (Coccomyxa peltigerae and Chloroidium ellipsoideum) at 3 early resynthesis stages. The fungus was co-inoculated with each alga separately and the stages of development were compared using quantitative measures. The first 3 stages of development of the lichen thallus were identified in the compatible interaction as the "pre-contact" stage (1 day post co-inoculation (PCI)), "contact" stage (8 days PCI), and "growth together" stage (21 days PCI). Compatible interactions showed significantly shorter internode length, significantly more new lateral hyphal branches, significantly greater appressorial frequency, and no reduction in cell diameter of the algal cells, compared with incompatible interactions. At 21 days PCI, a parasitic interaction was observed between Cladonia rangiferina and Chloroidium ellipsoideum. These findings support the importance of recognition between compatible partners for successful lichenization. This study also revealed a strategy that may explain the success of this species in northern habitats. Identification of the resynthesis stages of Cladonia rangiferina is required before expression of the proteins involved in recognition and defense can be understood.

  15. Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gerdin, E. [Univ. Hospital, Dept. of Obstetrics and Gynecology, and Gynecologic Oncology, Uppsala (Sweden); Cnattingius, S. [Univ. Hospital, Dept. of Social Medicine, Uppsala (Sweden); Johnson, P. [Univ. Hospital, Dept. of Obstetrics and Gynecology, Uppsala (Sweden)

    1995-08-01

    Objective: To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods: In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files. Results: Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 23-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy. Conclusion: The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients. (au) 29 refs.

  16. Rehabilitation outcomes in patients with early and two-stage reconstruction of flexor tendon injuries.

    Science.gov (United States)

    Sade, Ilgin; İnanir, Murat; Şen, Suzan; Çakmak, Esra; Kablanoğlu, Serkan; Selçuk, Barin; Dursun, Nigar

    2016-08-01

    [Purpose] The primary aim of this study was to assess rehabilitation outcomes for early and two-stage repair of hand flexor tendon injuries. The secondary purpose of this study was to compare the findings between treatment groups. [Subjects and Methods] Twenty-three patients were included in this study. Early repair (n=14) and two-stage repair (n=9) groups were included in a rehabilitation program that used hand splints. This retrospective evaluated patients according to their demographic characteristics, including age, gender, injured hand, dominant hand, cause of injury, zone of injury, number of affected fingers, and accompanying injuries. Pain, range of motion, and grip strength were evaluated using a visual analog scale, goniometer, and dynamometer, respectively. [Results] Both groups showed significant improvements in pain and finger flexion after treatment compared with baseline measurements. However, no significant differences were observed between the two treatment groups. Similar results were obtained for grip strength and pinch grip, whereas gross grip was better in the early tendon repair group. [Conclusion] Early and two-stage reconstruction of patients with flexor tendon injuries can be performed with similarly favorable responses and effective rehabilitation programs.

  17. Gene expression-based biomarkers for discriminating early and late stage of clear cell renal cancer

    Science.gov (United States)

    Bhalla, Sherry; Chaudhary, Kumardeep; Kumar, Ritesh; Sehgal, Manika; Kaur, Harpreet; Sharma, Suresh; Raghava, Gajendra P. S.

    2017-01-01

    In this study, an attempt has been made to identify expression-based gene biomarkers that can discriminate early and late stage of clear cell renal cell carcinoma (ccRCC) patients. We have analyzed the gene expression of 523 samples to identify genes that are differentially expressed in the early and late stage of ccRCC. First, a threshold-based method has been developed, which attained a maximum accuracy of 71.12% with ROC 0.67 using single gene NR3C2. To improve the performance of threshold-based method, we combined two or more genes and achieved maximum accuracy of 70.19% with ROC of 0.74 using eight genes on the validation dataset. These eight genes include four underexpressed (NR3C2, ENAM, DNASE1L3, FRMPD2) and four overexpressed (PLEKHA9, MAP6D1, SMPD4, C11orf73) genes in the late stage of ccRCC. Second, models were developed using state-of-art techniques and achieved maximum accuracy of 72.64% and 0.81 ROC using 64 genes on validation dataset. Similar accuracy was obtained on 38 genes selected from subset of genes, involved in cancer hallmark biological processes. Our analysis further implied a need to develop gender-specific models for stage classification. A web server, CancerCSP, has been developed to predict stage of ccRCC using gene expression data derived from RNAseq experiments. PMID:28349958

  18. Clinical and laboratory characteristics of chronic hepatitis C on the early stages of development

    Directory of Open Access Journals (Sweden)

    N. S. Zhevnerova

    2016-01-01

    Full Text Available Aim of the research – to assess the clinical and laboratory parameters in patients with chronic hepatitis C (CHC on the early stages of development and their comparison with the level of galectin3. The study included 78 patients with oligosymptomatic course of the disease and minimal liver fibrosis in the most cases. In the most patients with stages of the disease exceeding 8 years, viral load was over a million copies/ml. In 10 % of patients on the early stages of the disease, changes corresponding to severe liver fibrosis and cirrhosis F3 and F4 were detected. Moderate correlation of ALT activity, viral load and low severity with the duration of the disease was identified. There is a trend towards a higher level of galectin3 in a long course of CHC in comparison with earlier stages of its development, with significantly higher average level of galectin-3 in patients with minimal liver fibrosis (F0–F1 as compared to advanced stages, suggesting its importance in the launching and initial mechanisms of fibrogenesis.

  19. Sleep Characteristics in Early Stages of Chronic Kidney Disease in the HypnoLaus Cohort

    Science.gov (United States)

    Ogna, Adam; Forni Ogna, Valentina; Haba Rubio, José; Tobback, Nadia; Andries, Dana; Preisig, Martin; Tafti, Mehdi; Vollenweider, Peter; Waeber, Gerard; Marques-Vidal, Pedro; Heinzer, Raphaël

    2016-01-01

    Study Objectives: To evaluate the association between early stages of chronic kidney disease (CKD) and sleep disordered breathing (SDB), restless legs syndrome (RLS), and subjective and objective sleep quality (SQ). Methods: Cross-sectional analysis of a general population-based cohort (HypnoLaus). 1,760 adults (862 men, 898 women; age 59.3 (± 11.4) y) underwent complete polysomnography at home. Results: 8.2% of participants had mild CKD (stage 1–2, estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2 with albuminuria) and 7.8% moderate CKD (stage 3, eGFR 30–60 mL/min/1.73 m2). 37.3% of our sample had moderate-to-severe SDB (apnea-hypopnea index [AHI] ≥ 15/h) and 15.3% had severe SDB (AHI ≥ 30/h). SDB prevalence was positively associated with CKD stages and negatively with eGFR. In multivariate analysis, age, male sex, and body mass index were independently associated with SDB (all P Haba Rubio J, Tobback N, Andries D, Preisig M, Tafti M, Vollenweider P, Waeber G, Marques-Vidal P, Heinzer R. Sleep characteristics in early stages of chronic kidney disease in the HypnoLaus cohort. SLEEP 2016;39(4):945–953. PMID:26715230

  20. Stage-dependent remodeling of the nuclear envelope and lamina during rabbit early embryonic development.

    Science.gov (United States)

    Popken, Jens; Schmid, Volker J; Strauss, Axel; Guengoer, Tuna; Wolf, Eckhard; Zakhartchenko, Valeri

    2016-04-22

    Utilizing 3D structured illumination microscopy, we investigated the quality and quantity of nuclear invaginations and the distribution of nuclear pores during rabbit early embryonic development and identified the exact time point of nucleoporin 153 (NUP153) association with chromatin during mitosis. Contrary to bovine early embryonic nuclei, featuring almost exclusively nuclear invaginations containing a small volume of cytoplasm, nuclei in rabbit early embryonic stages show additionally numerous invaginations containing a large volume of cytoplasm. Small-volume invaginations frequently emanated from large-volume nuclear invaginations but not vice versa, indicating a different underlying mechanism. Large- and small-volume nuclear envelope invaginations required the presence of chromatin, as they were restricted to chromatin-positive areas. The chromatin-free contact areas between nucleolar precursor bodies (NPBs) and large-volume invaginations were free of nuclear pores. Small-volume invaginations were not in contact with NPBs. The number of invaginations and isolated intranuclear vesicles per nucleus peaked at the 4-cell stage. At this stage, the nuclear surface showed highly concentrated clusters of nuclear pores surrounded by areas free of nuclear pores. Isolated intranuclear lamina vesicles were usually NUP153 negative. Cytoplasmic, randomly distributed NUP153-positive clusters were highly abundant at the zygote stage and decreased in number until they were almost absent at the 8-cell stage and later. These large NUP153 clusters may represent a maternally provided NUP153 deposit, but they were not visible as clusters during mitosis. Major genome activation at the 8- to 16-cell stage may mark the switch from a necessity for a deposit to on-demand production. NUP153 association with chromatin is initiated during metaphase before the initiation of the regeneration of the lamina. To our knowledge, the present study demonstrates for the first time major remodeling

  1. Usability of tablet computers by people with early-stage dementia.

    Science.gov (United States)

    Lim, Fabian S; Wallace, Tim; Luszcz, Mary A; Reynolds, Karen J

    2013-01-01

    Tablet computers are generally associated with an intuitive interface. The adoption and use of tablet computers within the early-stage dementia context could potentially assist in daily living and provide users with a source for leisure activities and social networking. As dementia mainly affects the older adult population, it is expected that many people with dementia and even their carers do not use tablet computers as part of their everyday living. This paper explores the usability of tablet computers within the early-stage dementia context as a source of leisure for people with dementia. The main advantage of the use of tablet computers in this manner is to provide carers some reprieve from the constant care and attention often required in caring for people with dementia. Seven-day in-home trials were conducted to determine whether people with early-stage dementia were -capable of using a tablet computer independently. Twenty-one people with early-stage dementia and carer dyads participated in the trial. Feedback was gathered through questionnaires from both the person with dementia and their carer regarding the use of a tablet computer as part of their everyday living. Approximately half the participants with dementia were able to engage with and use the tablet computer independently, which proved to be helpful to their carers. No significant traits were observed to help identify those who were less likely to use a tablet computer. Carer relief was quantified by the amount of time participants with dementia spent using the device without supervision. The results and feedback from the trial provide significant insights to introducing new technology within the early-stage dementia context. Users' needs must be considered on a case-by-case basis to successfully facilitate the uptake of tablet computers in the dementia context. The trial has provided sufficient justification to further explore more uses of tablet computers in the dementia context, and not just for

  2. Radiofrequency ablation versus resection for Barcelona clinic liver cancer very early/early stage hepatocellular carcinoma: a systematic review

    Directory of Open Access Journals (Sweden)

    He ZX

    2016-02-01

    Full Text Available Zhen-Xin He,1 Pu Xiang,2 Jian-Ping Gong,1 Nan-Sheng Cheng,3 Wei Zhang4 1Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, 2State Key Laboratory of Biotherapy and Cancer Center, 3Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu, 4Department of Hepatobiliary Surgery, Yue Bei People’s Hospital, Shaoguan, Guangdong, People’s Republic of China Aim: To compare the long-term survival outcomes of radiofrequency ablation and liver resection for single very early/early stage hepatocellular carcinoma (HCC. Methods: The Cochrane Library (Issue 3, 2015, Embase (1974 to March 15, 2015, PubMed (1950 to March 15, 2015, Web of Science (1900 to March 15, 2015, and Chinese Biomedical Literature Database (1978 to March 15, 2015 were searched to identify relevant trials. Only trials that compared radiofrequency ablation and liver resection for single very early stage (≤2 cm or early stage (≤3 cm HCC according to the Barcelona clinic liver cancer (BCLC staging system were considered for inclusion in this review. The primary outcomes that we analyzed were the 3-year and 5-year overall survival (OS rates, and the secondary outcomes that we analyzed were the 3-year and 5-year disease-free survival (DFS rates. Review Manager 5.3 was used to perform a cumulative meta-analysis. Possible publication bias was examined using a funnel plot. A random-effects model was applied to summarize the various outcomes. Results: Six studies involving 947 patients were identified that compared radiofrequency ablation (n=528 to liver resection (n=419 for single BCLC very early HCC. In these six studies, the rates of 3-year OS, 5-year OS, 3-year DFS, and 5-year DFS were significantly lower in the radiofrequency ablation group than in the liver resection group (risk ratio [RR] =0.90, 95% confidence interval [CI]: 0.83–0.98, P=0.01; RR =0.84, 95% CI: 0.75–0.95, P=0.004; RR =0.77, 95% CI

  3. The effects of bromazepam on the early stage of visual information processing (P100).

    Science.gov (United States)

    Puga, Fernanda; Sampaio, Isabel; Veiga, Heloisa; Ferreira, Camila; Cagy, Maurício; Piedade, Roberto; Ribeiro, Pedro

    2007-12-01

    The early stages of visual information processing, involving the detection and perception of simple visual stimuli, have been demonstrated to be sensitive to psychotropic agents. The present study investigated the effects of an acute dose of bromazepam (3 mg), compared with placebo, on the P100 component of the visual evoked potential and reaction time. The sample, consisting of 14 healthy subjects (6 male and 8 female), was submitted to a visual discrimination task, which employed the "oddball" paradigm. Results suggest that bromazepam (3 mg) impairs the initial stage of visual information processing, as observed by an increase in P100 latency.

  4. Analysis of corneal morphologic and pathologic changes in early-stage congenital aniridic keratopathy

    Science.gov (United States)

    Du, Juan; Liu, Rong-Qiang; Ye, Lei; Li, Zhi-Hui; Zhao, Feng-Tu; Jiang, Nan; Ye, Lin-Hong; Shao, Yi

    2017-01-01

    AIM To determine typical corneal changes of congenital aniridic keratopathy (CAK) using corneal topography and confocal systems, and to identify characteristics that might assist in early diagnosis. METHODS Patients with CAK and healthy control subjects underwent detailed ophthalmic examinations including axial length, corneal thickness, tear film condition, corneal topography, and laser-scanning in vivo confocal microscopy (IVCM). RESULTS In early stage aniridic keratopathy, Schirmer I test (SIT), break-up time (BUT), mean keratometry (mean K) and simulated keratometry (sim K) were reduced relative to controls (Pcorneal astigmatism (sim A) and corneal thickness were increased (Pcorneal morphology in borderline situations can be useful to confirm the diagnosis of CAK. PMID:28393028

  5. Extended Culture of Early Stage Embryos in Frozen-thawed Cycles

    Institute of Scientific and Technical Information of China (English)

    Hong-bo WANG; Yan-hui LI

    2009-01-01

    Objective To investigate the impact of extended culture of early stage embryos on pregnancy outcome of frozen embryo transfer (FET).Methods The survival rates of embryos after thawing and pregnancy outcome following FET were compared retrospectively between zygote and cleavage embryos which cultured to cleavage stage or extended cultured to blastocysts. Results A total of 425 zygote embryos in 67 cycles were thawed. After thawing, the survival rate was 94.4% and with an average transfer of 2.8 embryos, the clinical pregnancy rate was 55.2% (37/67). In 222 FET cycles, totally 1 270 cleavage stage embryos were thawed and the overall survival rates were 80.3%. With an average transfer of 2.7 embryos, the clinical pregnancy rate was 55.4% (123/222). A significantly lower percentage of degenerated embryos were found for zygotes (5.6%) than that for cleavage stage embryos (19.7%) (P0.05). Conclusion Although the clinical pregnancy rate was not different between patients with freeze-thaw zygote and cleavage stage embryo transfer, higher survival rate for zygote was shown compared with that for cleavage stage embryo. However, the present studies did not demonstrate that extended culture thawing embryos to blastocyst could achieve favor clinical outcome.

  6. Transarterial embolization chemotherapy at early stage after hepatectomy of 45 patients with large hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    LI Chao-long; ZHU Wei-bing; FANG Xue-jun; ZHOU jie; ZOU Yan-tai; LIN Jian-hua; LIN Zhi-qi; YU Xiao-yuan; L(U) Xiang-zhi

    2001-01-01

    To investigate the effect of transarterial embolization (TAE) at early stage postoperatively to prevent tumor recurence after hepatectomy in patients with large hepatocellular carcinoma (HCC). Methods: Forty-five volunteer patients with large HCC received TAE 2 to 4 weeks after the hepatectomy. Another 48 patients with large HCC without postoperative TAE treatment served as control. Results: No severe complications associated with TAE or hepatectomy occurred, and follow-up visit of all patients revealed that 1-year recurrence rate for patients with PAE was markedly lower than those without (43.24 %vs 70.73%, P<0.05). Conclusion: The treatment with TAE at early stage after hepatectomy is safe and feasible for the patients with liver function Child-Pugh score not higher than 8, and it may help reduce the postoperative recurrence of hepatocellular carcinoma.

  7. CdiGMP signaling at early stages of biofilm formation in Pseudomonas Aeruginosa

    Science.gov (United States)

    Zhao, Kun; Gibiansky, Maxsim; Xian, Wujing; Utada, Andrew; Wong, Gerard

    2014-03-01

    Biofilm communities on surfaces constitute an important physiological state of bacteria. CdiGMP is a secondary messenger that has recently emerged as a master regulator of biofilm behavior. It has been shown that cdiGMP can affect bacterial adhesion, motility and exopolysaccharides production, which are important in regulating biofilm formation. However, at a single cell level, the details of how cdiGMP regulate bacterial behavior are largely unknown. Here we examine the dynamics of intracellular cdiGMP levels at early stages of biofilm in Pseudomonas Aeruginosa, by using cell tracking techniques. We show that cells with different cdiGMP levels play different roles in the microcolony development at early stages of biofilm. The correlation between Psl and cdiGMP levels is also investigated.

  8. Early-stage tumor detection using photoacoustic microscopy: a pattern recognition approach

    Science.gov (United States)

    Yeh, Chenghung; Wang, Liang; Liang, Jinyang; Zhou, Yong; Hu, Song; Sohn, Rebecca E.; Arbeit, Jeffrey M.; Wang, Lihong V.

    2017-03-01

    We report photoacoustic microscopy (PAM) of arteriovenous (AV) shunts in early stage tumors in vivo, and develop a pattern recognition framework for computerized tumor detection. Here, using a high-resolution photoacoustic microscope, we implement a new blood oxygenation (sO2)-based disease marker induced by the AV shunt effect in tumor angiogenesis. We discovered a striking biological phenomenon: There can be two dramatically different sO2 values in bloodstreams flowing side-by-side in a single vessel. By tracing abnormal sO2 values in the blood vessels, we can identify a tumor region at an early stage. To further automate tumor detection based on our findings, we adopt widely used pattern recognition methods and develop an efficient computerized classification framework. The test result shows over 80% averaged detection accuracy with false positive contributing 18.52% of error test samples on a 50 PAM image dataset.

  9. Building energy optimization in the early design stages: A simplified method

    DEFF Research Database (Denmark)

    Negendahl, Kristoffer; Nielsen, Toke Rammer

    2015-01-01

    This paper presents the application of multi-objective genetic algorithms for holistic building design that considers multiple criteria; building energy use, capital cost, daylight distribution and thermal indoor environment. The optimization focus is related to building envelope parameters....... To obtain relevant feedback from multi-objective optimizations in early design stages, evaluation speed is a key concern. The paper presents a fast evaluation method fit for the early design stages. It uses a combination of two different quasi-steady-state methods for energy and indoor environment...... evaluations, a Radiance implementation for daylight simulations and a scripted algorithm for capital cost evaluations. The application of the method is developed around an integrated dynamic model which allows visual design feedback from all evaluations to be an integrated part of the design tool experience...

  10. Imaging vascular function for early stage clinical trials using dynamic contrast-enhanced magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leach, M.O.; Orton, M. [Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Morgan, B. [Univ. of Leicester, College of Medicine, Biological Sciences and Psychology, Leicester (United Kingdom); Tofts, P.S. [Brighton and Sussex Medical School, Univ. of Sussex, Clinical Imaging Sciences Centre, Sussex (United Kingdom); Buckley, D.L. [University of Leeds, Division of Medical Physics, Leeds (United Kingdom); Huang, W. [Oregon Health and Science Univ., Advanced Imaging Research Centre, Portland, OR (United States); Horsfield, M.A. [Medical Physics Section, Leicester Royal Infirmary, Dept. of Cardiovascular Sciences, Leicester (United Kingdom); Chenevert, T.L. [Univ. of Michigan Health System, Ann Arbor, MI (United States); Collins, D.J. [Royal Marsden Hospital NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Jackson, A. [Univ. of Manchester, Wolfson Molecular Imaging Centre, Withington, Manchester, M20 3LJ (United Kingdom); Lomas, D. [Univ. of Cambridge, Dept. of Radiology, Cambridge (United Kingdom); Whitcher, B. [Unit 2 Greenways Business Park, Mango Solutions, Chippenham (United Kingdom); Clarke, L. [Cancer Imaging Program, Imaging Technology Development Branch, Rockville, MD (United States); Plummer, R. [Univ. of Newcastle Upon Tyne, The Medical School, Medical Oncology, Northern Inst. for Cancer Research, Newcastle Upon Tyne (United Kingdom); Judson, I. [Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Jones, R. [Beatson West of Scotland Cancer Centre, Glasgow (United Kingdom); Alonzi, R. [Mount Vernon Cancer Centre, Northwood (United Kingdom); Brunner, T. [Gray Inst. for Radiation, Oncology and Biology, Oxford (United Kingdom); Koh, D.M. [Royal Marsden NHS Foundation Trust, Diagnostic Radiology, Sutton, Surrey (United Kingdom)] [and others

    2012-07-15

    Many therapeutic approaches to cancer affect the tumour vasculature, either indirectly or as a direct target. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important means of investigating this action, both pre-clinically and in early stage clinical trials. For such trials, it is essential that the measurement process (i.e. image acquisition and analysis) can be performed effectively and with consistency among contributing centres. As the technique continues to develop in order to provide potential improvements in sensitivity and physiological relevance, there is considerable scope for between-centre variation in techniques. A workshop was convened by the Imaging Committee of the Experimental Cancer Medicine Centres (ECMC) to review the current status of DCE-MRI and to provide recommendations on how the technique can best be used for early stage trials. This review and the consequent recommendations are summarised here. (orig.)

  11. Method for simulating predictive control of building systems operation in the early stages of building design

    DEFF Research Database (Denmark)

    Petersen, Steffen; Svendsen, Svend

    2011-01-01

    A method for simulating predictive control of building systems operation in the early stages of building design is presented. The method uses building simulation based on weather forecasts to predict whether there is a future heating or cooling requirement. This information enables the thermal...... control systems of the building to respond proactively to keep the operational temperature within the thermal comfort range with the minimum use of energy. The method is implemented in an existing building simulation tool designed to inform decisions in the early stages of building design through...... parametric analysis. This enables building designers to predict the performance of the method and include it as a part of the solution space. The method furthermore facilitates the task of configuring appropriate building systems control schemes in the tool, and it eliminates time consuming manual...

  12. Emotional enhancement of perceptual priming is preserved in aging and early-stage Alzheimer's disease.

    Science.gov (United States)

    LaBar, Kevin S; Torpey, Dana C; Cook, Craig A; Johnson, Stephanie R; Warren, Lauren H; Burke, James R; Welsh-Bohmer, Kathleen A

    2005-01-01

    Perceptual priming for emotionally-negative and neutral scenes was tested in early-stage Alzheimer's disease (AD) patients and healthy younger, middle-aged and older adults. In the study phase, participants rated the scenes for their arousal properties. In the test phase, studied and novel scenes were initially presented subliminally, and the exposure duration was gradually increased until a valence categorization was made. The difference in exposure duration required to categorize novel versus studied items was the dependent measure of priming. Aversive content increased the magnitude of priming, an effect that was preserved in healthy aging and AD. Results from an immediate recognition memory test showed that the priming effects could not be attributable to enhanced explicit memory for the aversive scenes. These findings implicate a dissociation between the modulatory effect of emotion across implicit and explicit forms of memory in aging and early-stage AD.

  13. Implementation of Life Cycle Assessment (LCA) in the early stages of product development

    DEFF Research Database (Denmark)

    2003-01-01

    of the paper is to provide an understanding of the environmental issues involved in the early stages of product development and the capacity of life cycle assessment techniques to address these issues. An Environmentally Conscious Design method is introduced and trade-offs are presented between design degrees...... of the paper is a definition of the requirements for performance measurement techniques and a performance measurement environment necessary to support life cycle evaluation throughout the evaluation of early stages of a product system....... of freedom and environmental solutions. Life cycle design frameworks and strategies are addressed. The paper collects experiences and ideas around the state-of-the-art in eco-design, from literature and personal experience and further provides eco-design life cycle assessment strategies. The result...

  14. Esophagectomy as a Treatment Consideration for Early-Stage Esophageal Cancer and High-Grade Dysplasia.

    Science.gov (United States)

    McLaren, Patrick J; Dolan, James P

    2016-10-01

    In recent years, a number of endoluminal procedures such as endoscopic resection and thermal ablation have emerged as less invasive treatment options for early esophageal cancer. These therapies have demonstrated excellent oncologic outcomes for dysplasia as well as intramucosal cancers. However, few studies have directly compared long-term outcomes of endoscopic therapy versus traditional esophagectomy. Current esophagectomy techniques now deliver consistently good outcomes in the hands of experienced surgeons at high volume centers, and this option should be considered an important treatment consideration for early esophageal cancer. Under current recommendations, esophagectomy should be considered for tumors invading the submucosa, tumors with high-risk pathologic features, bulky tumors, multinodular tumors, tumors within a long segment of Barrett's esophagus, and tumors adjacent to a hiatal hernia. Likewise, individual patient factors and comorbidities must also be considered when determining the best treatment for a patient with early esophageal cancer. The risk of missing metastatic disease or recurrence that is associated with endoscopic treatment must be weighed against the surgical risks of esophagectomy. With these considerations in mind, the aim of this article is to review the current guidelines and literature that explore the role of esophagectomy for early esophageal malignancy in the era of endoscopic therapies.

  15. Targeted labeling of an early-stage tumor spheroid in a chorioallantoic membrane model with upconversion nanoparticles

    NARCIS (Netherlands)

    K. Liu; J.A. Holz; Y. Ding; X. Liu; Y. Zhang; L. Tu; X. Kong; B. Priem; A. Nadort; S.A.G. Lambrechts; M.C.G. Aalders; W.J. Buma; Y. Liu; H. Zhang

    2015-01-01

    In vivo detection of cancer at an early-stage, i.e. smaller than 2 mm, is a challenge in biomedicine. In this work target labeling of an early-stage tumor spheroid (similar to 500 mu m) is realized for the first time in a chick embryo chorioallantoic membrane (CAM) model with monoclonal antibody fun

  16. The D-Optimality Item Selection Criterion in the Early Stage of CAT: A Study with the Graded Response Model

    Science.gov (United States)

    Passos, Valeria Lima; Berger, Martijn P. F.; Tan, Frans E. S.

    2008-01-01

    During the early stage of computerized adaptive testing (CAT), item selection criteria based on Fisher"s information often produce less stable latent trait estimates than the Kullback-Leibler global information criterion. Robustness against early stage instability has been reported for the D-optimality criterion in a polytomous CAT with the…

  17. Tadpoles of Early Breeding Amphibians are Negatively Affected by Leaf Litter From Invasive Chinese Tallow Trees

    Science.gov (United States)

    Leonard, N. E.

    2005-05-01

    As wetlands are invaded by Chinese tallow trees (Triadica sebifera), native trees are displaced and detrital inputs to amphibian breeding ponds are altered. I used a mesocosm experiment to examine the effect of Chinese tallow leaf litter on the survival to, size at, and time to metamorphosis of amphibian larvae. Fifty 1000-L cattle watering tanks were treated with 1500 g dry weight of one of five leaf litter treatments: Chinese tallow, laurel oak (Quercus laurifolia), water tupelo (Nyssa aquatica), slash pine (Pinus elliottii), or a 3:1:1:1 mixture. Each tank received 45 tadpoles of Pseudacris feriarum, Bufo terrestris, and Hyla cinerea in sequence according to their natural breeding phonologies. Every Pseudacris feriarum and Bufo terrestris tadpole exposed to Chinese tallow died prior to metamorphosis. Hyla cinerea survival in tanks with tallow-only was significantly lower than that observed for all other leaf treatments. Hyla cinerea tadpoles from tallow-only and mixed-leaf treatments were larger at metamorphosis and transformed faster than those in tanks with native leaves only. These results suggest that Chinese tallow leaf litter may negatively affect tadpoles of early breeding frogs and that Chinese tallow invasion may change the structure of amphibian communities in temporary ponds.

  18. Standardization of fungal polymerase chain reaction for the early diagnosis of invasive fungal infection

    Directory of Open Access Journals (Sweden)

    P Deshpande

    2011-01-01

    Full Text Available Background: An early initiation of antifungal therapy in invasive fungal infections (IFIs is critical in reducing the high mortality rate. Current diagnosis of fungal infection relies on microscopy, culture, antigen, antibody specific tests and histological diagnosis. However, these tests either lack sensitivity or specificity. There is thus the need for a rapid, specific and accurate diagnostic method. Objective: The aim of our study was to establish PCR for the rapid detection of Candida and Aspergillus species in clinical specimens with improved sensitivity and specificity. Materials and Methods: A total of 71 proven cases of IFI (confirmed by culture were collected. A total of 15 healthy, 15 patients suffering from bacterial sepsis and 15 patients with HIV, HBV viral infections were included as controls. Clinical specimens were subjected to a standardized nested amplification to produce Round I (504 bp and Round II (150 bp amplicons. Restriction digestion was performed on these products for further identification. Results: Analytical sensitivity was determined using 10 6 -10 CFU/ml of cell suspension. The lower detection limit of the assay was 10 CFU/ml of blood. This test was 100% sensitive and specific with a positive predictive value of 100% and a negative predictive value of 96.7%. Conclusion: The assay was found to be effective for the rapid detection of Candida and Aspergillus in clinical specimens.

  19. Subthalamic Nucleus Deep Brain Stimulation May Reduce Medication Costs in Early Stage Parkinson's Disease.

    Science.gov (United States)

    Hacker, Mallory L; Currie, Amanda D; Molinari, Anna L; Turchan, Maxim; Millan, Sarah M; Heusinkveld, Lauren E; Roach, Jonathon; Konrad, Peter E; Davis, Thomas L; Neimat, Joseph S; Phibbs, Fenna T; Hedera, Peter; Byrne, Daniel W; Charles, David

    2016-01-01

    Subthalamic nucleus deep brain stimulation (STN-DBS) is well-known to reduce medication burden in advanced stage Parkinson's disease (PD). Preliminary data from a prospective, single blind, controlled pilot trial demonstrated that early stage PD subjects treated with STN-DBS also required less medication than those treated with optimal drug therapy (ODT). The purpose of this study was to analyze medication cost and utilization from the pilot trial of DBS in early stage PD and to project 10 year medication costs. Medication data collected at each visit were used to calculate medication costs. Medications were converted to levodopa equivalent daily dose, categorized by medication class, and compared. Medication costs were projected to advanced stage PD, the time when a typical patient may be offered DBS. Medication costs increased 72% in the ODT group and decreased 16% in the DBS+ODT group from baseline to 24 months. This cost difference translates into a cumulative savings for the DBS+ODT group of $7,150 over the study period. Projected medication cost savings over 10 years reach $64,590. Additionally, DBS+ODT subjects were 80% less likely to require polypharmacy compared with ODT subjects at 24 months (p early PD reduced medication cost over the two-year study period. DBS may offer substantial long-term reduction in medication cost by maintaining a simplified, low dose medication regimen. Further study is needed to confirm these findings, and the FDA has approved a pivotal, multicenter clinical trial evaluating STN-DBS in early PD.

  20. Methods for assessment of innovative medical technologies during early stages of development.

    OpenAIRE

    Hagen, Anja; Schönermark, Matthias P.; Lühmann, Dagmar; Neumann, Ulrike; Bartelmes, Marc

    2009-01-01

    Conventional Health Technology Assessment (HTA) is usually conducted at a point in time at which the development of the respective technology may no longer be influenced. By this time developers and/or purchasers may have misinvested resources. Thus the demand for Technology Assessment (TA) which incorporates appropriate methods during early development stages of a technology becomes apparent. Against this health political background, the present report describes methods for a development-acc...

  1. [Signal exchange between plants and Arbuscular Mycorrhizae fungi during the early stage of symbiosis - A review].

    Science.gov (United States)

    Duan, Qianqian; Yang, Xiaohong; Huang, Xianzhi

    2015-07-04

    Much is known about Arbuscular Mycorrhizae (AM), an important component of the ecosystem, whereas little is known about the signal exchange that allows mutual recognition and reprograming for the anticipated physical interaction. This review addresses the latest advances of signal exchange between plants and AM, including signal substances and their function, related genes and regulation function in the early stage of plant-fungal symbiosis.

  2. OBSTETRIC AND REPRODUCTIVE CHALLENGES AFTER TRACHELECTOMY IN PATIENTS DIAGNOSED WITH EARLY STAGE CANCER

    OpenAIRE

    Delia NICOLAICIUC; Gabriela SIMIONESCU; Sorana Caterina ANTON; Maria BOLOTA; Emil ANTON; Diaconu, Iulia; Dumitru FILIPEANU

    2017-01-01

    Radical trachelectomy is an established method of fertility sparing in female patients with early stage cervical cancer. This paper aims to review the series of obstetric and reproductive challenges that may arise following trachelectomy. Additionally, the article emphasized the pregnancy rates achieved after radical abdominal trachelectomy, as presented in studies conducted worldwide, since patients who undergo trachelectomy usually need assisted reproductive technologies to conceive and the...

  3. Ultrastructure of basement membranes in monkey and shark teeth at an early stage of development.

    Science.gov (United States)

    Sawada, Takashi

    2003-12-01

    The basement membrane, which separates the inner enamel epithelium from the dental papilla in the early stages of tooth development, is known to play a significant role in odontogenesis. In this review article, this basement membrane was described in detail based on our recent findings with the use of high-resolution electron microscopy. Tooth germs of a monkey (Macaca fuscata) and a shark (Cephaloscyllium umbratile) were processed for thin-section observations. During the early stage of development, the basement membrane of the inner enamel (dental) epithelium was composed of a lamina lucida, lamina densa, and much wider lamina fibroreticularis. At higher magnification, the lamina densa in both species was made up of a fine network of cords, which are generally the main constituents of the basement membranes. In the monkey tooth, the lamina fibroreticularis was rich in fibrils, which were now characterized as basotubules, 10-nm-wide microfibril-like structures. The space between the basotubules was filled with a cord network that extended from the lamina densa. Dental papilla cell processes were inserted into the lamina fibroreticularis, and their surface was closely associated with numerous parallel basotubules via 1.5- to 3-nm-wide filaments. In the shark tooth during its early stage of development, the basotubules were absent in the lamina fibroreticularis and only narrow extensions, 60-90 nm wide and 1-2 microm long, of the cord network of the lamina densa were present. The dental papilla cells were immobilized by means of the binding of their processes to the extensions. These results indicate that basement membranes in both monkey and shark teeth at early stage of development are specialized for functions as anchoring and firm binding, which are essential for the successful differentiation of the odontoblasts.

  4. Cognitive rehabilitation for elderly people with early-stage Alzheimer’s disease

    OpenAIRE

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of cognitive rehabilitation including tasks of cognitive training on performance of everyday activities in elderly people with early-stage Alzheimer’s disease. [Subjects and Methods] Forty-three elderly people (15 men, 28 women) with a diagnosis of Alzheimer’s disease who had a Mini-Mental State Examination (MMSE) score of 18 or above were randomly assigned to two groups: the cognitive rehabilitation group (experimental) and co...

  5. Atomic Aggregation Processes in the Early Stages of Pt/Pt(111) Growth

    Institute of Scientific and Technical Information of China (English)

    ZHUANG Guo-Ce; ZHU Xiao-Bin; WANG Wei

    2000-01-01

    The atomic aggregation processes in the early stages of Pt/Pt(111) growth are studied by using kinetic Monte Carlo simulations. Our results show that the average neighbor coordination number of the atoms in a cluster is a function of temperature, agreeing well with the experiment observations of scanning tunneling microscopy. The influence of diffusion barriers of various atomic processes on the morphology of islands is also studied. Different morphologies of the islands (dendritic, fractal, or compact islands) are found.

  6. Proteomic Analysis of Phosphoproteins in the Rice Nucleus During the Early Stage of Seed Germination.

    Science.gov (United States)

    Li, Ming; Yin, Xiaojian; Sakata, Katsumi; Yang, Pingfang; Komatsu, Setsuko

    2015-07-01

    The early stage of seed germination is the first step in the plant life cycle without visible morphological change. To investigate the mechanism controlling the early stage of rice seed germination, we performed gel-and label-free nuclear phosphoproteomics. A total of 3467 phosphopeptides belonging to 102 nuclear phosphoproteins from rice embryos were identified. Protein-synthesis-related proteins were mainly phosphorylated. During the first 24 h following imbibition, 115 nuclear phosphoproteins were identified, and significant changes in the phosphorylation level over time were observed in 29 phosphoproteins. Cluster analysis indicated that nucleotide-binding proteins and zinc finger CCCH- and BED-type proteins increased in abundance during the first 12 h of imbibition and then decreased. The in silico protein-protein interactions for 29 nuclear phosphoproteins indicated that the Sas10/Utp3 protein, which functions in snoRNA binding and gene silencing, was the center of the phosphoprotein network in nuclei. The germination rate of seeds was significantly slowed with phosphatase inhibitor treatment. The mRNA expression of the zinc finger CCCH-type protein did not change, and the zinc finger BED-type protein was upregulated in rice embryos during the early stage of germination with phosphatase inhibitor treatment. These results suggest that the phosphorylation and dephosphorylation of nuclear proteins are involved in rice seed germination. Furthermore, transcription factors such as zinc finger CCCH- and BED-type proteins might play a key role through nuclear phosphoproteins, and Sas10/Utp3 protein might interact with nuclear phosphoproteins in rice embryos to mediate the early stage of seed germination.

  7. Atrophy patterns in early clinical stages across distinct phenotypes of Alzheimer's disease.

    Science.gov (United States)

    Ossenkoppele, Rik; Cohn-Sheehy, Brendan I; La Joie, Renaud; Vogel, Jacob W; Möller, Christiane; Lehmann, Manja; van Berckel, Bart N M; Seeley, William W; Pijnenburg, Yolande A; Gorno-Tempini, Maria L; Kramer, Joel H; Barkhof, Frederik; Rosen, Howard J; van der Flier, Wiesje M; Jagust, William J; Miller, Bruce L; Scheltens, Philip; Rabinovici, Gil D

    2015-11-01

    Alzheimer's disease (AD) can present with distinct clinical variants. Identifying the earliest neurodegenerative changes associated with each variant has implications for early diagnosis, and for understanding the mechanisms that underlie regional vulnerability and disease progression in AD. We performed voxel-based morphometry to detect atrophy patterns in early clinical stages of four AD phenotypes: Posterior cortical atrophy (PCA, "visual variant," n=93), logopenic variant primary progressive aphasia (lvPPA, "language variant," n=74), and memory-predominant AD categorized as early age-of-onset (EOAD, 65 years, n=114). Patients with each syndrome were stratified based on: (1) degree of functional impairment, as measured by the clinical dementia rating (CDR) scale, and (2) overall extent of brain atrophy, as measured by a neuroimaging approach that sums the number of brain voxels showing significantly lower gray matter volume than cognitively normal controls (n=80). Even at the earliest clinical stage (CDR=0.5 or bottom quartile of overall atrophy), patients with each syndrome showed both common and variant-specific atrophy. Common atrophy across variants was found in temporoparietal regions that comprise the posterior default mode network (DMN). Early syndrome-specific atrophy mirrored functional brain networks underlying functions that are uniquely affected in each variant: Language network in lvPPA, posterior cingulate cortex-hippocampal circuit in amnestic EOAD and LOAD, and visual networks in PCA. At more advanced stages, atrophy patterns largely converged across AD variants. These findings support a model in which neurodegeneration selectively targets both the DMN and syndrome-specific vulnerable networks at the earliest clinical stages of AD.

  8. Emission of spherical cesium-bearing particles from an early stage of the Fukushima nuclear accident

    OpenAIRE

    Kouji Adachi; Mizuo Kajino; Yuji Zaizen; Yasuhito Igarashi

    2013-01-01

    The Fukushima nuclear accident released radioactive materials into the environment over the entire Northern Hemisphere in March 2011, and the Japanese government is spending large amounts of money to clean up the contaminated residential areas and agricultural fields. However, we still do not know the exact physical and chemical properties of the radioactive materials. This study directly observed spherical Cs-bearing particles emitted during a relatively early stage (March 14–15) of the acci...

  9. Early life stages of plaice Pleuronectes platessa in cold-water nurseries

    Directory of Open Access Journals (Sweden)

    Filipe Martinho

    2015-11-01

    Full Text Available Plaice Pleuronectes platessa (Linnaeus, 1758 is one of the most important commercial flatfish in the European continent, whose captures have reduced considerably in recent decades due to the high pressure of fisheries. Despite the wide distribution of this species, most studies have focused on the North Sea, its central area of occurrence, and very little information is available concerning the populations living at the northern limit of its distribution. Age determination is essential to study population dynamics of commercially important species such as plaice, and can be inferred through otolith microstructure analysis. The aim of this work was to investigate the timing of early life events (spawning, larval, metamorphosis and settlement stage duration and growth of juvenile plaice in two cold-water nursery areas in northern Norway (Valosen estuary and Storfjord. A latitudinal cline was observed in the main life-history events, such as spawning, and the onset of larval and metamorphosis stages. Settlement to benthic habitats (which coincides with metamorphosis was estimated to have occurred between mid-May and early-September (peak from the end May and mid July in the Valosen, and between the end of May and early July (peak in June in the Storfjord. In the Storfjord area, larval and metamorphosis stage duration seemed to be shorter, probably due to a reduced window of opportunity for growth and survival at the northernmost extremes. Size at settlement was negatively related with hatch day, implying that the older larvae were larger at settlement, a consequence of higher fecundity of females earlier in the spawning season. A significant relationship between size at settlement and total length reinforced this evidence. The results demonstrate the influence of latitude in the early life stages of plaice, mainly by the regulatory effect of temperature in the growth and survival of larvae and juveniles.

  10. Subthalamic Nucleus Deep Brain Stimulation May Reduce Medication Costs in Early Stage Parkinson’s Disease

    Science.gov (United States)

    Hacker, Mallory L.; Currie, Amanda D.; Molinari, Anna L.; Turchan, Maxim; Millan, Sarah M.; Heusinkveld, Lauren E.; Roach, Jonathon; Konrad, Peter E.; Davis, Thomas L.; Neimat, Joseph S.; Phibbs, Fenna T.; Hedera, Peter; Byrne, Daniel W.; Charles, David

    2016-01-01

    Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is well-known to reduce medication burden in advanced stage Parkinson’s disease (PD). Preliminary data from a prospective, single blind, controlled pilot trial demonstrated that early stage PD subjects treated with STN-DBS also required less medication than those treated with optimal drug therapy (ODT). Objective: The purpose of this study was to analyze medication cost and utilization from the pilot trial of DBS in early stage PD and to project 10 year medication costs. Methods: Medication data collected at each visit were used to calculate medication costs. Medications were converted to levodopa equivalent daily dose, categorized by medication class, and compared. Medication costs were projected to advanced stage PD, the time when a typical patient may be offered DBS. Results: Medication costs increased 72% in the ODT group and decreased 16% in the DBS+ODT group from baseline to 24 months. This cost difference translates into a cumulative savings for the DBS+ODT group of $7,150 over the study period. Projected medication cost savings over 10 years reach $64,590. Additionally, DBS+ODT subjects were 80% less likely to require polypharmacy compared with ODT subjects at 24 months (p <  0.05; OR = 0.2; 95% CI: 0.04–0.97). Conclusions: STN-DBS in early PD reduced medication cost over the two-year study period. DBS may offer substantial long-term reduction in medication cost by maintaining a simplified, low dose medication regimen. Further study is needed to confirm these findings, and the FDA has approved a pivotal, multicenter clinical trial evaluating STN-DBS in early PD. PMID:26967937

  11. MACC1 as a prognostic biomarker for early-stage and AFP-normal hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Chan Xie

    Full Text Available BACKGROUND: The metastasis-associated in colon cancer 1 gene (MACC1 has been found to be associated with cancer development and progression. The aim of this study was to investigate the prognostic value of MACC1 in early-stage and AFP-normal hepatocellular carcinoma (HCC. METHODS: mRNA and protein levels of MACC1 expression in one normal liver epithelial cells THLE3 and 15 HCC cell lines were examined using reverse transcription-PCR and Western blot. MACC1 expression was also comparatively studied in 6 paired HCC lesions and the adjacent non-cancerous tissue samples. Immunohistochemistry was employed to analyze MACC1 expression in 308 clinicopathologically characterized HCC cases. Statistical analyses were applied to derive association between MACC1 expression scores and clinical staging as well as patient survival. RESULTS: Levels of MACC1 mRNA and protein were higher in HCC cell lines and HCC lesions than in normal liver epithelial cells and the paired adjacent noncancerous tissues. Significant difference in MACC1 expression was found in patients of different TNM stages (P<0.001. Overall survival analysis showed that high MACC1 expression level correlated with lower survival rate (P = 0.001. Importantly, an inverse correlation between MACC1 level and patient survival remained significant in subjects with early-stage HCC or with normal serum AFP level. CONCLUSIONS: MACC1 protein may represent a promising biomarker for predicting the prognosis of HCC, including in early-stage and AFP-normal patients.

  12. Deep brain stimulation in early stage Parkinson's disease: operative experience from a prospective randomised clinical trial.

    Science.gov (United States)

    Kahn, Elyne; D'Haese, Pierre-Francois; Dawant, Benoit; Allen, Laura; Kao, Chris; Charles, P David; Konrad, Peter

    2012-02-01

    Recent evidence suggests that deep brain stimulation of the subthalamic nucleus (STN-DBS) may have a disease modifying effect in early Parkinson's disease (PD). A randomised, prospective study is underway to determine whether STN-DBS in early PD is safe and tolerable. 15 of 30 early PD patients were randomised to receive STN-DBS implants in an institutional review board approved protocol. Operative technique, location of DBS leads and perioperative adverse events are reported. Active contact used for stimulation in these patients was compared with 47 advanced PD patients undergoing an identical procedure by the same surgeon. 14 of the 15 patients did not sustain any long term (>3 months) complications from the surgery. One subject suffered a stroke resulting in mild cognitive changes and slight right arm and face weakness. The average optimal contact used in symptomatic treatment of early PD patients was: anterior -1.1±1.7 mm, lateral 10.7±1.7 mm and superior -3.3±2.5 mm (anterior and posterior commissure coordinates). This location is statistically no different (0.77 mm, p>0.05) than the optimal contact used in the treatment of 47 advanced PD patients. The perioperative adverse events in this trial of subjects with early stage PD are comparable with those reported for STN-DBS in advanced PD. The active contact position used in early PD is not significantly different from that used in late stage disease. This is the first report of the operative experience from a randomised, surgical versus best medical therapy trial for the early treatment of PD.

  13. Toxicity of chlorine dioxide to early life stages of marine organisms

    Energy Technology Data Exchange (ETDEWEB)

    Hose, J.E.; Di Fiore, D.; Parker, H.S.; Sciarrotta, T.

    1989-03-01

    With increasing interest in minimizing exposure to chlorine, many electric generating and water treatment plants are exploring the use of alternative biocides such as chlorine dioxide. Unlike chlorine, chlorine dioxide does not react with ambient organic compounds to form potentially carcinogenic trihalomethanes such as chloroform. However, the toxicity of chlorine dioxide to aquatic organisms has received little study. No information exists on chlorine toxicity to marine organisms. Furthermore, West Coast electric power stations usually discharge chlorine intermittently once or twice daily and substantial mixing of receiving water occurs between treatments. Therefore, this study sought to obtain information on chlorine dioxide toxicity using an exposure schedule typical of generating stations which discharge into the marine environment. Early life history stages of a plant, invertebrate and fish were tested since these stages are generally acknowledged to be most sensitive to toxicants and are the stages that are most likely to be exposed to the effluent.

  14. Combined endorectal ultrasonography and strain elastography for the staging of early rectal cancer

    DEFF Research Database (Denmark)

    Waage, Jo Erling Riise; Bach, Simon P; Pfeffer, Frank

    2015-01-01

    AIM: Strain elastography is a novel approach to rectal tumour evaluation. Primary aim of this study was to correlate elastography to pT-stages of rectal tumours and to assess the ability of the method to differentiate rectal adenomas (pT0) from early rectal cancer (pT1-2). Secondary aims were...... to compare elastography with endorectal ultrasonography (ERUS) and to propose a combined strain elastography and ERUS staging algorithm. METHOD: 120 consecutive patients with a suspected rectal tumour were examined in this staging study. Patients receiving surgery without neo-adjuvant radiotherapy were...... included (n=59). All patients were examined with ERUS and elastography. Treatment decisions were made by multidisciplinary team (MDT) assessment, without considering the strain elastography examination. RESULTS: Histopathology identified 21 adenomas, 13 pT1, 9 pT2, 15 pT3 and one pT4. Mean elastography...

  15. Ontogeny and growth of early life stages of captive-bred European eel

    DEFF Research Database (Denmark)

    Sørensen, Sune Riis; Tomkiewicz, Jonna; Munk, Peter

    2016-01-01

    -sustained aquaculture of this high-value and critically endangered species. Statement of relevance: European eel is a high-value species in aquaculture, however, production is presently hampered by reliance on wild caught fry. Captive production of glass eels will reopen markets in Europe and Asia, benefiting European...... of viable eggs and larvae of European eel, providing the basis for studies on early life stages of this species in captivity. In this study, we describe and illustrate morphological characteristics of eggs, embryos, and larvae from fertilization to termination of the yolk sac stage and provide a comparison...... with additional commercially important eel species. Furthermore, we model growth during the critical first phase in larval ontogeny, i.e. the yolk sac stage, and test for maternal effects. The eggs of A. anguilla typically have numerous oil droplets that coalesce into a single large oil droplet, while the zygote...

  16. Neurophysiological Evidence of Compensatory Brain Mechanisms in Early-Stage Multiple Sclerosis

    Science.gov (United States)

    López-Góngora, Mariana; Escartín, Antonio; Martínez-Horta, Saul; Fernández-Bobadilla, Ramón; Querol, Luis; Romero, Sergio; Mañanas, Miquel Àngel; Riba, Jordi

    2015-01-01

    Multiple sclerosis (MS) is a chronic central nervous system disorder characterized by white matter inflammation, demyelination and neurodegeneration. Although cognitive dysfunction is a common manifestation, it may go unnoticed in recently-diagnosed patients. Prior studies suggest MS patients develop compensatory mechanisms potentially involving enhanced performance monitoring. Here we assessed the performance monitoring system in early-stage MS patients using the error-related negativity (ERN), an event-related brain potential (ERP) observed following behavioral errors. Twenty-seven early-stage MS patients and 31 controls were neuropsychologically assessed. Electroencephalography recordings were obtained while participants performed: a) a stop task and b) an auditory oddball task. Behavior and ERP measures were assessed. No differences in performance were found between groups in most neuropsychological tests or in behavior or ERP components in the auditory oddball task. However, the amplitude of the ERN associated with stop errors in the stop task was significantly higher in patients. ERN amplitude correlated positively with scores on the Expanded Disability Status Scale and the Multiple Sclerosis Severity Score, and negatively with the time since last relapse. Patients showed higher neuronal recruitment in tasks involving performance monitoring. Results suggest the development of compensatory brain mechanisms in early-stage MS and reflect the sensitivity of the ERN to detect these changes. PMID:26322632

  17. Effects of Losartan on expression of connexins at the early stage of atherosclerosis in rabbits

    Directory of Open Access Journals (Sweden)

    Li-ming Ruan, Wei Cai, Jun-zhu Chen, Jin-feng Duan

    2010-01-01

    Full Text Available Aim: to investigate effects of Losartan on expression of connexin 40 and 43 (Cx40 and Cx43, in arteries at the early stage of atherosclerosis in a rabbit model. Methods: A total of 28 male New Zealand white rabbits were divided into following groups: control group, high fat diet group, and Losartan group (10 mg/kg/day. Losartan was administrated in food for two weeks. Iliac arteries were obtained for immunohistochemistry, transmission electron microscopy, Western blot, and reverse transcriptase-polymerase chain reaction (RT-PCR. Results: Transmission electron microscopy revealed abundant gap junctions between neointimal smooth muscle cells (SMCs, which were markedly reduced by treatment. RT-PCR and Western blot assay showed that the mRNA and protein expression of Cx40 and Cx43 were elevated in the neointimal area at the early stage of atherosclerosis. The mRNA and protein expression of Cx43 were significantly down-regulated by losartan treatment but those of Cx40 were not markedly changed. Conclusion: Cx40 and Cx43 in the neointimal SMCs were up-regulated at the early stage of atherosclerosis. Losartan (an angiotensin-converting enzyme inhibitor could reduce neointima proliferation and down-regulate the elevated protein expression of Cx43, suggesting the rennin-angiotensin system (RAS plays an important role in the remodeling of gap junction between ventricular myocytes under pathological conditions.

  18. MicroRNA Expression Profiles Related to Early Stage Murine Concanavalin A-Induced Hepatitis

    Directory of Open Access Journals (Sweden)

    Hong-Yu Jia

    2014-06-01

    Full Text Available Background: Fulminant hepatitis is a severe liver disease characterized by massive hepatocyte necrosis and clinical signs of liver failure. This study explores the expression profile of microRNAs, which are regulators of a number of pathophysiological processes, during the early stage of concanavalin A (Con A-induced hepatitis. Methods: Balb/c mice were given ConA injections to induce fulminant hepatitis. miRNA expression profiling in liver tissues was carried out by microarray analysis. The differentially expressed miRNAs were subjected to time sequence profile analysis, gene-miRNA regulatory network analysis, and gene ontology-miRNA regulatory network analysis. Results: Eleven miRNAs among multiClass were found to be significantly differentially expressed between liver tissue in early stage fulminant hepatitis and normal control liver tissue. Mmu-miR-133a was the most differentially expressed with the strongest regulatory ability, regulating 47 mRNAs. Mmu-miR-10a was the most highly expressed in the microRNA-GO-Network and also exerted a strong regulatory ability. The expression profiles of miR-133a and miR-10a were verified by RT-PCR. Conclusions: These results show that, in the early stage, ConA-induced fulminant hepatitis induces a distinct miRNA expression profile. This differential miRNA expression profile may provide pathogenic clues and potential diagnostic and prognostic markers in acute and severe liver disease.

  19. Detection of early-stage research fronts——An example of complex networks research

    Institute of Scientific and Technical Information of China (English)

    Lihua; ZHANG; Zhiqiang; ZHANG

    2014-01-01

    Purpose:This study aims to detect research fronts of a scientific field in its early development stage using bibliometric indicators developed based on the features of research fronts.Design/methodology/approach:We first focused on conceptualization of"research fronts"and outlined 4 indicators to measure different aspects of the concept:Innovation,timeliness,stability and interdisciplinarity.Then research specialties obtained based on direct citation networks were evaluated with the 4 indicators and research fronts were identified.Finally,methodology was illustrated and verified in the research domain of complex networks.Findings:The results indicate that the proposed method is useful in detecting research fronts in a specific field which is at an early development stage.Research limitations:The quality of clustering results was not assessed.It needs to be further studied whether the method can be applicable to the fields that evolve slowly such as mathematics or are highly specialized like entomology and zoology.Practical implications:This study helps researchers keep abreast of emerging trends and policy-makers formulate science and technology policies and strategic plans.Originality/value:This research provides insights into a quantitative assessment method to detect research fronts of a scientific field in its early development stage.

  20. Effects of Columbia River water on early life-stages of white sturgeon (Acipenser transmontanus).

    Science.gov (United States)

    Tompsett, Amber R; Vardy, David W; Higley, Eric; Doering, Jon A; Allan, Marcie; Liber, Karsten; Giesy, John P; Hecker, Markus

    2014-03-01

    The white sturgeon (Acipenser transmontanus) population that resides in the Columbia River in British Columbia (BC), Canada, has suffered recruitment failures for more than three decades. During the summers of 2008 and 2009, studies were performed to determine whether exposure to water downstream of a metal smelter in Trail, BC affected survival or growth of early life-stages of white sturgeon through 60+ days post-fertilization (dpf). In both years, there were no significant differences in survival of fish that were exposed to water from downstream compared to water from upstream of the smelter. At 20-21dpf, average mortality was 2.4 percent and 12 percent in upstream water for 2008 and 2009, respectively, which was similar to the average mortality of 3.8 percent and 7.2 percent in downstream water for 2008 and 2009, respectively. Relatively great mortality after 20-21dpf complicated analysis of the subchronic exposure, but use of a survival analysis indicated that the average fish died at 25-29dpf, regardless of whether the water to which they were exposed came from upstream or downstream of the smelter. In addition, measured concentrations of metals in river water were less than the threshold for adverse effects on early life stages of white sturgeon. Based upon these analyses, it is not likely that current concentrations of metals in the Columbia River in southern BC are adversely affecting survival of early life stages of white sturgeon larvae.

  1. Promoting Quality and Evidence-Based Care in Early-Stage Breast Cancer Follow-up

    Science.gov (United States)

    Hayes, Daniel F.; Ramsey, Scott D.; Hortobagyi, Gabriel N.; Barlow, William E.; Gralow, Julie R.

    2014-01-01

    Evidence-based guidelines for long-term follow-up of early-stage breast cancer patients developed by oncology societies in the United States and Europe recommend that breast cancer survivors undergo regular evaluation with history and physical examination, as well as annual mammography. Routine blood tests, circulating tumor markers, and/or surveillance imaging studies beyond mammography are not recommended in the absence of concerning symptoms or physical examination findings because of lack of supportive clinical evidence. Despite these guidelines, studies have shown that 20% to 40% of oncologists assess serum tumor markers as part of routine monitoring of early-stage breast cancer patients. As part of efforts to both address the financial challenges confronting the health-care system and optimize patient outcomes, the American Society of Clinical Oncology’s Cost of Care Task Force identified adherence to breast cancer surveillance guidelines as an opportunity to improve care and reduce cost. However, these recommendations are based on trials done in an era of outdated technology and limited therapeutic options. It is possible that recent improvements in diagnostics and treatments could make earlier detection of recurrent disease important for improving both survival and quality of life outcomes. Research is necessary to further inform optimal breast cancer follow-up strategies, which could impact these recommendations. At this time, outside of well-conducted clinical trials, there is no role for ordering routine serial blood or imaging tests in monitoring for recurrence in early-stage breast cancer patients. PMID:24627271

  2. The treatment effect of porous titanium alloy rod on the early stage talar osteonecrosis of sheep.

    Directory of Open Access Journals (Sweden)

    Xiao-Kang Li

    Full Text Available Osteonecrosis of the talus (ONT may severely affect the function of the ankle joint. Most orthopedists believe that ONT should be treated at an early stage, but a concise and effective surgical treatment is lacking. In this study, porous titanium alloy rods were prepared and implanted into the tali of sheep with early-stage ONT (IM group. The curative effect of the rods was compared to treatment by core decompression (DC group. No significant differences in bone reconstruction were observed between the two groups at 1 month after intervention. After 3 months, the macroscopic view of gross specimens of the IM group showed ordinary contours, but the specimens of the DC group showed obvious partial bone defects and cartilage degeneration. Quantitative analysis of the reconstructed trabeculae by micro-CT and histological study suggested that the curative effect of the IM group was superior to that of the DC group at 3 months after intervention. These favorable short-term results of the implantation of porous titanium alloy rods into the tali of sheep with early-stage ONT may provide insight into an innovative surgical treatment for ONT.

  3. Predictors of Mild Cognitive Impairment in Early-Stage Parkinson's Disease

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    Brenda Hanna-Pladdy

    2013-05-01

    Full Text Available Aim: The aim of this study was to identify mild cognitive deficits in Parkinson's disease (PD prior to extensive neurodegeneration and to evaluate the extent to which dopamine depletion and other disease-related predictors can explain cognitive profiles. Methods: Neuropsychological performances of 40 nondemented early-stage PD patients and 42 healthy controls were compared across on or off dopaminergic medications. Stepwise regression evaluated cognitive predictors of early-stage PD and disease-related predictors of PD cognition (levodopa dose, disease duration, Unified Parkinson's Disease Rating Scale score, sleep, quality of life, and mood across on and off states. Results: Neuropsychological performance was lower in PD patients across cognitive domains with significant memory, naming, visuomotor, and complex attention/executive deficits, but with intact visuospatial, simple attention, and phonemic fluency functions. However, medication effects were absent except for simple attention. Regression analyses revealed age, working memory, and memory recall to be the best cognitive predictors of PD, while age, quality of life, disease duration, and anxiety predicted PD cognition in the off state. Conclusion: Nondemented early-stage PD patients presented with extensive mild cognitive deficits including prominent memory impairment. The profile was inconsistent with expected isolated frontostriatal dysfunction previously attributed to dopamine depletion and this highlights the need to further characterize extranigral sources of mild cognitive impairment in PD.

  4. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study.

    NARCIS (Netherlands)

    Hirsch, A.; Windhausen, F.; Tijssen, J.G.P.; Verheugt, F.W.A.; Cornel, J.H.; Winter, R.J. de

    2007-01-01

    BACKGROUND: The ICTUS trial was a study that compared an early invasive with a selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS). The study reported no difference between the strategies for frequency of death, myocardial infarction, or

  5. Development sites, feeding modes and early stages of seven European Palloptera species (Diptera, Pallopteridae).

    Science.gov (United States)

    Rotheray, Graham E

    2014-12-19

    Two hundred and ninety-eight rearing records and 87 larvae and puparia were obtained of seven species of Palloptera Fallén (Diptera, Pallopteridae), mainly in Scotland during 2012-2013. The third stage larva and puparium of each species were assessed morphologically and development sites and feeding modes investigated by rearing, observation and feeding tests. Early stages appear to be distinguished by the swollen, apico-lateral margins of the prothorax which are coated in vestiture and a poorly developed anal lobe with few spicules. Individual pallopteran species are separated by features of the head skeleton, locomotory spicules and the posterior respiratory organs. Five species can be distinguished by unique character states. Observations and feeding tests suggest that the frequently cited attribute of zoophagy is accidental and that saprophagy is the primary larval feeding mode with autumn/winter as the main period of development. Food plants were confirmed for flowerhead and stem developing species and rain is important for maintaining biofilms on which larvae feed. Due to difficulties in capturing adults, especially males, the distribution and abundance of many pallopteran species is probably underestimated. Better informed estimates are possible if early stages are included in biodiversity assessments. To facilitate this for the species investigated, a key to the third stage larva and puparium along with details on finding them, is provided. 

  6. Psycholinguistics discovers the operant: a review of Roger Brown's A first language: the early stages1

    Science.gov (United States)

    Segal, Evalyn F.

    1975-01-01

    Brown's book is selectively reviewed with the aim of noting points of similarity between Brown's psycholinguistic analysis of language acquisition and a functional analysis of verbal behavior. Brown divides early language acquisition into five stages, based on mean length of utterance in samples of child speech. His book concentrates on Stage I, when mean length of utterance first rises above 1.0, indicating that children are beginning to speak in multi-morphemic utterances, and Stage II, when mean length of utterance in morphemes is about 2.25. Multi-morphemic utterances in Stage I consist mainly of ordered sequences of uninflected nouns and verbs, the order being that of the simple declarative sentence (agent-action-indirect object-direct object-locative). The review attempts a theoretical analysis of the functional stimulus control of Stage I syntactic order, concluding that the control must originate partly in relations among events in the environment and partly in covert autoclitic verbal behavior. Increases in mean length of utterance in Stage II are mainly due to the appearance of several “grammatical morphemes” such as the progressive -ing inflection on verbs and the plural -s inflection on nouns. The review attempts a behavioral paraphrase, again in terms of tacts and autoclitics, of Brown's psycholinguistic analysis of grammatical morphemes, concluding that Stage II displays the further development, building on Stage I, of the combined control of verbal behavior by relations in the environment and covert self-generated verbal stimuli. Similarities between Brown's psycholinguistic analysis and a functional analysis of language acquisition suggest that the two viewpoints are converging on a common concern with the stimulus control of verbal behavior.

  7. Apoptosis-related genes induced in response to ketamine during early life stages of zebrafish.

    Science.gov (United States)

    Félix, Luís M; Serafim, Cindy; Valentim, Ana M; Antunes, Luís M; Matos, Manuela; Coimbra, Ana M

    2017-09-05

    Increasing evidence supports that ketamine, a widely used anaesthetic, potentiates apoptosis during development through the mitochondrial pathway of apoptosis. Defects in the apoptotic machinery can cause or contribute to the developmental abnormalities previously described in ketamine-exposed zebrafish. The involvement of the apoptotic machinery in ketamine-induced teratogenicity was addressed by assessing the apoptotic signals at 8 and 24 hpf following 20min exposure to ketamine at three stages of early zebrafish embryo development (256 cell, 50% epiboly and 1-4 somites stages). Exposure at the 256-cell stage to ketamine induced an up-regulation of casp8 and pcna at 8 hpf while changes in pcna at the mRNA level were observed at 24 hpf. After the 50% epiboly stage exposure, the mRNA levels of casp9 were increased at 8 and 24 hpf while aifm1 was affected at 24 hpf. Both tp53 and pcna expressions were increased at 8 hpf. After exposure during the 1-4 somites stage, no meaningful changes on transcript levels were observed. The distribution of apoptotic cells and the caspase-like enzymatic activities of caspase-3 and -9 were not affected by ketamine exposure. It is proposed that ketamine exposure at the 256-cell stage induced a cooperative mechanism between proliferation and cellular death while following exposure at the 50% epiboly, a p53-dependent and -independent caspase activation may occur. Finally, at the 1-4 somites stage, the defence mechanisms are already fully in place to protect against ketamine-insult. Thus, ketamine teratogenicity seems to be dependent on the functional mechanisms present in each developmental stage. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Identification of an early-stage gene of Chlamydia psittaci 6BC.

    Science.gov (United States)

    Wichlan, D G; Hatch, T P

    1993-05-01

    Chlamydiae are parasitic bacteria characterized by a temporally regulated developmental cycle. In the early stage of the cycle, metabolically inert elementary bodies reorganize to dividing reticulate bodies, a process about which little is known. The purpose of this investigation was to identify and clone chlamydial genes that are expressed preferentially during the early stage of the developmental cycle of Chlamydia psittaci 6BC. Several potential early genes were cloned with highly radioactive, host-free-generated RNA probes to screen a genomic library. One clone appeared to encode a gene that was particularly well expressed at 1 h postinfection. In further characterization, we found that it encodes two complete open reading frames and one partial open reading frame of 370 codons. The partial open reading frame, designated gltX, is very similar to bacterial glutamyl-tRNA synthetases and was demonstrated to be transcribed in vivo at 24 h postinfection by primer extension analysis. A lysine-rich open reading frame (LRO) of 117 codons was found upstream and divergent from gltX. The LRO lacks homology to known proteins, and we were unable to demonstrate that it is transcribed in vivo. The third open reading frame, of 182 codons, was found to be convergent with and partially overlap the LRO. It was confirmed to be preferentially expressed within the first 1.5 h of infection by Northern (RNA) blot analysis and was designated the early upstream open reading frame (EUO). Like the LRO, the EUO is not homologous to known proteins. A major potential transcription start site of the EUO was identified by primer extension analysis. However, the sequence upstream of the site does not closely resemble the consensus recognition sequences of bacterial sigma factors even though it is AT rich. The EUO is the first chlamydial gene specific to the early stage to be cloned and sequenced.

  9. The early development of the nervous system in staged insectivore and primate embryos.

    Science.gov (United States)

    Müller, F; O'Rahilly, R

    1980-10-01

    The early development of the nervous system was studied in stage embryos of hemicentetes semispinosus, Microcebus murinus, Alouatta seniculus, Cebus appella, Cebus albifrons, macaca mulatta, and Homo sapiens. The specimens were assigned to Carnegie stages 11-13. Serial transverse sections were examined and graphic reconstructions were prepared. The early development of the neural tube is basically similar in all the species investigated but differences in detail are noticeable. The mesencephalic flexure serves in all cases as a landmark for malpighi's tripartite subdivision of the brain. The nonhuman embryos seem to show a little more variation than the human in the closure of the neuropores in relation to somitic count. With the exception of the later-appearing terminal-vomeronasal component, all major portions of the neural crest as classified by O'Rahilly ('65) are represented in both the nonhuman and the human embryos studied. No crest is present at the level of rhombomere 1, nor at rhombomere 3 except in the platyrrhines and some human embryos, nor at rhombomere 5 except in certain human specimens. An indication of the division of the trigeminal ganglion into its primary divisions is rare at stage 11 (C. apella), may be visible at stage 12 (Alouatta, macaca, Homo), and is definite (in Homo) at stage 13. Ganglionic contributions from head ectoderm (epipharyngeal placodes), as previously described in the human and some other vertebrate embryos, were sought and found in Cebus apella. In both nonhuman and human, a tendency is noted whereby the rostral limit of the occipitospinal crest, high at stage 11, seems to descend relatively at stage 12, and ascend again at stage 13 (at least in the human) to become associated with the appearance of the accessory and hypoglossal nerves. In general, the motor components of the nerves are identifiable before the sensory elements, and, in the present study, nerve fibers were first observed in the human at stage 13 in some of

  10. Temperature influences selective mortality during the early life stages of a coral reef fish.

    Directory of Open Access Journals (Sweden)

    Tauna L Rankin

    Full Text Available For organisms with complex life cycles, processes occurring at the interface between life stages can disproportionately impact survival and population dynamics. Temperature is an important factor influencing growth in poikilotherms, and growth-related processes are frequently correlated with survival. We examined the influence of water temperature on growth-related early life history traits (ELHTs and differential mortality during the transition from larval to early juvenile stage in sixteen monthly cohorts of bicolor damselfish Stegastes partitus, sampled on reefs of the upper Florida Keys, USA over 6 years. Otolith analysis of settlers and juveniles coupled with environmental data revealed that mean near-reef water temperature explained a significant proportion of variation in pelagic larval duration (PLD, early larval growth, size-at-settlement, and growth during early juvenile life. Among all cohorts, surviving juveniles were consistently larger at settlement, but grew more slowly during the first 6 d post-settlement. For the other ELHTs, selective mortality varied seasonally: during winter and spring months, survivors exhibited faster larval growth and shorter PLDs, whereas during warmer summer months, selection on PLD reversed and selection on larval growth became non-linear. Our results demonstrate that temperature not only shapes growth-related traits, but can also influence the direction and intensity of selective mortality.

  11. Laparoscopy or laparotomy? A comparison of 240 patients with early-stage endometrial cancer.

    Science.gov (United States)

    Santi, Alessandro; Kuhn, Annette; Gyr, Thomas; Eberhard, Markus; Johann, Silke; Günthert, Andreas R; Mueller, Michael D

    2010-04-01

    This study aimed to compare the safety and efficacy of laparoscopy and laparotomy in the surgical treatment of early endometrial cancer, especially in obese women. The results obtained after laparoscopic surgical treatment of early endometrial cancer (International Federation of Gynecology and Obstetrics (FIGO) stage 1 or 2) in patients between 1996 and 2007 were compared with an age- and tumour-matched historical group of patients treated with laparotomy between 1988 and 1996. All the patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic + or - paraaortic lymphadenectomy. Both groups included 120 patients with a preoperative diagnosis of early endometrial cancer. The postoperative diagnosis was endometrial cancer stage 1 or 2 for 89% of the cases in both groups. The mean operating time was 170 min for the laparotomy group compared with 178 min for the laparoscopy group (nonsignificant difference). The estimated intraoperative blood loss was significantly greater in the laparotomy group, and the hospital stay was significantly shorter in the laparoscopy group. The results show that early endometrial cancer can be treated effectively by laparoscopy. Because of this study's retrospective design, the results should be interpreted with caution. However, the advantages of this method for obese patients are evident. The age and weight of these patients should not be used as a contraindication for laparoscopy.

  12. COMPARISON OF EARLY AND DELAYED UMBILICAL CORD CLAMPING IN THE THIRD STAGE OF LABOUR

    Directory of Open Access Journals (Sweden)

    Tamara Serdinšek

    2015-09-01

    Full Text Available Background: Umbilical cord clamping in the third stage of labour is still controversial. Early cord clamping is defined as clamping at 10, 15, 30 or 60 seconds after delivery and delayed as clamping after 60 seconds or at 2-5 minutes after delivery, when the cord stops pulsating or when the placenta is visible within the birth canal. Early clamping is one of the three components of active management of the third stage of labour, which has been used widely in modern obstetrics during the last century. However, in some northern European countries, various parts of the USA and Canada and in developing countries physiological management is preferred.Conclusions: After publication of several trials describing advantages of delayed clamping, this has recently been progressively replacing early clamping. The most important advantages of delayed cord clamping are higher haemoglobin and ferritin levels, higher iron stores, lower incidence of iron deficiency anaemia, better cardiopulmonary adaptation, lower rate of respiratory distress syndrome, and longer duration of early breastfeeding in term neonates, while there is no increase in the incidence of postpartum haemorrhage. Delayed clamping seems to bring some advantages for preterm neonates as well. However, caution is still advised because of the potential adverse effects, especially polycythaemia with hyperviscosity, hyperbilirubinaemia and respiratory distress.

  13. Circulating micro-RNAs as potential blood-based markers for early stage breast cancer detection.

    Directory of Open Access Journals (Sweden)

    Michael G Schrauder

    Full Text Available INTRODUCTION: MicroRNAs (miRNAs, miRs are a class of small, non-coding RNA molecules with relevance as regulators of gene expression thereby affecting crucial processes in cancer development. MiRNAs offer great potential as biomarkers for cancer detection due to their remarkable stability in blood and their characteristic expression in many different diseases. We investigated whether microarray-based miRNA profiling on whole blood could discriminate between early stage breast cancer patients and healthy controls. METHODS: We performed microarray-based miRNA profiling on whole blood of 48 early stage breast cancer patients at diagnosis along with 57 healthy individuals as controls. This was followed by a real-time semi-quantitative Polymerase Chain Reaction (RT-qPCR validation in a separate cohort of 24 early stage breast cancer patients from a breast cancer screening unit and 24 age matched controls using two differentially expressed miRNAs (miR-202, miR-718. RESULTS: Using the significance level of p<0.05, we found that 59 miRNAs were differentially expressed in whole blood of early stage breast cancer patients compared to healthy controls. 13 significantly up-regulated miRNAs and 46 significantly down-regulated miRNAs in our microarray panel of 1100 miRNAs and miRNA star sequences could be detected. A set of 240 miRNAs that was evaluated by radial basis function kernel support vector machines and 10-fold cross validation yielded a specificity of 78.8%, and a sensitivity of 92.5%, as well as an accuracy of 85.6%. Two miRNAs were validated by RT-qPCR in an independent cohort. The relative fold changes of the RT-qPCR validation were in line with the microarray data for both miRNAs, and statistically significant differences in miRNA-expression were found for miR-202. CONCLUSIONS: MiRNA profiling in whole blood has potential as a novel method for early stage breast cancer detection, but there are still challenges that need to be addressed to

  14. Clinical heterogeneity in patients with early-stage Parkinson's disease: a cluster analysis

    Institute of Scientific and Technical Information of China (English)

    Ping LIU; Tao FENG; Yong-jun WANG; Xuan ZHANG; Biao CHEN

    2011-01-01

    The aim of this study was to investigate the clinical heterogeneity of Parkinson's disease (PD) among a cohort of Chinese patients in early stages.Clinical data on demographics,motor variables,motor phenotypes,disease progression,global cognitive function,depression,apathy,sleep quality,constipation,fatigue,and L-dopa complications were collected from 138 Chinese PD subjects in early stages (Hoehn and Yahr stages 1-3).The PD subject subtypes were classified using k-means cluster analysis according to the clinical data from five- to three-cluster consecutively.Kappa statistical analysis was performed to evaluate the consistency among different subtype solutions.The cluster analysis indicated four main subtypes:the non-tremor dominant subtype (NTD,n=28,20.3%),rapid disease progression subtype (RDP,n=7,5.1%),young-onset subtype (YO,n=50,36.2%),and tremor dominant subtype (TD,n=53,38.4%).Overall,78.3% (108/138) of subjects were always classified between the same three groups (52 always in TD,7 in RDP,and 49 in NTD),and 98.6% (136/138) between five- and four-cluster solutions.However,subjects classified as NTD in the four-cluster analysis were dispersed into different subtypes in the three-cluster analysis,with low concordance between four- and three-cluster solutions (kappa value=-0.139,P=0.001 ).This study defines clinical heterogeneity of PD patients in early stages using a data-driven approach.The subtypes generated by the four-cluster solution appear to exhibit ideal internal cohesion and external isolation.

  15. Central Pain Processing in Early-Stage Parkinson's Disease: A Laser Pain fMRI Study

    Science.gov (United States)

    Petschow, Christine; Scheef, Lukas; Paus, Sebastian; Zimmermann, Nadine; Schild, Hans H.; Klockgether, Thomas; Boecker, Henning

    2016-01-01

    Background & Objective Pain is a common non-motor symptom in Parkinson’s disease. As dopaminergic dysfunction is suggested to affect intrinsic nociceptive processing, this study was designed to characterize laser-induced pain processing in early-stage Parkinson’s disease patients in the dopaminergic OFF state, using a multimodal experimental approach at behavioral, autonomic, imaging levels. Methods 13 right-handed early-stage Parkinson’s disease patients without cognitive or sensory impairment were investigated OFF medication, along with 13 age-matched healthy control subjects. Measurements included warmth perception thresholds, heat pain thresholds, and central pain processing with event-related functional magnetic resonance imaging (erfMRI) during laser-induced pain stimulation at lower (E = 440 mJ) and higher (E = 640 mJ) target energies. Additionally, electrodermal activity was characterized during delivery of 60 randomized pain stimuli ranging from 440 mJ to 640 mJ, along with evaluation of subjective pain ratings on a visual analogue scale. Results No significant differences in warmth perception thresholds, heat pain thresholds, electrodermal activity and subjective pain ratings were found between Parkinson’s disease patients and controls, and erfMRI revealed a generally comparable activation pattern induced by laser-pain stimuli in brain areas belonging to the central pain matrix. However, relatively reduced deactivation was found in Parkinson’s disease patients in posterior regions of the default mode network, notably the precuneus and the posterior cingulate cortex. Conclusion Our data during pain processing extend previous findings suggesting default mode network dysfunction in Parkinson’s disease. On the other hand, they argue against a genuine pain-specific processing abnormality in early-stage Parkinson’s disease. Future studies are now required using similar multimodal experimental designs to examine pain processing in more advanced

  16. Clinical Outcomes in International Federation of Gynecology and Obstetrics Stage IA Endometrial Cancer With Myometrial Invasion Treated With or Without Postoperative Vaginal Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Diavolitsis, V. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL (United States); Rademaker, A. [Department of Preventive Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL (United States); Lurain, J.; Hoekstra, A. [Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL (United States); Strauss, J. [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL (United States); Small, W., E-mail: wsmall@nmff.org [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL (United States)

    2012-10-01

    Purpose: To assess the clinical outcomes of patients with Stage IA endometrial cancer with myometrial invasion treated with postoperative vaginal brachytherapy (VBT) with those who received no adjuvant therapy (NAT). Methods and Materials: All patients treated with hysterectomy for endometrial cancer at Northwestern Memorial Hospital between 1978 and 2005 were identified. Those patients with Stage IA disease with myometrial invasion who were treated with VBT alone or NAT were identified and included in the present analysis. Results: Of 252 patients with Stage IA endometrial cancer with superficial (<50%) myometrial invasion who met the inclusion criteria, 169 underwent VBT and 83 received NAT. The median follow-up in the VBT and NAT groups was 103 and 61 months, respectively. In the VBT group, 56.8% had Grade 1, 37.9% had Grade 2, and 5.3% had Grade 3 tumors. In the NAT group, 75.9%, 20.5%, and 3.6% had Grade 1, 2, and 3 tumors, respectively. Lymphatic or vascular space invasion was noted in 12.4% of the VBT patients and 5.6% of the NAT patients. The 5-year overall survival rate was 95.5%. The 5-year recurrence-free survival rate was 92.4% for all patients, 94.4% for the VBT group, and 87.4% for the NAT group (p = NS). Of the 169 VBT patients and 83 NAT patients, 8 (4.7%) and 6 (7.2%) developed recurrent disease. One vaginal recurrence occurred in the VBT group (0.6%) and three in the NAT group (3.8%). Recurrences developed 2-102 months after surgical treatment. Two of the four vaginal recurrences were salvaged. No Grade 3 or higher acute or late radiation toxicity was noted. Conclusions: The use of postoperative VBT in patients with Stage I endometrial cancer with <50% myometrial invasion yielded excellent vaginal disease control and disease-free survival, with minimal toxicity.

  17. Subset Analysis of a Multicenter, Randomized Controlled Trial to Compare Magnifying Chromoendoscopy with Endoscopic Ultrasonography for Stage Diagnosis of Early Stage Colorectal Cancer.

    Directory of Open Access Journals (Sweden)

    Tomonori Yamada

    Full Text Available Our recent prospective study found equivalent accuracy of magnifying chromoendoscopy (MC and endoscopic ultrasonography (EUS for diagnosing the invasion depth of colorectal cancer (CRC; however, whether these tools show diagnostic differences in categories such as tumor size and morphology remains unclear. Hence, we conducted detailed subset analysis of the prospective data.In this multicenter, prospective, comparative trial, a total of 70 patients with early, flat CRC were enrolled from February 2011 to December 2012, and the results of 66 lesions were finally analyzed. Patients were randomly allocated to primary MC followed by EUS or to primary EUS followed by MC. Diagnoses of invasion depth by each tool were divided into intramucosal to slight submucosal invasion (invasion depth <1000 μm and deep submucosal invasion (invasion depth ≥1000 μm, and then compared with the final pathological diagnosis by an independent pathologist blinded to clinical data. To standardize diagnoses among examiners, this trial was started after achievement of a mean κ value of ≥0.6 which was calculated from the average of κ values between each pair of participating endoscopists.Both MC and EUS showed similar diagnostic outcomes, with no significant differences in prediction of invasion depth in subset analyses according to tumor size, location, and morphology. Lesions that were consistently diagnosed as Tis/T1-SMS or ≥T1-SMD with both tools revealed accuracy of 76-78%. Accuracy was low in borderline lesions with irregular pit pattern in MC and distorted findings of the third layer in EUS (MC, 58.5%; EUS, 50.0%.MC and EUS showed the same limited accuracy for predicting invasion depth in all categories of early CRC. Since the irregular pit pattern in MC, distorted findings to the third layer in EUS and inconsistent diagnosis between both tools were associated with low accuracy, further refinements or even novel methods are still needed for such lesions

  18. Sentinel lymph node mapping in early stage of endometrial and cervical cancers

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    Tajossadat Allameh

    2015-01-01

    Full Text Available Background: The sentinel lymph node (SLN is defined as the first chain node in the lymphatic basin that receives primary lymphatic flow. If the SLN is negative for metastatic disease, then other nodes are expected to be disease-free. SLN techniques have been extensively applied in the staging and treatment of many tumors, including melanoma, breast and vulvar cancers. This study aims to evaluate our technique in SLN mapping in early stage endometrial and cervical cancers. Materials and Methods: We scheduled a cross-sectional pilot study for patients undergoing staging surgery for endometrial and cervical cancer from November 2012 to February 2014 in Beheshti and Sadoughi Hospitals. Our SLN mapping technique included 1 h preoperative or intraoperative injection of 4 ml of 1% methylene blue dye in the tumor site. At the time of surgery, blue lymph nodes were removed and labeled as SLNs. Then systematic lymph node dissection was completed, and all of the nodes were sent for pathologic examination concerning metastatic involvement. All of the sentinel nodes were first stained with hematoxylin and eosin and examined. Those negative in this study were then stained with immunohistochemistry using anti-keratin antibody. Descriptive statistics, sensitivity, negative predictive values (NPV, false negative (FN and detection rates were calculated. Results: Twenty-three patients including 62% endometrial and 38% cervical cancers enrolled in the study. Median of SLN count in the endometrial and cervical cancers was 3 and 2, respectively. Among endometrial and cervical cancers, detection rate of metastatic disease was 80% and 87.5%, respectively. The FN rate for this technique was 0 and the sensitivity and NPV are 100% for both endometrial and cervical cancers. Conclusion: Considering the lower risk of metastases in early stage of both endometrial and cervical cancers, SLN technique allows for confident and accurate staging of cancer.

  19. Involvement of insulin in early development of mouse one-cell stage embryos

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Recent studies have suggested that growth factors and hormones play important roles in cell prolif-eration and differentiation during early embryonic development. In the present study, we examined the expression and localization of insulin in the mouse oocytes and one-cell stage embryos by quantitative ELISA, RT-PCR, Western blot and immunofluorescence. In the mouse oocytes and one-cell stage em-bryos, expression of insulin was uniformly distributed in the cytoplasm. We also examined the expres-sion, activity and localization of mTOR (mammalian target of rapamycin) and p70S6K. The expression of mTOR and p70S6K was not significantly different at the cell cycle of mouse one-cell stage embryos. mTOR and S6K were distributed evenly in the cytoplasm at G1, G2 and M phase phase, but at S phase, the distribution of mTOR and S6K was around the pronucleus. At different phases, the activity of mTOR fluctuated. We also used the PI3K specific inhibitor-Wortmannin to investigate the cleavage rate of eggs. The result showed that the rate obviously decreased. When the mTOR specific inhibitor Rapa-mycin was used, the first mitotic division of the mouse one-cell stage embryo was delayed. These re-sults suggested that insulin was expressed both in mouse oocytes and one-cell stage embryos, and may play functional roles in regulation of mouse early embryogenesis by activating the signal pathway of PI3K/PKB/mTOR/S6K.

  20. Monitoring of nosocomial invasive aspergillosis and early evidence of an outbreak using cumulative sum tests (CUSUM).

    Science.gov (United States)

    Menotti, J; Porcher, R; Ribaud, P; Lacroix, C; Jolivet, V; Hamane, S; Derouin, F

    2010-09-01

    In order to provide a statistically based evaluation of the incidence of invasive aspergillosis (IA) over time, we applied the cumulative sums (CUSUM) methodology, which was developed for quality control and has already been applied for the surveillance of hospital-acquired infections. Cases of IA were recorded during a 5-year period. Incidence rates of cases assumed to be hospital-acquired, i.e. nosocomial IA (NIA), were analysed using CUSUM tests. Relationships between NIA, fungal contamination and construction or renovation work were tested using time-series methods. Between January 2002 and December 2006, 81 cases of NIA were recorded. CUSUM analysis of NIA incidence showed no significant deviation from the expected monthly number of cases until August 2005, and then the CUSUM crossed the decision limit, i.e. identified a significant increase in NIA as compared with the reference period (January 2002 to December 2004). Up to April 2006, the learning-curve CUSUM stayed over its limit, supporting an ongoing outbreak involving 24 patients, and then it significantly decreased in May 2006. Follow-up after May 2006 indicated no out-of-control situation, supporting a return to the baseline situation. In haematology wards, significant links were found between NIA incidence and fungal contamination of several sites at each ward (mainly unprotected common sites). An environmental source of contamination could be suspected, but no significant relationship was found between NIA incidence and ongoing construction or renovation. In conclusion, the CUSUM test proved to be well suited for real-time monitoring of NIA and for early identification and follow-up of an outbreak.

  1. Challenges and developments in research of the early stages of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Elisa Brietzke

    Full Text Available Recently, attention in the field of bipolar disorder (BD has focused on prevention, including early detection and intervention, as these strategies have the potential to delay, lessen the severity, or even prevent full-blown episodes of BD. Although knowledge of the neurobiology of BD has advanced substantially in the last two decades, most research was conducted with chronic patients. The objective of this paper is to comprehensively review the literature regarding the early stages of BD, to explore recent discoveries on the neurobiology of these stages, and to discuss implications for research and clinical care. The following databases were searched: PubMed, PsycINFO, Cochrane Library, and SciELO. Articles published in English from inception to December 2015 were retrieved. Several research approaches were used, including examination of offspring studies, retrospective studies, prospective studies of clinical high-risk populations, and exploration of the progression after the first manic episode. Investigations with neuroimaging, cognition assessments, and biomarkers provide promising (although not definitive evidence of alterations in the neural substrate during the at-risk stage. Research on BD should be expanded to encompass at-risk states and aligned with recent methodological progress in neuroscience.

  2. Challenges and developments in research of the early stages of bipolar disorder.

    Science.gov (United States)

    Brietzke, Elisa; Rosa, Adriane R; Pedrini, Mariana; Noto, Mariane N; Kapczinski, Flavio; Scott, Jan

    2016-01-01

    Recently, attention in the field of bipolar disorder (BD) has focused on prevention, including early detection and intervention, as these strategies have the potential to delay, lessen the severity, or even prevent full-blown episodes of BD. Although knowledge of the neurobiology of BD has advanced substantially in the last two decades, most research was conducted with chronic patients. The objective of this paper is to comprehensively review the literature regarding the early stages of BD, to explore recent discoveries on the neurobiology of these stages, and to discuss implications for research and clinical care. The following databases were searched: PubMed, PsycINFO, Cochrane Library, and SciELO. Articles published in English from inception to December 2015 were retrieved. Several research approaches were used, including examination of offspring studies, retrospective studies, prospective studies of clinical high-risk populations, and exploration of the progression after the first manic episode. Investigations with neuroimaging, cognition assessments, and biomarkers provide promising (although not definitive) evidence of alterations in the neural substrate during the at-risk stage. Research on BD should be expanded to encompass at-risk states and aligned with recent methodological progress in neuroscience.

  3. Developing an inventor support service which performs early stage market and manufacturing evaluations. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    American businesses are learning the difficult high cost lesson of ignoring production and market factors (producibility, unit product cost (UPC), marketability, etc) during the engineering design phase of product development. Studies have shown that the Japanese spend three times as long as Americans in the design feasibility and decision process of new product introductions and one third the amount of time in the implementation of those products. There is a 20 to 1 cost benefit on effort applied in the design phase versus the production phase of the product life cycle. The number one goal of this project was to establish an organization that has, as one of its purposes, the providing of services responsive to the needs of independent inventors. The number two goal was to demonstrate the value of providing marketing and manufacturing counsel at an early stage in the product development process. The first study goal was met by providing the materials and information necessary to establish an evaluation team and an organization to handle such evaluations. The second study goal was met by demonstrating the impact of early market analysis and manufacturing considerations on product design and therefore on the description of the invention for four different inventions. These inventions were selected at various stages of development. Regardless of stage of development, the marketing and manufacturing reviews resulted in significant changes in design and/or market positioning.

  4. Developing an inventor support service which performs early stage market and manufacturing evaluations. [Final Report

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    American businesses are learning the difficult high cost lesson of ignoring production and market factors (producibility, unit product cost (UPC), marketability, etc) during the engineering design phase of product development. Studies have shown that the Japanese spend three times as long as Americans in the design feasibility and decision process of new product introductions and one third the amount of time in the implementation of those products. There is a 20 to 1 cost benefit on effort applied in the design phase versus the production phase of the product life cycle. The number one goal of this project was to establish an organization that has, as one of its purposes, the providing of services responsive to the needs of independent inventors. The number two goal was to demonstrate the value of providing marketing and manufacturing counsel at an early stage in the product development process. The first study goal was met by providing the materials and information necessary to establish an evaluation team and an organization to handle such evaluations. The second study goal was met by demonstrating the impact of early market analysis and manufacturing considerations on product design and therefore on the description of the invention for four different inventions. These inventions were selected at various stages of development. Regardless of stage of development, the marketing and manufacturing reviews resulted in significant changes in design and/or market positioning.

  5. Characteristics and prognosis of patients with early-stage endometrial cancer who refuse adjuvant radiotherapy.

    Science.gov (United States)

    Koskas, Martin; Huchon, Cyrille; Amant, Frederic

    2016-06-01

    To investigate the risk factors for refusing adjuvant radiotherapy in patients who have undergone surgery for early-stage endometrial cancer, and to compare their survival rates with patients who have undergone adjuvant radiotherapy. Data from the Surveillance, Epidemiology, and End Results database for patients operated on for histologically-proven early-stage endometrioid endometrial cancer, between 1988 and 2012, were screened. Univariate and multivariate logistic regression analyses tested the associations between refusal of adjuvant radiotherapy and demographic, tumoral, and management characteristics. Overall and cancer-related survival rates were compared between 376 patients who refused adjuvant radiotherapy and 752 patients who received adjuvant radiotherapy, matched for demographics (age, race, year of diagnosis, marital status, region), tumoral (grade, FIGO stage, size), and management (lymphadenectomy performed) criteria. 434 of the 16,014 patients (2.7%) who were proposed adjuvant radiotherapy refused this treatment. Older, widowed, divorced, or separated patients, who were recently diagnosed and managed in the Northern plains or Pacific coast (USA), with limited tumoral extension, were more likely to refuse adjuvant radiotherapy. Five-year cancer-related survival was significantly lower in patients who refused adjuvant radiotherapy (88.9% vs. 95.7%, pradiotherapy. Refusing adjuvant radiotherapy increased cancer-related death but probably does not reduce overall survival. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Genome-scale transcriptomic insights into early-stage fruit development in woodland strawberry Fragaria vesca.

    Science.gov (United States)

    Kang, Chunying; Darwish, Omar; Geretz, Aviva; Shahan, Rachel; Alkharouf, Nadim; Liu, Zhongchi

    2013-06-01

    Fragaria vesca, a diploid woodland strawberry with a small and sequenced genome, is an excellent model for studying fruit development. The strawberry fruit is unique in that the edible flesh is actually enlarged receptacle tissue. The true fruit are the numerous dry achenes dotting the receptacle's surface. Auxin produced from the achene is essential for the receptacle fruit set, a paradigm for studying crosstalk between hormone signaling and development. To investigate the molecular mechanism underlying strawberry fruit set, next-generation sequencing was employed to profile early-stage fruit development with five fruit tissue types and five developmental stages from floral anthesis to enlarged fruits. This two-dimensional data set provides a systems-level view of molecular events with precise spatial and temporal resolution. The data suggest that the endosperm and seed coat may play a more prominent role than the embryo in auxin and gibberellin biosynthesis for fruit set. A model is proposed to illustrate how hormonal signals produced in the endosperm and seed coat coordinate seed, ovary wall, and receptacle fruit development. The comprehensive fruit transcriptome data set provides a wealth of genomic resources for the strawberry and Rosaceae communities as well as unprecedented molecular insight into fruit set and early stage fruit development.

  7. Relationship between early and late stages of information processing: an event-related potential study

    Directory of Open Access Journals (Sweden)

    Claudio Portella

    2012-11-01

    Full Text Available The brain is capable of elaborating and executing different stages of information processing. However, exactly how these stages are processed in the brain remains largely unknown. This study aimed to analyze the possible correlation between early and late stages of information processing by assessing the latency to, and amplitude of, early and late event-related potential (ERP components, including P200, N200, premotor potential (PMP and P300, in healthy participants in the context of a visual oddball paradigm. We found a moderate positive correlation among the latency of P200 (electrode O2, N200 (electrode O2, PMP (electrode C3, P300 (electrode PZ and the reaction time (RT. In addition, moderate negative correlation between the amplitude of P200 and the latencies of N200 (electrode O2, PMP (electrode C3, P300 (electrode PZ was found. Therefore, we propose that if the secondary processing of visual input (P200 latency occurs faster, the following will also happen sooner: discrimination and classification process of this input (N200 latency, motor response processing (PMP latency, reorganization of attention and working memory update (P300 latency, and RT. N200, PMP, and P300 latencies are also anticipated when higher activation level of occipital areas involved in the secondary processing of visual input rise (P200 amplitude.

  8. The educative prevention of the early stage of educationist’s formation.

    Directory of Open Access Journals (Sweden)

    Marta Alfonso Nazco

    2010-04-01

    Full Text Available The article introduces a characterization of the educative prevention stage at the early professional formation process of educacionist in Sancti Spìritus province. The study is done by the indication analysis of assistant, learning, permanence and behavior at youths who course pedagogical carrers, and haven’t expressed a desire stage yet. The main shown results dealt with the assumption of the searching variables and its indicators, the construction of instruments and the definition of aspects concerning the educative prevention at the early stage of educationist’s formation in the selected choosing. Theoretical, empirical and statistical- math, methods were used which were helped by the constructed instruments and the triangulations among them thus arriving to generalizations for the caracterization. The results have better the work at the area project of the educative prevention in adolescents and youths in the territory, witch mainly concern the desing and implementation of actions withing the pedagogical process, foccuse in the integration of institutions, socializer and educative agents functioning to eductive prevention.

  9. Dynamics of laser ablation at the early stage during and after ultrashort pulse

    Science.gov (United States)

    Ilnitsky, D. K.; Khokhlov, V. A.; Zhakhovsky, V. V.; Petrov, Yu V.; Migdal, K. P.; Inogamov, N. A.

    2016-11-01

    Study of material flow in two-temperature states is needed for a fundamental understanding the physics of femtosecond laser ablation. To explore phenomena at a very early stage of laser action on a metallic target our in-house two-temperature hydrodynamics code is used here. The early stage covers duration of laser pulse with next first few picoseconds. We draw attention to the difference in behavior at this stage between the cases: (i) of an ultrathin film (thickness of order of skin depth d skin or less), (ii) thin films (thickness of a film is 4-7 of d skin for gold), and (iii) bulk targets (more than 10d skin for gold). We demonstrate that these differences follow from a competition among conductive cooling of laser excited electrons in a skin layer, electron-ion coupling, and hydrodynamics of unloading caused by excess of pressure of excited free electrons. Conductive cooling of the skin needs a heat sink, which is performed by the cold material outside the skin. Such sink is unavailable in the ultrathin films.

  10. Imaging and detection of early stage dental caries with an all-optical photoacoustic microscope

    Science.gov (United States)

    Hughes, D. A.; Sampathkumar, A.; Longbottom, C.; Kirk, K. J.

    2015-01-01

    Tooth decay, at its earliest stages, manifests itself as small, white, subsurface lesions in the enamel. Current methods for detection in the dental clinic are visual and tactile investigations, and bite-wing X-ray radiographs. These techniques suffer from poor sensitivity and specificity at the earliest (and reversible) stages of the disease due to the small size (<100μm) of the lesion. A fine-resolution (600 nm) ultra-broadband (200 MHz) all-optical photoacoustic microscopy system was is used to image the early signs of tooth decay. Ex-vivo tooth samples exhibiting white spot lesions were scanned and were found to generate a larger (one order of magnitude) photoacoustic (PA) signal in the lesion regions compared to healthy enamel. The high contrast in the PA images potentially allows lesions to be imaged and measured at a much earlier stage than current clinical techniques allow. PA images were cross referenced with histology photographs to validate our experimental results. Our PA system provides a noncontact method for early detection of white-spot lesions with a high detection bandwidth that offers advantages over previously demonstrated ultrasound methods. The technique provides the sensing depth of an ultrasound system, but with the spatial resolution of an optical system.

  11. Laparoscopic compared with open radical hysterectomy in obese women with early-stage cervical cancer.

    Science.gov (United States)

    Park, Jeong-Yeol; Kim, Dae-Yeon; Kim, Jong-Hyeok; Kim, Yong-Man; Kim, Young-Tak; Nam, Joo-Hyun

    2012-06-01

    To compare the surgical and oncological outcomes of laparoscopic radical hysterectomy and open radical hysterectomy in obese women with early-stage cervical cancer. The medical records of 166 patients with stage IA2-IIA2 cervical cancer and a body mass index of at least 30 who underwent laparoscopic radical hysterectomy (n=54) or open radical hysterectomy (n=112) at the Asan Medical Center between 1998 and 2011 were reviewed. None of the patients in the laparoscopic radical hysterectomy group required conversion to laparotomy. The resection margin was negative in 98.1% of the laparoscopic radical hysterectomy group and 98.2% of the open radical hysterectomy group (P=.976). No difference between the two groups was observed in terms of operating time, perioperative hemoglobin level change, transfusion requirement, or the number of retrieved lymph nodes. Compared with open radical hysterectomy, laparoscopic radical hysterectomy was associated with a significant reduction in the following: interval to return of bowel movements (2 days compared with 2.7 days, Plaparoscopic radical hysterectomy group and 85% for the open radical hysterectomy group (P=.682). The 5-year overall survival rate was 97% for the laparoscopic radical hysterectomy group and 90% for the open radical hysterectomy group (P=.220). Laparoscopic radical hysterectomy was a preferred alternative to open radical hysterectomy in the present cohort of obese women with early-stage cervical cancer because it is associated with a more favorable surgical outcome without compromising survival outcomes. II.

  12. Evaluation of bacteriology of middle ear in early quiescent stage of chronic otitis media

    Directory of Open Access Journals (Sweden)

    Ramesh Bhandari

    2013-09-01

    Full Text Available Objectives The objectives of this study were to determine whether any organism does exist in middle ear cavity during the early quiescent stage of chronic otitis media and to isolate their types. Materials and methods Forty-seven patients of age 13 years and above with diagnosis of chronic otitis media mucosal type in early quiescent stage were included. Swab was collected from middle ear cavity for culture and sensitivity in operation theatre prior to middle ear surgery and brought to microbiology laboratory within half an hour to inoculate in Blood agar, Chocolate agar and Mac Conkey agar. The isolates were identified with the use of standard bacteriological technique. Results Aerobic bacteria were isolated from 15 cases (31.9%. Staphylococcus aureus isolated in 12(80%, Pseudomonas aeruginosa in 2(13.3% and E. coli in 1(6.7%. Conclusion Aerobic bacteria were isolated from middle ear cavity in quiescent stage of chronic otitis media in 15(32% cases. Staphylococcus aureus was the most common organism. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 22-26 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8696

  13. Relationship between early and late stages of information processing: an event-related potential study

    Science.gov (United States)

    Portella, Claudio; Machado, Sergio; Arias-Carrión, Oscar; Sack, Alexander T.; Silva, Julio Guilherme; Orsini, Marco; Leite, Marco Antonio Araujo; Silva, Adriana Cardoso; Nardi, Antonio E.; Cagy, Mauricio; Piedade, Roberto; Ribeiro, Pedro

    2012-01-01

    The brain is capable of elaborating and executing different stages of information processing. However, exactly how these stages are processed in the brain remains largely unknown. This study aimed to analyze the possible correlation between early and late stages of information processing by assessing the latency to, and amplitude of, early and late event-related potential (ERP) components, including P200, N200, premotor potential (PMP) and P300, in healthy participants in the context of a visual oddball paradigm. We found a moderate positive correlation among the latency of P200 (electrode O2), N200 (electrode O2), PMP (electrode C3), P300 (electrode PZ) and the reaction time (RT). In addition, moderate negative correlation between the amplitude of P200 and the latencies of N200 (electrode O2), PMP (electrode C3), P300 (electrode PZ) was found. Therefore, we propose that if the secondary processing of visual input (P200 latency) occurs faster, the following will also happen sooner: discrimination and classification process of this input (N200 latency), motor response processing (PMP latency), reorganization of attention and working memory update (P300 latency), and RT. N200, PMP, and P300 latencies are also anticipated when higher activation level of occipital areas involved in the secondary processing of visual input rise (P200 amplitude). PMID:23355929

  14. Efficient and rapid isolation of early-stage embryos from Arabidopsis thaliana seeds.

    Science.gov (United States)

    Raissig, Michael T; Gagliardini, Valeria; Jaenisch, Johan; Grossniklaus, Ueli; Baroux, Célia

    2013-06-07

    In flowering plants, the embryo develops within a nourishing tissue - the endosperm - surrounded by the maternal seed integuments (or seed coat). As a consequence, the isolation of plant embryos at early stages (1 cell to globular stage) is technically challenging due to their relative inaccessibility. Efficient manual dissection at early stages is strongly impaired by the small size of young Arabidopsis seeds and the adhesiveness of the embryo to the surrounding tissues. Here, we describe a method that allows the efficient isolation of young Arabidopsis embryos, yielding up to 40 embryos in 1 hr to 4 hr, depending on the downstream application. Embryos are released into isolation buffer by slightly crushing 250-750 seeds with a plastic pestle in an Eppendorf tube. A glass microcapillary attached to either a standard laboratory pipette (via a rubber tube) or a hydraulically controlled microinjector is used to collect embryos from droplets placed on a multi-well slide on an inverted light microscope. The technical skills required are simple and easily transferable, and the basic setup does not require costly equipment. Collected embryos are suitable for a variety of downstream applications such as RT-PCR, RNA sequencing, DNA methylation analyses, fluorescence in situ hybridization (FISH), immunostaining, and reporter gene assays.

  15. Usefulness of the recombinant liver stage antigen-3 for an early serodiagnosis of Plasmodium falciparum infection.

    Science.gov (United States)

    Lee, Hyeong-Woo; Moon, Sung-Ung; Ryu, Hye-Sun; Kim, Yeon-Joo; Cho, Shin-Hyeong; Chung, Gyung-Tae; Lin, Khin; Na, Byoung-Kuk; Kong, Yoon; Chung, Kyung-Suk; Kim, Tong-Soo

    2006-03-01

    In order to develop tools for an early serodiagnosis of Plasmodium falciparum infection, we evaluated the usefulness of P. falciparum liver stage antigen-3 (LSA-3) as a serodiagnostic antigen. A portion of LSA-3 gene was cloned, and its recombinant protein (rLSA-3) was expressed in Escherichia coli and purified by column chromatography. The purified rLSA-3 and 120 test blood/serum samples collected from inhabitants in malaria-endemic areas of Mandalay, Myanmar were used for this study. In microscopic examinations of blood samples, P. falciparum positive rate was 39.1% (47/120) in thin smear trials, and 33.3% (40/120) in thick smear trials. Although the positive rate associated with the rLSA-3 (30.8%) was lower than that of the blood stage antigens (70.8%), rLSA-3 based enzyme-linked immunosorbent assay could detect 12 seropositive cases (10.0%), in which blood stage antigens were not detected. These results indicate that the LSA-3 is a useful antigen for an early serodiagnosis of P. falciparum infection.

  16. Drug Repositioning Discovery for Early- and Late-Stage Non-Small-Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Chien-Hung Huang

    2014-01-01

    Full Text Available Drug repositioning is a popular approach in the pharmaceutical industry for identifying potential new uses for existing drugs and accelerating the development time. Non-small-cell lung cancer (NSCLC is one of the leading causes of death worldwide. To reduce the biological heterogeneity effects among different individuals, both normal and cancer tissues were taken from the same patient, hence allowing pairwise testing. By comparing early- and late-stage cancer patients, we can identify stage-specific NSCLC genes. Differentially expressed genes are clustered separately to form up- and downregulated communities that are used as queries to perform enrichment analysis. The results suggest that pathways for early- and late-stage cancers are different. Sets of up- and downregulated genes were submitted to the cMap web resource to identify potential drugs. To achieve high confidence drug prediction, multiple microarray experimental results were merged by performing meta-analysis. The results of a few drug findings are supported by MTT assay or clonogenic assay data. In conclusion, we have been able to assess the potential existing drugs to identify novel anticancer drugs, which may be helpful in drug repositioning discovery for NSCLC.

  17. HIV-1 Nef sequesters MHC-I intracellularly by targeting early stages of endocytosis and recycling.

    Science.gov (United States)

    Dirk, Brennan S; Pawlak, Emily N; Johnson, Aaron L; Van Nynatten, Logan R; Jacob, Rajesh A; Heit, Bryan; Dikeakos, Jimmy D

    2016-11-14

    A defining characteristic of HIV-1 infection is the ability of the virus to persist within the host. Specifically, MHC-I downregulation by the HIV-1 accessory protein Nef is of critical importance in preventing infected cells from cytotoxic T-cell mediated killing. Nef downregulates MHC-I by modulating the host membrane trafficking machinery, resulting in the endocytosis and eventual sequestration of MHC-I within the cell. In the current report, we utilized the intracellular protein-protein interaction reporter system, bimolecular fluorescence complementation (BiFC), in combination with super-resolution microscopy, to track the Nef/MHC-I interaction and determine its subcellular localization in cells. We demonstrate that this interaction occurs upon Nef binding the MHC-I cytoplasmic tail early during endocytosis in a Rab5-positive endosome. Disruption of early endosome regulation inhibited Nef-dependent MHC-I downregulation, demonstrating that Nef hijacks the early endosome to sequester MHC-I within the cell. Furthermore, super-resolution imaging identified that the Nef:MHC-I BiFC complex transits through both early and late endosomes before ultimately residing at the trans-Golgi network. Together we demonstrate the importance of the early stages of the endocytic network in the removal of MHC-I from the cell surface and its re-localization within the cell, which allows HIV-1 to optimally evade host immune responses.

  18. ERCC2 2251A>C genetic polymorphism was highly correlated with early relapse in high-risk stage II and stage III colorectal cancer patients: A preliminary study

    Directory of Open Access Journals (Sweden)

    Lee Su-Chen

    2008-02-01

    Full Text Available Abstract Background Early relapse in colorectal cancer (CRC patients is attributed mainly to the higher malignant entity (such as an unfavorable genotype, deeper tumor invasion, lymph node metastasis and advance cancer stage and poor response to chemotherapy. Several investigations have demonstrated that genetic polymorphisms in drug-targeted genes, metabolizing enzymes, and DNA-repairing enzymes are all strongly correlated with inter-individual differences in the efficacy and toxicity of many treatment regimens. This preliminary study attempts to identify the correlation between genetic polymorphisms and clinicopathological features of CRC, and evaluates the relationship between genetic polymorphisms and chemotherapeutic susceptibility of Taiwanese CRC patients. To our knowledge, this study discusses, for the first time, early cancer relapse and its indication by multiple genes. Methods Six gene polymorphisms functional in drug-metabolism – GSTP1 Ile105Val, ABCB1 Ile1145Ile, MTHFR Ala222Val, TYMS double (2R or triple (3R tandem repeat – and DNA-repair genes – ERCC2 Lys751Gln and XRCC1 Arg399Gln – were assessed in 201 CRC patients using a polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP technique and DNA sequencing. Patients were diagnosed as either high-risk stage II (T2 and 3 N0 M0 or III (any T N1 and 2 M0 and were administered adjuvant chemotherapy regimens that included 5-fluorouracil (5FU and leucovorin (LV. The correlations between genetic polymorphisms and patient clinicopathological features and relapses were investigated. Results In this study, the distributions of GSTP1 (P = 0.003, ABCB1 (P = 0.001, TYMS (P ERCC2 (P XRCC1 (P = 0.006 genotypes in the Asian population, with the exception of MTHFR (P = 0.081, differed significantly from their distributions in a Caucasian population. However, the unfavorable genotype ERCC2 2251A>C (P = 0.006, tumor invasion depth (P = 0.025, lymph node metastasis (P = 0

  19. Early stages of HIV replication: how to hijack cellular functions for a successful infection.

    Science.gov (United States)

    Lehmann-Che, Jacqueline; Saïb, Ali

    2004-01-01

    From the cell surface to the nucleus, the human immunodeficiency virus type 1 (HIV-1) will face multiple obstacles, crossing the plasma and nuclear membranes, but also finding its path within the cytoplasm in which elements from the cytoskeleton, organelles, and high a protein concentration, limit intracellular movements. At the same time, HIV-1 has to counteract cellular defenses--known as restriction factors--interfering with early steps of the virus cycle. Although the general outcomes of these early stages have been identified since several decades, the stepwise interactions taking place between cellular and viral components during this early journey, which will transform the incoming viral-RNA genome into a double-strand DNA competent for integration, remain largely unknown. In that sense, the uncoating process and the molecular basis of intracellular trafficking of preintegration complexes (PICs) are still poorly defined. Additionally, other key stages, which have been the focus of many reports, still require some clarifications, as is the case for the precise determinants of nuclear import of PICs. Finally, whereas the molecular mechanisms of integration, the last event of the early phase of retroviral life cycle, are now well understood, the choice of the integration site remains mysterious. Fully elucidating the early steps of HIV-1 replication is therefore crucial, not only for developing new antiretroviral drugs, but also for improving the design of lentiviral vectors for gene therapy. Since the mechanisms of HIV-1 entry and innate cell defenses were recently the topic of excellent reviews, we will focus here on uncoating and intracellular trafficking of HIV-1.

  20. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance.

    Science.gov (United States)

    Lou, Feiran; Huang, James; Sima, Camelia S; Dycoco, Joseph; Rusch, Valerie; Bach, Peter B

    2013-01-01

    At present, there is no consensus on the optimal strategy for follow-up care after curative resection for lung cancer. We sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after resection for early-stage non-small cell lung cancer in patients who were followed by routine surveillance computed tomography scan. We reviewed the outcomes of consecutive patients who underwent resection for early-stage non-small cell lung cancer at Memorial Sloan-Kettering Cancer Center between 2004 and 2009. A total of 1294 consecutive patients with early-stage non-small cell lung cancer underwent resection. The median length of follow-up was 35 months. Recurrence was diagnosed in 257 patients (20%), and second primary lung cancer was diagnosed in 91 patients (7%). The majority of new primary cancers (85 [93%]) were identified by scheduled routine computed tomography scan, as were a smaller majority of recurrences (157 [61%]). During the first 4 years after surgery, the risk of recurrence ranged from 6% to 10% per person-year but decreased thereafter to 2%. Conversely, the risk of second primary lung cancer ranged from 3% to 6% per person-year and did not diminish over time. Additional testing after false-positive surveillance computed tomography scan results was performed for 329 patients (25%), but only 4 of these patients (0.3%) experienced complications as a result of subsequent invasive diagnostic procedures. Almost all second primary cancers and the majority of recurrences were detected by post-therapeutic surveillance computed tomography scan. The risk of recurrence for early-stage non-small cell lung cancer survivors persisted during the first 4 years after resection, and vigilance in surveillance should be maintained. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  1. In the hunt for therapeutic targets: mimicking the growth, metastasis, and stromal associations of early-stage lung cancer using a novel orthotopic animal model.

    Science.gov (United States)

    Weiss, Ido D; Ella, Ezra; Dominsky, Omri; Smith, Yoav; Abraham, Michal; Wald, Hanna; Shlomai, Zippora; Zamir, Gideon; Feigelson, Sara W; Shezen, Elias; Bar-Shai, Amir; Alon, Ronen; Izhar, Uzi; Peled, Amnon; Shapira, Oz M; Wald, Ori

    2015-01-01

    The existing shortage of animal models that properly mimic the progression of early-stage human lung cancer from a solitary confined tumor to an invasive metastatic disease hinders accurate characterization of key interactions between lung cancer cells and their stroma. We herein describe a novel orthotopic animal model that addresses these concerns and consequently serves as an attractive platform to study tumor-stromal cell interactions under conditions that reflect early-stage lung cancer. Unlike previous methodologies, we directly injected small numbers of human or murine lung cancer cells into murine's left lung and longitudinally monitored disease progression. Next, we used green fluorescent protein-tagged tumor cells and immuno-fluorescent staining to determine the tumor's microanatomic distribution and to look for tumor-infiltrating immune cells and stromal cells. Finally, we compared chemokine gene expression patterns in the tumor and lung microenvironment. We successfully generated a solitary pulmonary nodule surrounded by normal lung parenchyma that grew locally and spread distally over time. Notably, we found that both fibroblasts and leukocytes are recruited to the tumor's margins and that distinct myeloid cell attracting and CCR2-binding chemokines are specifically induced in the tumor microenvironment. Our orthotopic lung cancer model closely mimics the pathologic sequence of events that characterizes early-stage human lung cancer propagation. It further introduces new means to monitor tumor-stromal cell interactions and offers unique opportunities to test therapeutic targets under conditions that reflect early-stage lung cancer. We argue that for such purposes our model is superior to lung cancer models that are based either on genetic induction of epithelial transformation or on ectopic transplantation of malignant cells.

  2. Effect of salicylic acid on early life stages of common carp (Cyprinus carpio).

    Science.gov (United States)

    Zivna, Dana; Sehonova, Pavla; Plhalova, Lucie; Marsalek, Petr; Blahova, Jana; Prokes, Miroslav; Divisova, Lenka; Stancova, Vlasta; Dobsikova, Radka; Tichy, Frantisek; Siroka, Zuzana; Svobodova, Zdenka

    2015-07-01

    Environmental concentrations of pharmaceutical residues are often low; nevertheless, they are designed to have biological effects at low doses. The aim of this study was to assess the effects of salicylic acid on the growth and development of common carp (Cyprinus carpio) early life stages with respect to antioxidant defence enzymes. An embryo-larval toxicity test lasting 34 days was performed according to OECD guidelines 210 (Fish, Early-life Stage Toxicity Test). The tested concentrations were 0.004, 0.04, 0.4, 4 and 20mg/l of salicylic acid. Hatching, early ontogeny, and both morphometric and condition characteristics were significantly influenced by subchronic exposure to salicylic acid. Also, changes in antioxidant enzyme activity and an increase in lipid peroxidation were observed. The LOEC value was found to be 0.004 mg/l salicylic acid. The results of our study confirm the suggestion that subchronic exposure to salicylic acid at environmental concentrations can have significant effects on aquatic vertebrates.

  3. Discovery of piRNAs Pathway Associated with Early-Stage Spermatogenesis in Chicken.

    Science.gov (United States)

    Xu, Lu; Qiu, Lingling; Chang, Guobin; Guo, Qixin; Liu, Xiangping; Bi, Yulin; Zhang, Yu; Wang, Hongzhi; Li, Zhiteng; Guo, Xiaoming; Wan, Fang; Zhang, Yang; Xu, Qi; Chen, Guohong

    2016-01-01

    Piwi-interacting RNAs (piRNAs) play a key role in spermatogenesis. Here, we describe the piRNAs profiling of primordial germ cells (PGCs), spermatogonial stem cells (SSCs), and the spermatogonium (Sp) during early-stage spermatogenesis in chicken. We obtained 31,361,989 reads from PGCs, 31,757,666 reads from SSCs, and 46,448,327 reads from Sp cells. The length distribution of piRNAs in the three samples showed peaks at 33 nt. The resulting genes were subsequently annotated against the Gene Ontology (GO) database. Five genes (RPL7A, HSPA8, Pum1, CPXM2, and PRKCA) were found to be involved in cellular processes. Interactive pathway analysis (IPA) further revealed three important pathways in early-stage spermatogenesis including the FGF, Wnt, and EGF receptor signaling pathways. The gene Pum1 was found to promote germline stem cell proliferation, but it also plays a role in spermatogenesis. In conclusion, we revealed characteristics of piRNAs during early spermatogonial development in chicken and provided the basis for future research.

  4. Discovery of piRNAs Pathway Associated with Early-Stage Spermatogenesis in Chicken.

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    Lu Xu

    Full Text Available Piwi-interacting RNAs (piRNAs play a key role in spermatogenesis. Here, we describe the piRNAs profiling of primordial germ cells (PGCs, spermatogonial stem cells (SSCs, and the spermatogonium (Sp during early-stage spermatogenesis in chicken. We obtained 31,361,989 reads from PGCs, 31,757,666 reads from SSCs, and 46,448,327 reads from Sp cells. The length distribution of piRNAs in the three samples showed peaks at 33 nt. The resulting genes were subsequently annotated against the Gene Ontology (GO database. Five genes (RPL7A, HSPA8, Pum1, CPXM2, and PRKCA were found to be involved in cellular processes. Interactive pathway analysis (IPA further revealed three important pathways in early-stage spermatogenesis including the FGF, Wnt, and EGF receptor signaling pathways. The gene Pum1 was found to promote germline stem cell proliferation, but it also plays a role in spermatogenesis. In conclusion, we revealed characteristics of piRNAs during early spermatogonial development in chicken and provided the basis for future research.

  5. Meaningful end points and outcomes in men on active surveillance for early-stage prostate cancer.

    Science.gov (United States)

    Welty, Christopher J; Cooperberg, Matthew R; Carroll, Peter R

    2014-05-01

    Active surveillance is a management strategy for early-stage prostate cancer designed to balance early detection of aggressive disease and overtreatment of indolent disease. We evaluate recently reported outcomes and discuss the potentially most important endpoints for such an approach. The past 2 years have seen the publication of two trials of watchful waiting versus immediate treatment and updates of multiple active surveillance cohorts for men with early-stage prostate cancer. The watchful waiting trials demonstrated a small potential mortality benefit to immediate treatment when applied to all risk levels (6% absolute difference at 15 years), emphasizing the importance of a risk-adapted strategy. In reported active surveillance cohorts, prostate cancer death and metastasis remain rare events. Intermediate outcomes such as progression to treatment and upgrading/upstaging on final disease appear consistent among cohorts, but must be interpreted with caution when compared with historical controls of immediate treatment because of potential selection bias. The safety of active surveillance has been reinforced by recent reports. Accumulation of additional data on men with intermediate risk cancer and development and validation of new biomarkers of risk will allow refined and, likely, expanded use of this approach.

  6. Muscle fiber conduction velocity in different gait phases of early and late-stage diabetic neuropathy.

    Science.gov (United States)

    Suda, Eneida Yuri; Gomes, Aline A; Butugan, Marco Kenji; Sacco, Isabel C N

    2016-10-01

    We investigated the muscle fiber conduction velocity (MFCV) during gait phases of the lower limb muscles in individuals with various degrees of diabetic peripheral neuropathy (DPN). Forty-five patients were classified into severity degrees of DPN by a fuzzy model. The stages were absent (n=11), mild (n=14), moderate (n=11) and severe (n=9), with 10 matched healthy controls. While walking, all subjects had their sEMG (4 linear electrode arrays) recorded for tibialis anterior (TA), gastrocnemius medialis (GM), vastus lateralis (VL) and biceps femoris (BF). MFCV was calculated using a maximum likelihood algorithm with 30ms standard deviation Gaussian windows. In general, individuals in the earlier stages of DPN showed lower MFCV of TA, GM and BF, whilst individuals with severe DPN presented higher MFCV of the same muscles. We observed that mild patients already showed lower MFCV of TA at early stance and swing, and lower MFCV of BF at swing. All diabetic groups showed a markedly reduction in MFCV of VL, irrespective of DPN. Severe patients presented higher MFCV mainly in distal muscles, TA at early and swing phases and GM at propulsion and midstance. The absent group already showed MFCV of VL and GM reductions at the propulsion phase and of VL at early stance. Although MFCV changes were not as progressive as the DPN was, we clearly distinguished diabetic patients from controls, and severe patients from all others.

  7. Functional magnetic resonance imaging and cognition at the very early stage of MS.

    Science.gov (United States)

    Audoin, Bertrand; Au Duong, My Van; Malikova, Irina; Confort-Gouny, Sylviane; Ibarrola, Danielle; Cozzone, Patrick J; Pelletier, Jean; Ranjeva, Jean-Philippe

    2006-06-15

    Dysfunction of high controlled information processing is present in patients with multiple sclerosis (MS) right at the beginning of the disease. One hypothesis is that disruption of communication inside large-scale cortical networks, occurring as a consequence of white matter damage, may constitute the anatomical substrate of cognitive impairment at the very early stage of MS. Disturbance of interregional synchronization might be the main pathogenic factor in controlled information processing deficiency in early MS. Preliminary functional MRI studies (fMRI) have provided important clues to corroborate the connectivity hypotheses. First, brain connectivity assessed by fMRI has brought new data about the influence of diffuse white matter damage on connectivity efficiency inside large-scale networks. These studies have suggested that connectivity disturbances occur inside the working memory network in patients at the very early stage of MS and appear related to the extent of structural white matter damage. Also, fMRI studies have suggested that patients may partially compensate for connectivity impairment by a greater cognitive control. Such a compensatory mechanism could limit the determinant functional impact of diffuse white matter damage on high controlled information processing.

  8. Experimental early-stage coalification of a peat sample and a peatified wood sample from Indonesia

    Science.gov (United States)

    Orem, W.H.; Neuzil, S.G.; Lerch, H.E.; Cecil, C.B.

    1996-01-01

    Experimental coalification of a peat sample and a buried wood sample from domed peat deposits in Indonesia was carried out to examine chemical structural changes in organic matter during early-stage coalification. The experiment (125 C, 408 atm lithostatic pressure, and 177 atm fluid pressure for 75 days) was designed to maintain both lithostatic and fluid pressure on the sample, but allow by-products that may retard coalification to escape. We refer to this design as a geologically open system. Changes in the elemental composition, and 13C NMR and FTIR spectra of the peat and wood after experimental coalification suggest preferential thermal decomposition of O-containing aliphatic organic compounds (probably cellulose) during early-stage coalification. The elemental compositions and 13C NMR spectra of the experimentally coalified peat and wood were generally similar to those of Miocene coal and coalified wood samples from Indonesia. Yields of lignin phenols in the peat and wood samples decreased following experimental coalification; the wood sample exhibited a larger change. Lignin phenol yields from the experimentally coalified peat and wood were comparable to yields of lignin phenols from Miocene Indonesian lignite and coalified wood. Changes in syringyl/vanillyl and p-hydroxy/vanillyl ratios suggest direct demethoxylation as a secondary process to demethylation of methoxyl groups during early coalification, and changes in lignin phenol yields and acid/aldehyde ratios point to a coupling between demethoxylation processes and reactions in the alkyl side chain bonds of the ??-carbon in lignin phenols.

  9. Hematopoietic cytokines as therapeutic players in early stages Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Kyle eFarmer

    2015-07-01

    Full Text Available Parkinson's disease (PD is a devastating age related neurodegenerative disease that is believed to have a lengthy prodromal state. It is critical to find methods of interfering with the progression of this early degenerative stage by inducing compensatory recovery processes to slow or prevent the eventual clinical symptoms. The current perspective article argues that immune system signalling molecules represent such a promising therapeutic approach. Two cytokines of interest are granulocyte macrophage-colony stimulating factor (GM-CSF and erythropoietin (EPO. These hematopoietic cytokines have been protective in models of stroke, neuronal injury, and more recently PD. It is our belief that these trophic cytokines can be used not only for cell protection but also regeneration. However, success is likely dependent on early intervention. This paper will outline our perspective on the development of novel trophic recovery treatments for PD. In particular, we present new data from our lab suggesting that EPO and GM-CSF can foster neural re-innervation in a mild or partial lesion PD model that could be envisioned as reflecting the early stages of the disease.

  10. An Ordered Bipolar Outflow from a Massive Early-stage Core

    Science.gov (United States)

    Tan, Jonathan C.; Kong, Shuo; Zhang, Yichen; Fontani, Francesco; Caselli, Paola; Butler, Michael J.

    2016-04-01

    We present ALMA follow-up observations of two massive, early-stage core candidates, C1-N and C1-S, in IRDC G028.37+00.07, that were previously identified by their {{{N}}}2{{{D}}}+(3-2) emission, and show high levels of deuteration of this species. The cores are also dark at far-infrared wavelengths up to ˜ 100 μ {{m}}. We detect 12CO(2-1) from a narrow, highly collimated bipolar outflow that is being launched from near the center of the C1-S core, which is also the location of the peak 1.3 mm dust continuum emission. This protostar, C1-Sa, has associated dense gas traced by {{{C}}}18{{O}}(2-1) and DCN(3-2), from which we estimate that it has a radial velocity that is near the center of the range exhibited by the C1-S massive core. A second outflow-driving source is also detected within the projected boundary of C1-S, but it appears to be at a different radial velocity. After considering the properties of the outflows, we conclude that C1-Sa is a promising candidate for an early-stage massive protostar and as such it shows that these early phases of massive star formation can involve highly ordered outflow, and thus accretion, processes, similar to models developed to explain low-mass protostars.

  11. Shortened telomere length in bipolar disorder: a comparison of the early and late stages of disease

    Directory of Open Access Journals (Sweden)

    Florencia M. Barbé-Tuana

    Full Text Available Objective: Bipolar disorder (BD has been associated with increased rates of age-related diseases, such as type II diabetes, metabolic syndrome, osteoporosis, and cardiovascular disorders. Several biological findings have been associated with age-related disorders, including increased oxidative stress, inflammation, and telomere shortening. The objective of this study was to compare telomere length among participants with BD at early and late stages and age- and gender-matched healthy controls. Methods: Twenty-six euthymic subjects with BD and 34 healthy controls were recruited. Genomic DNA was extracted from peripheral blood and mean telomere length was measured using real-time quantitative polymerase chain reaction. Results: Telomere length was significantly shorter in both the early and late subgroups of BD subjects when compared to the respective controls (p = 0.002 and p = 0.005, respectively. The sample size prevented additional subgroup analyses, including potential effects of medication, smoking status, and lifestyle. Conclusion: This study is concordant with previous evidence of telomere shortening in BD, in both early and late stages of the disorder, and supports the notion of accelerated aging in BD.

  12. Exercise in the Early Stage after Stroke Enhances Hippocampal Brain-Derived Neurotrophic Factor Expression and Memory Function Recovery.

    Science.gov (United States)

    Himi, Naoyuki; Takahashi, Hisashi; Okabe, Naohiko; Nakamura, Emi; Shiromoto, Takashi; Narita, Kazuhiko; Koga, Tomoshige; Miyamoto, Osamu

    2016-12-01

    Exercise in the early stage after stroke onset has been shown to facilitate the recovery from physical dysfunction. However, the mechanism of recovery has not been clarified. In this study, the effect of exercise on spatial memory function recovery in the early stage was shown, and the mechanism of recovery was discussed using a rat model of brain embolism. Intra-arterial microsphere (MS) injection induced small emboli in the rat brain. Treadmill exercise was started at 24 hours (early group) or 8 days (late group) after MS injection. The non-exercise (NE) and sham-operated groups were included as controls. Memory function was evaluated by the Morris water maze test, and hippocampal levels of brain-derived neurotrophic factor (BDNF) were measured by enzyme-linked immunosorbent assays. To further investigate the effect of BDNF on memory function, BDNF was continuously infused into the hippocampus via implantable osmotic pumps in the early or late stage after stroke. Memory function significantly improved only in the early group compared with the late and the NE groups, although hippocampal BDNF concentrations were temporarily elevated after exercise in both the early and the late groups. Rats infused with BDNF in the early stage exhibited significant memory function recovery; however, rats that received BDNF infusion in the late stage showed no improvement. Exercise elevates hippocampal BDNF levels in the early stage after cerebral embolism, and this event facilitates memory function recovery. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Dissecting the active site of the collagenolytic cathepsin L3 protease of the invasive stage of Fasciola hepatica.

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    Ileana Corvo

    Full Text Available BACKGROUND: A family of secreted cathepsin L proteases with differential activities is essential for host colonization and survival in the parasitic flatworm Fasciola hepatica. While the blood feeding adult secretes predominantly FheCL1, an enzyme with a strong preference for Leu at the S2 pocket of the active site, the infective stage produces FheCL3, a unique enzyme with collagenolytic activity that favours Pro at P2. METHODOLOGY/PRINCIPAL FINDINGS: Using a novel unbiased multiplex substrate profiling and mass spectrometry methodology (MSP-MS, we compared the preferences of FheCL1 and FheCL3 along the complete active site cleft and confirm that while the S2 imposes the greatest influence on substrate selectivity, preferences can be indicated on other active site subsites. Notably, we discovered that the activity of FheCL1 and FheCL3 enzymes is very different, sharing only 50% of the cleavage sites, supporting the idea of functional specialization. We generated variants of FheCL1 and FheCL3 with S2 and S3 residues by mutagenesis and evaluated their substrate specificity using positional scanning synthetic combinatorial libraries (PS-SCL. Besides the rare P2 Pro preference, FheCL3 showed a distinctive specificity at the S3 pocket, accommodating preferentially the small Gly residue. Both P2 Pro and P3 Gly preferences were strongly reduced when Trp67 of FheCL3 was replaced by Leu, rendering the enzyme incapable of digesting collagen. In contrast, the inverse Leu67Trp substitution in FheCL1 only slightly reduced its Leu preference and improved Pro acceptance in P2, but greatly increased accommodation of Gly at S3. CONCLUSIONS/SIGNIFICANCE: These data reveal the significance of S2 and S3 interactions in substrate binding emphasizing the role for residue 67 in modulating both sites, providing a plausible explanation for the FheCL3 collagenolytic activity essential to host invasion. The unique specificity of FheCL3 could be exploited in the design of

  14. Investigation of early and advanced stages in ovarian cancer using human plasma by differential scanning calorimetry and mass spectrometry.

    Science.gov (United States)

    Kim, Nam Ah; Jin, Jing Hui; Kim, Kyung-Hee; Lim, Dae Gon; Cheong, Heesun; Kim, Yun Hwan; Ju, Woong; Kim, Seung Cheol; Jeong, Seong Hoon

    2016-05-01

    Ovarian cancer is recognized with high mortality due to asymptomatic nature of the disease and difficulties in diagnosing early stage of the cancer. The present study evaluates the use of differential scanning calorimetry (DSC) in differentiating the severity of ovarian cancer from healthy women. 47 diseased women were subdivided into four stages with respect to clinical relevance and severity. Stages I-II were regarded as early stages and stages III-IV were regarded as advanced stages. The two average transition temperatures (T m ) increased with disease severity from 64.84 and 70.32 °C (healthy) to 68.46 and 75.24 °C (stage IV), respectively. T m were increased depending on clinical groups. In addition, the change in heat capacity was also dependent on the disease severity. To further support and investigate the nature of the proposed interactions, matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis is employed. The results suggest the differences in peptide expression between early and advanced stage of ovarian cancer, affected abundant proteins in plasma. The combined DSC and MS approach was supportive in identifying a unique signature of ovarian cancer stages, and demonstrates the potential of DSC as a complementary diagnostic tool in the evaluation of early stage ovarian cancer.

  15. Organophosphorus pesticides effect on early stages of the axolotl Ambystoma mexicanum (Amphibia: Caudata).

    Science.gov (United States)

    Robles-Mendoza, C; García-Basilio, C; Cram-Heydrich, S; Hernández-Quiroz, M; Vanegas-Pérez, C

    2009-02-01

    Ambystoma mexicanum is an endemic salamander of Xochimilco, a wetland of the basin of Mexico valley. Nowadays, axolotl populations are decreasing due environmental stressors. Particularly, studies about organophosphorus pesticides (OPPs; i.e. chlorpyrifos and malathion) toxicity are of great importance due to their intensive use in agricultural activities in Xochimilco. Thus, the aim of this study was to evaluate under controlled conditions the toxicity of chlorpyrifos (CPF) and malathion (MLT) on embryos and larvae (stage 44 and 54) of A. mexicanum. Embryos and larvae were exposure 96h from 0.5 to 3mg CPFL(-1) and from 10 to 30mg MLTL(-1) in independent tests. Embryos at the end of this period were maintained 9d without pesticide in order to identify possible recuperation. Differences obtained in mortality, hatching success, development, morphological abnormalities, behaviour and activity, suggest that toxicity of CPF and MLT differs in embryos and larval stages. Embryos were less sensitive to OPPs acute exposure than axolotl larvae; additionally, toxicity of CPF in larval stages was greater than MLT. On the other hand, data obtained in axolotl embryos during the period of recuperation to CPF in particular as delay and inhibition of development, malformations and success of hatching, indicated that these responses turned out more sensitive than mortality. This study allowed to identify the toxicological potential of OPPs on early developmental stages of A. mexicanum and it is a valuable contribution for the future management of the axolotl wild population.

  16. Survival Implications Associated with Variation in Mastectomy Rates for Early-Staged Breast Cancer

    Science.gov (United States)

    Brooks, John M.; Chrischilles, Elizabeth A.; Landrum, Mary Beth; Wright, Kara B.; Fang, Gang; Winer, Eric P.; Keating, Nancy L.

    2012-01-01

    Despite a 20-year-old guideline from the National Institutes of Health (NIH) Consensus Development Conference recommending breast conserving surgery with radiation (BCSR) over mastectomy for woman with early-stage breast cancer (ESBC) because it preserves the breast, recent evidence shows mastectomy rates increasing and higher-staged ESBC patients are more likely to receive mastectomy. These observations suggest that some patients and their providers believe that mastectomy has advantages over BCSR and these advantages increase with stage. These beliefs may persist because the randomized controlled trials (RCTs) that served as the basis for the NIH guideline were populated mainly with lower-staged patients. Our objective is to assess the survival implications associated with mastectomy choice by patient alignment with the RCT populations. We used instrumental variable methods to estimate the relationship between surgery choice and survival for ESBC patients based on variation in local area surgery styles. We find results consistent with the RCTs for patients closely aligned to the RCT populations. However, for patients unlike those in the RCTs, our results suggest that higher mastectomy rates are associated with reduced survival. We are careful to interpret our estimates in terms of limitations of our estimation approach. PMID:22928097

  17. Trefoil Factor 1 Excretion Is Increased in Early Stages of Chronic Kidney Disease.

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    Diana Lebherz-Eichinger

    Full Text Available Chronic kidney disease (CKD is associated with high morbidity and mortality. In many patients CKD is diagnosed late during disease progression. Therefore, the implementation of potential biomarkers may facilitate the early identification of individuals at risk. Trefoil factor family (TFF peptides promote restitution processes of mucous epithelia and are abundant in the urinary tract. We therefore sought to investigate the TFF peptide levels in patients suffering from CKD and their potential as biomarkers for CKD. We analysed TFF1 and TFF3 in serum and urine of 115 patients with CKD stages 1-5 without dialysis by ELISA. 20 healthy volunteers served as controls. Our results showed, that urinary TFF1 levels were significantly increased with the onset of CKD in stages 1-4 as compared to controls and declined during disease progression (p = 0.003, 0.8. In conclusion our results show increased levels of TFF1 and TFF3 in CKD patients with a pronounced elevation of urinary TFF1 in lower CKD stages. Furthermore, TFF1 and TFF3 seems to be differently regulated and show potential to predict various CKD stages, as shown by ROC curve analysis.

  18. [Early Stages of Skull Embryogenesis in the Grass Snake, Natrix natrix (Serpentes, Colubridae)].

    Science.gov (United States)

    Kovtun, M F; Sheverdyukova, H V

    2015-01-01

    Studies of previous authors on snake skull embryogenesis have been performed on embryos obtained from eggs after oviposition. The aim of this study was to investigate the initial stages of chondrocranium development in Grass-snake Natrixnatrix Linnaeus, 1758, embryos before oviposition. Natrix natrix embryos at early developmental stages (24-27 according to the table of normal development by D. Zehr (1962)) were obtained by means of caesarean section. At developmental stages 25-27, previously undescribed structures were found in the region of future skull formation. These structures exist during one or two stages and then disappear. Therefore, we call them "temporary structures." The assumption about the nature of these structures is based on their topography and comparison with the structures of developing or fully formed chondrocranium in other vertebrates. It is hypothesized that the temporary structures in Natrix natrix chondrocranium are vestiges ofprimary chondrocranium of ancestral vertebrate forms, and they indicate the existence of several variants in the formation of chondrocranium in the historical vertebrates.' development.

  19. Stages in the early and larval development of the African catfish Clarias gariepinus (Teleostei, Clariidae).

    Science.gov (United States)

    Olaniyi, Wasiu Adekunle; Omitogun, Ofelia Galman

    2014-08-01

    The African catfish Clarias gariepinus Burchell 1822 is a favourite aquaculture fish in many parts of Africa and Asia because of its hardiness and fast growth rate. In this study, early, post-embryonic and larval developmental stages of C. gariepinus were examined chronologically and described. Photomicrographs of unfertilized matured oocytes from 0 min of fertilization through all cell stages to alevin, to complete yolk absorption, to free swimming larval stages are shown and documented live from lateral and top views, with the aid of a light microscope. Extruded oocytes had a mean diameter of 1 ± 0.1 mm, and possessed a thin perivitelline membrane whose space was filled with a protoplasmic layer. Heartbeat was in the range of 115-160/min prior to hatching. Hatchability rate was 85% and hatching occurred at 17 h at a controlled temperature of 28.5 ± 0.5°C, while ontogeny of the eyes and other organs were discernible. At day 4, larvae mean length was 9.3 ± 0.5 mm, exogenous feeding had commenced fully and melanophores spread cephalocaudally but were concentrated significantly on the head parts. This paper, for the first time, presents the significant chronological developmental stages of C. gariepinus embryology that will have significant implications for genetic manipulation and catfish seed production for aquaculture.

  20. Survival Implications Associated with Variation in Mastectomy Rates for Early-Staged Breast Cancer

    Directory of Open Access Journals (Sweden)

    John M. Brooks

    2012-01-01

    Full Text Available Despite a 20-year-old guideline from the National Institutes of Health (NIH Consensus Development Conference recommending breast conserving surgery with radiation (BCSR over mastectomy for woman with early-stage breast cancer (ESBC because it preserves the breast, recent evidence shows mastectomy rates increasing and higher-staged ESBC patients are more likely to receive mastectomy. These observations suggest that some patients and their providers believe that mastectomy has advantages over BCSR and these advantages increase with stage. These beliefs may persist because the randomized controlled trials (RCTs that served as the basis for the NIH guideline were populated mainly with lower-staged patients. Our objective is to assess the survival implications associated with mastectomy choice by patient alignment with the RCT populations. We used instrumental variable methods to estimate the relationship between surgery choice and survival for ESBC patients based on variation in local area surgery styles. We find results consistent with the RCTs for patients closely aligned to the RCT populations. However, for patients unlike those in the RCTs, our results suggest that higher mastectomy rates are associated with reduced survival. We are careful to interpret our estimates in terms of limitations of our estimation approach.

  1. Early stages in the biogenesis of eukaryotic β-barrel proteins.

    Science.gov (United States)

    Jores, Tobias; Rapaport, Doron

    2017-09-01

    The endosymbiotic organelles mitochondria and chloroplasts harbour, similarly to their prokaryotic progenitors, β-barrel proteins in their outer membrane. These proteins are encoded on nuclear DNA, translated on cytosolic ribosomes and imported into their target organelles by a dedicated machinery. Recent studies have provided insights into the import into the organelles and the membrane insertion of these proteins. Although the cytosolic stages of their biogenesis are less well defined, it is speculated that upon their synthesis, chaperones prevent β-barrel proteins from aggregation and keep them in an import-competent conformation. In this Review, we summarize the current knowledge about the biogenesis of β-barrel proteins, focusing on the early stages from the translation on cytosolic ribosomes to the recognition on the surface of the organelle. © 2017 Federation of European Biochemical Societies.

  2. [Ways to improve efficiency of patient clinical examinations during early stage of cholelithiasis].

    Science.gov (United States)

    Khokhlacheva, N A; Suchkova, E V; Vakhrushev, Ia M

    2013-01-01

    The aim of the work was to improve the organization and conduct of clinical examination of patients with gallstone disease (GSD). An integrated study of 396 patients with different pathologies of the hepatobiliary system and the medical check-up for three years for 101 patients. Built logistic model to predict the likelihood of developing gallstone disease and developed a predictive scoring table it possible to distinguish patients at risk of developing gall stones. The result of follow-up of the proposed method was prevented economic losses due to the lack of need for a cholecystectomy, which is made up of one patient 6766.22 rubles., The entire group of 1,004,966.63 rubles. Obtained to diagnose cholelithiasis at an early stage dokamennoy. Developed a screening questionnaire, predictive scoring table, the scheme of follow-up also improves clinical examination of patients with cholelithiasis dokamennoy stage.

  3. Low-Dose Consolidation Radiation Therapy for Early Stage Unfavorable Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Torok, Jordan A., E-mail: jordan.torok@dm.duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Wu, Yuan [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina (United States); Prosnitz, Leonard R.; Kim, Grace J. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Beaven, Anne W.; Diehl, Louis F. [Division of Hematologic Malignancy and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2015-05-01

    Purpose: The German Hodgkin Study Group (GHSG) trial HD11 established 4 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and 30 Gy of radiation therapy (RT) as a standard for early stage (I, II), unfavorable Hodgkin lymphoma (HL). Additional cycles of ABVD may allow for a reduction in RT dose and improved toxicity profile. Methods and Materials: Patients treated with combined modality therapy at the Duke Cancer Institute for early stage, unfavorable HL by GHSG criteria from 1994 to 2012 were included. Patients who did not undergo post-chemotherapy functional imaging (positron emission tomography or gallium imaging) or who failed to achieve a complete response were excluded. Clinical outcomes were estimated using the Kaplan-Meier method. Late effects were also evaluated. Results: A total of 90 patients met inclusion criteria for analysis. Median follow-up was 5 years. Chemotherapy consisted primarily of ABVD (88%) with a median number of 6 cycles. The median dose of consolidation RT was 23.4 Gy. Four patients had relapses, 2 of which were in-field. Ten-year progression-free survival (PFS) and overall survival (OS) were 93% (95% confidence interval [CI]: 0.82-0.97) and 98% (95% CI: 0.92-0.99), respectively. For the subset of patients (n=46) who received 5 to 6 cycles of chemotherapy and ≤24 Gy, the 10-year PFS and OS values were 88% (95% CI: 70%-96%) and 98% (95% CI: 85% - 99%), respectively. The most common late effect was hypothyroidism (20%) with no cardiac complications. Seven secondary malignancies were diagnosed, with only 1 arising within the RT field. Conclusions: Lower doses of RT may be sufficient when combined with more than 4 cycles of ABVD for early stage, unfavorable HL and may result in a more favorable toxicity profile than 4 cycles of ABVD and 30 Gy of RT.

  4. Adjuvant vaginal cuff brachytherapy for high-risk, early stage endometrial cancer

    Science.gov (United States)

    Eastwick, Gary; Anne, Pramila Rani; Rosenblum, Norman G.; Schilder, Russell J.; Chalian, Raffi; Zibelli, Allison M.; Kim, Christine H.; Den, Robert

    2014-01-01

    Purpose To report outcomes following adjuvant high-dose-rate vaginal brachytherapy (VBT) with or without chemotherapy for high-intermediate risk (HIR) and high-risk, early stage endometrial cancer as defined in Gynecologic Oncology Group trial 0249. Material and methods From May 2000 to January 2014, 68 women with HIR and high-risk endometrial cancer underwent surgical staging followed by VBT. Median VBT dose was 21 Gy delivered in three fractions prescribed to 0.5 cm depth. Paclitaxel 175 mg/m2 and carboplatin area under the curve 6 was administered every 21 days in sequence with VBT. Actuarial survival estimates were calculated using the Kaplan-Meier method. Results Patient demographics included a median age of 66 years (range: 36-91) and stages IA (49%), IB (38%), and II (13%), respectively. Thirty-one (46%) patients had HIR disease with endometrioid histology, and 33 (48%) patients had serous or clear cell histology. Thirty-seven (54%) patients received a median 3 cycles (range: 3-6) of chemotherapy in addition to VBT, and 65 patients (96%) completed all prescribed therapy. During a median follow up of 33.1 months (range: 4.0-161.7), four patients have recurred, including one vaginal recurrence. The 3-year estimates of vaginal, pelvic, and distant recurrences were 1.9%, 2.4%, and 9.1%, respectively. The 3-year rates of disease-free and overall survival were 87.7% and 93.9%, respectively. Conclusions Early outcomes with adjuvant VBT with or without chemotherapy demonstrate high rates of vaginal and pelvic control for women with HIR disease. Early vaginal and pelvic relapses in high-risk patients suggest that pelvic external beam radiotherapy is warranted in this subgroup, but additional data from large phase III trials is warranted. PMID:25337127

  5. Jasmonate signaling is activated in the very early stages of iron deficiency responses in rice roots.

    Science.gov (United States)

    Kobayashi, Takanori; Itai, Reiko Nakanishi; Senoura, Takeshi; Oikawa, Takaya; Ishimaru, Yasuhiro; Ueda, Minoru; Nakanishi, Hiromi; Nishizawa, Naoko K

    2016-07-01

    Under low iron availability, plants induce the expression of various genes involved in iron uptake and translocation at the transcriptional level. This iron deficiency response is affected by various plant hormones, but the roles of jasmonates in this response are not well-known. We investigated the involvement of jasmonates in rice iron deficiency responses. High rates of jasmonate-inducible genes were induced during the very early stages of iron deficiency treatment in rice roots. Many jasmonate-inducible genes were also negatively regulated by the ubiquitin ligases OsHRZ1 and OsHRZ2 and positively regulated by the transcription factor IDEF1. Ten out of 35 genes involved in jasmonate biosynthesis and signaling were rapidly induced at 3 h of iron deficiency treatment, and this induction preceded that of known iron deficiency-inducible genes involved in iron uptake and translocation. Twelve genes involved in jasmonate biosynthesis and signaling were also upregulated in HRZ-knockdown roots. Endogenous concentrations of jasmonic acid and jasmonoyl isoleucine tended to be rapidly increased in roots in response to iron deficiency treatment, whereas these concentrations were higher in HRZ-knockdown roots under iron-sufficient conditions. Analysis of the jasmonate-deficient cpm2 mutant revealed that jasmonates repress the expression of many iron deficiency-inducible genes involved in iron uptake and translocation under iron sufficiency, but this repression is partly canceled under an early stage of iron deficiency. These results indicate that jasmonate signaling is activated during the very early stages of iron deficiency, which is partly regulated by IDEF1 and OsHRZs.

  6. Toxicity of naproxen sodium and its mixture with tramadol hydrochloride on fish early life stages.

    Science.gov (United States)

    Sehonova, Pavla; Plhalova, Lucie; Blahova, Jana; Doubkova, Veronika; Prokes, Miroslav; Tichy, Frantisek; Fiorino, Emma; Faggio, Caterina; Svobodova, Zdenka

    2017-08-31

    Pharmaceuticals occur in water bodies as a consequence of their incomplete removal during waste water treatment processes. The occurence of pharmaceuticals in surface waters as well as their possible impact on aquatic vertebrates have received considerable attention in recent years. However, there is still a lack of informations on the chronic effects of widely used drugs as well as their possible mixture toxicity on non-target aquatic vertebrates as well as their possible mixture toxicity. The aim of this study was to assess the effects of naproxen sodium on early life stages of fish and evaluate its mixture toxicity with tramadol hydrochloride, which was assessed in our earlier study as a single substance. Two embryo-larval toxicity tests with common carp (Cyprinus carpio) were performed according to the OECD guideline 210 (Fish, Early-life Stage Toxicity Test) in order to assess the subchronic toxicity of naproxen sodium and tramadol hydrochlorid-naproxen sodium mixture at the concentrations of 10; 50; 100 and 200 μg/L. These experiments were conducted for 32 days. The subchronic exposure to naproxen sodium and naproxen sodium and tramadol hydrochloride mixture had a strong effect on the early life stages of common carp. Hatching, developmental rate, morphology, histopathology and, in the case of the naproxen sodium and tramadol hydrochloride mixture, mortality were influenced. The bioindicators of oxidative stress were also influenced. The LOEC was determined at 10 μg/L for both naproxen sodium and naproxen sodium and tramadol hydrochloride mixture. Copyright © 2017. Published by Elsevier Ltd.

  7. Elevated levels of circulating IL-7 and IL-15 in patients with early stage prostate cancer

    Directory of Open Access Journals (Sweden)

    Bachmann Alexander

    2011-09-01

    Full Text Available Abstract Background Chronic inflammation has been suggested to favour prostate cancer (PCA development. Interleukins (IL represent essential inflammation mediators. IL-2, IL-7, IL-15 and IL-21, sharing a common receptor γ chain (c-γ, control T lymphocyte homeostasis and proliferation and play major roles in regulating cancer-immune system interactions. We evaluated local IL-2, IL-7, IL-15 and IL-21 gene expression in prostate tissues from patients with early stage PCA or benign prostatic hyperplasia (BPH. As control, we used IL-6 gene, encoding an IL involved in PCA progression. IL-6, IL-7 and IL-15 titres were also measured in patients' sera. Methods Eighty patients with BPH and 79 with early (1 to 2c stage PCA were enrolled. Gene expression in prostate tissues was analyzed by quantitative real-time PCR (qRT-PCR. Serum IL concentrations and acute phase protein titres were evaluated by ELISA. Mann-Whitney, Wilcoxon and χ2 tests were used to compare IL gene expression and serum titers in the two groups of patients. Receiver operating characteristic (ROC curves were constructed to evaluate the possibility to distinguish sera from different groups of patients based on IL titers. Results IL-2 and IL-21 gene expression was comparably detectable, with low frequency and at low extents, in PCA and BPH tissues. In contrast, IL-6, IL-7 and IL-15 genes were expressed more frequently (p Conclusions Expression IL-7 and IL-15 genes in prostate tissues and corresponding serum titres are significantly increased in patients with early stage PCA as compared with patients with BPH.

  8. [Retrospective analysis for 104 cases of early-stage Hodgkin's Lymphoma treated with different modality therapies].

    Science.gov (United States)

    Du, Ting-Ting; Xiao, Xiu-Bin; Su, Hang; Da, Yong; Chen, Xin-Lin; Zhong, Kai-Li; Zhao, Shi-Hua; Lu, Yun; Wang, Shuang; Zhang, Wei-Jing

    2012-04-01

    This paper explored the curative effect of combined modality therapy and extended field radiotherapy for early-stage Hodgkin's Lymphoma. 104 cases of early-stage Hodgkin's Lymphoma from Jan 1987 to Dec 2010 in PLA Hospital 307 were retrospectively analyzed, including 76 cases in combined modality therapy group and 28 cases in extended field radiotherapy group, and the long-term efficacy and toxicity of two therapy modalities were evaluated. The results showed that the median survival time of 104 cases was 85.42 months, the complete remission rates of combined modality therapy and extended field radiotherapy groups were 72.4 and 71.4 respectively (P = 0.924); the overall response rates of combined modality therapy and extended field radiotherapy groups were 97.4 and 96.4 respectively (P = 0.779); the 5-year overall survival (OS) rates in the 2 groups were 89.5 and 89.1 respectively, and the 8-year OS rates of the 2 groups were 81.3 and 70.6. No statistical difference was found in above-mentioned 2 groups. Moreover, the 5-year progression free survival (PFS) rates of these 2 groups were 84.2 and 69.0 (P = 0.04), and 8-year PFS rates of these 2 groups were 80.0 and 55.5 (P = 0.04) respectively, the 5-year relapse rates of these 2 groups were 28.1 and 45.6 (P = 0.023) respectively. It is concluded that the combined modality therapy can raise the PFS rate and reduce the relapse rate as compared with extended field radiotherapy for early-stage Hodgkin's Lymphoma, but there is no difference in the overall survival rate between the 2 groups.

  9. Analysis of factors responsible for the image in early stage emphysema and research concerning the diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Hirotaka [Wakayama Medical Coll. (Japan)

    1998-11-01

    To clarify the utility of the CT image to a clinical diagnosis of the early stage emphysema, the relation of CT value to the level of the lung destruction, the change in the lung density and pulmonary function was examined. Experimental pulmonary emphysema model in canine was produced by inhalation of aerosolized papain solution. In this model, the relationship between the destruction in lung tissues and the analysis of CT images was investigated. Changes in the alveolar surface area per unit lung volume well reflected those in mean CT value in the lung parenchyma. Also, it was clarified that the degree of the lung destruction in this model corresponded to that in patients with the early stage emphysema. Mean CT value in the area that formed lowest 5th percentile of the CT value histogram (mCT (5%ile)) was developed to analyze CT images in emphysema. To develop this study, changes of the mCT (5%ile) at the respiratory level from 5% to 95% inspiratory vital capacity (mCT (5%ile (5-95%VC))) was examined. In experimental studies, there was statistical significance between control and emphysema model. In clinical study using 14 patients with emphysema, the mCT (5%ile (5-95%VC)) reflected well the values of pulmonary function tests which indicated air flow limitation such as %pred. FEV 1.0 and MMF. The present studies demonstrated that it might be useful to detect the pathological and functional impairment in the early stage emphysema by using mCT (5%ile (5-95%VC)). (author)

  10. Fertility-preserving treatment and pregnancy outcomes in the early stage of endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    TONG Xiao-mei; LIN Xiao-na; JIANG Hong-fei; JIANG Ling-ying; ZHANG Song-ying; LIANG Feng-bing

    2013-01-01

    Objective This study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility.Data sources The PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR"fertility preserving" AND "endometrial neoplasms" (MeSH).All relevant articles in English and the relevant references were collected.Study selection Data from published articles about fertility-preserving treatment of endometrial cancer,including the response and recurrence rate of conservative treatment,strategies of infertility treatment,pregnancy,and obstetric outcomes,were selected.Data were mainly extracted from 41 studies,which are listed in the reference section of this review.Results Hormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility.Sixty percent of the patients became pregnant after remission of the carcinoma.The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs.43.2%,P<0.01).A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group.The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer.The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%.Conclusions Assisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment.In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.

  11. Evaluation of the enhanced permeability and retention effect in the early stages of lymph node metastasis.

    Science.gov (United States)

    Mikada, Mamoru; Sukhbaatar, Ariunbuyan; Miura, Yoshinobu; Horie, Sachiko; Sakamoto, Maya; Mori, Shiro; Kodama, Tetsuya

    2017-02-17

    Most solid cancers spread to new sites via the lymphatics before hematogenous dissemination. However, only a small fraction of an intravenously administered anti-cancer drug enters the lymphatic system to reach metastatic lymph nodes (LNs). Here, we show that the enhanced permeability and retention (EPR) effect is not induced during the early stages of LN metastasis. Luciferase-expressing tumor cells were injected into the subiliac LN of the MXH10/Mo-lpr/lpr mouse to induce metastasis to the proper axillary LN (PALN). In vivo biofluorescence imaging was used to confirm metastasis induction and to quantify the EPR effect, measured as PALN accumulation of intravenously injected indocyanine green (ICG) liposomes. PALN blood vessel volume changes were measured by contrast-enhanced high-frequency ultrasound imaging. The volume and density of blood vessels in the PALN increased until day 29 after inoculation whereas the LN volume remained constant. ICG retention was first detected on day 29 post-inoculation. While CD31-positive cells increased up to day 29 post-inoculation, α-smooth muscle actin-positive cells were detected on day 29 post-inoculation for the first time. These results suggest that the EPR effect was not induced in the early stages of LN metastasis; therefore, systemic chemotherapy would likely not be beneficial during the early stages of LN metastasis. The development of an alternative drug delivery system, independent of the EPR effect, is required for the treatment of LN metastasis. This article is protected by copyright. All rights reserved.

  12. Echocardiography may help detect pulmonary vasculopathy in the early stages of pulmonary artery hypertension associated with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Serra Walter

    2010-07-01

    values (46 ± 8 mmHg, whereas right ventricular function was normal (TAPSE 23 ± 3 mm, and in line with the NYHA class. ACTpo was reduced in the patients with a systolic PAP of 0.001 and positively correlated with DLCO (p > 0.001 and the hemodynamic data. There was a good correlation between ACTpo and PVR (hemodynamic data (r = -0615; p > 0.01. Conclusions Although they need to be confirmed by studies of larger series of patients, our findings suggest that, in comparison with hemodynamic data, non-invasive echocardiographic measurements are an excellent means of identifying early-stage PAH.

  13. Overlapping DNA Methylation Dynamics in Mouse Intestinal Cell Differentiation and Early Stages of Malignant Progression

    Science.gov (United States)

    Forn, Marta; Díez-Villanueva, Anna; Merlos-Suárez, Anna; Muñoz, Mar; Lois, Sergi; Carriò, Elvira; Jordà, Mireia; Bigas, Anna; Batlle, Eduard; Peinado, Miguel A.

    2015-01-01

    Mouse models of intestinal crypt cell differentiation and tumorigenesis have been used to characterize the molecular mechanisms underlying both processes. DNA methylation is a key epigenetic mark and plays an important role in cell identity and differentiation programs and cancer. To get insights into the dynamics of cell differentiation and malignant transformation we have compared the DNA methylation profiles along the mouse small intestine crypt and early stages of tumorigenesis. Genome-scale analysis of DNA methylation together with microarray gene expression have been applied to compare intestinal crypt stem cells (EphB2high), differentiated cells (EphB2negative), ApcMin/+ adenomas and the corresponding non-tumor adjacent tissue, together with small and large intestine samples and the colon cancer cell line CT26. Compared with late stages, small intestine crypt differentiation and early stages of tumorigenesis display few and relatively small changes in DNA methylation. Hypermethylated loci are largely shared by the two processes and affect the proximities of promoter and enhancer regions, with enrichment in genes associated with the intestinal stem cell signature and the PRC2 complex. The hypermethylation is progressive, with minute levels in differentiated cells, as compared with intestinal stem cells, and reaching full methylation in advanced stages. Hypomethylation shows different signatures in differentiation and cancer and is already present in the non-tumor tissue adjacent to the adenomas in ApcMin/+ mice, but at lower levels than advanced cancers. This study provides a reference framework to decipher the mechanisms driving mouse intestinal tumorigenesis and also the human counterpart. PMID:25933092

  14. Evaluation of treatment outcomes of early-stage endometrial cancer radiotherapy: a single center experience.

    Science.gov (United States)

    Demiral, S; Beyzadeoglu, M; Sager, O; Dincoglan, F; Uysal, B; Gamsiz, H; Akin, M; Turker, T; Dirican, B

    2014-01-01

    Postoperative adjuvant radiotherapy (RT) in the management of early stage endometrial cancer (EC) is still controversial. Here we report our institutional experience with patients who received postoperative RT for stage I-II EC over a period of 35 years and assess potential predictors of local recurrence (LR), distant metastasis (DM), and overall survival (OS). A total of 188 patients undergoing postoperative RT for stage IA-II EC between 1977 and 2012 were evaluated. Some 96 received median 46 Gy whole pelvic radiotherapy (WPRT) (range: 40-60 Gy), 37 were given WPRT with vaginal cuff therapy (VCT), and 55 received only VCT either with brachytherapy (BT) or stereotactic body radiotherapy (SBRT). Chemotherapy was given to 5 patients with uterine papillary serous carcinoma (UPSC). Logistic regression analysis was used to assess the effect of clinicopathological factors on LR, DM, and OS. Median follow-up time was 11 years (range: 1-35 years). At the time of analysis, 34 patients were not alive. Of the 15 patients with LR, 7 (46.7%) recurred in the vaginal stump, 5 (33.3%) in the pelvic region, and 3 (20%) in the paraaortic nodal region, while 12 had distant metastasis. UPSC histology (p=0.027), sole VCT (p=0.041), high histologic grade (p=0.034), and age≥71 (p=0.04) were poor prognostic factors on univariate analysis. In our patients receiving radiotherapy for early-stage EC, grade III disease and age≥71 were associated with shorter OS whereas UPSC histology was an independent predictor for both LR and DM.

  15. Morphological and morphometric aspects of early life stages of piabanha Brycon gouldingi (Characidae).

    Science.gov (United States)

    Faustino, F; Makino, L C; Neumann, E; Nakaghi, L S O

    2015-05-01

    Adult specimens of piabanha Brycon gouldingi were collected from Rio das Mortes (Mato Grosso, Brazil), adapted to captivity and induced to spawn at Buriti Fisheries (Nova Mutum, MT, Brazil). The early developmental stages of B. gouldingi were then characterized. Samples were collected at pre-determined times from oocyte extrusion to total yolk absorption. Oocyte diameter, total larval length (LT ) and yolk-sac volume were measured. The mean ± s.d. duration of embryo developmental of B. gouldingi was 13·90 ± 0·06 h at 26·40 ± 1·13° C. The mean ± s.d. oocyte diameter was 1·13 ± 0·06 mm with 54% of oocytes ranging from 1·11 to 1·20 mm. Seven stages characterized the early developmental phase of this species: zygote, cleavage, morula, blastula, gastrula, histogenesis-organogenesis and hatching, with unique features related to each stage. At hatching, the larvae measured 3·40 ± 0·07 mm, presented an elongated shape with yolk-sac volume of 0·46 ± 0·08 µl, non-pigmented eyes and exhibited swimming ability. When the yolk was completely absorbed at 55 h post-hatch, mean ± larval LT was 6·68 ± 0·65 mm, the eyes were highly pigmented and the teeth were visible. These are the first reported findings on the initial developmental stages of B. gouldingi and could be used to improve captive breeding management and conservation practices. © 2015 The Fisheries Society of the British Isles.

  16. Effect of ocean acidification on early life stages of Atlantic herring (Clupea harengus L.

    Directory of Open Access Journals (Sweden)

    C. Clemmesen

    2011-12-01

    Full Text Available Due to atmospheric accumulation of anthropogenic CO2 the partial pressure of carbon dioxide (pCO2 in surface seawater increases and the pH decreases. This process known as ocean acidification might have severe effects on marine organisms and ecosystems. The present study addresses the effect of ocean acidification on early developmental stages, the most sensitive stages in life history, of the Atlantic herring (Clupea harengus L.. Eggs of the Atlantic herring were fertilized and incubated in artificially acidified seawater (pCO2 1260, 1859, 2626, 2903, 4635 μatm and a control treatment (pCO2 480 μatm until the main hatch of herring larvae occurred. The development of the embryos was monitored daily and newly hatched larvae were sampled to analyze their morphometrics, and their condition by measuring the RNA/DNA ratios. Elevated pCO2 neither affected the embryogenesis nor the hatch rate. Furthermore the results showed no linear relationship between pCO2 and total length, dry weight, yolk sac area and otolith area of the newly hatched larvae. For pCO2 and RNA/DNA ratio, however, a significant negative linear relationship was found. The RNA concentration at hatching was reduced at higher pCO2 levels, which could lead to a decreased protein biosynthesis. The results indicate that an increased pCO2 can affect the metabolism of herring embryos negatively. Accordingly, further somatic growth of the larvae could be reduced. This can have consequences for the larval fish, since smaller and slow growing individuals have a lower survival potential due to lower feeding success and increased predation mortality. The regulatory mechanisms necessary to compensate for effects of hypercapnia could therefore lead to lower larval survival. Since the recruitment of fish seems to be determined during the early life stages, future research on the factors influencing these stages are of great importance in fisheries science.

  17. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie

    2015-01-01

    . The overall incidence of complications was 15%, also with no significant difference between groups (p = 0.32). The most frequent complications were urinary tract infections (6%) and port site/wound infections (3%). A total of 21% of the women who had lymphadenectomy developed lymphoedema within 12 months....... CONCLUSION: The types and frequency of complications observed in this study resemble those reported in similar studies of RALH for malignant gynaecologic conditions. Health-care professionals treating and caring for women with early-stage endometrial cancer should know of the types and frequency of post...

  18. Method and simulation program informed decisions in the early stages of building design

    DEFF Research Database (Denmark)

    Petersen, Steffen; Svendsen, Svend

    2010-01-01

    for making informed decisions in the early stages of building design to fulfil performance requirements with regard to energy consumption and indoor environment. The method is operationalised in a program that utilises a simple simulation program to make performance predictions of user-defined parameter...... variations. The program then presents the output in a way that enables designers to make informed decisions. The method and the program reduce the need for design iterations, reducing time consumption and construction costs, to obtain the intended energy performance and indoor environment....

  19. Effects of Offshore Wind Farms on the Early Life Stages of Dicentrarchus labrax.

    Science.gov (United States)

    Debusschere, Elisabeth; De Coensel, Bert; Vandendriessche, Sofie; Botteldooren, Dick; Hostens, Kris; Vincx, Magda; Degraer, Steven

    2016-01-01

    Anthropogenically generated underwater noise in the marine environment is ubiquitous, comprising both intense impulse and continuous noise. The installation of offshore wind farms across the North Sea has triggered a range of ecological questions regarding the impact of anthropogenically produced underwater noise on marine wildlife. Our interest is on the impact on the "passive drifters," i.e., the early life stages of fish that form the basis of fish populations and are an important prey for pelagic predators. This study deals with the impact of pile driving and operational noise generated at offshore wind farms on Dicentrarchus labrax (sea bass) larvae.

  20. Non-linear Langevin model for the early-stage dynamics of electrospinning jets

    CERN Document Server

    Lauricella, Marco; Pisignano, Dario; Succi, Sauro

    2015-01-01

    We present a non-linear Langevin model to investigate the early-stage dynamics of electrified polymer jets in electrospinning experiments. In particular, we study the effects of air drag force on the uniaxial elongation of the charged jet, right after ejection from the nozzle. Numerical simulations show that the elongation of the jet filament close to the injection point is significantly affected by the non-linear drag exerted by the surrounding air. These result provide useful insights for the optimal design of current and future electrospinning experiments.

  1. Analysis Of Determinants Of EarlyStage Entrepreneurial Activity In Russia

    Directory of Open Access Journals (Sweden)

    Pawęta Elena

    2016-03-01

    Full Text Available Entrepreneurial activity is very important for the economic development of any country. The question often asked by researchers is: what causes growth in the level of entrepreneurial activity? In this paper we focused on the individual-level determinants of entrepreneurial activity − the attitudes and perceptions of entrepreneurship by individuals in the society. The objective of this research is to define how individual-level variables concerning opinions and beliefs in the society influence the early-stage entrepreneurship level in Russia.

  2. SSX2-4 expression in early-stage non-small cell lung cancer

    DEFF Research Database (Denmark)

    Greve, K B V; Pøhl, M; Olsen, K E

    2014-01-01

    The expression of cancer/testis antigens SSX2, SSX3, and SSX4 in non-small cell lung cancers (NSCLC) was examined, since they are considered promising targets for cancer immunotherapy due to their immunogenicity and testis-restricted normal tissue expression. We characterized three SSX antibodies...... was only detected in 5 of 143 early-stage NSCLCs, which is rare compared to other cancer/testis antigens (e.g. MAGE-A and GAGE). However, further studies are needed to determine whether SSX can be used as a prognostic or predictive biomarker in NSCLC....

  3. A case of painless thyroiditis in a very early stage of pregnancy.

    Science.gov (United States)

    Sato, Shiori; Endo, Kei; Iizaka, Toru; Saiki, Ryo; Iwaku, Kenji; Sato, Shotaro; Takahashi, Yasuyoshi; Otsuka, Fumiko; Taniyama, Matsuo

    2012-01-01

    We report a case of painless thyroiditis detected during the first trimester of pregnancy. A 29-year-old Japanese woman was hospitalized because of thyrotoxicosis and she was confirmed to be pregnant. The gestational age was 4 weeks. Blood examinations revealed negative TSH receptor antibodies, however, we started potassium iodide because we were unable to rule out Graves' disease. Thyroid hormone levels were normalized in 3 weeks and remained low even after discontinuation of medication. She received replacement therapy with levothyroxine sodium hydrate till 3 months after delivery. Painless thyroiditis can be one of the differential diagnoses of thyrotoxicosis in a very early stage of pregnancy.

  4. Study of early stages of Cu-NbC nanocomposite synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Marques, M.T. [INETI-DMTP, Estrada do Paco do Lumiar 22, 1649-038 Lisboa (Portugal)]. E-mail: tmarques@ineti.pt; Livramento, V. [INETI-DMTP, Estrada do Paco do Lumiar 22, 1649-038 Lisboa (Portugal); Correia, J.B. [INETI-DMTP, Estrada do Paco do Lumiar 22, 1649-038 Lisboa (Portugal); Almeida, A. [IST, Department of Materials Engineering, Av. Rovisco Pais, 1049-001 Lisboa (Portugal); Vilar, R. [IST, Department of Materials Engineering, Av. Rovisco Pais, 1049-001 Lisboa (Portugal)

    2007-05-31

    Cu-NbC nanocomposites with nominal compositions of 5, 10 and 20 vol.% of NbC were produced in situ via MA from elemental powders. The powders were milled for 1, 2, 4, 8, 16 and 32 h. The as-milled powders were characterised by X-ray diffraction (XRD) and scanning electron microscopy (SEM). X-ray diffraction results showed that the niobium carbide phase is formed in the early stages of milling and that the time necessary to complete the reaction ranges from 1 to about 8 h of milling.

  5. Microstructural evolution of 7012 alloy during the early stages of artificial ageing

    Energy Technology Data Exchange (ETDEWEB)

    Ferragut, R.; Somoza, A.; Tolley, A.

    1999-11-26

    A study of the microstructural evolution of a commercial 7012 (Al-Zn-Mg-Cu) age-hardenable alloy following artificial ageing by high resolution and conventional transmission electron microscopy and positron annihilation lifetime spectroscopy is presented. At the early stages of decomposition, the microstructure included precipitation of either pre-precipitate solute clusters or Guinier-Preston zones and semi-coherent {eta}{prime} precipitates, wit