Prognostic factors for patients with early-stage uterine serous carcinoma without adjuvant therapy.

Science.gov (United States)

Tate, Keisei; Yoshida, Hiroshi; Ishikawa, Mitsuya; Uehara, Takashi; Ikeda, Shun Ichi; Hiraoka, Nobuyoshi; Kato, Tomoyasu

2018-05-01

Uterine serous carcinoma (USC) is an aggressive type 2 endometrial cancer. Data on prognostic factors for patients with early-stage USC without adjuvant therapy are limited. This study aims to assess the baseline recurrence risk of early-stage USC patients without adjuvant treatment and to identify prognostic factors and patients who need adjuvant therapy. Sixty-eight patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-II USC between 1997 and 2016 were included. All the cases did not undergo adjuvant treatment as institutional practice. Clinicopathological features, recurrence patterns, and survival outcomes were analyzed to determine prognostic factors. FIGO stages IA, IB, and II were observed in 42, 7, and 19 cases, respectively. Median follow-up time was 60 months. Five-year disease-free survival (DFS) and overall survival (OS) rates for all cases were 73.9% and 78.0%, respectively. On multivariate analysis, cervical stromal involvement and positive pelvic cytology were significant predictors of DFS and OS, and ≥1/2 myometrial invasion was also a significant predictor of OS. Of 68 patients, 38 patients had no cervical stromal invasion or positive pelvic cytology and showed 88.8% 5-year DFS and 93.6% 5-year OS. Cervical stromal invasion and positive pelvic cytology are prognostic factors for stage I-II USC. Patients with stage IA or IB USC showing negative pelvic cytology may have an extremely favorable prognosis and need not receive any adjuvant therapies. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

High-risk clinical target volume delineation in CT-guided cervical cancer brachytherapy - Impact of information from FIGO stage with or without systematic inclusion of 3D documentation of clinical gynecological examination

Energy Technology Data Exchange (ETDEWEB)

Hegazy, Neamat [Dept. of Radiotherapy, Comprehensive Cancer Centre Vienna, Medical Univ. of Vienna, Vienna (Austria); Dept. of Clinical Oncology, Medical Univ. of Alexandria, Alexandria (Egypt); Poetter Rickard; Kirisits, Christian [Dept. of Radiotherapy, Comprehensive Cancer Centre Vienna, Medical Univ. of Vienna, Vienna (Austria); Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology, Medical Univ. Vienna (Austria); Berger, Daniel; Federico, Mario; Sturdza, Alina; Nesvacil, Nicole [Dept. of Radiotherapy, Comprehensive Cancer Centre Vienna, Medical Univ. of Vienna, Vienna (Austria)], e-mail: nicole.nesvacil@meduniwien.ac.at

2013-10-15

Purpose: The aim of the study was to improve computed tomography (CT)-based high-risk clinical target volume (HR CTV) delineation protocols for cervix cancer patients, in settings without any access to magnetic resonance imaging (MRI) at the time of brachytherapy. Therefore the value of a systematic integration of comprehensive three-dimensional (3D) documentation of repetitive gynecological examination for CT-based HR CTV delineation protocols, in addition to information from FIGO staging, was investigated. In addition to a comparison between reference MRI contours and two different CT-based contouring methods (using complementary information from FIGO staging with or without additional 3D clinical drawings), the use of standardized uterine heights was also investigated. Material and methods: Thirty-five cervix cancer patients with CT- and MR-images and 3D clinical drawings at time of diagnosis and brachytherapy were included. HR CTV{sub stage} was based on CT information and FIGO stage. HR CTV{sub stage} {sub +3Dclin} was contoured on CT using FIGO stage and 3D clinical drawing. Standardized HR CTV heights were: 1/1, 2/3 and 1/2 of uterine height. MRI-based HR CTV was delineated independently. Resulting widths, thicknesses, heights, and volumes of HR CTV{sub stage}, HR CTV{sub stage+3Dclin} and MRI-based HR CTV contours were compared. Results: The overall normalized volume ratios (mean{+-}SD of CT/MRI{sub ref} volume) of HR CTV{sub stage} and HR{sub stage+3Dclin} were 2.6 ({+-}0.6) and 2.1 ({+-}0.4) for 1/1 and 2.3 ({+-}0.5) and 1.8 ({+-}0.4), for 2/3, and 1.9 ({+-}0.5) and 1.5 ({+-}0.3), for 1/2 of uterine height. The mean normalized widths were 1.5{+-}0.2 and 1.2{+-}0.2 for HR CTV{sub stage} and HR CTV{sub stage+3Dclin}, respectively (p < 0.05). The mean normalized heights for HR CTV{sub stage} and HR CTV{sub stage+3Dclin} were both 1.7{+-}0.4 for 1/1 (p < 0.05.), 1.3{+-}0.3 for 2/3 (p < 0.05) and 1.1{+-}0.3 for 1/2 of uterine height. Conclusion: CT-based HR

Postoperative high dose rate vaginal apex brachytherapy in stage I endometrial adenocarcinoma

International Nuclear Information System (INIS)

Turner, B.; Knisely, J.; Kacinski, B.; Roberts, K.; Peschel, R.; Gumbs, A.; Rutherford, T.; Edraki, B.; Schwartz, P.; Chambers, J.; Kohorn, E.; Wilson, L.

1996-01-01

Introduction: Patients with stage I endometrial adenocarcinoma have traditionally been treated with TAH/BSO and radiation. The reported incidence of local recurrence in surgically treated patients with Figo stage IA or IB endometrial adenocarcinoma is 4-10% at 2 years. Combined surgery and radiation has resulted in a reduction of recurrence to 2-6%. We report the presentation, local and distant control, salvage rate, survival and complications for patients undergoing high dose rate (HDR) vaginal apex brachytherapy following surgery. Methods: Between 1985 and 1994 a total of 302 patients with Figo stage I endometrial carcinoma were treated with HDR Ir-192 vaginal apex brachytherapy to a total dose of 21 Gy in 3 fractions at 0.5 cm from the vaginal mucosa. The pathologic stage by treatment group was IA: 31%, IB: 68%, and IC: 1%. The histologic grade of the patient's tumors was grade 1: 69%, 2: 27%, and 3: 4%. The median time from surgery to radiation was 33 days (range 14-66 days). The median follow-up for 300 patients with stage IA (91 patients), IB (205 patients), and IC (4 patients) was respectively 36, 34 and 40 months (2 patients lost to follow-up prior to 6 months). Results: Patients presented with vaginal bleeding (94%) or abnormal pap smear (6%) at a median age for stage IA and IB, of 55 and 64 years, respectively. The crude overall survival of the patient population at 2 years is 95%. Median overall time to failure is 19.5 months (range 10-36 months). The overall failure rate was 2.7% (8 patients), local failure only 1.0% (38% of failed group), distant failure only 0.3% (12% of failed group) and combined local/distant failure 1.3% (50% of failed group). The local failure rate for pathologic stage IA patients was 1.0% and no distant disease was observed. The local failure rate for pathologic stage IB patients was 3.4% 7/205 and distant failure was 2.4% 5/205. The majority of patients with recurrence had grade 2 histologic changes 5/8. The overall salvage rate

Lymphangiogenesis in cervical cancer evaluated by expression of the VEGF-C gene in clinical stage IB-IIIB

Directory of Open Access Journals (Sweden)

Magdalena Franc

2015-02-01

Full Text Available Introduction : The aim of the present study was to evaluate the profile of VEGF-C gene expression in particular stages of cervical cancer (IB-IIIB and to estimate the correlation between VEGF-C mRNA quantity profile and clinical stage. Material and methods : Material for molecular analysis consisted of cervical cancer tissue specimens collected from 38 women (10, 15, 13 cases were classified as IB, IIB and IIIB, respectively. The control group was composed of normal cervical tissues collected from 10 women who underwent hysterectomy for non-oncological reasons. The number of VEGF-C mRNA copies in particular groups was estimated by the reverse transcription quantitative polymerase chain reaction (RT-qPCR method. Results: In the control group the average number of mRNA copies was 134 ± 36 (median: 106, in a group with stage IB it was 16 077 ± 7090 (median: 580, for stage IIB – 35 019 ± 8945 (median: 40 870. The highest number of mRNA VEGF-C copies was derived in a group of patients with cervical cancer of stage IIIB. The average quantity was 56 155 ± 12 470, whereas median 55 981. A statistically significantly higher level of VEGF-C gene expression was disclosed in cervical cancer specimens with stage IIB and IIIB than in the control group. In stage IIIB, the VEGF-C gene expression was significantly higher than in specimens derived from individuals in stage IB. Conclusions : In squamous cell carcinoma of the uterine cervix of stage IB-IIIB genes involved in lymphangio­genesis, especially VEGF-C , are expressed, which expression increases as the clinical stage of cervical cancer is higher.

Optimization of the extent of surgical treatment in patients with stage I in cervical cancer

Energy Technology Data Exchange (ETDEWEB)

Chernyshova, A. L.; Lyapunov, A. Yu., E-mail: Lyapunov1720.90@mail.ru [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Kolomiets, L. A. [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Siberian State Medical University, Moskovsky Trakt 2, Tomsk, 634050 (Russian Federation); Sinilkin, I. G.; Chernov, V. I. [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation)

2016-08-02

The study included 26 patients with FIGO stage Ia1–Ib1 cervical cancer who underwent fertility-sparing surgery (transabdominaltrachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of 99mTc-labelled nanocolloid was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using hand-held gamma probe was carried out to determine the radioactive counts over the draining lymph node basin. The sentinel lymph node detection in cervical cancer patients contributes to the accurate clinical assessment of the pelvic lymph node status, precise staging of the disease and tailoring of surgical treatment to individual patient.

Perioperative and postoperative complications of intracavitary radiation for FIGO stage I-III carcinoma of the cervix

International Nuclear Information System (INIS)

Jhingran, Anuja; Eifel, Patricia J.

2000-01-01

Purpose: To evaluate perioperative and postoperative complications of low-dose-rate (LDR) intracavitary radiation therapy in patients with FIGO Stage I-III carcinoma of the uterine cervix. Methods and Materials: We retrospectively reviewed the medical and radiotherapy records of all patients treated with radiation between 1960 and 1992 at The University of Texas M. D. Anderson Cancer Center for FIGO I-III carcinomas of the cervix. Patients who had had initial hysterectomy or whose treatment did not include intracavitary irradiation were excluded. The final study included 4043 patients who had undergone 7662 intracavitary procedures. Results: Eleven (0.3%) patients had documented or suspected cases of thromboembolism resulting in 4 deaths. Of these 11 patients, 8 had clinical or radiographic evidence of tumor involving pelvic nodes or fixed pelvic wall. The risk of postoperative thromboembolism did not decrease significantly with the routine use of mini-dose heparin prophylaxis (p = 0.3). Other life-threatening perioperative complications included myocardial infarction (1 death in 5 patients), cerebrovascular accident (2 patients), congestive heart failure or atrial fibrillation (3 patients), and halothane liver toxicity (2 deaths in 2 patients). Intraoperative complications included uterine perforation (2.8%) and vaginal laceration (0.3%), which occurred more frequently in patients ≥ 60 years old (p < 0.01). Fourteen percent of patients had a temperature ≥ 101 deg. F during at least one hospital stay. The only correlation between minor intraoperative complications and disease-specific survival was found in patients who had Stage III disease and uterine perforation; survival was significantly (p = 0.01) decreased in these patients. Conclusions: Fatal or life-threatening complications of intracavitary treatment were very rare. Deep venous thrombosis (DVT) and pulmonary embolism (PE) did not occur in otherwise healthy patients with early disease and were rare even

Effectiveness of postoperative radiation therapy in stage IB cervical cancer with residual disease

International Nuclear Information System (INIS)

Herman, J.; Perez-Tamayo, C.; Komaki, R.U.; Terada, K.; Roberts, J.A.; Morley, G.W.; Greenberg, M.; Mattingly, R.; Hopkins, M.

1987-01-01

Twenty-one patients with stage IB cervical cancer were treated with radical hysterectomy, pelvic lymph node dissection, and pelvic radiation therapy to approximately 5,090 rad. Patients were divided into two groups: group I, nine patients with involved parametria or positive margins at surgery; group II, 12 patients with metastatic pelvic lymph nodes. Patients in group I had an actuarial survival of 40% at 5 years and 20% at 10 years; patients in group II had an actuarial survival of 67% at 5 and 10 years (.01 < P < .05). The overall actuarial survival was 55% at 5 years and 43% at 10 years. Thus, patients with stage IB disease and involved parametrium or surgical margins do poorly. Alternative forms of therapy should be considered when this disease picture is clinically suspected preoperatively

Adjuvant Chemotherapy Improves the Probability of Freedom From Recurrence in Patients With Resected Stage IB Lung Adenocarcinoma.

Science.gov (United States)

Hung, Jung-Jyh; Wu, Yu-Chung; Chou, Teh-Ying; Jeng, Wen-Juei; Yeh, Yi-Chen; Hsu, Wen-Hu

2016-04-01

The benefit of adjuvant chemotherapy remains controversial for patients with stage IB non-small-cell lung cancer (NSCLC). This study investigated the effect of adjuvant chemotherapy and the predictors of benefit from adjuvant chemotherapy in patients with stage IB lung adenocarcinoma. A total of 243 patients with completely resected pathologic stage IB lung adenocarcinoma were included in the study. Predictors of the benefits of improved overall survival (OS) or probability of freedom from recurrence (FFR) from platinum-based adjuvant chemotherapy in patients with resected stage IB lung adenocarcinoma were investigated. Among the 243 patients, 70 (28.8%) had received platinum-based doublet adjuvant chemotherapy. A micropapillary/solid-predominant pattern (versus an acinar/papillary-predominant pattern) was a significantly worse prognostic factor for probability of FFR (p = 0.033). Although adjuvant chemotherapy (versus surgical intervention alone) was not a significant prognostic factor for OS (p = 0.303), it was a significant prognostic factor for a better probability of FFR (p = 0.029) on multivariate analysis. In propensity-score-matched pairs, there was no significant difference in OS between patients who received adjuvant chemotherapy and those who did not (p = 0.386). Patients who received adjuvant chemotherapy had a significantly better probability of FFR than those who did not (p = 0.043). For patients with a predominantly micropapillary/solid pattern, adjuvant chemotherapy (p = 0.033) was a significant prognostic factor for a better probability of FFR on multivariate analysis. Adjuvant chemotherapy is a favorable prognostic factor for the probability of FFR in patients with stage IB lung adenocarcinoma, particularly in those with a micropapillary/solid-predominant pattern. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Intensity-modulated whole abdomen irradiation following adjuvant carboplatin/taxane chemotherapy for FIGO stage III ovarian cancer. Four-year outcomes

International Nuclear Information System (INIS)

Rochet, Nathalie; Lindel, Katja; Katayama, Sonja; Schubert, Kai; Herfarth, Klaus; Harms, Wolfgang; Debus, Juergen; Schneeweiss, Andreas; Sohn, Christoph

2015-01-01

A prospective study to assess toxicity and survival outcomes after intensity-modulated whole-abdominal irradiation (IM-WAI) following surgery and adjuvant intravenous carboplatin/taxane chemotherapy in advanced FIGO stage III ovarian cancer. Between 2006 and 2009, 16 patients with optimally resected FIGO stage III ovarian cancer, who had received six cycles of adjuvant carboplatin/taxane chemotherapy were treated with consolidation IM-WAI. Radiotherapy was delivered to a total dose of 30 Gy in 1.5-Gy fractions, using step-and-shoot (n = 3) or helical tomotherapy (n = 13). The first 10 patients were treated within a phase I trial; the following patients received the same treatment modality. The target volume included the entire peritoneal cavity, the diaphragm, the liver capsule, and the pelvic and para-aortic node regions. Organs at risk were kidneys, liver, heart, and bone marrow. Median follow-up was 44 months (range 19.2-67.2 months). No grade 4 toxicities occurred during IM-WAI. Common Toxicity Criteria for Adverse Events (CTCAE) grade 3 toxicities were: diarrhea (25 %), leucopenia (19 %), nausea/vomiting (6 %), and thrombocytopenia (6 %). No toxicity-related treatment break was necessary. Small bowel obstruction occurred in a total of 6 patients: in 3 cases (19 %) due to postsurgical adhesions and in 3 cases due to local tumor recurrence (19 %). Median recurrence-free survival (RFS) was 27.6 months (95 % confidence interval, CI = 24-44 months) and median overall survival (OS) was 42.1 months (95 %CI = 17-68 months). The peritoneal cavity was the most frequent site of initial failure. Consolidation IM-WAI following surgery and adjuvant chemotherapy is feasible and can be performed with manageable acute and late toxicity. The favorable RFS outcome is promising and justifies further clinical trials. (orig.) [de

Poor Prognostic Factors in Patients with Malignant Pleural Mesothelioma Classified as Pathological Stage IB According to the Eighth Edition TNM Classification.

Science.gov (United States)

Takuwa, Teruhisa; Hashimoto, Masaki; Kuroda, Ayumi; Nakamura, Akifumi; Nakamichi, Toru; Fukuda, Akihiro; Matsumoto, Seiji; Kondo, Nobuyuki; Hasegawa, Seiki

2018-04-03

The change in TNM classification of malignant pleural mesothelioma (MPM) between the seventh and eighth edition classifications has resulted in the downstaging of many advanced-stage patients into pathological stage IB. Many mesotheliomas without lymph node metastasis have been classified as stage IB in the eighth edition classification. Stage IB mesotheliomas comprised a heterogeneous group with different prognosis. It is necessary to clarify the prognostic factors in this group. Between September 2009 and August 2016, a total of 89 patients with MPM underwent curative intent surgery [pleurectomy decortication n = 57 (64.1%), extrapleural pneumonectomy n = 32 (35.9%)] at our institution. Of these, 40 were reclassified as stage IB according to the eighth edition TNM classification. Independent unfavorable prognostic factors were identified by univariate analyses using the log-rank test and Cox proportional hazards regression models. Three independent significant factors were identified that indicated an unfavorable prognosis: a nonepithelioid subtype, lymphovascular invasion, and preoperative forced expiratory volume in 1 s (FEV1) < 2000 ml. Patients with no, one, and two of these risk factors showed 3-year overall survival probabilities of 94.7, 62.5, and 0%, respectively. The 3-year survival of patients with one factor did not differ significantly from that of patients with stage III MPM, whereas that of patients with two factors was significantly shorter (p = 0.015). Independent poor prognostic factors for patients with stage IB MPM patients, allowing subgroups with poorer and more favorable prognoses to be identified. This should help personalize decisions on adjuvant chemotherapy.

Intensity-modulated whole abdomen irradiation following adjuvant carboplatin/taxane chemotherapy for FIGO stage III ovarian cancer. Four-year outcomes

Energy Technology Data Exchange (ETDEWEB)

Rochet, Nathalie; Lindel, Katja; Katayama, Sonja; Schubert, Kai; Herfarth, Klaus; Harms, Wolfgang; Debus, Juergen [Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg (Germany); University of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Schneeweiss, Andreas [University of Heidelberg, Nationales Centrum fuer Tumorerkrankungen (NCT), Heidelberg (Germany); Sohn, Christoph [University of Heidelberg, Department of Gynecology, Heidelberg (Germany)

2015-07-15

A prospective study to assess toxicity and survival outcomes after intensity-modulated whole-abdominal irradiation (IM-WAI) following surgery and adjuvant intravenous carboplatin/taxane chemotherapy in advanced FIGO stage III ovarian cancer. Between 2006 and 2009, 16 patients with optimally resected FIGO stage III ovarian cancer, who had received six cycles of adjuvant carboplatin/taxane chemotherapy were treated with consolidation IM-WAI. Radiotherapy was delivered to a total dose of 30 Gy in 1.5-Gy fractions, using step-and-shoot (n = 3) or helical tomotherapy (n = 13). The first 10 patients were treated within a phase I trial; the following patients received the same treatment modality. The target volume included the entire peritoneal cavity, the diaphragm, the liver capsule, and the pelvic and para-aortic node regions. Organs at risk were kidneys, liver, heart, and bone marrow. Median follow-up was 44 months (range 19.2-67.2 months). No grade 4 toxicities occurred during IM-WAI. Common Toxicity Criteria for Adverse Events (CTCAE) grade 3 toxicities were: diarrhea (25 %), leucopenia (19 %), nausea/vomiting (6 %), and thrombocytopenia (6 %). No toxicity-related treatment break was necessary. Small bowel obstruction occurred in a total of 6 patients: in 3 cases (19 %) due to postsurgical adhesions and in 3 cases due to local tumor recurrence (19 %). Median recurrence-free survival (RFS) was 27.6 months (95 % confidence interval, CI = 24-44 months) and median overall survival (OS) was 42.1 months (95 %CI = 17-68 months). The peritoneal cavity was the most frequent site of initial failure. Consolidation IM-WAI following surgery and adjuvant chemotherapy is feasible and can be performed with manageable acute and late toxicity. The favorable RFS outcome is promising and justifies further clinical trials. (orig.) [German] Es wurden Akut- und Langzeittoxizitaet sowie Ueberlebensdaten der konsolidierenden intensitaetsmodulierten Ganzabdomenbestrahlung (&apos

A volumetric analysis of GTVD and CTVHR as defined by the GEC ESTRO recommendations in FIGO stage IIB and IIIB cervical cancer patients treated with IGABT in a prospective multicentric trial (EMBRACE)

DEFF Research Database (Denmark)

Jastaniyah, Noha; Yoshida, Kenji; Tanderup, Kari

2016-01-01

PURPOSE: To quantify the gross tumor volume at diagnosis (GTVD) and high-risk clinical target volume (CTVHR) at brachytherapy (BT) and describe subgroups of patients with different patterns of response to chemoradiotherapy (CRT) in patients with FIGO stage IIB and IIIB cervical cancer treated wit...

Restaging and Survival Analysis of 4036 Ovarian Cancer Patients According to the 2013 FIGO Classification for Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

DEFF Research Database (Denmark)

Rosendahl, Mikkel; Høgdall, Claus Kim; Mosgaard, Berit Jul

2016-01-01

OBJECTIVE: With the 2013 International Federation of Gynecology and Obstetrics (FIGO) staging for ovarian, fallopian tube, and primary peritoneal cancer, the number of substages changed from 10 to 14. Any classification of a malignancy should easily assign patients to prognostic groups, refer....... MATERIALS AND METHODS: Demographic, surgical, histological, and survival data from 4036 ovarian cancer patients were used in the analysis. Five-year survival rates (5YSR) and hazard ratios for the old and revised FIGO staging were calculated using Kaplan-Meier curves and Cox regression. RESULTS: A total...

FIGO Stage IIIB squamous cell carcinoma of the uterine cervix: natural history, treatment results, and prognostic factors

International Nuclear Information System (INIS)

Eifel, Patricia J.; Logsdon, Mark D.

1996-01-01

Purpose: To define patient, tumor, and treatment factors that influence the outcome of patients with FIGO Stage IIIB squamous cell carcinoma of the intact uterine cervix. Materials and Methods: The hospital and radiotherapy records of 1007 consecutive patients treated between 1960 and 1989 for FIGO Stage IIIB squamous cell carcinoma of the intact uterine cervix were reviewed retrospectively. All patients were treated with radiation therapy (RT) either with curative intent (903 patients) or to palliate symptoms (104 patients). Patients who were selected for palliative treatment usually had a combination of adverse characteristics including massive tumor with bilateral pelvic wall fixation, hydronephrosis, bulky adenopathy, pathologic evidence of extrapelvic disease, and poor performance status. 64 (7%) of 903 patients failed to complete planned curative RT either because of progressive disease, complications, or poor compliance. Of 903 patients treated with curative intent, 319 (35%) were treated with external beam radiotherapy (EBRT) alone and 586 (65%) were treated with a combination of EBRT and intracavitary irradiation (ICRT). EBRT was usually delivered using 18-25 MV photons and ICRT was administered with Fletcher-Suit-Delclos applicators. Treatment philosophies evolved during the study period with greater emphasis placed on EBRT between 1966 and 1979 (52% treated with EBRT alone) compared with the other study years (15% treated with EBRT alone). 206 patients received investigational treatments including neutrons (69 pts), hyperbaric oxygen (66 pts), concurrent chemotherapy (29 pts), or neoadjuvant chemotherapy (42 pts). 875 patients have been followed until death. Median follow up for surviving patients is 171 months with only 9 surviving patients followed for 10%, or hgb < 10 gm% before treatment or at any time during radiotherapy. DSS was significantly better for patients whose treatment included ICRT (43% vs 21%; P< 0.0001). Also, patients who received

Post-Infectious IBS (IBS-PI)

Science.gov (United States)

... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ...

Para-aortic lymphadenectomy in advanced stage cervical cancer, a protocol for comparing safety, feasibility and diagnostic accuracy of surgical staging versus PET-CT; PALDISC trial.

Science.gov (United States)

Tax, Casper; Abbink, Karin; Rovers, Maroeska M; Bekkers, Ruud L M; Zusterzeel, Petra L M

2018-01-01

Currently, a PET-CT is used to assess the need for extended field radiotherapy of para-aortic lymph nodes (PALN) in International Federation of Gynaecology and Obstetrics (FIGO) stage IB2, IIA2-IVA (locally advanced stage) cervical cancer. A small study established a sensitivity and specificity estimate for PALN metastases of 50% (95% CI; 7-93%) and 83% (95% CI; 52-98%), respectively. Surgical staging of PALN may lead to a higher diagnostic accuracy. However, surgical staging of para-aortic lymph nodes in locally advanced stage cervical cancer is not common practice. Therefore, a phase 2 randomised controlled trial is needed to assess its safety and feasibility. In addition to standard imaging (MRI or CT scan) with PET-CT, 30 adult women with FIGO stage IB2, IIA2-IVA cervical cancer will be randomised to receive either surgical staging or usual PET-CT staging. Administering extended field radiotherapy will be based on lymphadenectomy results for the intervention group and on the PET-CT results for the control group. Follow-up visits at 0, 3, 6, 9 and 12 months will assess health-related quality of life and progression-free survival.Primary safety and feasibility outcomes of surgical staging will be assessed by calculating means with 95% confidence intervals for duration of surgery, number of complications, blood loss, nodal yield after para-aortic lymphadenectomy and treatment delay due to surgical staging. Secondary patient-centred outcomes on quality of life and first year survival will be documented and compared between the two groups. Estimates of sensitivity, specificity and negative and positive predictive values of MRI, PET-CT and surgical staging will be presented with 95% CI.. All analysis will be performed according to the intention to treat principle. This study will assess safety and feasibility, expressed as the number and severity of complications, effect on quality of life and the treatment delay due to surgically staging para-aortic lymph nodes in

Adjuvant postoperative radiation therapy following simple hysterectomy and radical hysterectomy in stage IB cancer of the cervix: Analysis of risk factors and patterns of failure

International Nuclear Information System (INIS)

Kim, R.Y.; Weppelmann, B.; Sanford, S.P.; Salter, M.M.; Brascho, D.J.

1986-01-01

Between 1969 and 1980, 242 cases of stage IB cancer of the cervix were referred to the department of radiation oncology for curative radiation therapy. In 186 cases treatment was with radiation therapy alone. In 56 cases treatment included adjuvant postoperative radiation therapy; a minimum follow-up of 5 years has been carried out in this group. In 17 cases radiation therapy followed a simple hysterectomy for an unexpected stage IB cancer of the cervix. In 39 cases radiation therapy was given after a radical hysterectomy for stage IB cancer of the cervix because of positive margins and/or positive pelvic lymph nodes

Staging for vulvar cancer.

Science.gov (United States)

Hacker, Neville F; Barlow, Ellen L

2015-08-01

Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Studies on evaluation of staging of cancer of the uterine cervix by means of CT

Energy Technology Data Exchange (ETDEWEB)

Kakizaki, D

1987-03-01

The present study was undertaken to evaluate the stage classification (FIGO) by using CT in 50 cases with cancer of the uterine cervix in which the final stage had been diagnosed. An accurate diagnosis was obtained in 6 of 14 Ib cases, 14 of 21 IIa cases, 5 of 6 IIb cases, 2 of 3 IIIa cases, 3 of 3 IIIb cases and 3 of 3 IVa cases, for a total of 33 of 50 (66 %). The diagnostic rate for Ib and IIa staging was 57 %, while that for IIb or more was 87 %, but the accuracy rate in IIIb and IVa was 100 %. As the equipment, a high resolutional GE 9800 CT using a special technique was employed. Employing special pretreatment for the patient, it became possible to accurately grasp the pelvic condition of the patients. CT evaluation was related to the extent of the cervical cancer and the presence of infiltration into the vaginal wall. According to a 4-stage classification of the CT image, the extent of infiltration to surrounding parametrium and the bladder was determined. As a result, the sensitivity for evaluating invasion into surrounding tissue raised 92 %, and it showed 100 % for cases with adhesion or invasion of the bladder. Therefore, CT can an extremely effective method to determine the clinical staging of cancer of the uterine cervix.

Pretreatment prognostic Factors in Early Stage Carcinoma of the Uterine Cervix

International Nuclear Information System (INIS)

Kim, Mi Sook; Ha, Sung Whan

1992-01-01

From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stage IIA. In stage IB, five year locoregional control, five year disease A, five year locoregional control, five disease free survival, and five year overall survival were 78.0%, 66.8%, and 72.1%, respectively. To identify prognostic factor, pretreatment including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physical examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overal survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant pronostic factor on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregional control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivarate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-07-15

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

[Carcinoma of the uterine cervical canal. Staging and biometric assessment with magnetic resonance].

Science.gov (United States)

Fischetti, S G; Politi, G; Lomeo, E; Garozzo, G; Di Leo, S; Nuciforo, G

1994-10-01

In uterine cervical canal carcinoma, the current clinical FIGO criteria often fail not only to differentiate stage IA2 from stage IB but also to demonstrate possible parametrial involvement. Moreover, the analysis of tumor volume and of the depth of neoplastic stromal invasion is not very reliable. The authors investigated MR accuracy in the definition of such variables: to this purpose, 24 patients with histologically confirmed endocervical adenocarcinoma were submitted to MRI, which was performed with an 0.5-T superconductive magnet. Sagittal and oblique transverse or sometimes coronal SE images, oriented so as to be perpendicular to longitudinal cervical major axis were obtained with T2 weighting (TR 1800 ms, TE 25-90 ms). MR data were correlated with pathologic findings. MR accuracy in demonstrating parametrial involvement was 92%, its sensitivity was 86% and specificity 97%. Volumetric MR data showed a high correlation (r = 0.970) with those derived from pathologic findings. In 92% of cases stromal invasion exceeded 5 mm. MRI, thanks to its high accuracy, should be included in diagnostic pretreatment protocols, even though FIGO criteria do not require it yet, especially in the presence of an endocervical adenocarcinoma. Moreover, the accurate definition of tumor volume can allow less extensive surgery with the same survival rates and fewer complications, which are frequently observed after radical hysterectomy.

The effects of age on treatment and outcomes in women with stages IB1-IIB cervical cancer.

Science.gov (United States)

Roque, Dario R; Cronin, Beth; Robison, Katina; Lopes, Vrishali; Rizack, Tina; Dizon, Don S

2013-10-01

Age may affect the treatment choice and subsequent outcome in elderly patients with cervical cancer. Given the potential for cure with either surgery or chemoradiation in early stage disease, we aimed to determine whether a patient's age influenced treatment received and the ensuing outcome. We identified 303 patients with stages IB1-IIB cervical carcinoma treated at our institution between 2000 and 2010, who were divided into two groups based on age at time of diagnosis: stage at presentation, and grade. Women ≥ 65 years of age were less likely to receive primary surgical management (p=0.03). Age did not influence disease-specific or all-cause mortality. However, women over 65 years who underwent primary surgery were at significantly increased risk of all-cause mortality compared to younger women (HR 6.53, 95% CI: 2.57-16.6). Age appears to influence treatment received by patients with stages IB1-IIB cervical cancer. Although there was no difference in cancer-specific mortality stratified by type of treatment received, surgery was associated with a 6.5-fold increased risk of all-cause mortality among women 65 years or over. © 2013.

PATIENTS WITH SQUAMOUS-CELL VERSUS ADENO(SQUAMOUS) CARCINOMA OF THE CERVIX, WHAT FACTORS DETERMINE THE PROGNOSIS

NARCIS (Netherlands)

TINGA, DJ; BOUMA, J; AALDERS, JG

1992-01-01

Patients with squamous cell carcinoma of the cervix FIGO stages IB to IV (n = 306) were compared to patients with adeno(squamous) carcinoma (n = 70). There was no difference between the mean ages of the groups. In the patients who underwent radical surgical treatment, whether or not in combination

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)

International Nuclear Information System (INIS)

Lee, Hyun Jin; Han, Seungbong; Kim, Young Seok; Nam, Joo-Hyun; Kim, Hak Jae; Kim, Jae Weon; Park, Won; Kim, Byoung-Gie; Kim, Jin Hee; Cha, Soon Do; Kim, Juree; Lee, Ki-Heon; Yoon, Mee Sun

2013-01-01

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

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.

Randomized study of preoperative radiation and surgery or irradiation alone in the treatment of Stage IB and IIA carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Perez, C.A.; Camel, H.M.; Kao, M.S.; Askin, F.

1980-01-01

A prospective randomized study in selected patients with Stage IB and IIA carcinoma of the uterine cervix was carried out. Patients were randomized to be treated with 1) irradiation alone consisting of 1000 rad whole pelvis, additional 4000 rads to the parametria with a step wedge midline block, and two intracavitary insertions for 7500 mgh; and 2) irradiation and surgery, consisting of 2000 rad whole pelvis irradiation, one intracavitary insertion for 5000 to 6000 mgh followed in two to six weeks later by a radical hysterectomy with pelvic lymphadenectomy. The five-year, tumor-free actuarial survival for Stage IB patients treated with radiation was 87% and with preoperative radiation and surgery 82%. In Stage IIA, the actuarial five-year survival NED was 57% for the irradiation alone group and 71% for the patients treated with preoperative radiation and radical hysterectomy. Major complications of therapy were slightly higher in the patients trated with radiation alone (9.4%, consisting of one recto-vaginal fistula and one vesico-vaginal fistula and a combined recto-vesico-vaginal fistula in another patient). In the preoperative radiation group, only two ureteral strictures (4.1%) were noted. The present study shows no significant difference in therapeutic results or morbidity for invasive carcinoma of the uterine cervix Stage IB or IIA treated with irradiation alone or combined with a radical hysterectomy

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS with Diarrhea Nausea and IBS Bloating in IBS Sleep and ... IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS with Diarrhea Nausea and IBS Bloating in ...

Medications (for IBS)

Medline Plus

Full Text Available ... IBS? What is IBS? Facts About IBS Gut Bacteria and IBS IBS in Men Other Disorders Testing ... IBS? What is IBS? Facts About IBS Gut Bacteria and IBS IBS in Men Other Disorders Testing ...

Medications (for IBS)

Medline Plus

Full Text Available ... is IBS? What is IBS? Facts About IBS Gut Bacteria and IBS IBS in Men Other Disorders ... is IBS? What is IBS? Facts About IBS Gut Bacteria and IBS IBS in Men Other Disorders ...

Medications (for IBS)

Medline Plus

Full Text Available ... Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS with Diarrhea Nausea and IBS ... Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS with Diarrhea Nausea and IBS ...

Medications (for IBS)

Medline Plus

Full Text Available ... With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs ... With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs ...

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs IBS and Holidays Personal ... IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs IBS and Holidays Personal ...

Medications (for IBS)

Medline Plus

Full Text Available ... Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience ... Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience ...

Level of Concordance of Pre-, Intra-, and Postoperative Staging in Cervical Cancers (TREYA Study

Directory of Open Access Journals (Sweden)

M. Toure

2017-01-01

Full Text Available Concomitant radiochemotherapy is the therapeutic standard for locally advanced (Ib2 to IVa stage FIGO cervical cancer. In the absence of a radiotherapy in many of our Sub-Saharan African countries, surgical resection is the only therapeutic method available in hopes of achieving a definite cure. However, criteria for curative surgery are not always met due to preoperative understaging of most of our patients. In addition to socioeconomic factors, the causes for understaging are numerous. These include the lack of personnel or underqualified personnel and the absence of complete workup to assess the resectability of the tumor, but above all the lack of decision-making through multidisciplinary consultation meetings. This study makes a plea in order to provide our hospitals with qualified personnel and adequate technical platform to allow efficient management of our patients with cervical cancer.

Curative high dose rate vaginal apex brachytherapy in stage I papillary serous carcinoma of the endometrium

International Nuclear Information System (INIS)

Turner, B.C.; Kacinski, B.M.; Gumbs, A.; Peschel, R.E.; Haffty, B.G.; Wilson, L.D.

1996-01-01

Introduction: Uterine papillary serous carcinoma (UPSC) is a morphologically distinct variant of endometrial carcinoma that is associated with a poor prognosis, high recurrence rate, clinical understaging, and poor response to salvage treatment. We describe the presentation, local and distant control, survival, salvage rate, and complications for patients undergoing whole abdominal radiation therapy (WART), low dose rate (LDR) intracavitary brachytherapy, or high dose rate (HDR) vaginal brachytherapy in patients with stage I UPSC. Methods: Between 1976 and 1994 more than 1700 patients with endometrial carcinoma were treated with radiation therapy, 30 patients with stage I UPSC (1.8%) were treated with radiation before or following TAH/BSO. All patients underwent either preoperative Simon's packing or tandem and plaque which delivered 30-40 Gy to the serosa, WART, or HDR Ir-192 vaginal apex brachytherapy to a total dose of 21 Gy in 3 fractions at 0.5 cm from the vaginal mucosa. A total of 14 patients received HDR vaginal brachytherapy and (5(14)) patients received systemic chemotherapy. All patients presented with vaginal bleeding at a median age of 67 years (range 34-88). The group of 30 patients underwent TAH/BSO, 17 patients were completely staged pathologically (pelvic and para-aortic lymph nodes, omentectomy, and pelvic washings), and 2 patients underwent omental biopsy and pelvic washings only. All specimens revealed UPSC, nuclear grade 3, and lymphovascular invasion (23%). The pathologic stage was IA: 23% (7), IB: 67% (20), and IC: 10% (3). The median follow-up for all patients was 49 months (range 13-187 months). For the patients receiving postoperative HDR vaginal brachytherapy the median time from surgery to radiation was 42 days (range 29-91). Results: The 5-year actuarial disease free survival for Figo stage I UPSC patients treated with postoperative HDR vaginal brachytherapy and systemic chemotherapy was 100% compared to 74% for stage I UPSC patient

Medications (for IBS)

Medline Plus

Full Text Available ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ...

Medications (for IBS)

Medline Plus

Full Text Available ... Studies News You Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs ... Studies News You Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs ...

Medications (for IBS)

Medline Plus

Full Text Available ... About IBS Gut Bacteria and IBS IBS in Men Other Disorders Testing for IBS Signs and Symptoms ... About IBS Gut Bacteria and IBS IBS in Men Other Disorders Testing for IBS Signs and Symptoms ...

Medications (for IBS)

Medline Plus

Full Text Available ... Medications Psychological Treatments Online Studies Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS ... Medications Psychological Treatments Online Studies Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS ...

Medications (for IBS)

Medline Plus

Full Text Available ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation ...

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Patients' Experience and Unmet Needs IBS and Holidays Personal Stories IBS Awareness Month IBS Awareness Month ... IBS Patients' Experience and Unmet Needs IBS and Holidays Personal Stories IBS Awareness Month IBS Awareness Month ...

Medications (for IBS)

Medline Plus

Full Text Available ... Travel and IBS IBS Patients' Experience and Unmet Needs IBS and Holidays Personal Stories IBS Awareness Month ... Travel and IBS IBS Patients' Experience and Unmet Needs IBS and Holidays Personal Stories IBS Awareness Month ...

Medications (for IBS)

Medline Plus

Full Text Available ... Studies News You Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS ... Studies News You Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS ...

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Treatment Working with Your Physician Understanding and Managing Pain in IBS IBS Symptom Treatments Treating IBS ... IBS Treatment Working with Your Physician Understanding and Managing Pain in IBS IBS Symptom Treatments Treating IBS ...

Therapeutic Results of Surgery and Radiation Therapy in Younger Patients with Stage IB Cervical Cancer

International Nuclear Information System (INIS)

Huh, Gil Cha; Yang, Kwang Mo; Suh, Hyun Suk; Kim, Yong Bong; Lee, Eung Soo; Park, Sung Kwan

1995-01-01

Purpose : To evaluate the prognostic importance of age in patients with Stage IB cervical cancer, we examined the relationship between age and survival in patients. Methods and materials : Retrospective analysis was performed on 107 patients were treated with surgery followed by postoperative radiotherapy or radiation alone between October 1983 and August 1993 and 28 patients with Stage IB cervical cancer treated with surgery alone between January 1989 and August 1993 at Inje University Seoul Paik Hospital. Patients ranged in age from 26 to 74 (median 48) and were followed for a median period of 39 months. Patients were divided into two groups; Group A comprising 32 patients with≤age 40 and Group B comprising 75 patients with>age 40. Both Group A and Group B patients were comparable with respect to all covariables studied. Results : The overall 5-year survival and the disease free 5-year survival for the 107 patients studied were 85.2% and 82.1% respectively. The overall survival for group A and Group B was 92% and 83%, respectively(p>0.05). The disease free 5-year survival for Group A and Group B was 82.3% and 82.6%, respectively(p>0.05). There was no difference in both local and distant failure in Group A and Group B. Conclusion : On the basis of the this analysis it is concluded that age alone is a poor indicator of prognosis and should not be used as an indication for adjuvant treatment

Medications (for IBS)

Medline Plus

Full Text Available ... With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs IBS and ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics ...

Introduction to IBS

Science.gov (United States)

... Day Art of IBS Gallery Contact Us Search Introduction to IBS Details What is IBS? Last Updated: ... tax-deductible donation. Make Donation What is IBS? Introduction to IBS Symptoms of IBS What Causes IBS? ...

Medications (for IBS)

Medline Plus

Full Text Available ... and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ... Treatment Working with Your Physician Understanding and Managing Pain in IBS IBS Symptom Treatments Treating IBS Pain ...

Risk strata-based therapy and outcome in stage Ib-IIa carcinoma cervix: single-centre ten-year experience.

Science.gov (United States)

Kundargi, Rajshekar S; Guruprasad, B; Rathod, Praveen Shankar; Shakuntala, Pn; Shobha, K; Pallavi, Vr; Uma Devi, K; Bafna, Ud

2013-01-01

To review the outcome of stage (Ib, IIa), cervical cancer patients were primarily treated with radical hysterectomy and risk-based postoperative therapy. Between January 2001 and December 2011, 601 cases underwent surgery followed by tailored therapy. Patients were classified into low risk (pelvic lymph node negative, tumour less than 4 cm, no evidence of lympho-vascular invasion, less than one-third of thickness of surgical stoma involved), intermediate risk (positive lympho-vascular space invasion, tumour size more than 4 cm, and deep invasion of cervical stroma), and high risk (pelvic lymph node involved, positive parametrial, or vaginal margins) groups. Postoperative adju-vant therapy in the form of radiotherapy alone to those with intermediate risk and chemo-radiotherapy to those with high risk was given to patients. The median follow-up was 60 months. The majority of patients had intermediate risk. The overall event-free survival (EFS) at five years was 74.37%, with EFS of 86.5% in those from the low-risk group, 73% in those from the intermediate-risk group, and 64% in those from the high-risk group. In conclusion, risk strata-based adjuvant postoperative therapy is able to provide a favourable outcome in patients with stage Ib-IIa cervical cancer with a nearly 11% improvement in survival compared with historical control.

Effective treatment of Stage I uterine papillary serous carcinoma with high dose-rate vaginal apex radiation (192Ir) and chemotherapy

International Nuclear Information System (INIS)

Turner, Bruce C.; Knisely, Jonathan P. S.; Kacinski, Barry M.; Haffty, Bruce G.; Gumbs, Andrew A.; Roberts, Kenneth B.; Frank, Alex H.; Peschel, Richard E.; Rutherford, Thomas J.; Edraki, Babak; Kohorn, Ernest I.; Chambers, Setsuko K.; Schwartz, Peter E.; Wilson, Lynn D.

1998-01-01

% (18 patients). The 5-year actuarial OS for Stage I UPSC patients treated with HDR vaginal apex brachytherapy and chemotherapy who underwent complete surgical staging was 100% (15 patients). The 5-year actuarial OS for the 20 Stage I UPSC patients treated with combinations of pre- and postoperative LDR brachytherapy and postop WART was 65%. None of the 6 surgically staged UPSC patients treated with LDR radiation and WART/WPRT developed recurrent disease. For patients with FIGO Stage IA, IB, and IC UPSC who underwent complete surgical staging, the 5-year actuarial DFS by depth of myometrial invasion was 100, 71, and 40%, respectively (p = 0.006). The overall salvage rate for local and distant recurrence was 0%. Complications following HDR vaginal apex brachytherapy included only Radiation Therapy Oncology Group (RTOG) grade 1 and 2 toxicity in 16% of patients. However, complications from patients treated with WART/WPRT, and/or LDR brachytherapy, included RTOG grade 3 and 4 toxicity in 15% of patients. Conclusion: Patients with UPSC should undergo complete surgical staging, and completely surgically staged FIGO Stage I UPSC patients can be effectively and safely treated with HDR vaginal apex brachytherapy and chemotherapy. Both OS and DFS of patients with UPSC are dependent on depth of myometrial invasion. The salvage rate for both local and distant UPSC recurrences is extremely poor. Complications from HDR vaginal apex brachytherapy were minimal

Medications (for IBS)

Medline Plus

Full Text Available ... Unmet Needs IBS and Holidays Personal Stories IBS Awareness Month IBS Awareness Month Tips of the Day Art of IBS ... Unmet Needs IBS and Holidays Personal Stories IBS Awareness Month IBS Awareness Month Tips of the Day ...

Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (<4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)

Energy Technology Data Exchange (ETDEWEB)

Toita, Takafumi, E-mail: b983255@med.u-ryukyu.ac.jp [Department of Radiology, Graduate School of Medical Science, University of Ryukyus, Okinawa (Japan); Kato, Shingo [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Ehime (Japan); Shikama, Naoto [Department of Radiation Oncology, Saku Central Hospital, Saku (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Tokumaru, Sunao [Department of Radiology, Saga University, Saga (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tsukuba (Japan); Numasaki, Hodaka; Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Osaka (Japan); Oguchi, Masahiko [Department of Radiation Oncology, Cancer Institute Hospital, Tokyo (Japan); Kagami, Yoshikazu [Radiation Oncology Division, National Cancer Center Hospital, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

2012-01-01

Purpose: To determine the efficacy of a definitive radiotherapy protocol using high-dose-rate intracavitary brachytherapy (HDR-ICBT) with a low cumulative dose schedule in nonbulky early-stage cervical cancer patients, we conducted a prospective multi-institutional study. Methods and Materials: Eligible patients had squamous cell carcinoma of the intact uterine cervix, Federation of Gynecologic Oncology and Obstetrics (FIGO) stages Ib1, IIa, and IIb, tumor size <40 mm in diameter (assessed by T2-weighted magnetic resonance imaging), and no pelvic/para-aortic lymphadenopathy. The treatment protocol consisted of whole-pelvis external beam radiotherapy (EBRT) of 20 Gy/10 fractions, pelvic EBRT with midline block of 30 Gy/15 fractions, and HDR-ICBT of 24 Gy/4 fractions (at point A). The cumulative biologically effective dose (BED) was 62 Gy{sub 10} ({alpha}/{beta} = 10) at point A. The primary endpoint was the 2-year pelvic disease progression-free (PDPF) rate. All patients received a radiotherapy quality assurance review. Results: Between September 2004 and July 2007, 60 eligible patients were enrolled. Thirty-six patients were assessed with FIGO stage Ib1; 12 patients with stage IIa; and 12 patients with stage IIb. Median tumor diameter was 28 mm (range, 6-39 mm). Median overall treatment time was 43 days. Median follow-up was 49 months (range, 7-72 months). Seven patients developed recurrences: 3 patients had pelvic recurrences (2 central, 1 nodal), and 4 patients had distant metastases. The 2-year PDPF was 96% (95% confidence interval [CI], 92%-100%). The 2-year disease-free and overall survival rates were 90% (95% CI, 82%-98%) and 95% (95% CI, 89%-100%), respectively. The 2-year late complication rates (according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer of Grade {>=}1) were 18% (95% CI, 8%-28%) for large intestine/rectum, 4% (95% CI, 0%-8%) for small intestine, and 0% for bladder. No Grade {>=}3 cases were

Medications (for IBS)

Medline Plus

Full Text Available Donate Find a Doctor Join eNewsletter Sidebar × MOBILE MENU About Us What is IBS? What is IBS? Facts About IBS Gut Bacteria and IBS IBS in Men ... Art of IBS Gallery Contact Us About IBS Twitter Facebook YouTube Search Search ... About Us What is ...

Phase II study evaluating consolidation whole abdominal intensity-modulated radiotherapy (IMRT in patients with advanced ovarian cancer stage FIGO III - The OVAR-IMRT-02 Study

Directory of Open Access Journals (Sweden)

Eichbaum Michael H

2011-01-01

Full Text Available Abstract Background The prognosis for patients with advanced FIGO stage III epithelial ovarian cancer remains poor despite the aggressive standard treatment, consisting of maximal cytoreductive surgery and platinum-based chemotherapy. The median time to recurrence is less than 2 years, with a 5-years survival rate of -20-25%. Recurrences of the disease occur mostly intraperitoneally. Ovarian cancer is a radiosensitive tumor, so that the use of whole abdominal radiotherapy (WAR as a consolidation therapy would appear to be a logical strategy. WAR used to be the standard treatment after surgery before the chemotherapy era; however, it has been almost totally excluded from the treatment of ovarian cancer during the past decade because of its high toxicity. Modern intensity-modulated radiation therapy (IMRT has the potential of sparing organs at risk like kidneys, liver, and bone marrow while still adequately covering the peritoneal cavity with a homogenous dose. Our previous phase I study showed for the first time the clinical feasibility of intensity-modulated WAR and pointed out promising results concerning treatment tolerance. The current phase-II study succeeds to the phase-I study to further evaluate the toxicity of this new treatment. Methods/design The OVAR-IMRT-02 study is a single-center one arm phase-II trial. Thirty seven patients with optimally debulked ovarian cancer stage FIGO III having a complete remission after chemotherapy will be treated with intensity-modulated WAR as a consolidation therapy. A total dose of 30 Gy in 20 fractions of 1.5 Gy will be applied to the entire peritoneal cavity including the liver surface and the pelvic and para-aortic node regions. Organ at risk are kidneys, liver (except the 1 cm-outer border, heart, vertebral bodies and pelvic bones. Primary endpoint is tolerability; secondary objectives are toxicity, quality of life, progression-free and overall survival. Discussion Intensity-modulated WAR provides

Phase II study evaluating consolidation whole abdominal intensity-modulated radiotherapy (IMRT) in patients with advanced ovarian cancer stage FIGO III - The OVAR-IMRT-02 Study

International Nuclear Information System (INIS)

Rochet, Nathalie; Debus, Juergen; Kieser, Meinhard; Sterzing, Florian; Krause, Sonja; Lindel, Katja; Harms, Wolfgang; Eichbaum, Michael H; Schneeweiss, Andreas; Sohn, Christof

2011-01-01

The prognosis for patients with advanced FIGO stage III epithelial ovarian cancer remains poor despite the aggressive standard treatment, consisting of maximal cytoreductive surgery and platinum-based chemotherapy. The median time to recurrence is less than 2 years, with a 5-years survival rate of -20-25%. Recurrences of the disease occur mostly intraperitoneally. Ovarian cancer is a radiosensitive tumor, so that the use of whole abdominal radiotherapy (WAR) as a consolidation therapy would appear to be a logical strategy. WAR used to be the standard treatment after surgery before the chemotherapy era; however, it has been almost totally excluded from the treatment of ovarian cancer during the past decade because of its high toxicity. Modern intensity-modulated radiation therapy (IMRT) has the potential of sparing organs at risk like kidneys, liver, and bone marrow while still adequately covering the peritoneal cavity with a homogenous dose. Our previous phase I study showed for the first time the clinical feasibility of intensity-modulated WAR and pointed out promising results concerning treatment tolerance. The current phase-II study succeeds to the phase-I study to further evaluate the toxicity of this new treatment. The OVAR-IMRT-02 study is a single-center one arm phase-II trial. Thirty seven patients with optimally debulked ovarian cancer stage FIGO III having a complete remission after chemotherapy will be treated with intensity-modulated WAR as a consolidation therapy. A total dose of 30 Gy in 20 fractions of 1.5 Gy will be applied to the entire peritoneal cavity including the liver surface and the pelvic and para-aortic node regions. Organ at risk are kidneys, liver (except the 1 cm-outer border), heart, vertebral bodies and pelvic bones. Primary endpoint is tolerability; secondary objectives are toxicity, quality of life, progression-free and overall survival. Intensity-modulated WAR provides a new promising option in the consolidation treatment of

Radical Abdominal Trachelectomy for IB1 Cervical Cancer at 17 Weeks of Gestation: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Yoichi Aoki

2014-01-01

Full Text Available Background. With regard to the therapy for early invasive cervical carcinoma during pregnancy, radical trachelectomy is also a treatment of choice, along with its advantages and disadvantages. Case Report. A 28-year-old woman, para 1-0-0-1, was diagnosed with FIGO stage IB1 squamous cell carcinoma of the cervix at 12 weeks of gestation. The patient underwent radical abdominal trachelectomy with pelvic lymphadenectomy at 17 weeks of gestation. Her pregnancy was successfully maintained after the surgery. The patient underwent a planned cesarean section at 38 weeks of gestation. A healthy baby girl weighing 2970 g was born with an Apgar score of 8/9. The mother and child in overall good health were discharged. Ten months after the delivery, there was no clinical evidence of recurrence. Conclusions. We believe that it is appropriate to perform radical abdominal trachelectomy in the early second trimester with preserving uterine arteries, although it is a technically challenging approach. It may be possible that radical abdominal trachelectomy during pregnancy can help women avoid the triple losses of a desired pregnancy, fertility, and motherhood.

Medications (for IBS)

Medline Plus

Full Text Available ... Treating IBS Pain IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological ... Treating IBS Pain IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological ...

Mapping the extent of disease by multislice computed tomography, magnetic resonance imaging and sentinel node evaluation in stage I and II cervical carcinoma

Directory of Open Access Journals (Sweden)

Rajaram S

2010-01-01

Full Text Available Aims: (1 To map the extent of disease in women with stage I and II carcinoma cervix by multislice spiral computed tomography (CT, magnetic resonance imaging (MRI and sentinel nodes. (2 To assess accuracy of each modality individually and in conjunction with FIGO clinical staging. Design and Setting: Prospective, single-blind study. Departments of Obstetrics and Gynaecology, Radiodiagnosis, and Pathology, UCMS and GTBH and Division of Radiological Imaging and Bioinformatics, INMAS, Delhi. Material and Method: The study was conducted on 25 women with cervical cancer FIGO stage I and II. Each woman underwent clinical staging, multislice spiral CT and MRI which was compared to the gold-standard histopathology/cytology. The overall accuracy of each modality and improvement of clinical staging by CT/MRI were noted. Sentinel nodes were evaluated by intracervical Patent Blue V dye injection. Statistical Analysis: Sensitivity, specificity, positive and negative predictive values were calculated by 2Χ2 contingency tables. Results: The accuracy of staging by FIGO, CT and MRI was 68%, 52% and 80%, respectively. MRI and CT improved the overall accuracy of FIGO staging to 96% and 80%, respectively. Sentinel nodes were identified in 89% of patients with 91% accuracy. Conclusion: MRI emerges as the most valuable stand-alone modality improving accuracy of FIGO staging to 96%. Sentinel lymph-node evaluation appears promising in evaluating spread beyond cervix.

Prophylactic lower para-aortic irradiation using intensity-modulated radiotherapy mitigates the risk of para-aortic recurrence in locally advanced cervical cancer: A 10-year institutional experience.

Science.gov (United States)

Lee, Jie; Lin, Jhen-Bin; Chang, Chih-Long; Jan, Ya-Ting; Sun, Fang-Ju; Wu, Meng-Hao; Chen, Yu-Jen

2017-07-01

To evaluate the effects of prophylactic sub-renal vein radiotherapy (SRVRT) using intensity-modulated radiotherapy (IMRT) for cervical cancer. A total of 206 patients with FIGO stage IB2-IVA cervical cancer and negative para-aortic lymph nodes (PALNs) who underwent pelvic IMRT (PRT) or SRVRT between 2004 and 2013 at our institution were reviewed. SRVRT cranially extended the PRT field for PALNs up to the left renal vein level. The prescribed dose was consistent 50.4Gy in 28 fractions. Overall, 110 and 96 patients underwent PRT and SRVRT, respectively. The SRVRT group had more advanced disease based on FIGO stage and positive pelvic lymph nodes (PLNs). The median follow-up time was 60months (range, 7-143). For the total study population, the 5-year PALN recurrence-free survival (PARFS) and overall survival (OS) for PRT vs. SRVRT were 87.6% vs. 97.9% (p=0.03) and 74.5% vs. 87.8% (p=0.04), respectively. In patients with FIGO III-IVA or positive PLNs, the 5-year PARFS and OS for PRT vs. SRVRT were 80.1% vs. 96.4% (p=0.02) and 58.1% vs. 83.5% (p=0.012), respectively. However, there were no significant differences in these outcomes for patients with FIGO IB-IIB and negative PLNs. In a multivariate analysis, only SRVRT was associated with better PARFS (HR, 0.21; 95% CI, 0.06-0.78; p=0.02). The SRVRT did not significantly increase severe late toxicities. Prophylactic SRVRT using IMRT reduced PALN recurrence with tolerable toxicities, supporting the application of risk-based radiation fields for cervical cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Medications (for IBS)

Medline Plus

Full Text Available ... Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS IBS Patients' Experience and Unmet Needs ...

Medications (for IBS)

Medline Plus

Full Text Available ... Irritable Bowel Syndrome Symptom Diary Testing in IBS Changes You Should Not Ignore if You Have IBS Treatment Working with Your Physician Understanding and Managing Pain in IBS IBS Symptom Treatments Treating IBS ...

Medications (for IBS)

Medline Plus

Full Text Available ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us About IBS Twitter ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us Search Medications Details ...

Medications (for IBS)

Medline Plus

Full Text Available ... Irritable Bowel Syndrome Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in IBS Changes You Should Not Ignore if You Have IBS Treatment Working with Your Physician Understanding and Managing Pain in IBS IBS Symptom Treatments Treating IBS Pain ...

Medications (for IBS)

Medline Plus

Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome (IBS) ... of multiple symptoms in IBS patients. However, new therapies for IBS have been recently ... – have limited benefit for treating IBS. In some persons they relieve ...

Role of computed tomography (CT scan in staging of cervical carcinoma

Directory of Open Access Journals (Sweden)

T V Prasad

2014-01-01

Full Text Available Background & objectives: Staging of cervical carcinoma is done clinically using International Federation of Obstetrics and Gynecology (FIGO guidelines. It is based on physical examination findings and also includes results of biopsy, endoscopy and conventional radiological tests like chest radiograph, intravenous urography and barium enema. These conventional radiological investigations have largely been replaced by computed tomography (CT and magnetic resonance imaging (MRI at present. FIGO staging system does not consider CT and MRI mandatory; however, use of these modalities are encouraged. This prospective study was conducted to determine the role of CT in staging work up in women diagnosed with cervical carcinoma. Methods: Fifty three women diagnosed with cervical carcinoma were evaluated with contrast enhanced CT scan of abdomen and pelvis. CT scan images were especially evaluated to determine tumour size, invasion of parmetrium, pelvic walls, rectum, urinary bladder and ureters, pelvic or retroperitoneal lymphadenopathy and distant metastases. CT findings were associated with clinical findings and staging, including findings from cystoscopy and sigmoidoscopy. Results: There was a poor agreement between clinical and CT staging of cervical carcinoma. Primary tumour was demonstrated on CT in 36 (70% of 53 patients. CT underestimated the parametrial, vaginal and pelvic wall invasion when compared with physical examination. CT overestimated the urinary bladder and rectal invasion when compared with cysto-sigmoidoscopy, however, CT had 100 per cent negative predictive value (NPV to exclude bladder and rectal involvement. CT detection of lymph node enlargement and lung metastases influenced the management. Interpretation & conclusions: Our findings show that CT scan does not reliably correlate with clinical FIGO staging of cervical cancer. However, it can detect urinary obstruction as well as nodal or distant metastases and thus improves the

Medications (for IBS)

Medline Plus

Full Text Available ... and Holidays Personal Stories IBS Awareness Month IBS Awareness Month Tips of the Day ... IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome (IBS) ...

MR imaging for staging of cervical carcinoma: Update

Energy Technology Data Exchange (ETDEWEB)

Yoon, Seong Kuk; Kim, Dong Won [Dong A University Hospital, Busan(Korea, Republic of)

2017-08-15

Uterine cervical cancer is globally the third most common cancer among women, and shows high mortality with invasive cervical carcinoma. Early detection of the disease, its correct staging, and treatment are therefore of great importance. The staging system updated in 2009 by the International Federation of Gynecology and Obstetrics (FIGO), is commonly used for planning the treatment. However, there are significant inaccuracies in the FIGO staging system. Accurate tumor staging is very important to decide the treatment strategy. Although not included in the staging system, magnetic resonance (MR) imaging is a valuable tool for local staging of the disease, and is useful in assessing the spread of the tumor and metastatic lymph nodes, thereby becoming a more accurate substitute for clinical staging of cervical carcinoma. In addition, it is capable of assessing the disease response to surgery or chemoradiation. This review briefly describes the role of MR imaging and the basic MR scanning protocol in evaluating cervical carcinoma. The MR findings with staging, and MR evaluation of treatment response, are further addressed.

PREFERÊNCIA SENSORIAL DE COMPOTA E DOCE DE FRUTA EM CALDA ELABORADOS COM FIGO EM FUNÇÃO DO MODO DE PREPARO

OpenAIRE

Caetano, Priscilla Kárim; FCA/UNESP; Mendonça, Veridiana Zoocoler de; FCA/UNESP; Daiuto, Érica Regina; Faculdade de Ciências Agronômicas (FCA/UNESP-Botucatu); Vieites, Rogério Lopes; FCA/UNESP

2015-01-01

Objetivou-se nesta pesquisa verificar a preferência sensorial entre compota e doce em calda de figo calda em função do modo de preparo. Foram realizados três tratamentos: compota de figo - tratamento térmico por 20 minutos, sem cozimento do fruto na calda (T1), doce de figo em calda - tratamento térmico dos frutos por 10 minutos e cozimento dos frutos na calda por 10 minutos (T2) e doce de figo em calda - sem tratamento térmico e cozimento do fruto na calda por 20 minutos (T3).  A calda utili...

Medications (for IBS)

Medline Plus

Full Text Available ... with Diarrhea Nausea and IBS Bloating in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable ... with Diarrhea Nausea and IBS Bloating in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable ...

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies ... IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies ...

Medications (for IBS)

Medline Plus

Full Text Available ... Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships and IBS Pregnancy ... Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships and IBS Pregnancy ...

Medications (for IBS)

Medline Plus

Full Text Available ... Gallery Contact Us About IBS Twitter Facebook YouTube Search Search ... About Us What is IBS? What is IBS? ... the Day Art of IBS Gallery Contact Us Search Medications Details Medications Last Updated: 01 July 2017 ...

Produtividade e qualidade de figos Roxo de Valinhos submetidos à fertirrigação e ao armazenamento refrigerado

Directory of Open Access Journals (Sweden)

Diniz Fronza

2010-08-01

Full Text Available A baixa produtividade de figos no Brasil geralmente está relacionada com as deficiências hídrica e nutricional. Este trabalho teve como objetivo avaliar o efeito da fertirrigação com doses de nitrogênio e potássio sobre a produtividade e qualidade dos figos do cultivar Roxo de Valinhos durante o armazenamento refrigerado. O experimento de campo foi realizado durante dois anos, e que no último ano os frutos foram armazenados na temperatura de 0,5 °C por 15 dias. Os tratamentos consistiram da combinação das doses de 150, 250, 350 e 450 kg ha-1 de nitrogênio (N e 150, 250 e 350 kg ha¹ de potássio (K fornecidas via fertirrigação. Segundo os resultados, doses de até 250 kg ha-1 de N e K na fertirrigação elevam a produtividade de figos Roxo de Valinhos, e estas doses conduzem a maior produtividade entre os tratamentos avaliados. A fertirrigação aumentou em 96,7% a produtividade de figos verdes e 49% a de figos maduros em comparação ao tratamento padrão. Os níveis de N, K e a forma de aplicação não influenciam a qualidade dos frutos durante o armazenamento refrigerado.

Crescimento, produção e qualidade de frutos da bananeira 'Figo cinza', em Botucatu-SP Growth, yield and quality of 'Figo cinza' banana fruits in Botucatu-SP

Directory of Open Access Journals (Sweden)

Dayana Portes Ramos

2009-09-01

Full Text Available A bananeira Figo Cinza é uma cultivar do grupo ABB, subgrupo Figo, que apresenta tolerância ao mal-do-panamá e às sigatokas amarela e negra, demonstrando ser uma cultivar interessante para programas de melhoramento genético. Devido a isso, o presente trabalho teve como objetivo avaliar características do 1º ciclo da planta, como o crescimento, produção e atributos físico-químicos dos frutos dessa cultivar, no município de Botucatu-SP. Foram avaliadas as seguintes características de crescimento: altura de plantas, circunferência do pseudocaule e número de folhas, medidas na época de emissão da inflorescência; número de dias entre o plantio e o florescimento, número de dias entre o florescimento e a colheita, e número de dias do plantio à colheita. Também foram mensuradas as seguintes características de produção: peso do cacho, número de frutos, peso médio dos frutos, número de pencas e produtividade; na 2ª penca foram avaliados peso, número, comprimento e diâmetro dos frutos. Os atributos fisico-químicos analisados foram: textura, pH, acidez titulável, sólidos solúveis, açúcares totais, amido e teor de potássio. Foi utilizado o método das estatísticas descritivas para a caracterização da cultivar, através dos cálculos das médias. Os resultados mostraram que 'Figo Cinza' apresentou porte médio (2,9 m, ciclo de 420 dias, produtividade média de 12,74 t ha -1 e frutos com baixa acidez (0,06%.'Figo Cinza' is a cultivar of the genomic group ABB, Figo subgroup, which provides tolerance to Panama and Sigatoka diseases that may be useful in genetic breeding programs. Then, this work aimed to evaluate the plants growth, production and also the physical and chemical characteristics of the fruits from this cultivar in Botucatu city, São Paulo state, Brazil. Some growth characteristics were evaluated such as: plant height, the pseudostem circumference, number of leaves, number of days between planting and

Results of radiation therapy alone in the treatment of carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Kim, R.Y.; Trotti, A.; Wu, C.J.; Soog, S.J.; Salter, M.M.

1988-01-01

This is a retrospective analysis of treatment results in 569 patients with invasive cancer of the uterine cervix treated with irradiation along between 1969 and 1980. The actuarial 5-year survival was 92% in 22 patients with stage IA, 82% in 169 patients with stage IB, 78% in 83 patients with stage IIA, 65% in 196 patients with stage IIB, 48% in 16 patients with stage IIIA, 27% in 70 patients with stage IIIB, and 27% in 13 patients with stage IVA cancer. In early-stage disease (FIGOIA, IB, IIA), pelvic failure was 4.6%, 11.2%, and 8.2%, respectively. In late-stage disease (FIGO IIB, III, and IVA), pelvic failure was 30.1%, 52.3%, and 69.2%, respectively. Distant metastases were noted in 9.5% of patients with stage IB, 12.0% of those with stage IIA, 14.3% of those with stage IIB, 17.5% of those with stage III, and 15.4% of those with stage IVA disease. The incidence of grade II and grade III radiation-induced complication was 2.3% and 4.0%, respectively. Further analysis revealed that total dose at point A is clearly related to pelvic control. In late-stage disease, higher doses are necessary to improve pelvic control

Retrospective case-control study of surgical treatment of stage IB-IIA cervical carcinomas after neoadjuvant radiotherapy

International Nuclear Information System (INIS)

Cigriejiene, V. M.; Kajenas, S.; Balnys, M.; Mikuckaite, L.

2004-01-01

To evaluate if preoperative radiotherapy influences course of operation (radical hysterectomy and lymphadenectomy) and postoperative period in series of stage IB-IIA cervical carcinomas. Retrospective comparative study was performed. During the study we analyzed 101 case histories of patients who underwent radical type II hysterectomy with lymphadenectomy in Kaunas University of Medicine Hospital and Kaunas Hospital of Oncology between 1995 and 2002. Mean operation time was shorter, hemoglobin and hematocrit values after operation were better, stay in hospital was longer, demand for narcotic analgetics was bigger, function of ovaries was maintained more rarely (p 0.05). In our study, preoperative radiotherapy did not seem to complicate course of radical hysterectomy. (author)

Out of the shadows and 6000 reasons to celebrate: An update from FIGO's fistula surgery training initiative.

Science.gov (United States)

Slinger, Gillian; Trautvetter, Lilli; Browning, Andrew; Rane, Ajay

2018-06-01

Obstetric fistula is a devastating childbirth injury caused by unrelieved obstructed labor. Obstetric fistula leads to chronic incontinence and, in most cases, significant physical and emotional suffering. The condition continues to blight the lives of 1-2 million women in low-resource settings, with 50 000-100 000 new cases each year adding to the backlog. A trained, skilled fistula surgeon is essential to repair an obstetric fistula; however, owing to a global shortage of these surgeons, few women are able to receive life-restoring treatment. In 2011, to address the treatment gap, FIGO and partners released the Global Competency-Based Fistula Surgery Training Manual, the first standardized curriculum to train fistula surgeons. To increase the number of fistula surgeons, the FIGO Fistula Surgery Training Initiative was launched in 2012, and FIGO Fellows started to enter the program to train as fistula surgeons. Following a funding boost in 2014, the initiative has grown considerably. With 52 fellows involved and a new Expert Advisory Group in place, the program is achieving major milestones, with a record-breaking number of fistula repairs performed by FIGO Fellows in 2017, bringing the total number of repairs since the start of the project to more than 6000. © 2018 International Federation of Gynecology and Obstetrics.

Adjuvant whole abdominal intensity modulated radiotherapy (IMRT) for high risk stage FIGO III patients with ovarian cancer (OVAR-IMRT-01) – Pilot trial of a phase I/II study: study protocol

International Nuclear Information System (INIS)

Rochet, Nathalie; Jensen, Alexandra D; Sterzing, Florian; Munter, Marc W; Eichbaum, Michael H; Schneeweiss, Andreas; Sohn, Christof; Debus, Juergen; Harms, Wolfgang

2007-01-01

The prognosis for patients with advanced epithelial ovarian cancer remains poor despite aggressive surgical resection and platinum-based chemotherapy. More than 60% of patients will develop recurrent disease, principally intraperitoneal, and die within 5 years. The use of whole abdominal irradiation (WAI) as consolidation therapy would appear to be a logical strategy given its ability to sterilize small tumour volumes. Despite the clinically proven efficacy of whole abdominal irradiation, the use of radiotherapy in ovarian cancer has profoundly decreased mainly due to high treatment-related toxicity. Modern intensity-modulated radiation therapy (IMRT) could allow to spare kidneys, liver, and bone marrow while still adequately covering the peritoneal cavity with a homogenous dose. The OVAR-IMRT-01 study is a single center pilot trial of a phase I/II study. Patients with advanced ovarian cancer stage FIGO III (R1 or R2< 1 cm) after surgical resection and platinum-based chemotherapy will be treated with whole abdomen irradiation as consolidation therapy using intensity modulated radiation therapy (IMRT) to a total dose of 30 Gy in 1.5 Gy fractions. A total of 8 patients will be included in this trial. For treatment planning bone marrow, kidneys, liver, spinal cord, vertebral bodies and pelvic bones are defined as organs at risk. The planning target volume includes the entire peritoneal cavity plus pelvic and para-aortic node regions. The primary endpoint of the study is the evaluation of the feasibility of intensity-modulated WAI and the evaluation of the study protocol. Secondary endpoint is evaluation of the toxicity of intensity modulated WAI before continuing with the phase I/II study. The aim is to explore the potential of IMRT as a new method for WAI to decrease the dose to kidneys, liver, bone marrow while covering the peritoneal cavity with a homogenous dose, and to implement whole abdominal intensity-modulated radiotherapy into the adjuvant multimodal

Preoperative radium therapy and radical hysterectomy in the treatment of cervical cancer stage IB, IIA, and initial IIB

International Nuclear Information System (INIS)

Salum, Resalla; Lopes, Edison R.; Souza, Maria A.H. de

1995-01-01

Patients with IB, IIa and in initial IIb cervical cancer were randomized for combined therapy, consisting of one or two radium insertion followed by Wertheim Meigs operation performed 40 days later. We look for the early and late complications of the treatment, residual cancer after radiotherapy and survival without recurrence. The project begin in 1965 and ended in 1986. All the operations were done by one of the investigators and 116 patients were analysed. The age ranged from 21 to 75 years with an average of 4.18 years. During the operations 31 (26.72%) patients needed 1.500 cc or greater amount of blood transfusion and we have 3 iliac veins lesions. Managing the ureters, we do our best to leave the posterior fascia as intact as possible. Post operative complications ranged from minor (fever, localised pelvic infections, temporary popliteal nerve paralysis) to evisceration (3 patients) deep venous thrombosis (3 patients) and two early urinary fistulas. Late complications were seen in patients submitted to sequential teletherapy irradiation. One uretrovaginal fistula occurred 10 month after treatment, another one, 7 years later and the third one 24 years later. One patient develop hydronefrosis and enterocolite after 7.000 rads of teletherapy and another one rectovaginal fistula 13 years after initial therapy. The shortening of the vagina making impossible the intercourse was seen in 7 patients. By the histological examination, the cervix was sterilized in 73.3 % of the patients. Residual cancer was found according the original size of the tumour and the stage of the disease. Studying different combinations between the existence of residual cervical cancer with positive or negative limphnodes and making a correlation with survival, we found the critical points is to have positive cervix and [positive lymphonodes. The five years survival (life table methodology) for stage 1 lesion was 96%; stage II, 67%. At ten years survival was slighted different. With positive

Medications (for IBS)

Medline Plus

Full Text Available ... IBS) patients with moderate to severe symptoms which do not respond to physician counseling and dietary manipulations. ... Treatments IBS Global Treatments IBS Diet What to Do and What to Avoid Foods That Cause Cramping ...

Medications (for IBS)

Medline Plus

Full Text Available ... About IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With Your Physician Treating IBS Pain IBS Diet Low-FODMAP Diet Complimentary or Alternative Treatments Medications Psychological ... Site ...

Medications (for IBS)

Medline Plus

Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome (IBS) ... include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve ...

Medications (for IBS)

Medline Plus

Full Text Available ... Know Changing Doctors IBS Symptom Treatments IBS Global Treatments IBS Diet What to Do and What to Avoid Foods That Cause Cramping and Diarrhea Foods that Cause Gas and Bloating Dietary Fiber 12 Week Elimination Diet ...

Medications (for IBS)

Medline Plus

Full Text Available ... of IBS Gallery Contact Us About IBS Twitter Facebook YouTube Search Search ... About Us What is IBS? ... and more! Sign up for eNewsletter: Site map | Privacy & Security | Terms of Use | Contact Us This information ...

Molecular Characterization and Growth Association of Two Apolipoprotein A-Ib Genes in Common Carp (Cyprinus carpio).

Science.gov (United States)

Wang, Xinhua; Yu, Xiaomu; Tong, Jingou

2016-09-16

Apolipoprotein A-I (ApoA-I) is functionally involved in the transportation and metabolism of lipids in vertebrates. In this study, two isoforms of apoA-Ib in common carp (Cyprinus carpio L.) were characterized. Sequence comparison and phylogenetic analysis showed that C. carpio ApoA-Ib is relatively conserved within cyprinid fishes. During embryonic development, C. carpio apoA-Ib was first expressed at the stage of multi-cells, and the highest mRNA level was observed at the stage of optic vesicle. A ubiquitous expression pattern was detected in various tissues with extreme predominance in the liver. Significantly different expression levels were observed between light and heavy body weight groups and also in the compensatory growth test. Seventeen and eight single-nucleotide polymorphisms (SNPs) were identified in matured mRNA of the C. carpio apoA-Ib.1 and apoA-Ib.2, respectively. Two of these SNPs (apoA-Ib.2-g.183A>T and apoA-Ib.2-g.1753C>T) were significantly associated with body weight and body length in two populations of common carp. These results indicate that apoA-Ib may play an important role in the modulation of growth and development in common carp.

The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy in ION SOLCA, Guayaquil Ecuador from November 1 to October 2002

International Nuclear Information System (INIS)

Gamboa, Eugenia; Falquez, Roberto

2003-01-01

To determine if the additional vaginal cuff irradiation is necessary or not in patients with cervix cancer, stages IB 1- IB 2, that has been treated previously with radical hysterectomies and pelvic radiotherapy, to get better local control and global survival versus presence of complications. We studied 54 patients from Radiation Oncology Department of ION SOLCA Guayaquil Ecuador, with cervix cancer stages IB1 - IB2, that have been treated with surgery plus pelvic radiotherapy plus or not brachytherapy. They have been divides into two arms, group one included surgery plus Rx T (radiotherapy) plus BxT (Brachytherapy), and group two included those patients with surgery plus external RxT alone. We studied, aged, histologic type, surgery type, doses and techniques of teletherapy and brachytherapy and we analyzed the presence of complications. Conclusions: The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy is not useful to get better local control and global survival in some patients carefully chosen without desfavorable factors, because this therapy represent and increase in the complication. (The author)

Associação entre a expressão das proteínas p53 e Ki-67 e os achados clínico-patológicos em pacientes com carcinoma invasor do colo uterino Association between p53 and Ki-67 expression and clinicopathologic features in patients with carcinoma of the cervix

Directory of Open Access Journals (Sweden)

Agnaldo L. Silva-Filho

2005-05-01

Full Text Available OBJETIVO: avaliar a associação da expressão das proteínas p53 e Ki-67 no tumor com achados clínico-patológicos em pacientes com carcinoma invasor de colo uterino. MÉTODOS: foram estudadas amostras de tumor obtidas de 36 pacientes submetidas a histerectomia radical para tratamento de carcinoma invasor do colo uterino estádio IB (FIGO. Amostras do tumor foram fixadas em formol e incluídas em parafina. O material foi analisado pela histopatologia (hematoxilina e eosina e processado para marcação imuno-histoquímica por anticorpos monoclonais contra as proteínas p53 e Ki-67. Os dados foram analisados pelo teste de chi2 para a avaliação das diferenças entre os grupos. RESULTADOS: a idade das pacientes variou de 27 a 73 anos (48,7±10,4 anos. O estadiamento clínico (FIGO foi IB1 em 27 casos (75% e IB2 em 9 casos (25%. A expressão tumoral da proteína p53 foi positiva em metade dos casos. Em relação à expressão do Ki-67, foi evidenciado alto grau de proliferação celular em 73,3% dos casos. Não houve associação da expressão das proteínas p53 e Ki-67 no tumor com idade (p=0,091 e 0,900, estadiamento (p=0,054 e 0,667, tipo histológico (p=0,674 e 0,674, grau de diferenciação (p=0,07 e 0,282, presença de invasão linfovascular (p=0,248 e 0,667, acometimento parametrial (p=0,729 e 0,763 e metástases para os linfonodos pélvicos (p=0,729 e 0,636, respectivamente. CONCLUSÕES: a expressão tumoral das proteínas p53 e Ki-67 não se associou com achados clínico-patológicos em pacientes com carcinoma invasor do colo uterino estádio IB.PURPOSE: to evaluate the association between p53 and Ki-67 expression in the tumor and clinicopathological features in patients with carcinoma of the cervix. METHODS: samples were taken from the tumor of 36 patients with stage IB (FIGO cervical carcinoma submitted to radical hysterectomy. Tissue samples were taken from the tumor, fixed in formalin and embedded in paraffin. The specimens were

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

Science.gov (United States)

Frielink, Lindy M J; Pijlman, Brenda M; Ezendam, Nicole P M; Pijnenborg, Johanna M A

2016-01-01

Adjuvant platinum-based chemotherapy improves survival in women with early-stage epithelial ovarian cancer (EOC). Yet, there is a wide variety in clinical practice. All patients diagnosed with FIGO I and IIa EOC (2006-2010) in the south of the Netherlands were analyzed. The percentage of patients that received adjuvant chemotherapy was determined as well as the comprehensiveness of staging and outcome. Forty percent (54/135) of the patients with early-stage EOC received adjuvant chemotherapy. Treatment with adjuvant chemotherapy was associated with FIGO stage, clear-cell histology and nonoptimal staging. Optimal staging was achieved in 50%, and nonoptimal staging was associated with advanced age, comorbidity and treatment in a non-referral hospital. Overall, there was no difference in outcome between patients with and without adjuvant chemotherapy. Yet, in grade 3 tumors, adjuvant chemotherapy seems beneficial. Selective treatment of patients with early-stage EOC might reduce adjuvant chemotherapy without compromising outcome. © 2016 S. Karger AG, Basel.

FIGO IIIB squamous cell carcinoma of the cervix: an analysis of prognostic factors emphasizing the balance between external beam and intracavitary radiation therapy

International Nuclear Information System (INIS)

Logsdon, Mark D.; Eifel, Patricia J.

1999-01-01

Purpose: To define patient, tumor, and treatment factors that influence the outcome of patients with FIGO Stage IIIB squamous cell carcinoma of the intact uterine cervix. Methods and Materials: The records of 1,096 patients treated with radiation therapy between 1960 and 1993 for FIGO Stage IIIB squamous cell carcinoma of the intact uterine cervix were reviewed retrospectively. Of these, 983 (90%) were treated with curative intent and 113 were treated only to achieve palliation of symptoms. Of 907 patients who completed the intended curative treatment, 641 (71%) were treated with a combination of external beam irradiation (EBRT) and intracavitary irradiation (ICRT) and 266 (29%) were treated with EBRT only. The median duration of treatment for these 907 patients was 51 days. Between 1966 and 1980, only 52% of patients who completed treatment with curative intent received ICRT, compared with 92% of patients treated during 1981-1993, an increase that reflects an evolution in the philosophy of treatment for advanced tumors. In general, the intensity of ICRT correlated inversely with the dose of EBRT to the central pelvis. Median follow-up of surviving patients was 134 months. Results: For 983 patients treated with initial curative intent, disease-specific survival (DSS) was significantly worse for those who were 52 Gy of EBRT to the central pelvis had DSS rates of 27-34%, compared with 53% for patients treated with lower doses of EBRT to the central pelvis and more intensive ICRT (p 52 Gy of EBRT to the central pelvis (57-68%), compared with those who had 48-52 Gy (28%) and those who had ≤ 47 Gy of EBRT to the central pelvis (15%) (p < 0.0001). Outcome was also compared for four time periods during which different treatment policies were in place for patients with Stage IIIB disease. The highest DSS (51%) and lowest actuarial complication rate (17%) were achieved during the most recent period (1981-1993) when modest doses of EBRT were combined with relatively

IBS Diet

Science.gov (United States)

... the most common questions IBS patients have is what food to avoid. This can drive a person to ... Global Treatments IBS Diet What to Do and What to Avoid Foods That Cause Cramping and Diarrhea Foods that Cause ...

Treatment results of radical radiotherapy in uterine cervix cancer

Energy Technology Data Exchange (ETDEWEB)

Huh, Seung Jae; Kim, Bo Kyong; Lim, Do Hoon; Shin, Seong Soo; Lee, Jeong Eun; Kang, Min Kyu; Ahn, Yong Chan [Samsung Medical center, sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2002-09-15

This study was conducted to evaluate the treatment results, prognostic factors, and complication rates after high dose rate (HDR) brachytherapy in patients with uterine cervix cancer who were treated with curative aim. Of 269 cervix cancer patients treated at the department of radiation oncology, Samsung Medical Center from September 1994 to July 1998, the 106 who were treated with radical radiotherapy were analyzed. The median age was 61 years (range 22 to 89). All patients except 4 with carcinoma in situ (CIS) were given external beam radiotherapy (range 30.6 {approx} 50.4 Gy to whole pelvis) and HDR brachytherapy. The common regimens of HDR brachytherapy were a total dose of 24 {approx} 28 Gy with 6 {approx} 7 fractions to point A at two fractions per week. The median overall treatment time was 55 days (range 44 to 104) in patients given both external beam radiotherapy and HDR brachytherapy. Early response of radiotherapy were evaluated by gynecologic examination and follow-up MRI 1 month after radiotherapy. Treatment responses were complete remission in 72 patients, partial response in 33 and no response in 1. The overall survival (OS) rate of all patients was 82%, and 73%, and the disease free survival (DFS) rate was 72%, and 69%, at 3, and 5 years, respectively. The pelvic control rate (PCR) was 79% at both 3 and 5 years. According to the FIGO stage, 3 and 5 year OS were 100% and 50% in CIS/IA, 100% in 100% in IB, 83% and 69% in IIA, 87% and 80% in IIB, and 62% and 62% in III, respectively. The 3 year OS in 4 patients with stage IVA was 100%. Three-year DFS were 80% in CIS/IA, 88% in IB, 100% in IIA, 64% in IIB, 58% in III, and 75% in IVA. Three-year PCR were 100% in CIS/IA, 94% in IB, 100% in IIA, 84% in IIB, 69% in III, and 50% in IVA. By univariate analysis, FIGO stage and treatment response were significant factors for OS. The significant factors for DFS were age, FIGO stage, treatment response and overall treatment time (OTT). For pelvic control rate

Dose-response and failure pattern for bulky or barrel-shaped stage IB cervical cancer treated by combined photon irradiation and extrafascial hysterectomy

International Nuclear Information System (INIS)

Maruyama, Y.; van Nagell, J.R.; Yoneda, J.; Donaldson, E.; Gallion, H.H.; Higgins, R.; Powell, D.; Kryscio, R.; Berner, B.

1989-01-01

From 1975 to 1987, 80 patients with bulky or barrel-shaped Stage IB cervical cancer were treated with preoperative irradiation and Cs-137 intracavitary implant therapy, before a planned extrafascial abdominal hysterectomy, using a consistent treatment policy. Of the hysterectomy specimens obtained, 37% were positive histologically at 89 +/- 2.3 days after the start of radiotherapy and at 4 to 6 weeks after the completion of radiation therapy. Sixty-three percent were negative after a total external and internal cervix irradiation dose of 9642 cGy at point T. The average point A dose contributed by intracavitary therapy was 2104 cGy. The survival rate at 5 years was 84%: At 10 years the survival rate was 78%. The failure pattern was analyzed for patients who had positive and negative specimens. The patients with positive specimens failed pelvically or pelvically and distantly. Patients with negative specimens failed in extrapelvic or distant metastatic sites. Preoperative radiotherapy led to excellent local and pelvic control of tumor, and the failures became predominantly distant metastases. The combined radiosurgical therapy was tolerated well and allowed surgical staging of disease. This permitted earlier and selective consideration of adjunctive therapy (i.e., paraaortic irradiation, chemotherapy, or chemoradiotherapy). The dose-response data give insight into the effects of photon radiotherapy on bulky or barrel Stage IB cervical cancers and correlate histologic status with failure pattern, outcome, and long-term survival

Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

International Nuclear Information System (INIS)

Sakuragi, Noriaki

2007-01-01

Lymph node metastasis (LNM), together with parametrial infiltration and positive surgical margins, is an important prognostic factor in cervical cancer. The incidence of LNM increases with International Federation of Gynecology and Obstetrics (FIGO) stage, with rates being 12%-22% in stage Ib, 10%-27% in stage IIa, and 34%-43% in stage IIb. Radical hysterectomy and pelvic lymphadenectomy are widely used treatments for early-stage (Ib to IIa) cervical cancer, as well as for stage IIb disease, in some European and Asian countries. In several types of cancer, the therapeutic significance of systematic lymphadenectomy has been demonstrated by recent reports showing that a larger number of lymph nodes removed relates to better survival. In cervical cancer, a significant relationship between the number of lymph nodes removed and disease-free survival has been reported in node-positive patients. Preoperative evaluation of nodal status with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging techniques is not sensitive enough to replace the histological examination of dissected nodes. The sentinel node procedure may be an alternative to systematic lymphadenectomy to reduce treatment-related morbidity, but more work on this is needed. Although the presence of LNM does not change FIGO staging, it will modulate postoperative therapy. Progression-free and overall survivals were significantly improved by the addition of chemotherapy to adjuvant radiotherapy after radical hysterectomy and lymphadenectomy. Adjuvant chemotherapy combined solely with radical hysterectomy and systematic lymphadenectomy may also provide a survival benefit. In conclusion, efforts to establish more tailored surgical strategies, by introducing advanced imaging technologies and molecular diagnostic procedures, are needed for cervical cancer. (author)

When Does Neoadjuvant Chemotherapy Really Avoid Radiotherapy? Clinical Predictors of Adjuvant Radiotherapy in Cervical Cancer.

Science.gov (United States)

Papadia, Andrea; Bellati, Filippo; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Lorusso, Domenica; Donfrancesco, Cristina; Gasparri, Maria Luisa; Raspagliesi, Francesco

2015-12-01

The aim of this study was to identify clinical variables that may predict the need for adjuvant radiotherapy after neoadjuvant chemotherapy (NACT) and radical surgery in locally advanced cervical cancer patients. A retrospective series of cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB2-IIB treated with NACT followed by radical surgery was analyzed. Clinical predictors of persistence of intermediate- and/or high-risk factors at final pathological analysis were investigated. Statistical analysis was performed using univariate and multivariate analysis and using a model based on artificial intelligence known as artificial neuronal network (ANN) analysis. Overall, 101 patients were available for the analyses. Fifty-two (51 %) patients were considered at high risk secondary to parametrial, resection margin and/or lymph node involvement. When disease was confined to the cervix, four (4 %) patients were considered at intermediate risk. At univariate analysis, FIGO grade 3, stage IIB disease at diagnosis and the presence of enlarged nodes before NACT predicted the presence of intermediate- and/or high-risk factors at final pathological analysis. At multivariate analysis, only FIGO grade 3 and tumor diameter maintained statistical significance. The specificity of ANN models in evaluating predictive variables was slightly superior to conventional multivariable models. FIGO grade, stage, tumor diameter, and histology are associated with persistence of pathological intermediate- and/or high-risk factors after NACT and radical surgery. This information is useful in counseling patients at the time of treatment planning with regard to the probability of being subjected to pelvic radiotherapy after completion of the initially planned treatment.

Treatment of bulky stage IB and IIB cervical cancers with outpatient neutron brachytherapy, external pelvic radiation and extrafascial hysterectomy

International Nuclear Information System (INIS)

Van Nagell, J.R.; Maruyama, Y.; Yoneda, J.; Donaldson, E.S.; Hanson, M.B.; Gallion, H.H.; Powell, D.E.; Kryscio, R.J.

1986-01-01

From January, 1977, to December, 1982, twenty-nine patients with bulky (>4 cms diameter) Stage IB or IIB cervical cancer were treated at the University of Kentucky Medical Center by a combination of out-patient neutron brachytherapy (Cf-252) and external pelvic radiation followed by extrafascial hysterectomy. Residual tumor was present in the hysterectomy specimens of 25 per cent. Complications during and following radiation therapy and surgery were minimal and included vaginal stenosis, proctitis, and hemorrhagic cystitis. The mean duration of hospitalization for surgery in these patients was 6.6 days (range 5-15 days) and postoperative morbidity was low. No patient required blood transfusion. Four patients developed urinary tract infections and two had superficial wound separations. Following treatment, patients were seen at monthly intervals for one year, every three months for two years, and every six months thereafter. No patient has been lost to follow-up. Two patients (7 per cent) developed tumor recurrence and have died of disease (1 of distant metastases; 1 local). The remaining 27 patients (93 per cent) are alive and well with no evidence of disease 24-89 months (mean 48 months) after therapy. No radiogenic fistulae or bowel obstruction were observed. These preliminary results suggest that the combination of outpatient neutron brachytherapy, external pelvic radiation, and extrafascial hysterectomy for patients with Stage IB and IIB cervical cancer is well tolerated. Complications associated with this treatment regimen have been minimal, and the recurrence rate is low. The duration of intracavitary neutron brachytherapy was short, and outpatient therapy was well received by patients

Development and validation of a surgical-pathologic staging and scoring system for cervical cancer.

Science.gov (United States)

Li, Shuang; Li, Xiong; Zhang, Yuan; Zhou, Hang; Tang, Fangxu; Jia, Yao; Hu, Ting; Sun, Haiying; Yang, Ru; Chen, Yile; Cheng, Xiaodong; Lv, Weiguo; Wu, Li; Zhou, Jin; Wang, Shaoshuai; Huang, Kecheng; Wang, Lin; Yao, Yuan; Yang, Qifeng; Yang, Xingsheng; Zhang, Qinghua; Han, Xiaobing; Lin, Zhongqiu; Xing, Hui; Qu, Pengpeng; Cai, Hongbing; Song, Xiaojie; Tian, Xiaoyu; Shen, Jian; Xi, Ling; Li, Kezhen; Deng, Dongrui; Wang, Hui; Wang, Changyu; Wu, Mingfu; Zhu, Tao; Chen, Gang; Gao, Qinglei; Wang, Shixuan; Hu, Junbo; Kong, Beihua; Xie, Xing; Ma, Ding

2016-04-12

Most cervical cancer patients worldwide receive surgical treatments, and yet the current International Federation of Gynecology and Obstetrics (FIGO) staging system do not consider surgical-pathologic data. We propose a more comprehensive and prognostically valuable surgical-pathologic staging and scoring system (SPSs). Records from 4,220 eligible cervical cancer cases (Cohort 1) were screened for surgical-pathologic risk factors. We constructed a surgical-pathologic staging and SPSs, which was subsequently validated in a prospective study of 1,104 cervical cancer patients (Cohort 2). In Cohort 1, seven independent risk factors were associated with patient outcome: lymph node metastasis (LNM), parametrial involvement, histological type, grade, tumor size, stromal invasion, and lymph-vascular space invasion (LVSI). The FIGO staging system was revised and expanded into a surgical-pathologic staging system by including additional criteria of LNM, stromal invasion, and LVSI. LNM was subdivided into three categories based on number and location of metastases. Inclusion of all seven prognostic risk factors improves practical applicability. Patients were stratified into three SPSs risk categories: zero-, low-, and high-score with scores of 0, 1 to 3, and ≥4 (P=1.08E-45; P=6.15E-55). In Cohort 2, 5-year overall survival (OS) and disease-free survival (DFS) outcomes decreased with increased SPSs scores (P=9.04E-15; P=3.23E-16), validating the approach. Surgical-pathologic staging and SPSs show greater homogeneity and discriminatory utility than FIGO staging. Surgical-pathologic staging and SPSs improve characterization of tumor severity and disease invasion, which may more accurately predict outcome and guide postoperative therapy.

Adenocarcinoma of the endometrium treated with combined irradiation and surgery: Study of 437 patients

International Nuclear Information System (INIS)

Touboul, Emmanuel; Belkacemi, Yazid; Buffat, Laurent; Deniaud-Alexandre, Elisabeth; Lefranc, Jean-Pierre; Lhuillier, Pierre; Uzan, Serge; Jannet, Denis; Uzan, Michele; Antoine, Martine; Huart, Judith; Ganansia, Valerie; Milliez, Jacques; Blondon, Jean; Housset, Martin; Schlienger, Michel

2001-01-01

Purpose: To identify prognostic factors and treatment toxicity in a series of operable endometrial adenocarcinomas. Methods and Materials: Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system (225 Stage IB, 107 Stage IC, 4 Stage IIA, 35 Stage IIB, 30 Stage IIIA, 6 Stage IIIB, and 30 Stage IIIC), underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n=140) or with (n=297) pelvic lymph node dissection. The chronology of adjuvant RT was not randomized and depended on the usual practices of the surgical teams. Seventy-nine pts (Group I) received preoperative low-dose-rate uterovaginal brachytherapy (mean dose [MD]: 57 Gy). Three hundred fifty-eight pts (Group II) received postoperative RT. One hundred ninety-six pts received low-dose-rate vaginal brachytherapy alone (MD: 50 Gy). One hundred fifty-eight pts had external beam pelvic RT (MD: 46 Gy) followed by low-dose-rate vaginal brachytherapy (MD: 17 Gy). Four pts had external beam pelvic RT alone (MD: 47 Gy). The mean follow-up from the beginning of treatment was 128 months. Results: The 10-year disease-free survival rate was 86%. From 57 recurrences, only 12 were isolated locoregional recurrences. The independent factors decreasing the probability of disease-free survival were as follows: histologic type (clear-cell carcinoma, p=0.038), largest histologic tumor diameter >3 cm (p=0.015), histologic grade (p=0.008), myometrial invasion > 1/2 (p=0.005), and 1988 FIGO staging system (p=9.10 -8 ). In Group II, the addition of external beam pelvic RT did not seem to independently improve vaginal or pelvic control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were stage FIGO (p=0.02) and pelvic lymph node dissection (p=0.011). The 10-year rate for Grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3

Medications (for IBS)

Medline Plus

Full Text Available ... Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online ...

Medications (for IBS)

Medline Plus

Full Text Available ... July 2017 Print Jump to Topic Medications for IBS Laxatives Anticholinergic/Antispasmodic Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, ...

Flexibility of Supply Chain in Industrialised Building System (IBS

Directory of Open Access Journals (Sweden)

Kassim U.

2014-01-01

Full Text Available It is irrefutable that the construction industry is in need of a highly technological construction method or system for the simple aim of giving it a push it deserves. In Malaysia this technologically enhanced method is known as the Indutrialised Building System (IBS. Concerted efforts have been made for the past decade by various responsible parties especially by the government. Therefore, the IBS ‘Road Map’ 2003–2010 was introduced and now continues with the IBS ‘road map’ 2011-2015. However, its performance is still at its infancy, which target is only at an initial stage. This study seeks to identify and analyse the factor of the IBS’ system’s supply chain flexibility as a factor on the success of the system itself. It has been a suspicion that there exists a condition and situation where the supply chain is too rigid and is not flexible in fulfilling the needs and demands of the IBS development in Malaysia. This inflexible situation has brought about a broad range of problems and has stood in the way of the development of the industrialised building system, despite it being introduced since 1964, or 49 years ago. Flexibility in the IBS supply chain is very important and is associated with other industries like transportation, manufacturing industry, and others. Up until now, we have yet to discover any special studies related to the flexibility in the IBS supply chain in this country. Responding to this challenge, this research is hoped to be able to provide sufficient feedback to the solution to the IBS supply chain flexibility issue. The researcher is confident that the poor system flow of supply chain has impeded the advancement of the Industrialised Building System that has long been open to debate.

[Validation of the IBS-SSS].

Science.gov (United States)

Betz, C; Mannsdörfer, K; Bischoff, S C

2013-10-01

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by abdominal pain, associated with stool abnormalities and changes in stool consistency. Diagnosis of IBS is based on characteristic symptoms and exclusion of other gastrointestinal diseases. A number of questionnaires exist to assist diagnosis and assessment of severity of the disease. One of these is the irritable bowel syndrome - severity scoring system (IBS-SSS). The IBS-SSS was validated 1997 in its English version. In the present study, the IBS-SSS has been validated in German language. To do this, a cohort of 60 patients with IBS according to the Rome III criteria, was compared with a control group of healthy individuals (n = 38). We studied sensitivity and reproducibility of the score, as well as the sensitivity to detect changes of symptom severity. The results of the German validation largely reflect the results of the English validation. The German version of the IBS-SSS is also a valid, meaningful and reproducible questionnaire with a high sensitivity to assess changes in symptom severity, especially in IBS patients with moderate symptoms. It is unclear if the IBS-SSS is also a valid questionnaire in IBS patients with severe symptoms because this group of patients was not studied. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of the response of concurrent high dose rate intracavitary brachytherapy with external beam radiotherapy in management of early stage carcinoma cervix.

Science.gov (United States)

Patidar, Arvind Kumar; Kumar, H S; Walke, Rahul V; Hirapara, Pushpendra H; Jakhar, Shankar Lal; Bardia, M R

2012-10-01

To evaluate local disease control and early complications of concomitant brachytherapy with external beam-radiotherapy in early stage carcinoma cervix. Fifty patients of early stage carcinoma cervix (FIGO-IB/IIA) were randomly divided into study group concomitant external beam irradiation (EBRT) and HDR-ICBT (intra-cavitary brachytherapy, xrt = 50 Gy/25 Fr, HDR 5.2 Gy*5 Fr) and the control group EBRT followed by HDR-ICBT (xrt = 50 Gy/25 Fr, HDR 7.5 Gy*3 Fr). Acute reactions and local disease response were compared between treatment and at 6-month follow up. Median overall treatment times were 38 and 61 days in the study and the control groups, respectively. Acute skin reactions and diarrhea were more in the study but manageable. At the completion of the study, there were 80 and 68 % complete responses, 16 and 20 % partial responses, 0 and 8 % stable diseases in the study group and the control group, respectively. Response was better in the study group but statistically insignificant. Larger number of patients and longer follow up are required to arrive at concrete conclusion.

Medications (for IBS)

Medline Plus

Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications ... Psychological Treatments Understanding Stress Cognitive Behavioral ...

Medications (for IBS)

Medline Plus

Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS ... Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral ...

Medications (for IBS)

Medline Plus

Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and ... Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Estadiamento cirúrgico do câncer de colo de útero localmente avançado Surgical staging of locally advanced uterine cervix cancer

Directory of Open Access Journals (Sweden)

Heitor Ricardo Cosiski Marana

2005-12-01

controle locorregional da doença na pelve.PURPOSE: to assess to what extent the surgical staging differs from the clinical staging among cases of advanced uterine cervix carcinoma, and also to assess the percentage of cases with positive para-aortic ganglia in this group of patients. METHODS: this is a descriptive prospective study in which 36 patients with histological diagnosis of uterine cervix carcinoma considered locally advanced were included (stages IB2, IIB, IIIA and B, and IVA. The cases were submitted to clinical staging, according to FIGO criteria. All patients were to be treated with neoadjuvant chemotherapy. Age ranged from 40 to 73 years, with a mean of 56.2±7.9. The procedure started with pelvic lymphadenectomy followed by para-aortic lymphadenectomy, in case the pelvic lymph nodes were positive on surgical examination. Examination of the abdominal cavity and lymphadenectomy were done either through laparotomy or laparoscopy, chosen at random. In each case, the clinical staging was compared to the surgical staging, considered the gold standard. RESULTS: in the clinical staging (CS, 7 cases were classified as IB2 (tumors larger than 4 cm, 22 cases as CSII and 7 cases as CSIII. The surgical assessment changed the clinical staging as follows: the stage was decreased in six cases, and increased in 13. There was agreement only in 18 cases (50%. The para-aortic lymph nodes were affected in six cases. CONCLUSIONS: clinical staging of locally advanced uterine cervix carcinoma is incorrect in most of the cases. Such inconsistency may lead to excessive treatment in some cases, but about one fourth of the patients with positive para-aortic ganglia would not be adequately treated with the current standard treatment radiotherapy with chemosensitization, which aims at the local regional control of the pelvic disease.

Medications (for IBS)

Medline Plus

Full Text Available ... the lack of effective treatment for the overall improvement of multiple symptoms in IBS patients. However, new ... IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With ...

Medications (for IBS)

Medline Plus

Full Text Available ... by a physician who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and ... IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take ...

Medications (for IBS)

Medline Plus

Full Text Available ... the lack of effective treatment for the overall improvement of multiple symptoms in IBS patients. However, new ... effective in treating IBS in multi-center, high quality clinical trials. These are prescription medications intended for ...

Medications (for IBS)

Medline Plus

Full Text Available ... in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in ... in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in ...

Medications (for IBS)

Medline Plus

Full Text Available ... Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You ... Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You ...

Medications (for IBS)

Medline Plus

Full Text Available ... Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS ... Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS ...

Medications (for IBS)

Medline Plus

Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online Studies Working With Your Doctor Successful relationships with healthcare providers are an important part of ...

Medications (for IBS)

Medline Plus

Full Text Available ... have limited benefit for treating IBS. In some persons they relieve abdominal pain or discomfort, usually if ... Anti-anxiety medications – can be helpful for some people with IBS, mainly those with emotional distress. There ...

Medications (for IBS)

Medline Plus

Full Text Available ... Tips on Finding a Doctor Doctor Visit Worksheet Words to Know Changing Doctors IBS Symptom Treatments IBS ... arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). All ...

Medications (for IBS)

Medline Plus

Full Text Available ... Global Treatments IBS Diet What to Do and What to Avoid Foods That Cause Cramping and Diarrhea Foods that Cause ... 12 Week Elimination Diet for IBS Rice-Based Foods Low-FODMAP Diet What Are FODMAPs? Effects of FODMAPs on the Gut ...

IBS Treatment Options

Science.gov (United States)

... 01 July 2017 Print A short bout of abdominal pain and diarrhea or constipation now and then is not unusual. But long-term or recurring symptoms are not normal. They may signal irritable bowel syndrome (IBS) – and are generally treatable. IBS Treatments Depend ...

Medications (for IBS)

Medline Plus

Full Text Available ... Global Treatments IBS Diet What to Do and What to Avoid Foods That Cause Cramping and Diarrhea Foods that Cause Gas and Bloating Dietary Fiber 12 Week Elimination Diet for IBS Rice-Based Foods Low-FODMAP Diet What Are FODMAPs? Effects of FODMAPs on the Gut ...

Low morbidity following 9,000-rad intracavitary endocurietherapy (ECT) using the Kumar cervical applicator and external-beam radiotherapy (EXRT) in the management of carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Kumar, P.P.; Good, R.R.; Scott, J.C.; Jones, E.O.; Lynch, G.; McCaul, G.F.

1988-01-01

The Kumar Cervical Applicator minimizes patient discomfort and improves patient mobility while reducing the tendency of the applicator to rotate during the 40 to 50 hours of uterine intracavitary endocurietherapy. Patients with previously untreated invasive carcinoma of the uterine cervix, F.I.G.O. stages IB-IVA, were treated with two Kumar intracavitary endocurietherapy (ECT) applications of 2,500 rad each to point ''A,'' and 4,000 rad external-beam radiotherapy (EXRT) to midplane, for a total dose of 9,000 rad. The major complication rate was 2.7 %, and the local control rate was 85 % (22/26 patients) for stage I and II, and 91 % (10/11 patients) for stage III and IVA. (author)

Stage I/II endometrial carcinomas: preoperative radiotherapy: results

International Nuclear Information System (INIS)

Maingon, P.; Belichard, C.; Horiot, J.C.; Barillot, I.; Fraisse, J.; Collin, F.

1996-01-01

The AIM of this retrospective study is to analyse the indications and the results of treatment of endometrial carcinomas by preoperative radiotherapy. MATERIAL: From 1976 to 1995, 183 patients FIGO stage I or II were treated by preoperative radiotherapy consisting in 95 cases of external radiotherapy (XRT) and brachytherapy (BT) followed by surgery (S) and, in 88 cases of BT alone before surgery, XRT was indicated in cases of grade 2 or 3 and/or cervical involvement. METHODS: XRT was delivered with a 4-fields technique to 40 Gy in 20 fractions with a medial shielding at 30 Gy. BT was done with low dose rate Cs137 and Fletcher-Suit-Delclos applicators with two intra-uterine tubes and vaginal ovoieds. Complications were scored using the French-Italian syllabus. RESULTS: Five-year actuarial survival rates per stage are: Ia=91%, Ib=83%, II=71%, and per grade: G1=80%, G2=79%, G3=90%. Failures were pelvic in 5/183 (2.7%), vaginal in 4 cases (2%) and nodal in 2 cases (1%). Twelve patients developed metastases (6.5%). Complications were analysed during the radiotherapy, after the surgery and with unlimited follow-up. After BT/S, 12 grade 1, 1 grade 2 and 1 grade 3 complications were observed. In the group of patients treated by RT/BT/S, 22 grade 1, 11 grade 2, 4 grade 3 occurred. There is no statistical correlation between complications and parameters of treatment (XRT, hwt, HWT, reference dose to the bladder and rectum, dose rate of brachytherapy). SUMMARY: Preoperative irradiation is an effective and safe treatment of high risk stage I/II endometrial carcinomas. Results seem independent of the pathology grade

Study of a new tumor marker, CYFRA 21-1, in squamous cell carcinoma of the cervix, and comparison with squamous cell carcinoma antigen

International Nuclear Information System (INIS)

Tsai, S.Ch.; KAo, CH.H.; Wang, S.J.

1996-01-01

The diagnosis value of a new tumor marker, CYFRA 21-1, was studied in the blood samples collected from 22 controls, and 87 pre-treatment patients with squamous cell carcinoma of the cervix. Sensitivity and specificity of CYFRA 21-1 was was compared with those of squamous cell carcinoma antigen (SCC) measured in the sera of the same patients. Serum CYFRA 21-1 levels were higher in patients with squamous cell carcinoma than in controls (p < 0.05), and correlated with FIGO stage (Stage IIb-IV vs. Stage Ib-IIa, p = 0.0477). Using 2.5 ng/ml as cut-off value, elevated CYFRA 21-1 levels were found in 13.6% of controls, 34.8% of patients with Stage Ib-IIa squamous cell carcinoma of the cervix, and 63.5% of patients with Stage IIb-IV squamous cell carcinoma of the cervix. However, there was less sensitivity and specificity of CYFRA 21-1 than those of SCC in detecting squamous cell carcinoma of the cervix. CYFRA 21-1 may not be a better tumor marker than SCC for squamous cell carcinoma of the cervix. (author)

IBS for non-gaussian distributions

International Nuclear Information System (INIS)

Fedotov, A.; Sidorin, A.O.; Smirnov, A.V.

2010-01-01

In many situations distribution can significantly deviate from Gaussian which requires accurate treatment of IBS. Our original interest in this problem was motivated by the need to have an accurate description of beam evolution due to IBS while distribution is strongly affected by the external electron cooling force. A variety of models with various degrees of approximation were developed and implemented in BETACOOL in the past to address this topic. A more complete treatment based on the friction coefficient and full 3-D diffusion tensor was introduced in BETACOOL at the end of 2007 under the name 'local IBS model'. Such a model allowed us calculation of IBS for an arbitrary beam distribution. The numerical benchmarking of this local IBS algorithm and its comparison with other models was reported before. In this paper, after briefly describing the model and its limitations, they present its comparison with available experimental data.

Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT)

DEFF Research Database (Denmark)

Schou Karlsen, Nikoline Marie; Karlsen, Mona Aarenstrup; Høgdall, Estrid

2016-01-01

.1% in FIGO stages II-IV. Relapse of BOT was detected in 3.7%, hereof 40.5% with malignant transformation. The five-year disease-free survival was 97.6% in FIGO stage I and 87.3% in FIGO stages II-IV. Younger age, laparoscopic surgical approach, fertility sparing surgery, FIGO stages II-IV, bilateral tumour...... presence, serous histology, implants and microinvasion of the tumour were significantly associated with relapse in univariate analyses. The overall five-year survival rate was 92.2% in FIGO stage I and 89.0% in FIGO stages II-IV. Out of 77 deaths in total, only seven women died from BOT. CONCLUSIONS...

Disparities in Adherence to National Comprehensive Cancer Network Treatment Guidelines and Survival for Stage IB-IIA Cervical Cancer in California.

Science.gov (United States)

Pfaendler, Krista S; Chang, Jenny; Ziogas, Argyrios; Bristow, Robert E; Penner, Kristine R

2018-05-01

To evaluate the association of sociodemographic and hospital characteristics with adherence to National Comprehensive Cancer Network treatment guidelines for stage IB-IIA cervical cancer and to analyze the relationship between adherent care and survival. This is a retrospective population-based cohort study of patients with stage IB-IIA invasive cervical cancer reported to the California Cancer Registry from January 1, 1995, through December 31, 2009. Adherence to National Comprehensive Cancer Network guideline care was defined by year- and stage-appropriate surgical procedures, radiation, and chemotherapy. Multivariate logistic regression, Kaplan-Meier estimate, and Cox proportional hazard models were used to examine associations between patient, tumor, and treatment characteristics and National Comprehensive Cancer Network guideline adherence and cervical cancer-specific 5-year survival. A total of 6,063 patients were identified. Forty-seven percent received National Comprehensive Cancer Network guideline-adherent care, and 18.8% were treated in high-volume centers (20 or more patients/year). On multivariate analysis, lowest socioeconomic status (adjusted odds ratio [OR] 0.69, 95% CI 0.57-0.84), low-middle socioeconomic status (adjusted OR 0.76, 95% CI 0.64-0.92), and Charlson-Deyo comorbidity score 1 or higher (adjusted OR 0.78, 95% CI 0.69-0.89) were patient characteristics associated with receipt of nonguideline care. Receiving adherent care was less common in low-volume centers (45.9%) than in high-volume centers (50.9%) (effect size 0.90, 95% CI 0.84-0.96). Death from cervical cancer was more common in the nonadherent group (13.3%) than in the adherent group (8.6%) (effect size 1.55, 95% CI 1.34-1.80). Black race (adjusted hazard ratio 1.56, 95% CI 1.08-2.27), Medicaid payer status (adjusted hazard ratio 1.47, 95% CI 1.15-1.87), and Charlson-Deyo comorbidity score 1 or higher (adjusted hazard ratio 2.07, 95% CI 1.68-2.56) were all associated with increased

Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

Science.gov (United States)

2017-05-03

Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

Preoperative radium therapy and radical hysterectomy in the treatment of cervical cancer stage IB, IIA, and initial IIB.; Radiumterapia pre-operatoria e histerectomia radical no tratamento do cancer do colo uterino IB, IIA e IIB inicial

Energy Technology Data Exchange (ETDEWEB)

Salum, Resalla; Lopes, Edison R.; Souza, Maria A.H. de [Faculdade de Medicina do Triangulo Mineiro, Uberaba, MG (Brazil). Hospital Escola

1995-07-01

Patients with IB, IIa and in initial IIb cervical cancer were randomized for combined therapy, consisting of one or two radium insertion followed by Wertheim Meigs operation performed 40 days later. We look for the early and late complications of the treatment, residual cancer after radiotherapy and survival without recurrence. The project begin in 1965 and ended in 1986. All the operations were done by one of the investigators and 116 patients were analysed. The age ranged from 21 to 75 years with an average of 4.18 years. During the operations 31 (26.72%) patients needed 1.500 cc or greater amount of blood transfusion and we have 3 iliac veins lesions. Managing the ureters, we do our best to leave the posterior fascia as intact as possible. Post operative complications ranged from minor (fever, localised pelvic infections, temporary popliteal nerve paralysis) to evisceration (3 patients) deep venous thrombosis (3 patients) and two early urinary fistulas. Late complications were seen in patients submitted to sequential teletherapy irradiation. One uretrovaginal fistula occurred 10 month after treatment, another one, 7 years later and the third one 24 years later. One patient develop hydronefrosis and enterocolite after 7.000 rads of teletherapy and another one rectovaginal fistula 13 years after initial therapy. The shortening of the vagina making impossible the intercourse was seen in 7 patients. By the histological examination, the cervix was sterilized in 73.3 % of the patients. Residual cancer was found according the original size of the tumour and the stage of the disease. Studying different combinations between the existence of residual cervical cancer with positive or negative limphnodes and making a correlation with survival, we found the critical points is to have positive cervix and positive lymphonodes. The five years survival (life table methodology) for stage 1 lesion was 96%; stage II, 67%. At ten years survival was slighted different. With positive

Radical surgery compared with intracavitary cesium followed by radical surgery in cervical carcinoma stage IB

Energy Technology Data Exchange (ETDEWEB)

Tinga, D.J.; Bouma, J.; Aalders, J.G. (Dept. of Obstetrics and Gynaecology, State Univ. Hospital, Groningen (Netherlands)); Hollema, H. (Dept. of Pathology, State Univ. Hospital, Groningen (Netherlands))

1990-01-01

Forty-nine patients aged {le} 45 years, with cervical carcinoma stage IB ({le} 3 cm) were treated with either primary radical surgery (n = 26), or intracavitary irradiation followed by radical surgery (n = 23). With primary surgery, ovarian function had been preserved in 15 of the 25 patients, who were alive and well. Seven of the primary surgery patients were irradiated postoperatively and 2 others with a central recurrence were cured by irradiation. One other patient, who was not irradiated postoperatively, had an intestinal metastasis and died of the disease. If any of the adverse prognostic factors (as reported in the literature) had been considered as an indication for postoperative irradiation, 17 patients instead of 7 would have been irradiated after primary radical surgery. In the comparable group of 23 patients treated by intracavitary irradiation and radical surgery (and in 4 cases postoperative irradiation as well) there was no recurrence. There was no significant statistical difference between the treatment results in the cesium + surgery group and those who underwent primary radical surgery. Young patients with early cervical carcinoma without prognostic indicators for postoperative irradiation can benefit from primary radical surgery, because their ovarian function can be preserved. (authors).

Radical surgery compared with intracavitary cesium followed by radical surgery in cervical carcinoma stage IB

International Nuclear Information System (INIS)

Tinga, D.J.; Bouma, J.; Aalders, J.G.; Hollema, H.

1990-01-01

Forty-nine patients aged ≤ 45 years, with cervical carcinoma stage IB (≤ 3 cm) were treated with either primary radical surgery (n = 26), or intracavitary irradiation followed by radical surgery (n = 23). With primary surgery, ovarian function had been preserved in 15 of the 25 patients, who were alive and well. Seven of the primary surgery patients were irradiated postoperatively and 2 others with a central recurrence were cured by irradiation. One other patient, who was not irradiated postoperatively, had an intestinal metastasis and died of the disease. If any of the adverse prognostic factors (as reported in the literature) had been considered as an indication for postoperative irradiation, 17 patients instead of 7 would have been irradiated after primary radical surgery. In the comparable group of 23 patients treated by intracavitary irradiation and radical surgery (and in 4 cases postoperative irradiation as well) there was no recurrence. There was no significant statistical difference between the treatment results in the cesium + surgery group and those who underwent primary radical surgery. Young patients with early cervical carcinoma without prognostic indicators for postoperative irradiation can benefit from primary radical surgery, because their ovarian function can be preserved. (authors)

Management pathway for patients with cervical cancer in the Auckland region 2003–2007

International Nuclear Information System (INIS)

Capelle, Lisa; Brooks, Susan; Stevens, Wendy

2011-01-01

This review was performed to describe the patient pathway and timelines involved in the treatment of FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IVA cervical cancer in a New Zealand cancer centre. Retrospective audit of women with a new diagnosis of FIGO Stage IB1–IVA cervical cancer in the Auckland/Northland regions between 2003 and 2007. Two hundred and seven patients were identified. Median time from referral to first specialist assessment (FSA) was 10 days, from FSA to decision to treat (DTT) 50 days and from DTT to start of treatment 26 days. Overall median time from referral to start of treatment was 97 days. There was no difference in median time from referral to DTT for patients treated with primary surgery (48 days) or radiotherapy (47 days). On univariate analysis, factors associated with reduced time from referral to start of treatment were less socioeconomic deprivation (P = 0.001), shorter time to completion of radiological investigations (P < 0.0005) and private FSA (P < 0.0005). Only private FSA remained significant on multivariate analysis. The greatest delay in the pathway was between FSA and DTT, encompassing presentation at multidisciplinary meeting, examination under anaesthetic and obtaining radiological investigations. Median overall treatment time (OTT) for patients treated with definitive radiotherapy was 56 days and was increased by a median of 3 days where there were delays accessing operating theatre time for brachytherapy insertions. Overall patient pathway and radiotherapy OTT were longer than optimal, and areas of delay potentially amenable to modification were identified.

topIb, a phylogenetic hallmark gene of Thaumarchaeota encodes a functional eukaryote-like topoisomerase IB.

Science.gov (United States)

Dahmane, Narimane; Gadelle, Danièle; Delmas, Stéphane; Criscuolo, Alexis; Eberhard, Stephan; Desnoues, Nicole; Collin, Sylvie; Zhang, Hongliang; Pommier, Yves; Forterre, Patrick; Sezonov, Guennadi

2016-04-07

Type IB DNA topoisomerases can eliminate torsional stresses produced during replication and transcription. These enzymes are found in all eukaryotes and a short version is present in some bacteria and viruses. Among prokaryotes, the long eukaryotic version is only observed in archaea of the phylum Thaumarchaeota. However, the activities and the roles of these topoisomerases have remained an open question. Here, we demonstrate that all available thaumarchaeal genomes contain a topoisomerase IB gene that defines a monophyletic group closely related to the eukaryotic enzymes. We show that the topIB gene is expressed in the model thaumarchaeon Nitrososphaera viennensis and we purified the recombinant enzyme from the uncultivated thaumarchaeon Candidatus Caldiarchaeum subterraneum. This enzyme is active in vitro at high temperature, making it the first thermophilic topoisomerase IB characterized so far. We have compared this archaeal type IB enzyme to its human mitochondrial and nuclear counterparts. The archaeal enzyme relaxes both negatively and positively supercoiled DNA like the eukaryotic enzymes. However, its pattern of DNA cleavage specificity is different and it is resistant to camptothecins (CPTs) and non-CPT Top1 inhibitors, LMP744 and lamellarin D. This newly described thermostable topoisomerases IB should be a promising new model for evolutionary, mechanistic and structural studies. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

6 Tips: IBS and Complementary Health Practices

Science.gov (United States)

... health practice for IBS, here are 6 tips: Hypnotherapy (hypnosis). This practice involves the power of suggestion by ... IBS. According to reviews of the scientific literature, hypnotherapy may be a helpful treatment for managing IBS ...

Clinical practice of adjuvant chemotherapy in patients with early-stage epithelial ovarian cancer

NARCIS (Netherlands)

Frielink, Lindy M J; Pijlman, Brenda M; Ezendam, N.P.M.; Pijnenborg, Johanna 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

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

New FIGO and Swedish intrapartum cardiotocography classification systems incorporated in the fetal ECG ST analysis (STAN) interpretation algorithm: agreements and discrepancies in cardiotocography classification and evaluation of significant ST events.

Science.gov (United States)

Olofsson, Per; Norén, Håkan; Carlsson, Ann

2018-02-01

The updated intrapartum cardiotocography (CTG) classification system by FIGO in 2015 (FIGO2015) and the FIGO2015-approached classification by the Swedish Society of Obstetricians and Gynecologist in 2017 (SSOG2017) are not harmonized with the fetal ECG ST analysis (STAN) algorithm from 2007 (STAN2007). The study aimed to reveal homogeneity and agreement between the systems in classifying CTG and ST events, and relate them to maternal and perinatal outcomes. Among CTG traces with ST events, 100 traces originally classified as normal, 100 as suspicious and 100 as pathological were randomly selected from a STAN database and classified by two experts in consensus. Homogeneity and agreement statistics between the CTG classifications were performed. Maternal and perinatal outcomes were evaluated in cases with clinically hidden ST data (n = 151). A two-tailed p ST events, heterogeneities were significant and agreements moderate to almost perfect (STAN2007 vs. FIGO2015 0.86, 0.72; STAN2007 vs. SSOG2017 0.92, 0.84; FIGO2015 vs. SSOG2017 0.94, 0.87). Significant ST events occurred more often combined with STAN2007 than with FIGO2015 classification, but not with SSOG2017; correct identification of adverse outcomes was not significantly different between the systems. There are discrepancies in the classification of CTG patterns and significant ST events between the old and new systems. The clinical relevance of the findings remains to be shown. © 2017 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

The Role of Vaginal Brachytherapy in the Treatment of Surgical Stage I Papillary Serous or Clear Cell Endometrial Cancer

International Nuclear Information System (INIS)

Barney, Brandon M.; Petersen, Ivy A.; Mariani, Andrea; Dowdy, Sean C.; Bakkum-Gamez, Jamie N.; Haddock, Michael G.

2013-01-01

Objectives: The optimal adjuvant therapy for International Federation of Gynecology and Obstetrics (FIGO) stage I papillary serous (UPSC) or clear cell (CC) endometrial cancer is unknown. We report on the largest single-institution experience using adjuvant high-dose-rate vaginal brachytherapy (VBT) for surgically staged women with FIGO stage I UPSC or CC endometrial cancer. Methods and Materials: From 1998-2011, 103 women with FIGO 2009 stage I UPSC (n=74), CC (n=21), or mixed UPSC/CC (n=8) endometrial cancer underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adjuvant high-dose-rate VBT. Nearly all patients (n=98, 95%) also underwent extended lymph node dissection of pelvic and paraortic lymph nodes. All VBT was performed with a vaginal cylinder, treating to a dose of 2100 cGy in 3 fractions. Thirty-five patients (34%) also received adjuvant chemotherapy. Results: At a median follow-up time of 36 months (range, 1-146 months), 2 patients had experienced vaginal recurrence, and the 5-year Kaplan Meier estimate of vaginal recurrence was 3%. The rates of isolated pelvic recurrence, locoregional recurrence (vaginal + pelvic), and extrapelvic recurrence (including intraabdominal) were similarly low, with 5-year Kaplan-Meier estimates of 4%, 7%, and 10%, respectively. The estimated 5-year overall survival was 84%. On univariate analysis, delivery of chemotherapy did not affect recurrence or survival. Conclusions: VBT is effective at preventing vaginal relapse in women with surgical stage I UPSC or CC endometrial cancer. In this cohort of patients who underwent comprehensive surgical staging, the risk of isolated pelvic or extrapelvic relapse was low, implying that more extensive adjuvant radiation therapy is likely unnecessary.

Processamento e qualidade de compotas de figo diet e convencional

Directory of Open Access Journals (Sweden)

Priscilla Kárim Caetano

2017-03-01

Full Text Available Resumo O objetivo desta pesquisa foi avaliar as características físico-químicas de qualidade de compotas de figo diet e convencional. A variedade utilizada neste experimento foi Figos cv. roxo, sendo avaliadas diferentes formulações com edulcorantes. Os testes foram realizados com nove tratamentos e três repetições, totalizando 27 amostras. As formulações da calda foram: calda de açúcar (TA; Sorbitol (TS; Eritritol (TE; Sorbitol e Erititol (TSE; Steviosídeo (TST; Ciclamato de Sódio, Sucralose e Sacarina Sódica (TCSuSa; Ciclamato sódico e Sacarina sódica (TSC; Acessulfame-K e Sucralose (TAcSu; Steviosídeo, Sacarina Sódica e Ciclamato de Sódio (TSSC. Os atributos físico-químicos avaliados, de acordo com a literatura e a legislação para este tipo de produto, foram pH, sólidos solúveis, acidez titulável, açúcar redutor, açúcar redutor total, proteína, lipídeo, cinzas e umidade. Observe-se que os resultados obtidos também estão de acordo com a literatura e a legislação para este tipo de produto. Em relação aos parâmetros de qualidade, todos os tratamentos apresentaram resultados satisfatórios, com valores de pH que variaram de 3,98 a 4,47, presença de vácuo de 11 a 13 pol Hg–1 e teores de sólidos solúveis que variaram de 9,43 a 3,90, para os tratamentos com edulcorantes. O produto desenvolvido, por suas características, se enquadra na categoria de produtos diet.

Adjuvant postoperative radiation therapy for carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Lee, Kyung Ja; Moon, Hye Seong; Kim, Seung Cheol; Kim, Chong Il; Ahn, Jung Ja

2003-01-01

This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study, The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, Iymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was 45 - 50 Gy. Vagina cuff irradiation was performed, after completion of the external beam irradiation, al a low-dose rate of CS-137, with the total dose of 4488-4932 chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months (15-108 months), The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95% and 94%, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Our results indicate that postoperative radiation therapy can

Diagnostic imaging in the staging of gynecologic cancers

International Nuclear Information System (INIS)

Forstner, R.; Graf, A.

1999-01-01

The prognosis in patients with gynecologic cancers depends not only on the stage but also on a wide spectrum of other findings. Cross-sectional imaging modalities, including sonography, CT and MRI, have increasingly been used for optimal treatment planning in gynecologic cancers. Their staging criteria are based on the well-established FIGO staging system. CT and MRI compete with sonography, which plays a pivotal role in the valuation of the female pelvis. This paper reviews the role of sonography, CT and MRI in the staging of gynecologic malignancies. It puts the emphasis on MRI, which has been established as imaging modality of choice in the preoperative evaluation of cervical and endometrial cancer, and which seems slightly superior to CT in the staging of ovarian cancer. (orig.) [de

Effect of hydronephrosis on survival in advanced stage cervical cancer.

Science.gov (United States)

Goklu, Mehmet Rıfat; Seckin, Kerem Doga; Togrul, Cihan; Goklu, Yasemin; Tahaoglu, Ali Emre; Oz, Murat; Ertas, Ibrahim Egemen

2015-01-01

Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (phydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (pHydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

Streptococcus sanguinis Class Ib Ribonucleotide Reductase

Science.gov (United States)

Makhlynets, Olga; Boal, Amie K.; Rhodes, DeLacy V.; Kitten, Todd; Rosenzweig, Amy C.; Stubbe, JoAnne

2014-01-01

Streptococcus sanguinis is a causative agent of infective endocarditis. Deletion of SsaB, a manganese transporter, drastically reduces S. sanguinis virulence. Many pathogenic organisms require class Ib ribonucleotide reductase (RNR) to catalyze the conversion of nucleotides to deoxynucleotides under aerobic conditions, and recent studies demonstrate that this enzyme uses a dimanganese-tyrosyl radical (MnIII2-Y•) cofactor in vivo. The proteins required for S. sanguinis ribonucleotide reduction (NrdE and NrdF, α and β subunits of RNR; NrdH and TrxR, a glutaredoxin-like thioredoxin and a thioredoxin reductase; and NrdI, a flavodoxin essential for assembly of the RNR metallo-cofactor) have been identified and characterized. Apo-NrdF with FeII and O2 can self-assemble a diferric-tyrosyl radical (FeIII2-Y•) cofactor (1.2 Y•/β2) and with the help of NrdI can assemble a MnIII2-Y• cofactor (0.9 Y•/β2). The activity of RNR with its endogenous reductants, NrdH and TrxR, is 5,000 and 1,500 units/mg for the Mn- and Fe-NrdFs (Fe-loaded NrdF), respectively. X-ray structures of S. sanguinis NrdIox and MnII2-NrdF are reported and provide a possible rationale for the weak affinity (2.9 μm) between them. These streptococcal proteins form a structurally distinct subclass relative to other Ib proteins with unique features likely important in cluster assembly, including a long and negatively charged loop near the NrdI flavin and a bulky residue (Thr) at a constriction in the oxidant channel to the NrdI interface. These studies set the stage for identifying the active form of S. sanguinis class Ib RNR in an animal model for infective endocarditis and establishing whether the manganese requirement for pathogenesis is associated with RNR. PMID:24381172

Clinical outcomes of adjuvant radiation therapy and prognostic factors in early stage uterine cervical cancer

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Ju; Rhee, Woo Joong; Choi, Seo Hee; Kim, Gwi Eon; Kim, Yong Bae [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Nam, EunJi; Kim, Sang Wun; Kim, Sung Hoon [Dept. of Radiation Oncology, Obstetrics and Gynecology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2015-06-15

To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic

L1CAM in Early-Stage Type I Endometrial Cancer: Results of a Large Multicenter Evaluation

NARCIS (Netherlands)

Zeimet, A.G.; Reimer, D.; Huszar, M.; Winterhoff, B.; Puistola, U.; Azim, S.A.; Muller-Holzner, E.; Ben-Arie, A.; Kempen, L.C.L.T. van; Petru, E.; Jahn, S.; Geels, Y.P.; Massuger, L.F.A.G.; Amant, F.; Polterauer, S.; Lappi-Blanco, E.; Bulten, J.; Meuter, A.; Tanouye, S.; Oppelt, P.; Stroh-Weigert, M.; Reinthaller, A.; Mariani, A.; Hackl, W.; Netzer, M.; Schirmer, U.; Vergote, I.; Altevogt, P.; Marth, C.; Fogel, M.

2013-01-01

BACKGROUND: Despite the excellent prognosis of Federation Internationale de Gynecologie et d'Obstetrique (FIGO) stage I, type I endometrial cancers, a substantial number of patients experience recurrence and die from this disease. We analyzed the value of immunohistochemical L1CAM determination to

IBS SURVEY 2010: DRIVERS, BARRIERS AND CRITICAL SUCCESS FACTORS IN ADOPTING INDUSTRIALISED BUILDING SYSTEM (IBS CONSTRUCTION BY G7 CONTRACTORS IN MALAYSIA

Directory of Open Access Journals (Sweden)

KAMARUL ANUAR MOHAMAD KAMAR

2014-08-01

Full Text Available The industrialised building system (IBS survey has become an essential tool for ensuring the IBS Roadmap (2003 to 2010 meets its goals and target. As part of the process review survey, it also records the trend achievement of Malaysia in the usage of IBS in the building construction industry. The first and second IBS surveys were published in 2003 and 2005, respectively. Afterward, the IBS Roadmap’s midterm review was conducted. The third and the most recent IBS surveys were conducted in 2008 and 2010, respectively. This paper aims to highlight a part of the IBS survey report in 2010, which has been conducted to measure the drivers, barriers and the critical success factors of G7 contractors in adopting IBS construction. G7 is a Construction Industry Development Board contractor grade that can apply tender without limit. The importance of this paper is that it guides the policy and implementation strategy of IBS by G7 contractors. The survey shows that the acceptance, adoption, and deployment of IBS in the Malaysian construction industry are still low and do not address the persisting problems, such as productivity, dependency on foreign workers and high level of construction wastage.

Does adjuvant therapy improve overall survival for stage IA/B pancreatic adenocarcinoma?

Science.gov (United States)

Ostapoff, Katherine T; Gabriel, Emmanuel; Attwood, Kristopher; Kuvshinoff, Boris W; Nurkin, Steven J; Hochwald, Steven N

2017-07-01

Current guidelines recommend adjuvant chemotherapy for resected pancreatic adenocarcinoma (PDAC). However, no studies have addressed its survival benefit for stage I patients as they comprise IA or IB PDAC were identified. Median OS was 60.3 months (mo) for stage IA and 36.9 mo for IB. 45.5% received adjuvant chemotherapy; 19.9% received adjuvant chemoradiation. There was OS benefit for both stage IA/IB patients with adjuvant chemotherapy (HR = 0.73 and 0.76 for IA and IB, respectively, p = 0.002 and IA disease (n = 1,477, 37.8%), age ≥70 (p < 0.001), higher grade (p < 0.001), ≤10 lymph nodes examined (p = 0.008), positive margins (p < 0.001), and receipt of adjuvant chemoradiation (p = 0.002) were associated with worse OS. For stage IB patients (n = 2,432, 62.2%), similar associations were observed with the exception of adjuvant chemoradiation whereby there was no significant association (p = 0.35). Adjuvant chemotherapy was associated with an OS benefit for patients with stage I PDAC; adjuvant chemoradiation was either of no benefit or associated with worse OS. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Shyamkishore Shrivastava

2013-01-01

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

Composição de bagas de 'Niágara Rosada' e 'Folha-de-Figo' relacionadas ao sistema de condução Fruit composition of 'Niágara Rosada' and 'Folha-de-Figo' grapevines under different training systems

Directory of Open Access Journals (Sweden)

Renata Vieira da Mota

2010-12-01

Full Text Available RESUMO Este trabalho teve como objetivo avaliar a influência do sistema de condução na qualidade de bagas de uvas 'Niágara Rosada' e 'Folha-de-Figo' cultivadas em Caldas-MG. Foram avaliados a produção por planta, o diâmetro, a massa, o teor de potássio e a temperatura das bagas, pH, teor de sólidos solúveis, açúcares redutores, acidez total e ácidos orgânicos do mosto, compostos fenólicos nas cascas e sementes, e antocianinas. As plantas foram conduzidas em espaldeira, lira, latada ou cordão simples, e os frutos, avaliados nas safras de 2006 e 2007. As videiras de 'Niágara Rosada' cultivadas em latada e 'Folha-de-Figo' em lira apresentaram produção significativamente superior aos demais sistemas de condução. Em todos os casos, as bagas apresentaram temperatura inferior à ambiente, indicando sombreamento completo ou parcial dos cachos. No sistema latada, houve menor acúmulo de sólidos solúveis e açúcares redutores nas duas cultivares. Estes resultados preliminares indicam que a composição das bagas foi pouco influenciada pelo sistema de condução.ABSTRACT This work aimed on evaluating the influence of training systems in berries composition of 'Niágara Rosada' and 'Folha-de-Figo' grapevines grown in Caldas, MG. Yield per plant; diameter, weight, temperature and potassium content of the berries; pH, soluble solids, reducing sugars, total acidity and organic acids of the must; anthocyanins and phenolic compounds of the skins and phenolic compounds of the seeds were evaluated in grapevines training in vertical shoot position, lyre trellis, pergola Veronese or simple string in 2006 and 2007 seasons. 'Niágara Rosada' and 'Folha-de-Figo' grapevines training in pergola Veronese and lyre trellis, respectively, showed higher yield than the other training systems under study. Berries grown under the four different training systems were cooler than ambient temperature, resulting from partial or deep shade clusters. Berries

TSH elevations as the first laboratory evidence for pseudohypoparathyroidism type Ib (PHP-Ib).

Science.gov (United States)

Molinaro, Angelo; Tiosano, Dov; Takatani, Rieko; Chrysis, Dionisios; Russell, William; Koscielniak, Nikolas; Kottler, Marie-Laure; Agretti, Patrizia; De Marco, Giuseppina; Ahtiainen, Petteri; Christov, Marta; Mäkitie, Outi; Tonacchera, Massimo; Jüppner, Harald

2015-05-01

Hypocalcemia and hyperphosphatemia because of resistance toward parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder, which is caused by GNAS methylation changes, resistance can occur toward other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are usually not recognized until PTH-resistant hypocalcemia becomes clinically apparent. We now describe four pediatric patients, first diagnosed with subclinical or overt hypothyroidism between the ages of 0.2 and 15 years, who developed overt PTH-resistance 3 to 20 years later. Although anti-thyroperoxidase (anti-TPO) antibodies provided a plausible explanation for hypothyroidism in one of these patients, this and two other patients revealed broad epigenetic GNAS abnormalities, which included loss of methylation (LOM) at exons AS, XL, and A/B, and gain of methylation at exon NESP55; ie, findings consistent with PHP-Ib. LOM at GNAS exon A/B alone led in the fourth patient to the identification of a maternally inherited 3-kb STX16 deletion, a well-established cause of autosomal dominant PHP-Ib. Although GNAS methylation changes were not detected in additional pediatric and adult patients with subclinical hypothyroidism (23 pediatric and 39 adult cases), hypothyroidism can obviously be the initial finding in PHP-Ib patients. One should therefore consider measuring PTH, along with calcium and phosphate, in patients with unexplained hypothyroidism for extended periods of time to avoid hypocalcemia and associated clinical complications. © 2014 American Society for Bone and Mineral Research.

IBS and Non-GI Functional Disorders

Science.gov (United States)

... of IBS patients have at least one coexisting somatic symptom and many IBS patients meet diagnostic criteria ... up-to-date on the latest news, stories, tips, research highlights, and more! Sign up for eNewsletter: ...

Endocannabinoid and cannabinoid-like fatty acid amide levels correlate with pain-related symptoms in patients with IBS-D and IBS-C: a pilot study.

Directory of Open Access Journals (Sweden)

Jakub Fichna

Full Text Available AIMS: Irritable bowel syndrome (IBS is a functional gastrointestinal (GI disorder, associated with alterations of bowel function, abdominal pain and other symptoms related to the GI tract. Recently the endogenous cannabinoid system (ECS was shown to be involved in the physiological and pathophysiological control of the GI function. The aim of this pilot study was to investigate whether IBS defining symptoms correlate with changes in endocannabinoids or cannabinoid like fatty acid levels in IBS patients. METHODS: AEA, 2-AG, OEA and PEA plasma levels were determined in diarrhoea-predominant (IBS-D and constipation-predominant (IBS-C patients and were compared to healthy subjects, following the establishment of correlations between biolipid contents and disease symptoms. FAAH mRNA levels were evaluated in colonic biopsies from IBS-D and IBS-C patients and matched controls. RESULTS: Patients with IBS-D had higher levels of 2AG and lower levels of OEA and PEA. In contrast, patients with IBS-C had higher levels of OEA. Multivariate analysis found that lower PEA levels are associated with cramping abdominal pain. FAAH mRNA levels were lower in patients with IBS-C. CONCLUSION: IBS subtypes and their symptoms show distinct alterations of endocannabinoid and endocannabinoid-like fatty acid levels. These changes may partially result from reduced FAAH expression. The here reported changes support the notion that the ECS is involved in the pathophysiology of IBS and the development of IBS symptoms.

Paternal uniparental isodisomy of the entire chromosome 20 as a molecular cause of pseudohypoparathyroidism type Ib (PHP-Ib).

Science.gov (United States)

Bastepe, Murat; Altug-Teber, Ozge; Agarwal, Chhavi; Oberfield, Sharon E; Bonin, Michael; Jüppner, Harald

2011-03-01

Pseudohypoparathyoridism type Ib (PHP-Ib) typically defines the presence of end-organ resistance to parathyroid hormone in the absence of Albright's hereditary osteodystrophy. Patients affected by this disorder present with imprinting defects in the complex GNAS locus. Microdeletions within STX16 or GNAS have been identified in familial cases with PHP-Ib, but the molecular cause of the GNAS imprinting defects in sporadic PHP-Ib cases remains poorly defined. We now report a case with sporadic PHP-Ib for whom a SNPlex analysis revealed loss of the maternal GNAS allele. Further analysis of the entire genome with a 100K SNP chip identified a paternal uniparental isodisomy affecting the entire chromosome 20 without evidence for another chromosomal abnormality. Our findings explain the observed GNAS methylation changes and the patient's hormone resistance, and furthermore suggest that chromosome 20 harbors, besides GNAS, no additional imprinted region that contributes to the clinical and laboratory phenotype. Copyright © 2010 Elsevier Inc. All rights reserved.

Medications (for IBS)

Medline Plus

Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for ...

TSH elevations as the first laboratory evidence for pseudohypoparathyroidism type Ib (PHP-Ib)†

Science.gov (United States)

Molinaro, Angelo; Tiosano, Dov; Takatani, Rieko; Chrysis, Dionisios; Russell, William; Koscielniak, Nikolas; Kottler, Marie-Laure; Agretti, Patrizia; De Marco, Giuseppina; Ahtiainen, Petteri; Christov, Marta; Mäkitie, Outi; Tonacchera, Massimo; Jüppner, Harald

2014-01-01

Hypocalcemia and hyperphosphatemia because of resistance towards parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder that is caused by GNAS methylation changes, resistance can occur towards other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are usually not recognized until PTH-resistant hypocalcemia becomes clinically apparent. We now describe four pediatric patients, first diagnosed with subclinical or overt hypothyroidism between the ages of 0.2 and 15 years, who developed overt PTH-resistance 3-20 years later. Although anti-TPO antibodies provided a plausible explanation for hypothyroidism in one of these patients, this and two other patients revealed broad epigenetic GNAS abnormalities, which included loss of methylation (LOM) at exons AS, XL and A/B, and gain of methylation at exon NESP55, i.e. findings consistent with PHP-Ib. LOM at GNAS exon A/B alone led in the fourth patient to the identification of a maternally inherited 3-kb STX16 deletion, a well-established cause of autosomal dominant PHP-Ib. Although GNAS methylation changes were not detected in additional pediatric and adult patients with subclinical hypothyroidism (23 pediatric and 39 adult cases), hypothyroidism can obviously be the initial finding in PHP-Ib patients. One should therefore consider measuring PTH, along with calcium and phosphate, in patients with unexplained hypothyroidism for extended periods of time to avoid hypocalcemia and associated clinical complications. PMID:25403028

TSH elevations as the first laboratory evidence for pseudohypoparathyroidism type Ib (PHP-Ib)†

OpenAIRE

Molinaro, Angelo; Tiosano, Dov; Takatani, Rieko; Chrysis, Dionisios; Russell, William; Koscielniak, Nikolas; Kottler, Marie-Laure; Agretti, Patrizia; De Marco, Giuseppina; Ahtiainen, Petteri; Christov, Marta; Mäkitie, Outi; Tonacchera, Massimo; Jüppner, Harald

2015-01-01

Hypocalcemia and hyperphosphatemia because of resistance towards parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder that is caused by GNAS methylation changes, resistance can occur towards other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are...

Treatment outcome after adjuvant radiotherapy following surgery for patients with stage I endometrial cancer

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji Young; Lee, Kyung Ja; Park, Kyung Ran [Dept. of Radiation Oncology, Ewha Womans University School of Medicine, Seoul (Korea, Republic of); and others

2016-12-15

The purpose of this study is to evaluate the treatment outcomes of adjuvant radiotherapy using vaginal brachytherapy (VB) with a lower dose per fraction and/or external beam radiotherapy (EBRT) following surgery for patients with stage I endometrial carcinoma. The subjects were 43 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer who underwent adjuvant radiotherapy following surgery between March 2000 and April 2014. Of these, 25 received postoperative VB alone, while 18 received postoperative EBRT to the whole pelvis; 3 of these were treated with EBRT plus VB. The median EBRT dose was 50.0 Gy (45.0–50.4 Gy) and the VB dose was 24 Gy in 6 fractions. Tumor dose was prescribed at a depth of 5 mm from the cylinder surface and delivered twice per week. The median follow-up period for all patients was 57 months (range, 9 to 188 months). Five-year disease-free survival (DFS) and overall survival (OS) for all patients were 92.5% and 95.3%, respectively. Adjuvant radiotherapy was performed according to risk factors and stage IB, grade 3 and lymphovascular invasion were observed more frequently in the EBRT group. Five-year DFS for EBRT and VB alone were 88.1% and 96.0%, respectively (p = 0.42), and 5-year OS for EBRT and VB alone were 94.4% and 96%, respectively (p = 0.38). There was no locoregional recurrence in any patient. Two patients who received EBRT and 1 patient who received VB alone developed distant metastatic disease. Two patients who received EBRT had severe complications, one each of grade 3 gastrointestinal complication and pelvic bone insufficiency fracture. Adjuvant radiotherapy achieved high DFS and OS with acceptable toxicity in stage I endometrial cancer. VB (with a lower dose per fraction) may be a viable option for selected patients with early-stage endometrial cancer following surgery.

Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT).

Science.gov (United States)

Karlsen, Nikoline Marie Schou; Karlsen, Mona Aarenstrup; Høgdall, Estrid; Nedergaard, Lotte; Christensen, Ib Jarle; Høgdall, Claus

2016-07-01

The aim of the study was to evaluate the rate of relapse as well as disease-free, overall, and disease-specific survival in women with borderline ovarian tumour (BOT). Furthermore, the study aims to identify the clinical parameters correlated to relapse. National clinical data of women diagnosed with BOT from January 2005 to January 2013 constituted the basis for our study population. The prognostic influence of clinical variables was evaluated using univariate and multivariate analyses. A total of 1143 women were eligible for analysis, with 87.9% in FIGO stage I and 12.1% in FIGO stages II-IV. Relapse of BOT was detected in 3.7%, hereof 40.5% with malignant transformation. The five-year disease-free survival was 97.6% in FIGO stage I and 87.3% in FIGO stages II-IV. Younger age, laparoscopic surgical approach, fertility sparing surgery, FIGO stages II-IV, bilateral tumour presence, serous histology, implants and microinvasion of the tumour were significantly associated with relapse in univariate analyses. The overall five-year survival rate was 92.2% in FIGO stage I and 89.0% in FIGO stages II-IV. Out of 77 deaths in total, only seven women died from BOT. A general favourable prognosis in women with BOT was confirmed in our study. Our findings indicate that systematic, long-term follow-up does not seem necessary in women treated for FIGO stage IA BOT with no residual disease or microinvasion. Copyright © 2016 Elsevier Inc. All rights reserved.

Phase II study of a trimodal preoperative treatment followed by radical surgery or radiotherapy in non-resectable cervical cancer ≥ Figo IIB

International Nuclear Information System (INIS)

Cho, C.; Gellermann, J.; Jungnickel, K.; Kuemmel, S.; Hildebrandt, B.; Wust, P

2005-01-01

Full text: Regional hyperthermia is combined with radiochemotherapy to achieve resectability in non-resectable cervical carcinoma. In a phase II study at the Charite Medical School approved by the institutionals ethical committee non-resectable cervical carcinoma of at least FIGO IIB were treated with radiochemotherapy combined with regional hyperthermia. The treatment concept comprises cisplatinum therapy of 40 mg/sqm body surface once weekly during regional hyperthermia supplementing radiation therapy of 5 x 1.8 Gy to a total dose of 45 - 50.4 Gy. A gynecological status and imaging is performed for evaluation of resectability of the tumor. If a tumor resection was not feasable radiation was completed to 59.4 - 63 Gy supplemented by 4 - 5 afterloading sessions. Regional hyperthermia was conducted with SIGMA 60 or SIGMA Eye applicator of the system BSD-2000, on average steady state temperatures between 40-41 o C were achieved over the therapeutic time. From 2000 to 2003 we recruited 30 patients. Acute toxicity was in the usual range (10-15 % grade ≥ 3). Two thirds were FIGO stage III/IV with tumor diameters > 6 cm. After treatment 20/30 (67 %) of the former inoperable cases were evaluated as resectable, 3 of these patients refused surgery. Of the remaining 17 cases 14 patients were R0-resected, 2 patients were R1-resected, and 1 patient had a positive paraaortal lymphnode. In 13/30 patients nonsurgical treatment was continued. Response was achieved in 23/30 patients (77 %), i.e. 14 resectable cases with downstaging and 9 partial remissions (PR) after hyperthermic radiochemotherapy with 45 - 50.4 Gy. Response correlated well with thermal parameters, in particular the mean temperature in the vaginal reference point. For the whole group a three year overall survival of 60 % was achieved together with a moderate late toxicity ≥ 3 in 4/30 patients (13 %). R0-resected patients have an excellent prognosis with a 3-year survival of 95 % and a late toxicity ≥ 3 below

More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS--a case-control study in primary care.

Science.gov (United States)

Grodzinsky, Ewa; Walter, Susanna; Viktorsson, Lisa; Carlsson, Ann-Kristin; Jones, Michael P; Faresjö, Åshild

2015-01-28

Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care. A case-control study in primary care setting among IBS patients meeting the ROME III criteria (n = 140) compared to controls i.e. non-IBS patients (n = 213) without any present or previous gastrointestinal complaints. The data were collected through self-reported questionnaires of psychosocial factors. IBS-patients reported significantly more negative self-esteem (p IBS-cases were also less likely to report 'good' health status (p IBS patients remained statistically significant (p = 0.02), as did the lower scores for sense of coherence among IBS cases (p = 0.04). The more frequently reported negative self-esteem and inferior coping strategies among IBS patients found in this study suggest the possibility that psychological therapies might be helpful for these patients. However these data do not indicate the causal direction of the observed associations. More research is therefore warranted to determine whether these psychosocial constructs are more frequent in IBS patients.

The IB Diploma and UK University Degree Qualifications

Science.gov (United States)

Frank-Gemmill, Gerda

2013-01-01

In recent years the International Baccalaureate (IB) Diploma has become widely accepted as a university-entry qualification in the UK, but there has been little quantitative research into the achievements of IB students at degree level. This study investigates IB students from one selective independent school who entered UK universities between…

Abridged republication of FIGO's staging classification for cancer of the ovary, fallopian tube, and peritoneum.

Science.gov (United States)

Prat, Jaime

2015-10-01

Ovarian, fallopian tube, and peritoneal cancers have a similar clinical presentation and are treated similarly, and current evidence supports staging all 3 cancers in a single system. The primary site (i.e. ovary, fallopian tube, or peritoneum) should be designated where possible. The histologic type should be recorded. Intraoperative rupture ("surgical spill") is IC1; capsule ruptured before surgery or tumor on ovarian or fallopian tube surface is IC2; and positive peritoneal cytology with or without rupture is IC3. The new staging includes a revision of stage III patients; assignment to stage IIIA1 is based on spread to the retroperitoneal lymph nodes without intraperitoneal dissemination. Extension of tumor from omentum to spleen or liver (stage IIIC) should be differentiated from isolated parenchymal metastases (stage IVB). © 2015 American Cancer Society.

Produção de sorvetes e iogurtes a partir dos frutos figo da índia e mandacaru

Directory of Open Access Journals (Sweden)

V. R. L. Fidelis

2015-10-01

Full Text Available O figo da índia é a fruta que juntamente com o mandacaru fazem parte das espécies nativas da caatinga. Objetivou-se neste trabalho elaborar e caracterizar sorvetes e iogurte a partir do figo da índia e da polpa e casa do fruto do mandacaru. Foi obtido o sorvete de creme e iogurte natural para base e acrescido com polpa e casca para as formulações. Para a caracterização foram realizadas as análises físico-químicas de pH, vitamina C, sólidos solúveis (SS e a acidez titulável (AT. O sorvete e o iogurte apresentaram comportamento ácido. O figo da índia e o fruto do mandacaru mostraram-se com grande potencial para o desenvolvimento de subprodutos com o sorvete e iogurte. Os valores de AT do iogurte (ᴓ 0,62 estão dentro dos padrões pré-estabelecidos.Production of ice cream and yoghurt from the cactus pearfruit and mandacaruAbstract: The Opuntia is a fruit, which together with the Cereus jamacaru are native species of the savanna. The objective of this study was to prepare and characterize ice cream and yogurt from the Opuntia and pulp and peel of Cereus jamacaru fruit. The ice cream and natural yoghurt for base and increased with pulp and peel were obtained for the formulations. For the characterization were performed physicochemical analysis of pH, vitamin C, soluble solids (SS and titratable acidity (TA. The ice cream and yogurt showed acidic behavior. The Opuntia and the fruit of Cereus jamacaru have come out with great potential for the development of by-products with the ice cream and yogurt. AT values of yogurt (ᴓ 0.62 are within the pre-established by the standards.

Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

Energy Technology Data Exchange (ETDEWEB)

Hansen, Henrik Villibald [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Section for Radiotherapy, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); Loft, Annika [University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Christensen, Ib Jarle [University of Copenhagen, The Finsen Laboratory, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Biotech Research and Innovation Centre (BRIC), Copenhagen (Denmark); Hoegdall, Claus [University of Copenhagen, Department of Gynecology, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

2015-11-15

In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

International Nuclear Information System (INIS)

Hansen, Henrik Villibald; Loft, Annika; Berthelsen, Anne Kiil; Christensen, Ib Jarle; Hoegdall, Claus; Engelholm, Svend Aage

2015-01-01

In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

Integrated Baseline Bystem (IBS) Version 1.03: Models guide

Energy Technology Data Exchange (ETDEWEB)

1993-01-01

The Integrated Baseline System)(IBS), operated by the Federal Emergency Management Agency (FEMA), is a system of computerized tools for emergency planning and analysis. This document is the models guide for the IBS and explains how to use the emergency related computer models. This document provides information for the experienced system user, and is the primary reference for the computer modeling software supplied with the system. It is designed for emergency managers and planners, and others familiar with the concepts of computer modeling. Although the IBS manual set covers basic and advanced operations, it is not a complete reference document set. Emergency situation modeling software in the IBS is supported by additional technical documents. Some of the other IBS software is commercial software for which more complete documentation is available. The IBS manuals reference such documentation where necessary.

Medications (for IBS)

Medline Plus

Full Text Available ... IBS Medications Probiotics and Antibiotics Psychological ... With Your Doctor Successful relationships with healthcare providers are an important part of managing life with a long-term digestive disorder. Working with ...

Experience with IBS-suppression lattice in RHIC

International Nuclear Information System (INIS)

Litvinenko, V.N.; Luo, Y.; Ptitsyn, V.; Satogata, T.; Tepikian, S.; Bai, M.; Bruno, D.; Cameron, P.; Connolly, R.; Della Penna, A.; Drees, A.; Fedotov, A.; Ganetis, G.; Hoff, L.; Louie, W.; Malitsky, N.; Marr, G.; Marusic, A.; Montag, C.; Pilat, F.; Roser, T.; Trbojevic, D.; Tsoupas, N.

2008-01-01

An intra-beam scattering (IBS) is the limiting factor of the luminosity lifetime for RHIC operating with heavy ions. In order to suppress the IBS we designed and implemented new lattice with higher betatron tunes. This lattice had been developed during last three years and had been used for gold ions in yellow ring of the RHIC during d-Au part of the RHIC Run-8. The use of this lattice allowed both significant increases in the luminosity lifetime and the luminosity levels via reduction of beta-stars in the IPS. In this paper we report on the development, the tests and the performance of IBS-suppression lattice in RHIC, including the resulting increases in the peak and the average luminosity. We also report on our plans for future steps with the IBS suppression

"STUDY OF CONCURRENT CISPLATIN AND EXTERNAL RADIOTHERAPY PRIOR TO RADICAL HYSTERECTOMY AND LYMPHADENECTOMY IN PATIENTS WITH STAGE IB-IIB CERVICAL CANCER"

Directory of Open Access Journals (Sweden)

M. Modares Gilani

2004-06-01

Full Text Available The purpose of this study was to describe the feasibility of a combined preoperative chemoradiation program Ib-IIa, bulky and suspicious IIb by radical surgery in patients with stage Ib-IIb cervical cancer. From September 1999 to April 2002, 30 patients with carcinoma of the cervix were treated with preoperative external beam radiotherapy of 45 Gy in 5 weeks. Patients received concurrent continuous infusion of cisplatin 50 mg/m2 for one day in week during 5 weeks of radiation. Radical surgery was performed 4-6 weeks after completion of the preoperative treatment. Toxicity with chemoradiation was usually mild. Two patients developed vesicovaginal fistula, and four developed long-term hydronephrosis that needed ureteral stenting. Clinical response was observed in 100% of the patients (23.7% complete response. The analysis of the surgical specimens revealed complete pathological response in 43.3% of the cases and partial pathological response in 56.7%. The degree of pathological response was not predictable by the degree of clinical response. Thirty months disease-free survival and overall survival were 66.3% and 77.31%, respectively. Patients with complete and partial pathological response were not significantly different in terms of disease-free survival (p= 0.08 and overall survival (p= 0.3. Cisplatin in preoperative chemoradiation is effective and usually welltolerated in bulky cervical cancer and parametrial invasion, inducing a high rate of clinical and pathological complete responses. When this therapy is followed by radical surgery, disease-free and overall survival rates are higher. The latter may be possible only through extensive surgical resection with a parallel increase in complication rates.

Clinical relevance of hemoglobin level in cervical cancer patients administered definitive radiotherapy

International Nuclear Information System (INIS)

Serkies, Krystyna; Badzio, Andrzej; Jassem, Jacek

2006-01-01

The prognostic impact of pretreatment hemoglobin (Hb) level and its changes during definitive radiotherapy was evaluated by univariate and multivariate analysis in the group of 453 FIGO IB-IIIB cervical cancer patients. Pretreatment anemia (Hb 12 g/dl; p∼0.001). Baseline Hb =12 g/dl was also associated with longer disease-free survival and improved local control. Declining Hb level during radiotherapy predicted for impaired 5-year disease-free survival and local control probability. In multivariate analysis, low pretreatment Hb level remained associated with worse overall and disease-free survival, whereas adverse impact of declining Hb level on outcome was not observed. With regard to other clinical factors, stage and tumor extension (uni- or bilateral parametrium involvement for Stage III) were the only independent determinants of prognosis

Medications (for IBS)

Medline Plus

Full Text Available ... Read more about antidiarrheal agents. Anti-anxiety medications – can be helpful for some people with IBS, mainly those with emotional distress. There are also effective medications available that relieve ...

Platelet Glycoprotein Ib-IX and Malignancy

Science.gov (United States)

2010-09-01

provide a unique microenvironment supporting the accumulation of more platelets and the elaboration of a fibrin - rich network produced by coagulation...process and can initiate the formation of a platelet - rich thrombus by tethering the platelet to a thrombogenic surface. Several ligands binding to GP Ib... Platelet Glycoprotein Ib-IX and Malignancy PRINCIPAL INVESTIGATOR: Jerry Ware, Ph.D

Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

International Nuclear Information System (INIS)

Bhosale, P.R.; Iyer, R.B.; Ramalingam, P.; Schmeler, K.M.; Wei, W.; Bassett, R.L.; Ramirez, P.T.; Frumovitz, M.

2016-01-01

Aim: To determine the ability of magnetic resonance imaging (MRI) in detecting tumour-free margins from the internal os (IO). Materials and methods: A database search yielded 79 women with early-stage cervical cancer who underwent radical hysterectomy and preoperative MRI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI in assessment of ≤5 and >5 mm IO involvement were calculated with histopathological surgical specimen findings considered to be the reference standard. A main and subset analysis was performed. The subset analysis included only those patients who would have been considered for radical trachelectomy. Results: For predicting a distance between the tumour and the IO of ≤5 mm, MRI had a sensitivity of 73%, a specificity of 98.3%, a PPV of 95%, a NPV of 88.1%, and an accuracy of 89.8% for the main analysis, and sensitivity of 81.8%, a specificity of 93.2% a PPV of 69.2% a NPV of 96.5% and an accuracy of 91.4% for the subset analysis. Conclusion: MRI has high specificity, NPV, and accuracy in detecting tumour from the IO, making MRI suitable for treatment planning in patients desiring trachelectomy to preserve fertility. - Highlights: • Cervical cancer patients who underwent hysterectomy were analyzed on MRI and pathology for involvement of the internal os. • Distance of the tumor from the internal-os was measured on MRI and Pathology and findings were tabulated as > and ≤ 5 mm from the internal os. • MRI has the ability to identify tumor involvement of the internal os. • MRI can help select patients who can undergo trachelectomy safely.

A CMMS Expert using BIM for IBS Building Maintenance

Directory of Open Access Journals (Sweden)

Hamzah Noraini

2016-01-01

Full Text Available In the IBS building maintenance, the conventional methods to the project delivery and its failure to form effective communication channel between complementary knowledge on IBS construction and related members that is conducted in the sequential manner has resulted in ineffectiveness for managing building maintenance, where a paradigm shift within the IBS traditional approach is necessary. The research results described are concerned with i an integrated system to record, diagnose and analyse information for IBS building maintenance to detect patent or latent defect, select an effective repair method, provide appropriate planning decision and reduce risks of defect throughout the building lifetime. ii building a decision making support in diagnosis in IBS building maintenance based on robust data collection about concrete defects and causes including in the selection of a durable replacement design and material or the proper rehabilitation method. The system development was based on analysis of number of interviews and case studies conducted with professional engineers working in IBS building maintenance departments. The paper concludes that implementing a CMMS Expert using BIM can help improve the performance of IBS building design, construction and maintenance operations.

Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

Energy Technology Data Exchange (ETDEWEB)

Soisson, A.P.; Soper, J.T.; Clarke-Pearson, D.L.; Berchuck, A.; Montana, G.; Creasman, W.T. (Duke Univ. Medical Center, Durham, NC (USA))

1990-06-01

From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.

The diagnostic value of PET/CT scanning in patients with cervical cancer

DEFF Research Database (Denmark)

Loft, Annika; Berthelsen, Anne Kiil; Roed, Henrik

2007-01-01

OBJECTIVE: To investigate the clinical value of PET/CT as a supplement to FIGO staging in patients with cervical cancer stage >or=1B. METHODS: This prospective study included 120 consecutive patients. After staging, a whole-body PET/CT scan was performed and these examinations were divided into two....../CT scanning for newly diagnosed cervical cancer FIGO stage >or=1B has a high sensitivity and specificity, and can be a valuable supplement to the FIGO staging procedure....

MR staging of endometrial carcinoma

International Nuclear Information System (INIS)

Innocenti, P.; Agostini, S.; Erroi, C.; Ambrogetti, D.; Cellerini, A.; Nori, J.

1991-01-01

Biopsy is the technique of choice for the definitive diagnosis of endometrial carcinoma. Since lymphatic tumor spread has been demonstrated to depend on the degree of myometrial involvement, the definition of the latter with imaging techniques may significantly affect both pfognosis and therapy. We investigated, by means of MR imaging at 0.5 T, 14 patients with endometrial carcinoma, to assess both tumor stage and myometrial involvement. FIGO staging system was employed, and M parameter evaluated (M0= no myometrial involvement; M1involvement confined to the inner third; M2= Involvement confined to the middle third; M3= involvement of the whole myometrium). Another parameter was the characteristic high signal of the tumor on PD and T2W images. The patients were then operated and MR information was correlated with surgical findings. Overall diagnostic accuracy of MR imaging was 85.7% in tumor staging, and 92.2% in defining M parameter. Tumor spread into adnexa and into cervical canal was poorly demonstrated by MR imaging

Medications (for IBS)

Medline Plus

Full Text Available ... be taken on a more long-term basis. These include low dose antidepressant agents or the relatively ... IBS in multi-center, high quality clinical trials. These are prescription medications intended for specific use under ...

Medications (for IBS)

Medline Plus

Full Text Available ... Beth Israel Deaconess Medical Center, Boston, MA. Last modified on February 23, 2015 at 12:18:55 ... Dietary Fiber 12 Week Elimination Diet for IBS Rice-Based Foods Low-FODMAP Diet What Are FODMAPs? ...

Medications (for IBS)

Medline Plus

Full Text Available ... for some people with IBS, mainly those with emotional distress. There are also effective medications available that ... not linked to depression, but rather likely to effects on the brain and the gut. Antidepressant medications ...

Medications (for IBS)

Medline Plus

Full Text Available ... have limited benefit for treating IBS. In some persons they relieve abdominal pain or discomfort, usually if ... Summary The effectiveness of various agents differs between individuals. A medication regimen must be carefully chosen by ...

Medications (for IBS)

Medline Plus

Full Text Available ... He or she can help you monitor quality, effectiveness, possible interactions with other medicines you may be ... Read more about newer IBS medications. Summary The effectiveness of various agents differs between individuals. A medication ...

Medications (for IBS)

Medline Plus

Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... limited by prescription only. It might be a drug or a supplement; manufactured or "natural." It might ...

Medications (for IBS)

Medline Plus

Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... take for a therapeutic effect counts as a medicine. It can be readily available over-the-counter, ...

Medications (for IBS)

Medline Plus

Full Text Available ... Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and ... About IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working ...

Medications (for IBS)

Medline Plus

Full Text Available ... for some people with IBS, mainly those with emotional distress. There are also effective medications available that ... This Article Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, ...

Medications (for IBS)

Medline Plus

Full Text Available ... effective medications available that relieve the pain and improve the changes in bowel habit. They may need ... effective in treating IBS in multi-center, high quality clinical trials. These are prescription medications intended for ...

Medications (for IBS)

Medline Plus

Full Text Available ... J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, ... About IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working ...

Medications (for IBS)

Medline Plus

Full Text Available ... do not respond to physician counseling and dietary manipulations. What's a medication? Anything you take for a ... Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online Studies Working ...

Medications (for IBS)

Medline Plus

Full Text Available ... You? IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support ... IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With ...

Medications (for IBS)

Medline Plus

Full Text Available ... MA. Last modified on February 23, 2015 at 12:18:55 PM Treatment Understanding and Managing Pain ... Foods that Cause Gas and Bloating Dietary Fiber 12 Week Elimination Diet for IBS Rice-Based Foods ...

Medications (for IBS)

Medline Plus

Full Text Available ... depression, but rather likely to effects on the brain and the gut. Antidepressant medications can reduce the intensity of pain signals going from gut to brain. Read more about antidepressant medications. Newer IBS-Targeted ...

Medications (for IBS)

Medline Plus

Full Text Available ... discomfort, usually if the symptoms occur soon after eating. Examples include dicyclomine (Bentyl), and hyoscyamine (Levsin). Read ... treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain ...

Medications (for IBS)

Medline Plus

Full Text Available ... severe symptoms which do not respond to physician counseling and dietary manipulations. What's a medication? Anything you ... Therapy Relaxation Techniques for IBS Take Part in Online Studies Working With Your Doctor Successful relationships with ...

Medications (for IBS)

Medline Plus

Full Text Available ... it. He or she can help you monitor quality, effectiveness, possible interactions with other medicines you may ... effective in treating IBS in multi-center, high quality clinical trials. These are prescription medications intended for ...

Stages of Adult Soft Tissue Sarcoma

Science.gov (United States)

... deep (in the muscle and may be in connective or subcutaneous tissue). In stage IB , the tumor is low-grade (likely to grow and spread ... deep (in the muscle and may be in connective or subcutaneous tissue). In stage IIB , the tumor is mid-grade (somewhat likely to grow and ...

Medications (for IBS)

Medline Plus

Full Text Available ... your doctor about it. He or she can help you monitor quality, effectiveness, possible interactions with other ... effectively treat multiple symptoms of IBS. Laxatives – can help treat symptoms of constipation. Laxatives should be used ...

Medications (for IBS)

Medline Plus

Full Text Available ... include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve ... This Article Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, ...

Medications (for IBS)

Medline Plus

Full Text Available ... of constipation. Laxatives should be used under the supervision of a physician. Read more about laxatives. Bulking ... medications intended for specific use under a doctor’s supervision. Read more about newer IBS medications. Summary The ...

Medications (for IBS)

Medline Plus

Full Text Available ... treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain ... problem arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). ...

Medications (for IBS)

Medline Plus

Full Text Available ... IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With ... doctor. We advise seeing a physician whenever a health problem arises requiring an expert’s care. © Copyright 1998- ...

Medications (for IBS)

Medline Plus

Full Text Available ... treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain ... whenever a health problem arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal ...

Medications (for IBS)

Medline Plus

Full Text Available ... IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With ... We advise seeing a physician whenever a health problem arises requiring an expert’s care. © Copyright 1998-2018 ...

Functional Expression of a DNA-Topoisomerase IB from Cryptosporidium parvum

Directory of Open Access Journals (Sweden)

César Ordóñez

2009-01-01

Full Text Available Cryptosporidium parvum, one of the most important causative organisms of human diarrheas during childhood, contains a monomeric DNA-topoisomerase IB (CpTopIB in chromosome 7. Heterologous expression of CpTopIB gene in a budding yeast strain lacking this activity proves that the cryptosporidial enzyme is functional in vivo. The enzymatic activity is comprised in a single polypeptide, which contains all the structural features defining a fully active TopIB. Relaxation activity of the yeast extracts was detected only when CpTopIB ORF was expressed in a yeast expression system showing time and protein dependence under steady state kinetic conditions. The susceptibility of CpTopIB-transformed yeast to the irreversible inhibitor camptothecin and its water-soluble derivatives (topotecan and SN-38 was assessed.

Medications (for IBS)

Medline Plus

Full Text Available ... include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve abdominal pain or discomfort, usually if the symptoms occur soon after eating. Examples include dicyclomine (Bentyl), and hyoscyamine (Levsin). Read ...

iB1350 no.3. Passive double confinement and SA population dose evaluation for the iB1350

International Nuclear Information System (INIS)

Sato, Takashi; Matsumoto, Keiji; Hosomi, Kenji; Iwasaki, Ryuji

2017-01-01

iB1350 stands for an innovative, intelligent and inexpensive BWR 1350. It is the first Generation III.7 reactor after the Fukushima Daiichi accident. The iB1350 uses the Mark W containment and the in-containment filtered venting system (IFVS). The Mark W containment is made of reinforced concrete and has double cylinder FP barriers. There are also IC/iPCCS pools, a fuel pool and a dryer separator (DS) pool on the top slab of the containment. These pools work as water seal for FP leakage through the top slab. Most FP such as CsI are scrubbed in the pools. The containment head is also submerged in the reactor well pool. The pool water works as shielding for radiation from the reactor core during normal operation and water seal for FP scrubbing during a severe accident. The base mat concrete is covered with the S/P and the core catcher that is also submerged with corium flooding water during an accident. Therefore, the Mark W containment has passive double confinement barriers for FP. Moreover, the IFVS works as in-containment filtered venting system that scrubs FP from the wet well (WW) and the dry well (DW). The filtered venting tank is arranged in the outer well (OW) of the Mark W containment. Even noble gases and organic iodine going through the filtered venting system are still confined inside the containment and never released directly to the environment. The IFVS uses the innovative passive containment cooling system (iPCCS) as the pre-stage heat removal system. The iPCCS has a normal open suction line from the WW. Therefore, FP are scrubbed in the S/P at first and then vented into the filtered venting tank. After the DW suction line of the iPCCS is opened all the steam is cooled and condensed in the heat exchanger. Most FP are trapped in the condensate and returned into the WW through the condensate return line of the iPCCS. Therefore, the Mark W containment has excellent FP double confinement barriers and the in-containment filtered venting system that enable

Motivational Factors on Adopting Modular Coordination Concept in Industrialized Building System (IBS

Directory of Open Access Journals (Sweden)

Yunus Riduan

2016-01-01

Full Text Available Modular coordination (MC is recognized as a tool towards rationalization and industrialization. The implementation of MC concept in the design stage may improve the constructability and construction time. However, the implementation of MC in Industrialized Building System (IBS implementation is still low compare to other developed countries such as the United Kingdom, Sweden and Japan. This paper examined the interrelationship between motivational factors of stakeholders in adopting MC concept using Interpretative Structural Modeling (ISM. Questionnaire survey was engaged in this study to identify significant motivational factors. Then, semi-structure interviews were used to collect qualitative data. ISM was adopted to build relationship between factors and develop an initial model to promote the adoption of MC in IBS construction. Seven (7 significant motivational factors were identified in this research namely 1 ‘stakeholder’s commitment’, 2 ‘reduce site disruption’, 3 ‘increase productivity’, 4 ‘high skilled workers’, 5 ‘site sustainability (environment, economy and social benefits’ 6 ‘standardization’ and 7 ‘enabling ‘open building’ concept’. The result using Matrice d’Impacts Croises Multiplication Applique an Clasment (MICMAC shows that there are three factors can be categorized as Independent / Driving Factors namely ‘stakeholder’s commitment’, ‘standardization’ and ‘enabling “open building” concept’. These factors should be explored in details to enhance the adoption of IBS in Malaysia. The findings provide a very good platform for a further research in formulating an efficient solution to promote MC concept adoption among the stakeholders. This scenario will improve the deliverables of IBS construction and eliminate negative perception in its implementation.

Exclusion of the GNAS locus in PHP-Ib patients with broad GNAS methylation changes: evidence for an autosomal recessive form of PHP-Ib?

Science.gov (United States)

Fernández-Rebollo, Eduardo; Pérez de Nanclares, Guiomar; Lecumberri, Beatriz; Turan, Serap; Anda, Emma; Pérez-Nanclares, Gustavo; Feig, Denice; Nik-Zainal, Serena; Bastepe, Murat; Jüppner, Harald

2011-08-01

Most patients with autosomal dominant pseudohypoparathyroidism type Ib (AD-PHP-Ib) carry maternally inherited microdeletions upstream of GNAS that are associated with loss of methylation restricted to GNAS exon A/B. Only few AD-PHP-Ib patients carry microdeletions within GNAS that are associated with loss of all maternal methylation imprints. These epigenetic changes are often indistinguishable from those observed in patients affected by an apparently sporadic PHP-Ib form that has not yet been defined genetically. We have now investigated six female patients affected by PHP-Ib (four unrelated and two sisters) with complete or almost complete loss of GNAS methylation, whose healthy children (11 in total) showed no epigenetic changes at this locus. Analysis of several microsatellite markers throughout the 20q13 region made it unlikely that PHP-Ib is caused in these patients by large deletions involving GNAS or by paternal uniparental isodisomy or heterodisomy of chromosome 20 (patUPD20). Microsatellite and single-nucleotide variation (SNV) data revealed that the two affected sisters share their maternally inherited GNAS alleles with unaffected relatives that lack evidence for abnormal GNAS methylation, thus excluding linkage to this locus. Consistent with these findings, healthy children of two unrelated sporadic PHP-Ib patients had inherited different maternal GNAS alleles, also arguing against linkage to this locus. Based on our data, it appears plausible that some forms of PHP-Ib are caused by homozygous or compound heterozygous mutation(s) in an unknown gene involved in establishing or maintaining GNAS methylation. Copyright © 2011 American Society for Bone and Mineral Research.

Integrals for IBS and Beam Cooling

International Nuclear Information System (INIS)

Burov, A.

2005-01-01

Simulation of beam cooling usually requires performing certain integral transformations every time step or so, which is a significant burden on the CPU. Examples are the dispersion integrals (Hilbert transforms) in the stochastic cooling, wake fields and IBS integrals. An original method is suggested for fast and sufficiently accurate computation of the integrals. This method is applied for the dispersion integral. Some methodical aspects of the IBS analysis are discussed

Survival and Complication Rate of Radiation Therapy in Stage I and II Carcinoma of uterine Cervix

International Nuclear Information System (INIS)

Ma, Sun Young; Cho, Heung Lea; Sohn, Seung Chang

1995-01-01

Purpose : To analyze survival rate and late rectal and bladder complication for patients with stage with stage I and II carcinoma of uterine cervix treated by radiation alone or combined with chemotherapy. Materials and Methods : Between November 1984 and December 1993, 127 patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined therapy of radiation and chemotherapy. Retrospective analysis for survival rate was carried out on eligible 107 patients and review for complication was possible in 91 patients. The median follow-up was 47 months (range 3-118) and the median age of patients was 56 years (range 31-76). 26 patients were stage IB by FIGO classification. 40 were stage IIA and 41 were stage IIB. 86 cases were treated by radiation alone and 21 were treated by radiation and chemotherapy. 101 patients were treated with intracavitary radiation therapy (ICRT), of these, 80 were received low dose rate (LDR) ICRT and 21 were received high dose rate (HDR) ICRT. Of the patients who received LDR ICRT, 63 were treated by 1 intracavitary insertion and 17 were underwent 2 insertions. And we evaluated the external radiation dose and midline shield. Results : Acturial survival rate at 5 years was 92% for stage IB, 75% for stage IIA, 53% for stage IIB and 69% in all patients. Grade 1 rectal complications were developed in 20 cases(22%), grade 2 were in 22 cases (24%), 22 cases (24%) of grade 1 urinary complications and 17 cases (19%) of grade 2 urinary complications were observed But no patients had severe complications that needed surgical management or admission care. Maximum bladder dose for the group of patients with urinary complications was higher than that for the patients without urinary complications(7608cGy v 6960cGy, p<0.01). Maximum rectal dose for the group of patients with rectal complications was higher than that for the patients without urinary complications (7041cGy v 6269cGy, p<0.01). While there was no significant

Medications (for IBS)

Medline Plus

Full Text Available ... of a physician. Read more about laxatives. Bulking agents – provided they relieve and don’t worsen symptoms, can ease stool passage. Examples include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve ...

Adenocarcinoma of the endometrium treated with combined irradiation and surgery: study of 437 patients; Adenocarcinome de l'endometre traite par association radiochirurgicale: a propos de 437 cas

Energy Technology Data Exchange (ETDEWEB)

Touboul, E.; Belkacemi, Y.; Deniaud-Alexandre, E.; Ganansia, V.; Schlienger, M. [Hopital Tenon, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Buffat, L. [Hopital Tenon, Service de Biostatistique, Centre des Tumeurs, 75 - Paris (France); Lefranc, J.P.; Blondon, J. [Groupe Hospitalier Pitie-Salpetriere, Service de Chirurgie Gynecologique, 75 - Paris (France); Lhuillier, P. [Centre Hospitalier de Fontainebleau, Service de Gynecologie Obstetrique, 77 - Fontainebleau (France); Uzan, S. [Hopital Tenon, Service de Gynecologie Obstetrique, Centre des Tumeurs, 75 - Paris (France); Jannet, D.; Milliez, J. [Hopital Saint Antoine, Service de Gynecologie Obstetrique, 75 - Paris (France); Uzan, M. [Hopital Jean Verdier, Service de Gynecologie Obstetrique, 93 - Bondy (France); Antoine, M. [Hopital Tenon, Service d' Anatomopathologie, 75 - Paris (France); Ginesty, C. [Groupe Hospitalier Pitie-Salpetriere, Service d' Anatomopathologie, 75 - Paris (France); Jamali, M. [Hopital Saint Antoine, Service d' Anatomopathologie, 75 - Paris (France)

2001-08-01

To identify prognostic actors and treatment toxicity in a series of operable endometrial adenocarcinomas. Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n = 140) or with (n = 297) pelvic lymph node dissection. The chronology of RT was not randomized and depended on the usual practices of the surgical teams. Group I: 79 pts received preoperative utero-vaginal brachytherapy (mean total dose [MD]: 57 Gy). Group II: 358 pts received postoperative RT (196 pts received vaginal brachytherapy alone [MD: 50 Gy], 158 pts had external beam pelvis RT [EPRT] [MD: 46 Gy over 5 weeks] followed by vaginal brachytherapy [MD: 17 Gy], and 4 pts had EPRT alone [MD: 46 Gy over 5 weeks]). The mean follow-up was 128 months. The 10-year disease-free survival rate was 86%. From 57 recurrences, 12 were isolated loco-regionally. Multivariate analysis showed that independent factors decreasing the probability of disease-free survival were: histologic type (clear cell carcinoma, p = 0.038), largest histologic tumor diameter > 3 cm (p = 0.015), histologic grade (p = 0.008), myometrial invasion > 1/2 (p 0.0055), and 1988 FIGO staging system (p= 9.10{sup -8}). In group II, the addition of EPRT did not seem to improve locoregional control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were FIGO stage (p = 0.02) and pelvic lymph node dissection (p = 0.011). The 10-year rate for grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3.1 %. EPRT independently increased the 10-year rate for grade 3 and 4 late radiation complications (R.R.: 5.6, p = 0.0096). EPRT increases the risk of late radiation complications. After surgical and histopathologic staging with pelvic lymph node dissection, in a subgroup of intermediate risk

Adenocarcinoma of the endometrium treated with combined irradiation and surgery: study of 437 patients

International Nuclear Information System (INIS)

Touboul, E.; Belkacemi, Y.; Deniaud-Alexandre, E.; Ganansia, V.; Schlienger, M.; Buffat, L.; Lefranc, J.P.; Blondon, J.; Lhuillier, P.; Uzan, S.; Jannet, D.; Milliez, J.; Uzan, M.; Antoine, M.; Ginesty, C.; Jamali, M.

2001-01-01

To identify prognostic actors and treatment toxicity in a series of operable endometrial adenocarcinomas. Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n = 140) or with (n = 297) pelvic lymph node dissection. The chronology of RT was not randomized and depended on the usual practices of the surgical teams. Group I: 79 pts received preoperative utero-vaginal brachytherapy (mean total dose [MD]: 57 Gy). Group II: 358 pts received postoperative RT (196 pts received vaginal brachytherapy alone [MD: 50 Gy], 158 pts had external beam pelvis RT [EPRT] [MD: 46 Gy over 5 weeks] followed by vaginal brachytherapy [MD: 17 Gy], and 4 pts had EPRT alone [MD: 46 Gy over 5 weeks]). The mean follow-up was 128 months. The 10-year disease-free survival rate was 86%. From 57 recurrences, 12 were isolated loco-regionally. Multivariate analysis showed that independent factors decreasing the probability of disease-free survival were: histologic type (clear cell carcinoma, p = 0.038), largest histologic tumor diameter > 3 cm (p = 0.015), histologic grade (p = 0.008), myometrial invasion > 1/2 (p 0.0055), and 1988 FIGO staging system (p= 9.10 -8 ). In group II, the addition of EPRT did not seem to improve locoregional control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were FIGO stage (p = 0.02) and pelvic lymph node dissection (p = 0.011). The 10-year rate for grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3.1 %. EPRT independently increased the 10-year rate for grade 3 and 4 late radiation complications (R.R.: 5.6, p = 0.0096). EPRT increases the risk of late radiation complications. After surgical and histopathologic staging with pelvic lymph node dissection, in a subgroup of intermediate risk

The Role & Action of Prohibition, an Antiproliferative Gene, in Ovarian Cancer

National Research Council Canada - National Science Library

Thompson, Winston E

2007-01-01

... expression pattern of prohibitin in normal ovary, ovarian tumors of patients with early (FIGO stage 1) and advanced (FIGO stage II-IV) stages of ovarian cancer, using immunohistochemistry, in situ hybridization, Western and Northern blot analyses...

High dose-rate brachytherapy for elderly patients with uterine cervical cancer

International Nuclear Information System (INIS)

Chen, Shang-Wen; Liang, Ji-An; Yang, Shih-Neng; Lin, Fang-Jen

2003-01-01

The need for radiotherapy (RT) in cancer treatment for the elderly patient is growing. The purpose of this study was to analyze the efficacy and complication rate for radiotherapy, using external-beam irradiation (EBRT) and high dose-rate intracavitary brachytherapy (HDRICB), for patients aged 70 years or older with carcinoma of the uterine cervix. From September 1992 to December 1997, 295 patients diagnosed with uterine cervical cancer completed RT at the Shin Kong Memorial Hospital and China Medical College Hospital. Two hundred and fifty-eight patients [International Federation of Gynecology and Obstetrics (FIGO) stage distribution: 35 Ib, 26 IIa, 122 IIb, 10 IIIa, 58 IIIb, 7 IVa] who had undergone at least two courses of HDRICB and a minimum of 3 years of follow-up, were evaluated. A retrospective analysis was conducted to compare the outcome of radiation therapy for the 179 patients under 70 years of age (younger group) and the 79 patients aged 70 years or older (older group). The RT consisted of EBRT followed by HDRICB. After a total EBRT dose of 40-45 Gy/20 in 25 fractions, irradiating the whole pelvis over 4-5 weeks, dosage for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease was boosted to 54-58 Gy, with central shielding. HDRICB was administered at 1-week intervals using an Ir-192 remote after-loading technique. Ninety-nine patients (38.4%) received three fractions of HDRICB, while 156 patients (60.5%) had four fractions. Total prescribed Point A dosages (EBRT+HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while for larger lesions (stage IIB-IVA) analogous dosages were 59-75.6 Gy (median, 65.6 Gy). Median follow-up durations for the older and younger groups were 56/55 months, respectively. The respective 5-year actuarial survivals (AS) for the older and younger groups were 82/85% for stage Ib, 65/65% for IIa, 61/71% for IIb and 35/59% for IIIa-b. The 5-year cause-specific survivals (CSS) for the older and

Formas de preparo de figo-da-índia minimamente processado¹

Directory of Open Access Journals (Sweden)

Kelly Magalhães Marques

2011-10-01

Full Text Available O trabalho teve como objetivo avaliar a influência da forma de preparo na conservação pós-colheita de figos-da-índia minimamente processados. Foram utilizados figos-da-índia maduros de polpa alaranjada, provenientes de pomar comercial da região de Valinhos-SP. Após a seleção, os frutos foram lavados e higienizados em solução com Sumaveg® a 200 mg 100g-1 de cloro livre, por 5 minutos. Em seguida, os frutos foram levados à câmara fria, a 12±2°C, onde permaneceram por 12 horas prévias ao processamento. O processamento constituiu na retirada da casca e das extremidades para a obtenção dos frutos inteiros. Para a obtenção das metades, foi realizado um corte no sentido longitudinal da fruta descascada e, para obtenção das rodelas, foram realizados cortes, a cada 2 cm, transversais à altura do fruto descascado. Os tratamentos assim obtidos foram acondicionados em contentores de tereftalato de polietileno transparente e com tampa, com capacidade de 1.000 mL (marca Neoform® N-94. As embalagens foram armazenadas em expositores refrigerados a 3°C, por um período de 16 dias, sendo as análises realizadas a cada 4 dias. O delineamento adotado foi o inteiramente casualizado, num esquema fatorial 3x5: três processamentos e cinco datas de amostragem (0;4;8;12 e 16 dias, com três repetições por tratamento. Avaliaram-se a perda de massa fresca, os teores de sólidos solúveis (SS, acidez titulável (AT, a relação (SS/AT, ácido ascórbico, além da análise sensorial dos produtos. Os frutos inteiros foram os preferidos quanto à intenção de compra e apresentaram melhores resultados quanto ao teor de sólidos solúveis, de acidez titulável, relação sólidos solúveis/acidez titulável e teor de ácido ascórbico. A maior perda de massa fresca foi verificada no processamento em rodelas.

Patient educational media preferences for information about irritable bowel syndrome (IBS).

Science.gov (United States)

Halpert, Albena; Dalton, Christine B; Palsson, Olafur; Morris, Carolyn; Hu, Yuming; Bangdiwala, Shrikant; Hankins, Jane; Norton, Nancy; Drossman, Douglas A

2008-12-01

To identify the educational media preferences of patients with irritable bowel syndrome (IBS). The IBS-Patient Education Questionnaire (PEQ) was administered to a national sample of IBS patients. Frequencies of item endorsements were compared and meaningful clinical differences were used to identify differences among subgroups. 1,242 patients completed the survey, mean age 39.3 years, 85% female, IBS duration 6.9 years, 79% had seen an MD for IBS within 6 months, and 92.6% used the web for medical information. The most desired source of education was "my doctor" (68%), followed by Internet (62%) and brochure (45%). Notably, patients favored an increase in use of media in the future (past vs. future): doctor (43 vs. 68%); Internet (36 vs. 62%); and brochures (26 vs. 45%). IBS patients expect more education than they have received. Understanding IBS patients' learning preferences can be highly valuable in the development or implementation of educational interventions.

Evaluation of the 8th AJCC staging system for pathologically versus clinically staged pancreatic adenocarcinoma: A time to revisit a dogma?

Science.gov (United States)

Abdel-Rahman, Omar

2018-02-01

The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic exocrine adenocarcinoma has been released. The current study seeks to assess the 7th and 8th editions among patients registered within the surveillance, epidemiology and end results (SEER) database. SEER database (2010-2013) has been accessed through SEER*Stat program and AJCC 8th edition stages were reconstructed utilizing the collaborative stage descriptions. Kaplan-Meier analysis of overall survival and pancreatic cancer-specific survival analyses (according to both 7th and 8th editions and according to whether pathological or clinical staging were conducted) has been performed. Multivariate analysis of factors affecting pancreatic cancer-specific survival was also conducted through a Cox proportional hazard model. A total of 18  948 patients with pancreatic adenocarcinoma were identified in the period from 2010-2013. Pancreatic cancer-specific survival among pathologically staged patients and according to the 8th edition showed significant differences for all pair wise comparisons among different stages (P < 0.0001) except for the comparison between stage IA and stage IB (P = 0.307) and the comparison between stage IB and stage IIA (P = 0.116). Moreover, P value for stage IA vs IIA was 0.014; while pancreatic cancer-specific survival according to the 7th edition among pathologically staged patients showed significant differences for all pair wise comparisons among different stages (P < 0.0001) except for the comparison between IA and IB (P = 0.072), the comparison between stage IIA and stage IIB (P = 0.065), the comparison between stage IIA and stage III (P = 0.059) and the comparison between IIB and III (P = 0.595). Among clinically staged patients (i.e. those who did not undergo initial radical surgery), the prognostic performance of both 7th and 8th stages for both overall survival and pancreatic cancer-specific survival was

Heavy Metal Exposure in Predicting Peripheral Neuropathy in Patients With Stage I-III Breast Cancer Undergoing Chemotherapy

Science.gov (United States)

2017-06-14

Male Breast Cancer; Neurotoxicity; Peripheral Neuropathy; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Minocycline Hydrochloride in Reducing Chemotherapy Induced Depression and Anxiety in Patients With Stage I-III Breast Cancer

Science.gov (United States)

2017-08-07

Anxiety Disorder; Depression; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Patterns of care in patients with cervical cancer 2012. Results of a survey among German radiotherapy departments and out-patient health care centers

Energy Technology Data Exchange (ETDEWEB)

Marnitz, S.; Rauer, A.; Budach, V. [Charite Universitaetsmedizin, Department of Radiooncology, Berlin (Germany); Koehler, C.; Schneider, A.; Mangler, M. [Charite Universitaetsmedizin, Department of Gynecology, Berlin (Germany); Tsunoda, A. [Barretos Cancer Centre, Department of Gynecologic Oncology, Barretos (Brazil)

2014-01-15

.) [German] Die platinbasierte primaere oder adjuvante Radiochemotherapie zaehlt zur Therapie der Wahl bei der Behandlung von Patientinnen mit Zervixkarzinom. Trotz nationaler Leitlinien und internationale Empfehlungen basieren viele Aspekte der Diagnose, Therapie und des Follow-up nicht auf validen Daten. Um aktuelle Aspekte der Therapie bei Patientinnen mit einem Zervixkarzinom zu evaluieren, wurde 2012 ein Fragebogen mit 25 Positionen an 281 radioonkologische Kliniken und ambulante Zentren in ganz Deutschland gesandt. Die Ruecklaufrate des Fragebogens lag bei 51 %. Pro Jahr behandelten 87 % der Kliniken 0-25 Patientinnen, 12 % zwischen 26 und 50 und nur 1 % mehr als 50 Patientinnen. Im Befragungszeitraum 2011 war die Stadienverteilung von 1706 behandelten Frauen mit Zervixkarzinom folgendermassen: FIGO IB1 11 %, IB2 12 %, IIA 11 %, IIB 22 %, IIIA/IIIB 28 % und IV 16 %. Zum Staging wurden hauptsaechlich CT (90 %) und MRT (86 %) eingesetzt, seltener ein PET-CT (14 %). Interessanterweise empfahlen 27 % der radioonkologischen Kliniken ein chirurgisches Staging vor der Radiochemotherapie. In der Mehrzahl der befragten Abteilungen wurden 3-D-basierte (70 %) und intensitaetsmodulierte (76 %) Konzepte zur perkutanen Radiatio eingesetzt, weniger haeufig die ''Volumetric Arc Technique'' (VMAT; 26 %). Fast alle Radioonkologen (99,3 %) applizierten konventionelle Fraktionen mit 1,8-2 Gy bei der EBRT, 19 % kombinierten diese mit einem simultanen Boost (SIB). 90 % der Radioonkologen setzten Cisplatin mono als Radiosensitizer ein mit woechentlich 40 mg/m{sup 2}. Zur Boost-Behandlung in der Primaertherapie wurde am haeufigsten eine HDR-Brachytherapie eingesetzt (84 %). In den FIGO-Stadien 1B1/1B2 nach radikaler Hysterektomie wurde in 16-97 % trotz negativer Lymphknoten und freier Abtragungsebenen eine RCT angewandt, wenn 1-4 weitere intermediate Risikofaktoren auftraten. Fuer Patientinnen in den FIGO-Stadien IIB und IVA wird ein breites Therapiespektrum primaer

Short Course Vaginal Cuff Brachytherapy in Treating Patients With Stage I-II Endometrial Cancer

Science.gov (United States)

2018-04-17

Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage I Uterine Corpus Cancer; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Uterine Corpus Carcinosarcoma; Uterine Corpus Sarcoma

Quality of life in patients with Irritable Bowel Syndrome (IBS), assessed using the IBS-Quality of Life (IBS-QOL) measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China.

Science.gov (United States)

Hou, Xiaohua; Chen, Shengliang; Zhang, Yali; Sha, Weihong; Yu, Xiaofeng; Elsawah, Hesham; Afifi, Afifi Fahmy; El-Khayat, Hisham Raafat; Nouh, Alaa; Hassan, Mohamed Fathalla; Fatah, Ayman Abdel; Rucker Joerg, Isabel; Sánchez Núñez, Juan Manuel; Osthoff Rueda, Rodolfo; Jurkowska, Grazyna; Walczak, Michal; Malecka-Panas, Ewa; Linke, Krzysztof; Hartleb, Marek; Janssen-van Solingen, Gwendolyn

2014-11-01

Irritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS-Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide. This was a prospective observational cohort study in patients with IBS, diagnosed using the Rome III criteria in four countries (Poland, Egypt, Mexico and China). A total of 607 patients were enrolled. At baseline, the IBS-QOL total scores were 52.0 in Poland, 48.9 in Egypt, 51.9 in Mexico, 76.4 in China and 56.4 overall. Increases in IBS-QOL total score were statistically significant at Weeks 4 and 8 overall and in each country (overall: 11.8 at Week 4, 24.3 at Week 8; p < 0.001). Improvements were shown in all IBS-QOL subscales and scores. Symptoms and health economic outcomes were improved. Furthermore, the favourable safety profile of these treatments was confirmed in this study. This study demonstrated that IBS patients have a substantially reduced HR-QoL and that treatment with mebeverine hydrochloride or pinaverium bromide improved HR-QoL.

Randomised controlled trial of mesalazine in IBS.

Science.gov (United States)

Barbara, Giovanni; Cremon, Cesare; Annese, Vito; Basilisco, Guido; Bazzoli, Franco; Bellini, Massimo; Benedetti, Antonio; Benini, Luigi; Bossa, Fabrizio; Buldrini, Paola; Cicala, Michele; Cuomo, Rosario; Germanà, Bastianello; Molteni, Paola; Neri, Matteo; Rodi, Marcello; Saggioro, Alfredo; Scribano, Maria Lia; Vecchi, Maurizio; Zoli, Giorgio; Corinaldesi, Roberto; Stanghellini, Vincenzo

2016-01-01

Low-grade intestinal inflammation plays a role in the pathophysiology of IBS. In this trial, we aimed at evaluating the efficacy and safety of mesalazine in patients with IBS. We conducted a phase 3, multicentre, tertiary setting, randomised, double-blind, placebo-controlled trial in patients with Rome III confirmed IBS. Patients were randomly assigned to either mesalazine, 800 mg, or placebo, three times daily for 12 weeks, and were followed for additional 12 weeks. The primary efficacy endpoint was satisfactory relief of abdominal pain/discomfort for at least half of the weeks of the treatment period. The key secondary endpoint was satisfactory relief of overall IBS symptoms. Supportive analyses were also performed classifying as responders patients with a percentage of affirmative answers of at least 75% or >75% of time. A total of 185 patients with IBS were enrolled from 21 centres. For the primary endpoint, the responder patients were 68.6% in the mesalazine group versus 67.4% in the placebo group (p=0.870; 95% CI -12.8 to 15.1). In explorative analyses, with the 75% rule or >75% rule, the percentage of responders was greater in the mesalazine group with a difference over placebo of 11.6% (p=0.115; 95% CI -2.7% to 26.0%) and 5.9% (p=0.404; 95% CI -7.8% to 19.4%), respectively, although these differences were not significant. For the key secondary endpoint, overall symptoms improved in the mesalazine group and reached a significant difference of 15.1% versus placebo (p=0.032; 95% CI 1.5% to 28.7%) with the >75% rule. Mesalazine treatment was not superior than placebo on the study primary endpoint. However, a subgroup of patients with IBS showed a sustained therapy response and benefits from a mesalazine therapy. ClincialTrials.gov number, NCT00626288. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Insight of Industrialised Building System (IBS By Bumiputera Construction Players

Directory of Open Access Journals (Sweden)

Muhammad W. M. N. W.

2016-01-01

Full Text Available The term Industrialised Building System (IBS is widely recognised by construction players in Malaysia since its first implementation since 1960s for IBS pilot projects of Pekeliling Flats and Rifle Range Flats. The aim for the implementation is to promote better system in delivering construction end-products which offers efficiency and effectiveness. At the same time, Bumiputera construction players are the majority of parties in construction industry especially in Small and Medium Enterprises (SMEs. Therefore, the purpose of this paper is to identify the perception and awareness of IBS implementation among Bumiputera players. It is found that, Bumiputera construction players have sound knowledge on the IBS and optimistic towards further implementation for future projects. Nonetheless, issues on payment methods and coordination of IBS project delivery are found to be the negative perceptions which are considered as hindrance for Bumiputera construction players’ involvement in IBS project.

Pseudohypoparathyroidism type Ib associated with novel duplications in the GNAS locus.

Directory of Open Access Journals (Sweden)

Gustavo Perez-Nanclares

Full Text Available Pseudohypoparathyroidism type 1b (PHP-Ib is characterized by renal resistance to PTH (and, sometimes, a mild resistance to TSH and absence of any features of Albright's hereditary osteodystrophy. Patients with PHP-Ib suffer of defects in the methylation pattern of the complex GNAS locus. PHP-Ib can be either sporadic or inherited in an autosomal dominant pattern. Whereas familial PHP-Ib is well characterized at the molecular level, the genetic cause of sporadic PHP-Ib cases remains elusive, although some molecular mechanisms have been associated with this subtype.The aim of the study was to investigate the molecular and imprinting defects in the GNAS locus in two unrelated patients with PHP-Ib.We have analyzed the GNAS locus by direct sequencing, Methylation-Specific Multiplex Ligation-dependent Probe Amplification, microsatellites, Quantitative Multiplex PCR of Short Fluorescent fragments and array-Comparative Genomic Hybridization studies in order to characterize two unrelated families with clinical features of PHP-Ib.We identified two duplications in the GNAS region in two patients with PHP-Ib: one of them, comprising ∼ 320 kb, occurred 'de novo' in the patient, whereas the other one, of ∼ 179 kb in length, was inherited from the maternal allele. In both cases, no other known genetic cause was observed.In this article, we describe the to-our-knowledge biggest duplications reported so far in the GNAS region. Both are associated to PHP-Ib, one of them occurring 'de novo' and the other one being maternally inherited.

Data Management Guide: Integrated Baseline System (IBS). Version 2.1

Energy Technology Data Exchange (ETDEWEB)

Bower, J.C. [Bower Software Services, Kennewick, Washington (United States); Burford, M.J.; Downing, T.R.; Moise, M.C.; Williams, J.R. [Pacific Northwest Lab., Richland, WA (United States)

1995-01-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Nuclear and Chemical Agency (USANCA). The IBS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain a site-specific map database. Data and system managers use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of the IBS. This document provides a description of the data files and structures necessary for running the IBS software and using the site map database.

Integrated Baseline System (IBS) Version 1.03: Utilities guide

Energy Technology Data Exchange (ETDEWEB)

Burford, M.J.; Downing, T.R.; Pottier, M.C.; Schrank, E.E.; Williams, J.R.

1993-01-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that was developed under the direction of the Federal Emergency Management Agency (FEMA). This Utilities Guide explains how to operate utility programs that are supplied as a part of the IBS. These utility programs are chiefly for managing and manipulating various kinds of IBS data and system administration files. Many of the utilities are for creating, editing, converting, or displaying map data and other data that are related to geographic location.

Integrated Baseline System (IBS) Version 2.0: Utilities Guide

Energy Technology Data Exchange (ETDEWEB)

Burford, M.J.; Downing, T.R.; Williams, J.R. [Pacific Northwest Lab., Richland, WA (United States); Bower, J.C. [Bower Software Services, Kennewick, WA (United States)

1994-03-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool being developed under the direction of the US Army Nuclear and Chemical Agency. This Utilities Guide explains how you can use the IBS utility programs to manage and manipulate various kinds of IBS data. These programs include utilities for creating, editing, and displaying maps and other data that are referenced to geographic location. The intended audience for this document are chiefly data managers but also system managers and some emergency management planners and analysts.

Protein kinase activity associated with the corticosteroid binder IB

International Nuclear Information System (INIS)

Vujicic, M.; Djordjevic-Markovic, R.; Radic, O.; Krstic, M.; Kanazir, D.

1997-01-01

The physiological effects elicited by glucocorticoids are mediated via glucocorticoid receptors (GR). Analysis of specific glucocorticoid binding to radioactively labelled [ 3 H] triamcinolone acetonide in rat liver cytosol and analysis by ion exchange chromatography have revealed the presence of two distinct molecular species. The major form, designated as binder II appears to correspond to the well characterized glucocorticoid receptor by virtue of its size, charge, steroid binding characteristics and ability to bind to DNA.The second form, designated as corticosteroid binder IB, is a minor binding component in the liver. The binder IB differs from the binder II receptor by virtue of its lower molecular weight and its elution in the pre gradient of DEAE-Sephadex A-50 column which retains the un activated binder II receptor complexes. We examined the kinase activity of partially purified corticosteroid binder IB. Using (γ 3 2 P) ATP we detected kinase activity associated with the IB fraction from the rat liver. This kinase phosphorylate mixed histones and and dose not phosphorylate IB protein in vitro. The kinase activity is completely inhibited by the addition of Mg 2 + ions and is partially inhibited by the addition of Ca 2 +ions. (author)

2-Alkynoic fatty acids inhibit topoisomerase IB from Leishmania donovani.

Science.gov (United States)

Carballeira, Néstor M; Cartagena, Michelle; Sanabria, David; Tasdemir, Deniz; Prada, Christopher F; Reguera, Rosa M; Balaña-Fouce, Rafael

2012-10-01

2-Alkynoic fatty acids display antimycobacterial, antifungal, and pesticidal activities but their antiprotozoal activity has received little attention. In this work we synthesized the 2-octadecynoic acid (2-ODA), 2-hexadecynoic acid (2-HDA), and 2-tetradecynoic acid (2-TDA) and show that 2-ODA is the best inhibitor of the Leishmania donovani DNA topoisomerase IB enzyme (LdTopIB) with an EC(50)=5.3±0.7μM. The potency of LdTopIB inhibition follows the trend 2-ODA>2-HDA>2-TDA, indicating that the effectiveness of inhibition depends on the fatty acid carbon chain length. All of the studied 2-alkynoic fatty acids were less potent inhibitors of the human topoisomerase IB enzyme (hTopIB) as compared to LdTopIB. 2-ODA also displayed in vitro activity against Leishmania donovani (IC(50)=11.0μM), but it was less effective against other protozoa, Trypanosoma cruzi (IC(50)=48.1μM) and Trypanosoma brucei rhodesiense (IC(50)=64.5μM). The antiprotozoal activity of the 2-alkynoic fatty acids, in general, followed the trend 2-ODA>2-HDA>2-TDA. The experimental information gathered so far indicates that 2-ODA is a promising antileishmanial compound. Copyright © 2012 Elsevier Ltd. All rights reserved.

Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer

Science.gov (United States)

... diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body. The ... single ovary or fallopian tube. In stage IB, cancer is found inside both ovaries or fallopian tubes. In stage IC, cancer is ...

Influence of margin status and radiation on recurrence after radical hysterectomy in Stage IB cervical cancer

International Nuclear Information System (INIS)

Viswanathan, Akila N.; Lee, Hang; Hanson, Emily; Berkowitz, Ross S.; Crum, Christopher P.

2006-01-01

Purpose: To examine the relationship between margin status and local recurrence (LR) or any recurrence after radical hysterectomy (RH) in women treated with or without radiotherapy (RT) for Stage IB cervical carcinoma. Methods and Materials: This study included 284 patients after RH with assessable margins between 1980 and 2000. Each margin was scored as negative (≥1 cm), close (>0 and <1 cm), or positive. The outcomes measured were any recurrence, LR, and relapse-free survival. Results: The crude rate for any recurrence was 11%, 20%, and 38% for patients with negative, close, and positive margins, respectively. The crude rate for LR was 10%, 11%, and 38%, respectively. Postoperative RT decreased the rate of LR from 10% to 0% for negative, 17% to 0% for close, and 50% to 25% for positive margins. The significant predictors of decreased relapse-free survival on univariate analysis were the depth of tumor invasion (hazard ratio [HR] 2.14/cm increase, p = 0.007), positive margins (HR 3.92, p = 0.02), tumor size (HR 1.3/cm increase, p = 0.02), lymphovascular invasion (HR 2.19, p = 0.03), and margin status (HR 0.002/increasing millimeter from cancer for those with close margins, p = 0.03). Long-term side effects occurred in 8% after RH and 19% after RH and RT. Conclusion: The use of postoperative RT may decrease the risk of LR in patients with close paracervical margins. Patients with other adverse prognostic factors and close margins may also benefit from the use of postoperative RT. However, RT after RH may increase the risk of long-term side effects

Correlation between the treated volume, the GTV and the CTV at the time of brachytherapy and the histopathologic findings in 33 patients with operable cervix carcinoma

International Nuclear Information System (INIS)

Muschitz, S.; Petrow, P.; Briot, E.; Petit, C.; De Crevoisier, R.; Duvillard, P.; Morice, P.; Haie-Meder, C.

2004-01-01

Background and purpose: This study correlates the treated volume, the GTV and the CTV at the time of intracavitary brachytherapy (BT) with the histopathological findings obtained by surgery (S) in 33 patients (pts) with cervix carcinoma. Patients and methods: Sixteen pts (group I), FIGO stage IB1 (1), IB2 (4), IIB (10), IIIB (1), received external beam radiotherapy (EBT) with a total dose of 45 Gy in 5 weeks and concomitant CISPLATIN 40 mg/m 2 weekly, followed by BT up to a total dose of 15 Gy. S was performed 6-8 weeks thereafter. Seventeen pts (group II), FIGO IA2 (1), IB1 (14), IIB (2), were treated by BT alone with a total dose of 60 Gy and S after 6-8 weeks. All pts had a MRI examination after BT with a moulded applicator in situ for exact delineation of GTV, CTV and critical organs and a 3D dosimetry directly from MRI data. Results: In group I (EBT+BT+S), the histopathological findings showed complete tumour sterilization (CR) in 56% of pts. Residual disease (RD) was found in 43%. Dosimetric data showed in pts with CR a larger mean treated volume (213 vs. 166 cm 3 ) and a better mean coverage of the GTV and the CTV by the reference isodose (99 and 91%) as in pts with RD (85 and 77%). In group II (BT+S), CR was found in 52%, RD in 41%. Dosimetric data showed a larger mean treated volume (154 vs. 109 cm 3 ) for pts with RD and a mean coverage of the GTV and the CTV by the reference isodose of 97 and 84% vs. 89 and 80% for pts with CR. Conclusions: An incomplete coverage of the GTV and/or the CTV by the reference isodose is an important risk factor for RD at the time of surgery. Furthermore, for pts who received BT alone, tumour size seemed to be a limiting factor for an accurate coverage of the CTV by the reference isodose

Implications of inaccurate clinical nodal staging in pancreatic adenocarcinoma.

Science.gov (United States)

Swords, Douglas S; Firpo, Matthew A; Johnson, Kirsten M; Boucher, Kenneth M; Scaife, Courtney L; Mulvihill, Sean J

2017-07-01

Many patients with stage I-II pancreatic adenocarcinoma do not undergo resection. We hypothesized that (1) clinical staging underestimates nodal involvement, causing stage IIB to have a greater percent of resected patients and (2) this stage-shift causes discrepancies in observed survival. The Surveillance, Epidemiology, and End Results (SEER) research database was used to evaluate cause-specific survival in patients with pancreatic adenocarcinoma from 2004-2012. Survival was compared using the log-rank test. Single-center data on 105 patients who underwent resection of pancreatic adenocarcinoma without neoadjuvant treatment were used to compare clinical and pathologic nodal staging. In SEER data, medium-term survival in stage IIB was superior to IB and IIA, with median cause-specific survival of 14, 9, and 11 months, respectively (P < .001). Seventy-two percent of stage IIB patients underwent resection vs 28% in IB and 36% in IIA (P < .001). In our institutional data, 12.4% of patients had clinical evidence of nodal involvement vs 69.5% by pathologic staging (P < .001). Among clinical stage IA-IIA patients, 71.6% had nodal involvement by pathologic staging. Both SEER and institutional data support substantial underestimation of nodal involvement by clinical staging. This finding has implications in decisions regarding neoadjuvant therapy and analysis of outcomes in the absence of pathologic staging. Copyright © 2017 Elsevier Inc. All rights reserved.

Migraine, fibromyalgia, and depression among people with IBS: a prevalence study

Directory of Open Access Journals (Sweden)

Cabral Howard J

2006-09-01

Full Text Available Abstract Background Case descriptions suggest IBS patients are more likely to have other disorders, including migraine, fibromyalgia, and depression. We sought to examine the prevalence of these conditions in cohorts of people with and without IBS. Methods The source of data was a large U.S. health plan from January 1, 1996 though June 30, 2002. We identified all people with a medical claim associated with an ICD-9 code for IBS. A non-IBS cohort was a random sample of people with an ICD-9 code for routine medical care. In the cohorts, we identified all claims for migraine, depression, and fibromyalgia. We estimated the prevalence odds ratios (PORs of each of the three conditions using the Mantel-Haenszel method. We conducted quantitative sensitivity analyses to quantify the impact of residual confounding and in differential outcome identification. Results We identified 97,593 people in the IBS cohort, and a random sample of 27,402 people to compose the non-IBS comparison cohort. With adjustment, there was a 60% higher odds in the IBS cohort of having any one of the three disorders relative to the comparison cohort (POR 1.6, 95% CI 1.5 – 1.7. There was a 40% higher odds of depression in the IBS cohort (POR 1.4, 95% CI 1.3 – 1.4. The PORs for fibromyalgia and migraine were similar (POR for fibromyalgia 1.8, 95% CI 1.7 – 1.9; POR for migraine 1.6, 95% CI 1.4 – 1.7. Differential prevalence of an unmeasured confounder, or imperfect sensitivity or specificity of outcome detection would have impacted the observed results. Conclusion People in the IBS cohort had a 40% to 80% higher prevalence odds of migraine, fibromyalgia, and depression.

HLA class Ib in pregnancy and pregnancy-related disorders.

Science.gov (United States)

Persson, Gry; Melsted, Wenna Nascimento; Nilsson, Line Lynge; Hviid, Thomas Vauvert F

2017-08-01

The HLA class Ib genes, HLA-E, HLA-F, and HLA-G, were discovered long after the classical HLA class Ia genes. The elucidation of their functions had a modest beginning. However, their basic functions and involvement in pathophysiology and a range of diseases are now emerging. Although results from a range of studies support the functional roles for the HLA class Ib molecules in adult life, especially HLA-G and HLA-F have most intensively been, and were also primarily, studied in relation to reproduction and pregnancy. The expression of HLA class Ib proteins at the feto-maternal interface in the placenta seems to be important for the maternal acceptance of the semi-allogenic fetus. In contrast to the functions of HLA class Ia, HLA-G possesses immune-modulatory and tolerogenic functions. Here, we review an accumulating amount of data describing the functions of HLA class Ib molecules in relation to fertility, reproduction, and pregnancy, and a possible role for these molecules in certain pregnancy complications, such as implantation failure, recurrent spontaneous abortions, and pre-eclampsia. The results from different kinds of studies point toward a role for HLA class Ib, especially HLA-G, throughout the reproductive cycle from conception to the birth weight of the child.

Interactive Gentle Yoga in Improving Quality of Life in Patients With Stage I-III Breast Cancer Undergoing Radiation Therapy

Science.gov (United States)

2017-07-28

Anxiety Disorder; Depression; Ductal Breast Carcinoma in Situ; Fatigue; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Sequential versus "sandwich" sequencing of adjuvant chemoradiation for the treatment of stage III uterine endometrioid adenocarcinoma.

Science.gov (United States)

Lu, Sharon M; Chang-Halpenny, Christine; Hwang-Graziano, Julie

2015-04-01

To compare the efficacy and tolerance of adjuvant chemotherapy and radiotherapy delivered in sequential (chemotherapy followed by radiation) versus "sandwich" fashion (chemotherapy, interval radiation, and remaining chemotherapy) after surgery in patients with FIGO stage III uterine endometrioid adenocarcinoma. From 2004 to 2011, we identified 51 patients treated at our institution fitting the above criteria. All patients received surgical staging followed by adjuvant chemoradiation (external-beam radiation therapy (EBRT) with or without high-dose rate (HDR) vaginal brachytherapy (VB)). Of these, 73% and 27% of patients received their adjuvant therapy in sequential and sandwich fashion, respectively. There were no significant differences in clinical or pathologic factors between patients treated with either regimen. Thirty-nine (76%) patients had stage IIIC disease. The majority of patients received 6 cycles of paclitaxel with carboplatin or cisplatin. Median EBRT dose was 45 Gy and 54% of patients received HDR VB boost (median dose 21 Gy). There were no significant differences in the estimated 5-year overall survival, local progression-free survival, and distant metastasis-free survival between the sequential and sandwich groups: 87% vs. 77% (p=0.37), 89% vs. 100% (p=0.21), and 78% vs. 85% (p=0.79), respectively. No grade 3-4 genitourinary or gastrointestinal toxicities were reported in either group. There was a trend towards higher incidence of grade 3-4 hematologic toxicity in the sandwich group. Adjuvant chemoradiation for FIGO stage III endometrioid uterine cancer given in either sequential or sandwich fashion appears to offer equally excellent early clinical outcomes and acceptably low toxicity. Copyright © 2015 Elsevier Inc. All rights reserved.

Intravital Microscopy for Identifying Tumor Vessels in Patients With Stage IA-IV Melanoma That is Being Removed by Surgery

Science.gov (United States)

2017-06-05

Recurrent Melanoma; Stage IA Skin Melanoma; Stage IB Skin Melanoma; Stage IIA Skin Melanoma; Stage IIB Skin Melanoma; Stage IIC Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIB Skin Melanoma; Stage IIIC Skin Melanoma; Stage IV Skin Melanoma

Survival after Stage IA Endometrial Cancer; Can follow-up be altered?

DEFF Research Database (Denmark)

Lajer, Henrik; Elnegaard, Sandra; Christensen, René D

2012-01-01

IA (1988 classification) endometrial cancer patients prospectively included between 1986 and 1999. All patients had total abdominal hysterectomy and bilateral salpingo-oophorectomy without adjuvant therapy. Methods. The patient and the disease characteristics were drawn from the DEMCA database....... Of these recurrences, 15 of 23 (65%) were vaginal. Death from recurrence was observed in nine of 23 (39%) patients, and five of these nine had vaginal recurrences. Conclusions. Women with FIGO stage IA endometrial cancer have a very high disease-specific five year survival. Survival was related to histopathology...

Long-term results and prognostic factors in patients with stage III-IVA squamous cell carcinoma of the cervix treated with concurrent chemoradiotherapy from a single institution study

International Nuclear Information System (INIS)

Kudaka, Wataru; Nagai, Yutaka; Toita, Takafumi

2013-01-01

We evaluated the longer-term efficacy and safety of concurrent chemoradiotherapy (CCRT) incorporating high-dose-rate intracavitary brachytherapy (HDR-ICBT) with a lower cumulative radiotherapy (RT) protocol and analyzed prognostic risk factors for survival among patients with International Federation of Gynecology and Obstetrics (FIGO) stage III-IVA squamous cell carcinoma (SCC) of the cervix. Ninety-nine patients with FIGO stage III-IVA SCC of the cervix between 1997 and 2008 were treated with CCRT using cisplatin 20 mg/m 2 for 5 days every 3 weeks or 40 mg/m 2 weekly. Acute and late toxicities were evaluated. Overall survival (OS) and disease-free survival (DFS) were estimated by the Kaplan-Meier method. The Cox proportional hazard model was used for multivariate analysis. Median age was 53.5 years. Median follow-up period was 58 months (range 6-170 months). Pathologically complete response was achieved in 93 patients (96.9%). The 5-year OS and DFS were 72.0 and 69.3%, respectively. The 5-year local and distant DFS were 83.0 and 75.1%, respectively. Thirty-one patients (31.3%) experienced recurrence. Multivariate analysis showed that tumor size and pretreatment hemoglobin level remained an independent risk factor for OS and DFS. Acute toxicity was moderate. In terms of late adverse effects, 2 patients (2.0%) suffered from grade 4 late intestinal toxicity because of radiation enterocolitis, with both requiring intestinal surgery. Our study demonstrates that the CCRT schedule in patients with FIGO stage III-IVA SCC is efficacious and safe. In addition, the assessment of tumor size and pretreatment anemia can provide valuable prognostic information. (author)

Intravital Microscopy in Evaluating Patients With Primary Peritoneal, Fallopian Tube, or Stage IA-IV Ovarian Cancer

Science.gov (United States)

2018-06-04

Fallopian Tube Carcinoma; Primary Peritoneal Carcinoma; Stage I Ovarian Cancer; Stage IA Ovarian Cancer; Stage IB Ovarian Cancer; Stage IC Ovarian Cancer; Stage II Ovarian Cancer; Stage IIA Ovarian Cancer; Stage IIB Ovarian Cancer; Stage IIC Ovarian Cancer; Stage III Ovarian Cancer; Stage IIIA Ovarian Cancer; Stage IIIB Ovarian Cancer; Stage IIIC Ovarian Cancer; Stage IV Ovarian Cancer

Health and Recovery Program in Increasing Physical Activity Level in Stage IA-IIIA Endometrial Cancer Survivors

Science.gov (United States)

2018-03-05

Cancer Survivor; Endometrial Carcinoma; Stage I Uterine Corpus Cancer AJCC v7; Stage IA Uterine Corpus Cancer AJCC v7; Stage IB Uterine Corpus Cancer AJCC v7; Stage II Uterine Corpus Cancer AJCC v7; Stage IIIA Uterine Corpus Cancer AJCC v7

Medically inoperable stage I endometrial carcinoma: a few dilemmas in radiotherapeutic management

International Nuclear Information System (INIS)

Chao, Clifford K. S.; Grigsby, Perry W.; Perez, Carlos A.; Mutch, David G.; Herzog, Thomas; Camel, H. Marvin

1996-01-01

Purpose: The aggressiveness of radiation therapy for patients with medically inoperable endometrial carcinoma is controversial. Patients may die of their underlining medical disease before succumbing to cancer. We try to identify certain subgroup of patients who might benefit most from an aggressive approach and also investigate the impact of residual tumor present in dilatation and curettage (D and C) specimen obtained in second intracavitary implant (ICI). Methods and Materials: From 1965 to 1990, 101 patients were treated for clinical clinical Stage I endometrial carcinoma with RT alone due to medical problems. Ages ranged from 39 to 94 years (median 71 years). There were 18 patients with clinical Stage IA and 83 with clinical Stage IB disease. Histology included 44 well-differentiated, 37 moderately differentiated, and 20 poorly differentiated tumors. Radiation therapy consisted of external beam only in 3 patients, ICI alone in 26, whole pelvis plus ICI in 10, and whole pelvis plus split field plus ICI in 62. A second D and C was performed on 26 patients at the time of the second ICI. Minimum follow-up was 2 years (median, 6.3 years). Results: The 5-year actuarial disease-free survival (DFS) for the studied cohort is comparable to the expected survival of an age-matched population. Pelvic control was 100% for Stage IA and 88% for Stage IB with 5-year disease-free survivals of 80 and 84%, respectively. We also observed a greater disassociation of DFS and overall survival among patients older than 75 years (84 and 55%, respectively) than in younger patients (84 and 78%, respectively). This is mainly because older patients succumbed to their medical illness. Well-differentiated disease demonstrated the trend toward a better outcome than moderately or poorly differentiated lesions in Stage IB patients (p 0.05), but not in Stage IA patients. Aggressive radiation therapy approach showed the trend toward a better result in Stage IB patients 75 years of age or younger

Anti-Inflammatory Activities of a Chinese Herbal Formula IBS-20 In Vitro and In Vivo

Directory of Open Access Journals (Sweden)

Zhonghan Yang

2012-01-01

Full Text Available Irritable bowel syndrome (IBS is a functional bowel disorder and the etiology is not well understood. Currently there is no cure for IBS and no existing medication induces symptom relief in all patients. IBS-20 is a 20-herb Chinese medicinal formula that offers beneficial effects in patients with IBS; however, the underlying mechanisms are largely unknown. This study showed that IBS-20 potently inhibited LPS- or IFNΓ-stimulated expression of pro-inflammatory cytokines, as well as classically activated macrophage marker nitric oxide synthase 2. Similarly, IBS-20 or the component herb Coptis chinensis decreased LPS-stimulated pro-inflammatory cytokine secretion from JAWS II dendritic cells. IBS-20 or the component herbs also blocked or attenuated the IFNΓ-induced drop in transepithelial electric resistance, an index of permeability, in fully differentiated Caco-2 monolayer. Finally, the up-regulation of key inflammatory cytokines in inflamed colon from TNBS-treated mice was suppressed significantly by orally administrated IBS-20, including IFNΓ and IL-12p40. These data indicate that the anti-inflammatory activities of IBS-20 may contribute to the beneficial effects of the herbal extract in patients with IBS, providing a potential mechanism of action for IBS-20. In addition, IBS-20 may be a potential therapeutic agent against other Th1-dominant gut pathologies such as inflammatory bowel disease.

Gene expression profiles as prognostic markers in women with ovarian cancer

DEFF Research Database (Denmark)

Jochumsen, Kirsten M; Tan, Qihua; Høgdall, Estrid V

2009-01-01

toward investigations for more individualized therapies and the use of gene expression profiles in the clinical practice. RNA from tumor tissue from 43 Danish patients with serous epithelial ovarian carcinoma (11 International Federation of Gynecology and Obstetrics [FIGO] stage I/II, 32 FIGO stage III...

Primary invasive carcinoma of the vagina after Le Fort partial colpocleisis for stage IV pelvic organ prolapse: a case report.

Science.gov (United States)

Cho, Moon Kyoung; Kim, Chul Hong; Kim, Yoon Ha

2011-11-01

We present here the case report of a postmenopausal woman who complained of recurrent pus-like vaginal discharge and perianal pain 1 year after Le Fort colpocleisis, which was subsequently identified as a primary invasive carcinoma of the vagina. Biopsy confirmed a squamous cell carcinoma in the vagina, and the disease was classified as stage III according to FIGO staging. The patient received pelvic radiotherapy. This case emphasizes that differential diagnosis of recurrent vaginal discharge that presents remote from obliterative procedure for pelvic organ prolapse should consider not only pyometra, but also other causes.

Caloric Restriction in Treating Patients With Stage 0-I Breast Cancer Undergoing Surgery and Radiation Therapy

Science.gov (United States)

2017-09-25

Ductal Breast Carcinoma in Situ; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Lobular Breast Carcinoma in Situ; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer

Acupuncture in Reducing Chemotherapy-Induced Peripheral Neuropathy in Participants With Stage I-III Breast Cancer

Science.gov (United States)

2018-05-30

Anatomic Stage I Breast Cancer AJCC v8; Anatomic Stage IA Breast Cancer AJCC v8; Anatomic Stage IB Breast Cancer AJCC v8; Anatomic Stage II Breast Cancer AJCC v8; Anatomic Stage IIA Breast Cancer AJCC v8; Anatomic Stage IIB Breast Cancer AJCC v8; Anatomic Stage III Breast Cancer AJCC v8; Anatomic Stage IIIA Breast Cancer AJCC v8; Anatomic Stage IIIB Breast Cancer AJCC v8; Anatomic Stage IIIC Breast Cancer AJCC v8; Grade 1 Peripheral Motor Neuropathy, CTCAE; Grade 1 Peripheral Sensory Neuropathy, CTCAE; Grade 2 Peripheral Motor Neuropathy, CTCAE; Grade 2 Peripheral Sensory Neuropathy, CTCAE; Prognostic Stage I Breast Cancer AJCC v8; Prognostic Stage IA Breast Cancer AJCC v8; Prognostic Stage IB Breast Cancer AJCC v8; Prognostic Stage II Breast Cancer AJCC v8; Prognostic Stage IIA Breast Cancer AJCC v8; Prognostic Stage IIB Breast Cancer AJCC v8; Prognostic Stage III Breast Cancer AJCC v8; Prognostic Stage IIIA Breast Cancer AJCC v8; Prognostic Stage IIIB Breast Cancer AJCC v8; Prognostic Stage IIIC Breast Cancer AJCC v8

Interactive Tailored Website to Promote Sun Protection and Skin Self-Check Behaviors in Patients With Stage 0-III Melanoma

Science.gov (United States)

2017-11-15

Stage 0 Skin Melanoma; Stage I Skin Melanoma; Stage IA Skin Melanoma; Stage IB Skin Melanoma; Stage II Skin Melanoma; Stage IIA Skin Melanoma; Stage IIB Skin Melanoma; Stage IIC Skin Melanoma; Stage III Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIB Skin Melanoma; Stage IIIC Skin Melanoma

Innovative Approach for IBS Vendor Selection Problem

Directory of Open Access Journals (Sweden)

Omar Mohd Faizal

2016-01-01

Full Text Available Supply chain management in Industrialised Building System (IBS construction management has significantly determined the successful of company and project performance. Due to the wide variety of criteria and vendor available, the vendor selection process for a specific project needs is becoming more difficult. The need of decision aid for vendor selection in other areas is widely discussed in previous research. However, study on vendor selection for IBS project is largely neglected. Decision Support System (DSS is proposed for this purpose. Yet, most of the DSS models are impractical since they are complicated and difficult for a layman such as project managers to use. Research indicates that the rapid development of ICT has highly potential towards simple and effective DSS. Thus, this paper highlights the importance and research approach for vendor selection in IBS project management. The study is based on Design Science Research Methodology with combination of case studies. It is anticipates that this study will yield an effective value-for-money decision making platform to manage vendor selection process.

Treatment Options by Stage (Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer)

Science.gov (United States)

... diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body. The ... single ovary or fallopian tube. In stage IB, cancer is found inside both ovaries or fallopian tubes. In stage IC, cancer is ...

El estudio de la Fauna Ibérica

Directory of Open Access Journals (Sweden)

Ramos Sánchez, María Ángeles

2007-10-01

Full Text Available Since the beginning in 1989, Fauna Ibérica has promoted coordinated research in Taxonomy bringing together more than 100 Spanish and non-Spanish experts. The programme supported by CSIC Presidency is lead by Museo Nacional de Ciencias Naturales. As a result, 30 Fauna Ibérica monographs has been published in addition to a year average of 50-60 scientific papers describing more than 50 new species per year. IBERFAUNA, the Data Bank of the Spanish Fauna, has been created including 38.000 out of the 61.000 species estimated to live in the Iberian Peninsula and Balearic Islands. This area is confirmed as one of the most biodiverse of the European Union with more than 50 % of the European species and more than 50 % of its endemics. Among future plans, a more stable organization is proposed in order to: maintaining dichotomy paper/digital publications, increasing interactivity among taxonomists and training, developing cyber-tools to facilitate public access to the information and increasing the strength of Fauna Ibérica through collaboration with other international initiatives and other areas of knowledge.Desde su inicio en 1989, Fauna Ibérica ha impulsado la investigación coordinada de más de 100 taxónomos españoles y extranjeros. El programa, apoyado por la Presidencia del CSIC, está dirigido por el Museo Nacional de Ciencias Naturales. Como resultado, se han publicado 30 monografías de la serie Fauna Ibérica, y un promedio anual de 50-60 artículos científicos que describen más de 50 nuevas especies por año. Se ha creado el Banco de Datos, IBERFAUNA, que cuenta ya con 38.000 de las aproximadamente 61.000 especies que habitan en la Península Ibérica y Baleares. Se confirma como una de las regiones más ricas en biodiversidad de la Unión Europea, con más del 50 % de las especies y más de un 50 % de sus endemismos. Entre los planes de futuro, se propone una estructura estable para Fauna Ibérica, que mantenga la dicotomía soporte

Long-term Outcome after Radiotherapy for FIGO Stage IIIB and IVA Carcinoma of the Cervix

International Nuclear Information System (INIS)

Yeung, Anamaria R.; Amdur, Robert J.; Morris, Christopher G.; Morgan, Linda S.; Mendenhall, William M.

2007-01-01

Purpose: To report the long-term outcome after radiotherapy with curative intent for Stage IIIB and IVA carcinoma of the cervix. Methods and Materials: We retrospectively reviewed 91 patients treated with radiotherapy with curative intent at University of Florida between January 1980 and December 2003 for Stage IIIB (84 patients) or IVA (7 patients) carcinoma of the cervix. Results: The median follow-up of the surviving patients was 8.8 years. The 5- and 10-year estimates of local control, regional control, locoregional control, relapse-free survival, and overall survival were 53% and 53%, 55% and 47%, 34% and 29%, 30% and 26%, and 29% and 21%, respectively. Ninety percent of the recurrences occurred within 2 years of treatment. Of these, 60% of all failures were local, 29% were regional, and 11% were distant failures alone. Also, 17% of the failures were in the paraaortic nodes with no evidence of failure in the pelvis. Univariate and multivariate analyses were conducted with the endpoint of relapse-free or overall survival. No factor was statistically significant. Complications from therapy were scored using the Radiation Therapy Oncology Group grading system; the overall severe late complication rate was 13% (Grade 3-5). Conclusion: This series is one of the most mature of published reports. With long-term follow-up, approximately one-third of patients with Stage IIIB or IVA carcinoma of the cervix were cured, with a 13% complication rate

Monitoring of chemotherapy successfulness of Platina/Taxol chemotherapy protocol by using determination of serum urokinase plasminogen activator (uPA and soluble urokinase plasminogen activator receptor (suPAR in patients with ovarian carcinoma FIGO II

Directory of Open Access Journals (Sweden)

Dženita Ljuca

2007-05-01

Full Text Available In about 70% of cases, ovarian carcinoma has been diagnosed at an advanced stage. Invasion and metastasis of solid tumors request protease activity resulting in basal membrane destruction and surrounding matrix. In that process, urokinase plasminogen activator (uPA and its receptor, urokinase plasminogen activator receptor (suPAR play a key role, that via plasmin activation lead to basal membrane and matrix degradation in surrounding of the tumor, enable to its invasion and metastasis. Determination of serum concentration of those tumor markers can be useful in preoperative as well as in postoperative period. Their serum concentrations in ovarian cancer patients may help in good monitoring of remission or progression during chemotherapy treatment. In late 1950s and eariy 1960s, when it was found out that malignant ovarian tumors were chemosensitive, their chemotherapy treatment has begun. In the beginning it was used only mono-therapy, and by discovering new cytostatics it was replaced by poly-chemotherapy. Now days, in the therapy of advanced stages of ovarian carcinoma combination of cisplatine or carboplatine with paclitaxel is considering as standard treatment. Aim of this study was to determine serum uPA, suPAR and CEA in FIGO II and III patients with different histo-logical type (serous, mucinous, clear cell tumor before and after PT chemotherapy protocol during following three cycles. In this prospective study we have analyzed 17 patients with ovarian carcinoma, those have been after surgery treated by chemotherapy. Serum levels of uPA and suPAR have been determined by ELISA-test (Imubind uPA, Imubind uPAR, American Diagnostica, and CEA by OPUS Imunoassay method. Results of this study have shown that uPA, suPAR and CEA met criteria for prognostic markers for monitoring of successful-ness of platina/taxol chemotherapy protocol for serous, mucinous and clear cell tumor FIGO II and III stage of ovarian carcinoma. In case of PT chemotherapy

Uterus and vagina. TNM classification of malignant tumours

International Nuclear Information System (INIS)

Harmer, M.H.

1984-01-01

Cervix uteri and Corpus uteri were amongst the first sites to be classified by the TNM system. The ''League of Nations'' Stages for carcinoma of the cervix have been used with minor modifications for nearly fifty years and because these are accepted by the Federation Internationale de Gynecologie et d'Obstetrique (FIGO), the TNM categories have been defined to correspond to the FIGO stages. Some amendments have been made in collaboration with FIGO and the classifications now published will remain unchanged until at least 1986

Ovary and abdomen. TNM classification of malignant tumours

International Nuclear Information System (INIS)

Harmer, M.H.

1984-01-01

Cervix uteri and Corpus uteri were amongst the first sites to be classified by the TNM system. The ''League of Nations'' Stages for carcinoma of the cervix have been used with minor modifications for nearly fifty years and because these are accepted by the Federation Internationale de Gynecologie et d'Obstetrique (FIGO), the TNM categories have been defined to correspond to the FIGO stages. Some amendments have been made in collaboration with FIGO and the classifications now published will remain unchanged until at least 1986

Trastuzumab Emtansine in Treating Older Patients With Human Epidermal Growth Factor Receptor 2-Positive Stage I-III Breast Cancer

Science.gov (United States)

2018-02-01

Estrogen Receptor Status; HER2 Positive Breast Carcinoma; Progesterone Receptor Status; Stage I Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage III Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer

Energy Technology Data Exchange (ETDEWEB)

Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl [Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Gruszczynska, Ewelina; Bijok, Michal [Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Jonska-Gmyrek, Joanna [Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Dabkowski, Mateusz [Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Staniaszek, Jagna [Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Michalski, Wojciech [Department of Clinical Trials and Biostatistics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Kowalczyk, Adam; Milanowska, Katarzyna [Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)

2016-09-01

Purpose: To evaluate the long-term results of computed tomography (CT)–planned high-dose-rate (HDR) brachytherapy (BT) for treating cervical cancer patients. Methods and Materials: CT-planned HDR BT was performed according to the adapted Group European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations in 216 consecutive patients with locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stage IB to IVA, who were treated with conformal external beam radiation therapy and concomitant chemotherapy. We analyzed outcomes and late side effects evaluated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Subjective, Objective, Management, Analysis evaluation scoring system and compared them with the results from a historical group. Results: The median age was 56 years (range, 32-83 years). The median follow-up time for living patients was 52 months (range 37-63 months). The 5-year cumulative incidence function for the local recurrence rate for patients with FIGO II and III was 5.5% and 20%, respectively (P=.001). The 5-year rates of overall survival (OS) and disease-free survival (DFS) were 66.4% and 58.5%, respectively. The relative risk of failure for OS and DFS for FIGO III in relation to FIGO II was 2.24 (P=.003) and 2.6 (P=.000) and for lymph node enlargement was 2.3 (P=.002) and 2 (P=.006), respectively. In 2 patients, rectovaginal fistula occurred, and in 1 patient, vesicovaginal fistula occurred without local progression. Comparison of late adverse effects in patients treated according to the GEC-ESTRO recommendations and in the historical group revealed a reduction in fistula formation of 59% and also a reduction in rectal grade 3 to 4 late toxicity of >59%. Conclusions: This is the largest report with mature data of CT-planned BT HDR for the treatment of cervical cancer with good local control and

Extended Cancer Education for Longer-Term Survivors in Primary Care for Patients With Stage I-II Breast or Prostate Cancer or Stage I-III Colorectal Cancer

Science.gov (United States)

2017-11-15

Stage I Breast Cancer; Stage I Colorectal Cancer AJCC v6 and v7; Stage I Prostate Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage II Colorectal Cancer AJCC v7; Stage II Prostate Cancer; Stage IIA Breast Cancer; Stage IIA Colorectal Cancer AJCC v7; Stage IIA Prostate Cancer; Stage IIB Breast Cancer; Stage IIB Colorectal Cancer AJCC v7; Stage IIB Prostate Cancer; Stage IIC Colorectal Cancer AJCC v7; Stage III Colorectal Cancer AJCC v7; Stage IIIA Colorectal Cancer AJCC v7; Stage IIIB Colorectal Cancer AJCC v7; Stage IIIC Colorectal Cancer AJCC v7

Key factors of successful JIT integration with IBS - An overview

Science.gov (United States)

Asri, Mohammad Azwanie Naim Mohammad; Nawi, Mohd Nasrun Mohd; Nadarajan, Santhirasegaran

2016-08-01

The Just-In-Time (JIT) philosophy has been used for many decades to increase productivity through waste elimination process. The purpose of this paper is to contribute to the knowledge by addressing the transportation and material delivery activities in Industrialized Building System (IBS) and integrating JIT to improve the performance of those activities. The literature review has been conducted through relevant database. It was found that there is a need for more holistic approach to be adopted to integrate JIT in IBS project. This paper discusses the key success factors for effective integration between JIT and IBS in the context of transportation and material delivery activities.

FRAGMENTATION ISSUE IN MALAYSIAN INDUSTRIALISED BUILDING SYSTEM (IBS PROJECTS

Directory of Open Access Journals (Sweden)

MOHD NASRUN MOHD NAWI

2014-02-01

Full Text Available As a developing country, Malaysian is currently driving for implementing a new or modern construction method, the Industrialised Building System (IBS, as an alternative towards enhancing construction performance. Currently, most of the IBS project developments in Malaysia are still conducted by using the traditional construction process approach. This traditional construction process has been widely criticised for its fragmented approach to project delivery and its failure to form effective teams thus created a number of issues such as reworks, time delay, rising costs, lack of communication and coordination, and wastages. This paper through literature review aims to highlight this fragmentation issue and clarify how far it affects the process of IBS implementation. Suggestions on how an integrated approach in design and construction in order to minimise the fragmentation gaps will be concluded.

Revised FIGO staging system for cancer of the ovary, fallopian tube, and peritoneum: important implications for radiologists.

Science.gov (United States)

Saida, Tsukasa; Tanaka, Yumiko Oishi; Matsumoto, Koji; Satoh, Toyomi; Yoshikawa, Hiroyuki; Minami, Manabu

2016-02-01

Ovarian cancer is the seventh most common cancer diagnosis among women worldwide. The International Federation of Gynecology and Obstetrics recently significantly revised staging criteria for cancer of the ovary. The latest revision was based on the concept that high-grade serous tubal intraepithelial carcinoma (STIC) may be the origin of some high-grade serous carcinomas of the ovary and peritoneum. Therefore, staging criteria for the ovary, fallopian tube, and peritoneum have been unified. Understanding this background and other important revised points are essential for radiologists concerned with imaging diagnosis in gynecologic oncology. Through this review, we introduce the STIC theory and show examples of diseases in accordance with the new staging criteria based on magnetic resonance imaging (MRI) and computed tomography (CT) results.

The Effect of Simvastatin on Breast Cancer Cell Growth in Women With Stage I-II Breast Cancer

Science.gov (United States)

2018-03-02

Invasive Breast Carcinoma; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

A unique set of SH3-SH3 interactions controls IB1 homodimerization

DEFF Research Database (Denmark)

Kristensen, Ole; Guenat, Sylvie; Dar, Imran

2006-01-01

Islet-brain 1 (IB1 or JIP-1) is a scaffold protein that interacts with components of the c-Jun N-terminal kinase (JNK) signal-transduction pathway. IB1 is expressed at high levels in neurons and in pancreatic beta-cells, where it controls expression of several insulin-secretory components...... reduces IB1-dependent basal JNK activity in 293T cells. Impaired dimerization also results in a reduction in glucose transporter type 2 expression and in glucose-dependent insulin secretion in pancreatic beta-cells. Taken together, these results indicate that IB1 homodimerization through its SH3 domain...

FDG uptake heterogeneity in FIGO IIb cervical carcinoma does not predict pelvic lymph node involvement.

Science.gov (United States)

Brooks, Frank J; Grigsby, Perry W

2013-12-23

Many types of cancer are located and assessed via positron emission tomography (PET) using the 18F-fluorodeoxyglucose (FDG) radiotracer of glucose uptake. There is rapidly increasing interest in exploiting the intra-tumor heterogeneity observed in these FDG-PET images as an indicator of disease outcome. If this image heterogeneity is of genuine prognostic value, then it either correlates to known prognostic factors, such as tumor stage, or it indicates some as yet unknown tumor quality. Therefore, the first step in demonstrating the clinical usefulness of image heterogeneity is to explore the dependence of image heterogeneity metrics upon established prognostic indicators and other clinically interesting factors. If it is shown that image heterogeneity is merely a surrogate for other important tumor properties or variations in patient populations, then the theoretical value of quantified biological heterogeneity may not yet translate into the clinic given current imaging technology. We explore the relation between pelvic lymph node status at diagnosis and the visually evident uptake heterogeneity often observed in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images of cervical carcinomas. We retrospectively studied the FDG-PET images of 47 node negative and 38 node positive patients, each having FIGO stage IIb tumors with squamous cell histology. Imaged tumors were segmented using 40% of the maximum tumor uptake as the tumor-defining threshold and then converted into sets of three-dimensional coordinates. We employed the sphericity, extent, Shannon entropy (S) and the accrued deviation from smoothest gradients (ζ) as image heterogeneity metrics. We analyze these metrics within tumor volume strata via: the Kolmogorov-Smirnov test, principal component analysis and contingency tables. We found no statistically significant difference between the positive and negative lymph node groups for any one metric or plausible combinations thereof. Additionally

FDG uptake heterogeneity in FIGO IIb cervical carcinoma does not predict pelvic lymph node involvement

International Nuclear Information System (INIS)

Brooks, Frank J; Grigsby, Perry W

2013-01-01

Many types of cancer are located and assessed via positron emission tomography (PET) using the 18F-fluorodeoxyglucose (FDG) radiotracer of glucose uptake. There is rapidly increasing interest in exploiting the intra-tumor heterogeneity observed in these FDG-PET images as an indicator of disease outcome. If this image heterogeneity is of genuine prognostic value, then it either correlates to known prognostic factors, such as tumor stage, or it indicates some as yet unknown tumor quality. Therefore, the first step in demonstrating the clinical usefulness of image heterogeneity is to explore the dependence of image heterogeneity metrics upon established prognostic indicators and other clinically interesting factors. If it is shown that image heterogeneity is merely a surrogate for other important tumor properties or variations in patient populations, then the theoretical value of quantified biological heterogeneity may not yet translate into the clinic given current imaging technology. We explore the relation between pelvic lymph node status at diagnosis and the visually evident uptake heterogeneity often observed in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images of cervical carcinomas. We retrospectively studied the FDG-PET images of 47 node negative and 38 node positive patients, each having FIGO stage IIb tumors with squamous cell histology. Imaged tumors were segmented using 40% of the maximum tumor uptake as the tumor-defining threshold and then converted into sets of three-dimensional coordinates. We employed the sphericity, extent, Shannon entropy (S) and the accrued deviation from smoothest gradients (ζ) as image heterogeneity metrics. We analyze these metrics within tumor volume strata via: the Kolmogorov-Smirnov test, principal component analysis and contingency tables. We found no statistically significant difference between the positive and negative lymph node groups for any one metric or plausible combinations thereof. Additionally

Nerve growth factor and diarrhea-predominant irritable bowel syndrome (IBS-D): a potential therapeutic target?

Science.gov (United States)

Xu, Xiao-juan; Liu, Liang; Yao, Shu-kun

2016-01-01

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain or discomfort associated with abnormal bowel habits. Diarrhea-predominant IBS (IBS-D) is a major subtype of IBS, the predominant manifestations of which are abdominal pain and diarrhea. The pathogenesis of IBS-D remained unknown until recently. The effects of psychosocial stress, central hypervigilance, neuroendocrine abnormality, disturbed gastrointestinal motility, mucosal immune activation, intestinal barrier dysfunction, visceral hypersensitivity (VH), altered gut flora, and genetic susceptibility may be involved in its development. Recently, increased attention has been placed on the neural-immune-endocrine network mechanism in IBS-D, especially the role of various neuroendocrine mediators. As a member of the neurotrophin family, nerve growth factor (NGF) has diverse biological effects, and participates in the pathogenesis of many diseases. Basic studies have demonstrated that NGF is associated with inflammatory- and stress-related VH, as well as stress-related intestinal barrier dysfunction. The aim of this study is to summarize recent literature and discuss the role of NGF in the pathophysiology of IBS-D, especially in VH and intestinal barrier dysfunction, as well as its potential as a therapeutic target in IBS-D.

Magnetic resonance imaging of cervical carcinoma using an endorectal surface coil

International Nuclear Information System (INIS)

Brocker, Kerstin A.; Alt, Céline D.; Gebauer, Gerhard; Sohn, Christof; Hallscheidt, Peter

2014-01-01

Introduction: The objective of this trial is to investigate the diagnostic value of magnetic resonance imaging (MRI) with an endorectal surface coil for precise local staging of patients with histologically proven cervical cancer by comparing the radiological, clinical, and histological results. Materials and methods: Women with cervical cancer were recruited for this trial between February 2007, and September 2010. All the patients were clinically staged according to the FIGO classification and underwent radiological staging by MRI that employed an endorectal surface coil. The staging results after surgery were compared to histopathology in all the operable patients. Results: A total of 74 consecutive patients were included in the trial. Forty-four (59.5%) patients underwent primary surgery, whereas 30 (40.5%) patients were inoperable according to FIGO and underwent primary radiochemotherapy. The mean age of the patients was 50.6 years. In 11 out of the 44 patients concordant staging results were obtained by all three staging modalities. Thirty-two of the 44 patients were concordantly staged by FIGO and histopathological examination, while only 16 were concordantly staged by eMRI and histopathological examination. eMRI overstaged tumors in 14 cases and understaged them in 7 cases. Conclusions: eMRI is applicable in patients with cervical cancer, yet of no benefit than staging with FIGO or standard pelvic MRI. The most precise preoperative staging procedure still appears to be the clinical examination

Prognosis of patients with stage IIIb-IVa squamous cell carcinoma of the cervix following intra-arterial neoadjuvant chemotherapy

International Nuclear Information System (INIS)

Fujiwaki, R.; Maede, Y.; Ohnishi, Y.; Watanabe, Y.; Hata, K.; Miyazaki, K.

1999-01-01

The aim was to determine the long-term prognosis in patients with stage IIIb-IVa squamous cell carcinoma of the cervix who were treated with intra-arterial neoadjuvant chemotherapy (NAC), and to analyze factors related to prognostic value. The authors assessed the disease-free survival of 21 patients with FIGO stage IIIb-IVa squamous cell carcinoma of the cervix treated with intra-arterial NAC followed by irradiation therapy. Before chemotherapy, five factors (age, clinical stage, histologic type, parametrial involvement and serum level of SCC) were evaluated for their correlation with disease-free survival. Univariate Cox's proportional hazard model also demonstrated that age was a significant prognostic factor as a continuous variable. Intra-arterial NAC thus appeared to be effective in treating older patients with stage IIIb-IVa squamous cell carcinoma of the cervix

Los materiales hercínicos de la cordillera ibérica en el contexto del macizo ibérico

Directory of Open Access Journals (Sweden)

Liñán, E.

1988-12-01

Full Text Available The discontinuity observed between the paleozoic outcrops of the Iberian Mountains and the ones of the Iberian Massif, has been the greatest incovenient to include those ones in a general Hercynian Iberian model. Two hypothesis have been proposed to the respect. One initial hypothesis postulates the inclusion of the Iberian Mountains paleozoic racks in the West Asturian-Leonese Zone (Lotze, 1961; Julivert et al., 1974. Other one postulates a double inelusion: the occidental part of the Iberian Chaines into the West Asturian-Leonese Zone and the oriental part of the Iberian Chaines into the Cantabrian Zona (Liñán, 1983. In this work new geological data are provided for the geological conexion between Cantabrian Zone and the oriental part of the Iberian Chains; they can be summarised in three points. One of them is referred to the paralellism between the Narcea and Paracuellos antiforms. Those antiforms are divided by a tectonic accident, wich separates different Precambrian sequences. Another point deals with the close relation of the stratigraphical sequences of the Paleozoic racks between the Cantabrian region and Iberian region at both sides of the Narcea and Paracuellos antiforms. the last point refers to the study of small outcrops located in the northwest of the Iberian Chains, that show a probably more similar geological structure to the Cantabrian Zone wich was defined as a fold and thrust belt.La falta de continuidad de los afloramientos paleozoicos de la Cordillera Ibérica con los del Macizo Ibérico han venido constituyendo un serio obstáculo para la inclusión de aquéllos dentro de un esquema general para el hercínico ibérico. Dos hipótesis han sido hasta ahora planteadas: su conexión con la Zona Asturoccidental-Leonesa, o su doble conexión con esta zona y con la zona Cantábrica. En este trabajo se aportan nuevos datos geológicos que son congruentes con la prolongación tanto de la Zona Cantábrica como de la Zona

Stage-specific mortality of Baltic cod ( Gadus morhua L.) eggs

DEFF Research Database (Denmark)

Wieland, Kai; Hinrichsen, H.H.; Grønkjær, P.

2000-01-01

A study on cod egg mortality was carried out in the Bornholm Basin (southern central Baltic Sea) toward the end of July 1996. An initial egg aggregation marked by a satellite-tracked drifter buoy was sampled repeatedly over an Ii-day period; profiles of temperature, salinity and dissolved oxygen...... were concurrently recorded. Three replicate estimates of mortality were obtained for each pair of subsequent developmental stages from newly spawned eggs to early larvae. A consistent pattern of stage-specific mortality coincided well with previous experimental observations. Average daily mortality...... rates were 7.2% (eggs IA/IB), 38.7% (eggs (IB/II), 25.6% (eggs II/III), 40.0% (eggs III/IV), and 42.3% (eggs IV/early larvae). The cumulative mortality until hatch amounted to 99.9%. Results from hydrodynamic modelling, however, indicated that the drifter's trajectory was influenced by wind stress...

Resistance to sulfur poisoning of Ni-based alloy with coinage (IB) metals

International Nuclear Information System (INIS)

Xu, Xiaopei; Zhang, Yanxing; Yang, Zongxian

2015-01-01

Highlights: • The effects of IB metal dopants on the S poisoning features of Ni are analyzed. • IB metal dopants can modify the surface electronic structure of Ni. • IB metal dopants can increase the S tolerance of Ni at an optimized concentration. • Au is a preferred dopant to increase the resistance to sulfur poisoning of Ni. - Abstract: The poisoning effects of S atom on the (1 0 0), (1 1 0) and (1 1 1) metal surfaces of pure Ni and Ni-based alloy with IB (coinage) metals (Cu, Ag, Au) are systematically studied. The effects of IB metal dopants on the S poisoning features are analyzed combining the density functional theory (DFT) results with thermodynamics data using the ab initio atomistic thermodynamic method. It is found that introducing IB doping metals into Ni surface can shift the d-band center downward from the Fermi level and weaken the adsorption of S on the (1 0 0) and (1 1 0) surfaces, and the S tolerance ability increases in the order of Ni, Cu/Ni, Ag/Ni and Au/Ni. Nevertheless, on the (1 1 1) surface, the S tolerance ability increases in the order of Ag/Ni (or Cu/Ni), Ni, and Au/Ni. When we increase the coverage of the IB metal dopants, we found that not only Au, but Cu and Ag can increase its S tolerance. We therefore propose that alloying can increase its S tolerance and alloying with Au would be a better way to increase the resistance to sulfur poisoning of the Ni anode as compared with the pure Ni and the Ag- or, Cu-doped Ni materials.

Nonsense mutation in the glycoprotein Ibα coding sequence associated with Bernard-Soulier syndrome

International Nuclear Information System (INIS)

Ware, J.; Russell, S.R.; Vicente, V.; Scharf, R.E.; Tomer, A.; McMillian, R.; Ruggeri, Z.M.

1990-01-01

Three distinct gene products, the α and β chains of glycoprotein (GP) Ib and GP IX, constitute the platelet membrane GP Ib-IX complex, a receptor for von Willebrand factor and thrombin involved in platelet adhesion and aggregation. Defective function of the GP Ib-IX complex is the hallmark of a rare congenital bleeding disorder of still undefined pathogenesis, the Bernard-Soulier syndrome. The authors have analyzed the molecular basis of the disease in one patient in whom immunoblotting of solubilized platelets demonstrated absence of normal GP Ibα but presence of a smaller immunoreactive species. The truncated polypeptide was also present, along with normal protein, in platelets from the patient's mother and two of his four children. Genetic characterization identified a nucleotide transition changing the Trp-343 codon (TGG) to a nonsense codon (TGA). Such a mutation explains the origin of the smaller GP Ibα, which by lacking half of the sequence on the carboxyl-terminal side, including the transmembrane domain, cannot be properly inserted in the platelet membrane. Both normal and mutant codons were found in the patient, suggesting that he is a compound heterozygote with a still unidentified defect in the other GP Ibα allele. Nonsense mutation and truncated GP Ibα polypeptide were found to cosegregate in four individuals through three generations and were associated with either Bernard-Soulier syndrome or carrier state phenotype. The molecular abnormality demonstrated in this family provides evidence that defective synthesis of GP Ibα alters the membrane expression of the GP Ib-IX complex and may be responsible for Bernard-Soulier syndrome

IB Offering Certificate for Careers

Science.gov (United States)

Robelen, Erik W.

2012-01-01

The International Baccalaureate (IB) organization, best known in the United States for its prestigious two-year diploma program for juniors and seniors, will enter new terrain this fall as it formally rolls out an initiative centered on a variety of career pathways that includes engineering, culinary arts, and automotive technology. The move comes…

Seventh edition (2010) of the AJCC/UICC staging system for gastric adenocarcinoma: is there room for improvement?

Science.gov (United States)

Patel, Manali I; Rhoads, Kim F; Ma, Yifei; Ford, James M; Visser, Brendan C; Kunz, Pamela L; Fisher, George A; Chang, Daniel T; Koong, Albert; Norton, Jeffrey A; Poultsides, George A

2013-05-01

The gastric cancer AJCC/UICC staging system recently underwent significant revisions, but studies on Asian patients have reported a lack of adequate discrimination between various consecutive stages. We sought to validate the new system on a U.S. population database. California Cancer Registry data linked to the Office of Statewide Health Planning and Development discharge abstracts were used to identify patients with gastric adenocarcinoma (esophagogastric junction and gastric cardia tumors excluded) who underwent curative-intent surgical resection in California from 2002 to 2006. AJCC/UICC stage was recalculated based on the latest seventh edition. Overall survival probabilities were calculated using the Kaplan-Meier method. Of 1905 patients analyzed, 54 % were males with a median age of 70 years. Median number of pathologically examined lymph nodes was 12 (range, 1-90); 40 % of patients received adjuvant chemotherapy, and 31 % received adjuvant radiotherapy. The seventh edition AJCC/UICC system did not distinguish outcome adequately between stages IB and IIA (P = 0.40), or IIB and IIIA (P = 0.34). By merging stage II into 1 category and moving T2N1 to stage IB and T2N2, T1N3 to stage IIIA, we propose a new grouping system with improved discriminatory ability In this first study validating the new seventh edition AJCC/UICC staging system for gastric cancer on a U.S. population with a relatively limited number of lymph nodes examined, we found stages IB and IIA, as well as IIB and IIIA to perform similarly. We propose a revised stage grouping for the AJCC/UICC staging system that better discriminates between outcomes.

Diffusion-weighted MRI of epithelial ovarian cancers: Correlation of apparent diffusion coefficient values with histologic grade and surgical stage

Energy Technology Data Exchange (ETDEWEB)

Oh, Ji-Won, E-mail: fromentin@naver.com [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701 (Korea, Republic of); Rha, Sung Eun, E-mail: serha@catholic.ac.kr [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701 (Korea, Republic of); Oh, Soon Nam, E-mail: hiohsn@catholic.ac.kr [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701 (Korea, Republic of); Park, Michael Yong, E-mail: digirave@kmle.com [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701 (Korea, Republic of); Byun, Jae Young, E-mail: jybyun@catholic.ac.kr [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701 (Korea, Republic of); Lee, Ahwon, E-mail: klee@catholic.ac.kr [Department of Hospital Pathology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701 (Korea, Republic of)

2015-04-15

Highlights: •The solid component of all invasive epithelial cancers showed high b{sub 1000} signal intensity. •ADCs can predict the histologic grade of epithelial ovarian cancer. •ADCs correlate negatively to the surgical stage of epithelial ovarian cancer. •ADCs may be useful imaging biomarkers to assess epithelial ovarian cancer. -- Abstract: Objective: The purpose of this article is to correlate the apparent diffusion coefficient (ADC) values of epithelial ovarian cancers with histologic grade and surgical stage. Materials and methods: We enrolled 43 patients with pathologically proven epithelial ovarian cancers for this retrospective study. All patients underwent preoperative pelvic magnetic resonance imaging (MRI) including diffusion-weighted images with b value of 0 and 1000 s/mm{sup 2} at 3.0-T unit. The mean ADC values of the solid portion of the tumor were measured and compared among different histologic grades and surgical stages. Results: The mean ADC values of epithelial ovarian cancers differed significantly between grade 1 (well-differentiated) and grade 2 (moderately-differentiated) (P = 0.013) as well as between grade 1 and grade 3 (poorly-differentiated) (P = 0.01); however, no statistically significant difference existed between grade 2 and grade 3 (P = 0.737). The receiver-operating characteristic analysis indicated that a cutoff ADC value of less than or equal to 1.09 × 10{sup −3} mm{sup 2}/s was associated with 94.4% sensitivity and 85.7% specificity in distinguishing grade 1 and grade 2/3 cancer. The difference in mean ADC values was statistically significant for early stage (FIGO stage I) and advanced stage (FIGO stage II-IV) cancer (P = 0.011). The interobserver agreement for the mean ADC values of epithelial ovarian cancers was excellent. Conclusion: The mean ADC values of the solid portion of epithelial ovarian cancers negatively correlated to histologic grade and surgical stage. The mean ADC values may be useful imaging

Composição de bagas de 'Niágara Rosada' e 'Folha-de-Figo' relacionadas ao sistema de condução

Directory of Open Access Journals (Sweden)

Renata Vieira da Mota

2010-12-01

Full Text Available RESUMO Este trabalho teve como objetivo avaliar a influência do sistema de condução na qualidade de bagas de uvas 'Niágara Rosada' e 'Folha-de-Figo' cultivadas em Caldas-MG. Foram avaliados a produção por planta, o diâmetro, a massa, o teor de potássio e a temperatura das bagas, pH, teor de sólidos solúveis, açúcares redutores, acidez total e ácidos orgânicos do mosto, compostos fenólicos nas cascas e sementes, e antocianinas. As plantas foram conduzidas em espaldeira, lira, latada ou cordão simples, e os frutos, avaliados nas safras de 2006 e 2007. As videiras de 'Niágara Rosada' cultivadas em latada e 'Folha-de-Figo' em lira apresentaram produção significativamente superior aos demais sistemas de condução. Em todos os casos, as bagas apresentaram temperatura inferior à ambiente, indicando sombreamento completo ou parcial dos cachos. No sistema latada, houve menor acúmulo de sólidos solúveis e açúcares redutores nas duas cultivares. Estes resultados preliminares indicam que a composição das bagas foi pouco influenciada pelo sistema de condução.

The International Baccalaureate (IB programme: An international gateway to higher education and beyond

Directory of Open Access Journals (Sweden)

Susan E. Saxton

2014-09-01

Full Text Available The aim of this article is to present the International Baccalaureate (IB Programme and briefly outline its core components, followed by a review of what authoritative reports identify as skills for the future, esteemed by universities and the job market. There is a striking match between these skills and IB outcomes; thus, DP graduates perform well in higher education and add to the reputation of those institutions. After a review of the literature, the authors found the IB Diploma Programme has been studied in many countries by both consultants and educational agencies, and also by a wide array of universities themselves; however, there are fewer qualitative studies concerning the degree to which IB graduates display attitudes, values, and behaviours in line with the IB Learner Profile. This is why the authors stress the claims made are supported by examples of significant research, noting that there is a dearth of qualitative longitudinal studies to sufficiently substantiate the affective domain claims that currently rely more on anecdotal evidence. The authors conclude by pointing out more research is needed in order to substantiate anecdotal evidence regarding future employment success for IB Diploma Programme graduates.  DOI: 10.18870/hlrc.v4i3.123

Downregulation of six microRNAs is associated with advanced stage, lymph node metastasis and poor prognosis in small cell carcinoma of the cervix.

Directory of Open Access Journals (Sweden)

Long Huang

Full Text Available BACKGROUND: Small cell carcinoma of the cervix (SCCC is very rare, and due to the long time period required to recruit sufficient numbers of patients, there is a paucity of information regarding the prognostic factors associated with survival. MicroRNAs (miRNAs have been used as cancer-related biomarkers in a variety of tumor types, and the objective of this study was to determine whether microRNA expression profiles can predict clinical outcome in SCCC. METHODOLOGY/PRINCIPAL FINDINGS: Forty-four patients with SCCC who underwent radical hysterectomy between January 2000 and October 2009 were enrolled. Using the GeneCopoeia All-in-One™ Customized Human qPCR Primer Array, the expression profiles of 30 miRNAs associated with tumor metastasis was obtained from the formalin-fixed paraffin embedded samples of all 44 patients. Seven miRNAs, has-let-7c, has-miR-10b, has-miR-100, has-miR-125b, has-miR-143, has-miR-145 and has-miR-199a-5p were significantly down-regulated in advanced stage SCCC patients (FIGO IB2-IV compared to early stage SCCC patients (FIGOIB1. Among, downregulation of six miRNAs, has-let-7c, has-miR-100, has-miR-125b, has-miR-143, has-miR-145 and has-miR-199a-5p were significantly associated with lymph node metastasis and reduced survival in SCCC. Kaplan-Meier survival analyses revealed that SCCC patients with low expression of has-miR-100 (P = 0.019 and has-miR-125b (P = 0.020 projected a significant tendency towards poorer prognosis. CONCLUSIONS/SIGNIFICANCE: This study demonstrates that downregulation of 7 miRNA associated with advanced stage, 6 miRNAs with metastasis and 2 with poor prognosis in SCCC. Functional analysis of these miRNAs may enhance our understanding of SCCC, as altered expression of specific miRNAs may regulate the metastatic pathway and provide novel targets for therapy.

Preoperative Concurrent Radiation Therapy and Chemotherapy for Bulky Stage IB2, IIA, and IIB Carcinoma of the Uterine Cervix With Proximal Parametrial Invasion

International Nuclear Information System (INIS)

Huguet, Florence; Cojocariu, Oana-Maria; Levy, Pierre; Lefranc, Jean-Pierre; Darai, Emile; Jannet, Denis; Ansquer, Yan; Lhuillier, Pierre-Eugene; Benifla, Jean-Louis; Seince, Nathalie; Touboul, Emmanuel

2008-01-01

Purpose: To evaluate toxicity, local tumor control, and survival after preoperative chemoradiation for operable bulky cervical carcinoma. Methods and Materials: Between December 1991 and July 2006, 92 patients with operable bulky stage IB2, IIA, and IIB cervical carcinoma without pelvic or para-aortic nodes on pretreatment imaging were treated. Treatment consisted of preoperative external beam pelvic radiation therapy (EBRT) and concomitant chemotherapy (CT) during the first and fourth weeks of radiation combining 5-fluorouracil and cisplatin. The pelvic radiation dose was 40.5 Gy over 4.5 weeks. EBRT was followed by low-dose rate uterovaginal brachytherapy with a total dose of 20 Gy in 62 patients. After a median rest period of 44 days, all patients underwent Class II modified radical hysterectomy with bilateral pelvic lymphadenectomy. Thirty patients who had not received preoperative uterovaginal brachytherapy underwent postoperative low-dose-rate vaginal brachytherapy at a dose of 20 Gy. The mean follow-up was 46 months. Results: Pathologic residual tumor was observed in 43 patients. After multivariate analysis, additional preoperative uterovaginal brachytherapy was the single significant predictive factor for pathologic complete response rate (p = 0.019). The 2- and 5-year disease-free survival (DFS) rates were 80.4% and 72.2%, respectively. Pathologic residual cervical tumor was the single independent factor decreasing the probability of DFS (p = 0.020). Acute toxicities were moderate. Two severe ureteral complications requiring surgical intervention were observed. Conclusions: Concomitant chemoradiation followed by surgery for operable bulky stage I-II cervical carcinoma without clinical lymph node involvement can be used with acceptable toxicity. Pathologic complete response increases the probability of DFS

Enhanced accumulation of carotenoids in sweetpotato plants overexpressing IbOr-Ins gene in purple-fleshed sweetpotato cultivar.

Science.gov (United States)

Park, Sung-Chul; Kim, Sun Ha; Park, Seyeon; Lee, Hyeong-Un; Lee, Joon Seol; Park, Woo Sung; Ahn, Mi-Jeong; Kim, Yun-Hee; Jeong, Jae Cheol; Lee, Haeng-Soon; Kwak, Sang-Soo

2015-01-01

Sweetpotato [Ipomoea batatas (L.) Lam] is an important root crop that produces low molecular weight antioxidants such as carotenoids and anthocyanin. The sweetpotato orange (IbOr) protein is involved in the accumulation of carotenoids. To increase the levels of carotenoids in the storage roots of sweetpotato, we generated transgenic sweetpotato plants overexpressing IbOr-Ins under the control of the cauliflower mosaic virus (CaMV) 35S promoter in an anthocyanin-rich purple-fleshed cultivar (referred to as IbOr plants). IbOr plants exhibited increased carotenoid levels (up to 7-fold) in their storage roots compared to wild type (WT) plants, as revealed by HPLC analysis. The carotenoid contents of IbOr plants were positively correlated with IbOr transcript levels. The levels of zeaxanthin were ∼ 12 times elevated in IbOr plants, whereas β-carotene increased ∼ 1.75 times higher than those of WT. Quantitative RT-PCR analysis revealed that most carotenoid biosynthetic pathway genes were up-regulated in the IbOr plants, including PDS, ZDS, LCY-β, CHY-β, ZEP and Pftf, whereas LCY-ɛ was down-regulated. Interestingly, CCD1, CCD4 and NCED, which are related to the degradation of carotenoids, were also up-regulated in the IbOr plants. Anthocyanin contents and transcription levels of associated biosynthetic genes seemed to be altered in the IbOr plants. The yields of storage roots and aerial parts of IbOr plants and WT plants were not significantly different under field cultivation. Taken together, these results indicate that overexpression of IbOr-Ins can increase the carotenoid contents of sweetpotato storage roots. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Multicenter Phase II Study Evaluating Two Cycles of Docetaxel, Cisplatin and Cetuximab as Induction Regimen Prior to Surgery in Chemotherapy-Naive Patients with NSCLC Stage IB-IIIA (INN06-Study.

Directory of Open Access Journals (Sweden)

Wolfgang Hilbe

Full Text Available Different strategies for neoadjuvant chemotherapy in patients with early stage NSCLC have already been evaluated. The aim of this study was to evaluate the tolerability and efficacy of a chemoimmunotherapy when limited to two cycles.Between 01/2007 and 03/2010 41 patients with primarily resectable NSCLC stage IB to IIIA were included. Treatment consisted of two cycles cisplatin (40 mg/m2 d1+2 and docetaxel (75 mg/m2 d1 q3 weeks, accompanied by the administration of cetuximab (400 mg/m2 d1, then 250 mg weekly. The primary endpoint was radiological response according to RECIST.40 patients were evaluable for toxicity, 39 for response. The main grade 3/4 toxicities were: neutropenia 25%, leucopenia 11%, febrile neutropenia 6%, nausea 8% and rash 8%. 20 patients achieved a partial response, 17 a stable disease, 2 were not evaluable. 37 patients (95% underwent surgery and in three of them a complete pathological response was achieved. At a median follow-up of 44.2 months, 41% of the patients had died, median progression-free survival was 22.5 months.Two cycles of cisplatin/ docetaxel/ cetuximab showed promising efficacy in the neoadjuvant treatment of early-stage NSCLC and rapid operation was possible in 95% of patients. Toxicities were manageable and as expected.EU Clinical Trials Register; Eudract-Nr: 2006-004639-31.

Risk of recurrence, prognosis, and follow-up for Danish women with cervical cancer in 2005-2013

DEFF Research Database (Denmark)

Taarnhøj, Gry Assam; Christensen, Ib Jarle; Lajer, Henrik

2018-01-01

BACKGROUND: In developed countries, women attend follow-up after treatment for cervical cancer to detect recurrence. The aim of this study was to describe the Danish population of women with early-stage cervical cancer at risk for recurrence and death due to recurrence. METHODS: Data were extracted...... from 3 nationwide databases to find women diagnosed with stage 1A1 to 1B1 cervical cancer in 2005-2013. Recurrences were determined from data on oncological or surgical treatment more than 3 months after the initial diagnosis and were cross-checked with patient journals. RESULTS: In all, 1523 patients...... were diagnosed with stage 1A1 to 1B1 cervical cancer. Eighty women experienced recurrences: 8 at International Federation of Gynecology and Obstetrics (FIGO) stage 1A1, 0 at FIGO stage 1A2, and 72 at FIGO stage 1B1. The 5-year recurrence rate was 6.4%; 67.5% of the women had symptomatic recurrences...

Alternative Dosing of Exemestane Before Surgery in Treating Postmenopausal Patients With Stage 0-II Estrogen Positive Breast Cancer

Science.gov (United States)

2018-04-09

Estrogen Receptor Positive; Postmenopausal; Stage 0 Breast Cancer AJCC v6 and v7; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

Purification, crystallization and preliminary X-ray analysis of Enterococcus faecium aminoglycoside-2′′-phosphotransferase-Ib [APH(2′′)-Ib

International Nuclear Information System (INIS)

Walanj, Rupa; Young, Paul; Baker, Heather M.; Baker, Edward N.; Metcalf, Peter; Chow, Joseph W.; Lerner, Stephen; Vakulenko, Sergei; Smith, Clyde A.

2005-01-01

APH(2′′)-Ib is an enzyme responsible for high-level gentamicin resistance in E. faecium isolates. Native crystals of this enzyme have been prepared and preliminary X-ray diffraction experiments have been undertaken. Bacterial resistance to the aminoglycoside antibiotics is primarily the result of deactivation of the drugs. Three families of enzymes are responsible for this activity, with one such family being the aminoglycoside phosphotransferases (APHs). The gene encoding one of these enzymes, APH(2′′)-Ib, has been cloned and the protein (comprising 299 amino-acid residues) expressed in Escherichia coli, purified and crystallized in the presence of 16%(w/v) PEG 3350 and gentamicin. The crystals belong to the monoclinic space group P2 1 , with approximate unit-cell parameters a = 79.7, b = 58.8, c = 81.4 Å, β = 98.4°, and preliminary X-ray diffraction analysis is consistent with the presence of two molecules in the asymmetric unit. Synchrotron diffraction data to approximately 2.65 Å resolution were collected from a native APH(2′′)-Ib crystal at beamline BL9-2 at SSRL (Stanford, CA, USA). Selenium-substituted crystals have also been produced and structure determination is proceeding

Overcoming ICT Barriers in IBS Management Process in Malaysia Construction Industry

Directory of Open Access Journals (Sweden)

Soon Ern Peniel Ang

2017-01-01

Full Text Available As the result of government’s initiative and future outlook in uprising the awareness towards the implementation of sustainable elements in construction industries, the Industrialized Building System (IBS is one of the approaches that had been introduced as an alternative to conventional building method and produce the new strategy of reducing the waste of materials in construction. The IBS approach is actively promoted through several strategies and incentives as an alternative to conventional building methods. Extensive uptakes of modern Information Communication Technology (ICT applications are able to support the different IBS processes for effective production. However, it is argued that ICT uptake at the organizational level needs to be regularly improved. Thus, this paper fulfills the need to identify the critical barriers to ICT employment and highlighting the ICT drivers in enhancing the IBS management process. Critical barriers and drivers to ICT uptake were identified through questionnaire survey with industry stakeholders and were analyzed using mean index and critical t-value with the use of SPSS software. The critical drivers are top management support and commitment and improving the availability of the technologies. The critical drivers which were identified are significant in ensuring the enhancement of ICT implementation. Hence, any system in place should avoid the highest ranked barriers or seek to alleviate their impact by focusing on the identified drivers in order to enhance implementation of ICT in IBS process management.

Translation and validation of a Japanese version of the irritable bowel syndrome-quality of life measure (IBS-QOL-J

Directory of Open Access Journals (Sweden)

Hongo Michio

2007-03-01

Full Text Available Abstract Aims To compare quality of life (QOL for patients with irritable bowel syndrome (IBS between the U.S. and Japan, it is indispensable to develop common instruments. The IBS-QOL, which is widely used in Western countries, was translated into Japanese as there has been a lack of Japanese disease-specific QOL measures for IBS. Methods The original 34 items of the IBS-QOL were translated from English into Japanese through two independent forward translations, resolution, back translation, and resolution of differences. Forty nine patients who had GI symptoms but did not have any organic diseases (including 30 IBS patients diagnosed by Rome II criteria were recruited from Tohoku University Hospital in Sendai, Japan and completed a Japanese version of the IBS-QOL (IBS-QOL-J concomitant with a Japanese version of the IBS severity index (IBSSI-J twice within 7–14 days. Results The IBS-QOL-J demonstrated high internal consistency (Cronbach's alpha; 0.96 and high reproducibility (intraclass correlation coefficient; 0.92, p Conclusion The IBS-QOL-J is a reliable instrument to assess the disease-specific QOL for IBS. Considering cross-cultural comparison, this measure is likely to be a valuable tool to investigate the QOL in Japanese patients with IBS.

Improving the stability of alpha-conotoxin AuIB through N-to-C cyclization

DEFF Research Database (Denmark)

Armishaw, Christopher J; Jensen, Anders A; Balle, Lena D

2011-01-01

Modification of alpha-conotoxin frameworks through cyclization via an oligopeptide linker has previously been shown as an effective strategy for improving in vivo stability. We have extended this strategy by investigating cyclic analogs of alpha-conotoxin AuIB, a selective alpha3beta4 nicotinic a......-AuIB. As such, the cAuIB-2 globular isomer could constitute a useful probe for studying the role of the alpha3beta4 nicotinic acetylcholine receptor in a range of in vivo experimental paradigms....

La Inscripción Ibérica en escritura jonia, Serreta IX.

OpenAIRE

Silgo Gauche, Luís

1997-01-01

S’estudía una nova inscripció sobre làmina de plom, localitzada casualment en l’àrea del poblat ibèric de la Serreta (Alcoi, Cocentaina, Penàguila), en l’escriptura del qual es van emprar caracters greco-ibèrics.

Contributions of type II and Ib/c supernovae to Galactic chemical evolution

International Nuclear Information System (INIS)

Sahijpal Sandeep

2014-01-01

Type II and Ib/c supernovae (SNe II and Ib/c) have made major stellar nucleosynthetic contributions to the inventories of stable nuclides during chemical evolution of the Galaxy. A case study is performed here with the help of recently developed numerical simulations of Galactic chemical evolution in the solar neighborhood to understand the contributions of SNe II and Ib/c by comparing the stellar nucleosynthetic yields obtained by two leading groups in this field. These stellar nucleosynthetic yields differ in terms of their treatment of stellar evolution and nucleosynthesis. The formulation describing Galactic chemical evolution is developed with the recently revised solar metallicity of ∼0.014. Furthermore, the recent nucleosynthetic yields of stellar models based on the revised solar metallicity are also used. The analysis suggests that it could be difficult to explain, in a self-consistent manner, the various features associated with the elemental evolutionary trends over Galactic timescales by any single adopted stellar nucleosynthetic model that incorporates SNe II and Ib/c

Measuring IBS patient reported outcomes with an abdominal pain numeric rating scale: results from the proof cohort

Science.gov (United States)

SPIEGEL, B.; BOLUS, R.; HARRIS, L. A.; LUCAK, S.; NALIBOFF, B.; ESRAILIAN, E.; CHEY, W. D.; LEMBO, A.; KARSAN, H.; TILLISCH, K.; TALLEY, J.; MAYER, E.; CHANG, L.

2009-01-01

Background Controversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in the non-IBS pain literature. The FDA has proposed using the NRS in IBS. Aim To test the psychometrics of an abdominal pain NRS in IBS. Methods We analyzed data from a longitudinal cohort of Rome III IBS subjects. At entry, subjects completed a 10-point NRS, bowel symptoms, IBS severity measurements (IBSSS, FBDSI), health related quality of life indices (IBS-QOL, EQ5D), and the worker productivity activity index (WPAI). We repeated assessments at 3 months along with a response scale to calculate the minimal clinically important difference (MCID). Results There were 277 subjects (82% women; age=42±15) at baseline and 90 at 3 months. The NRS correlated cross-sectionally with IBSSS (r=0.60; p<0.0011), FBDSI (r=0.49; p<0.0001), IBS-QOL (r=0.43; p<0.0001), EQ5D (r=0.48; p<0.0001), presenteeism (r=0.39; p<0.0001), absenteeism (r=0.17; p=0.04), and distension (r=0.46; p<0.0001), but not stool frequency or form. The MCID was 2.2 points, correlating with a 29.5% reduction over time. Conclusions An abdominal pain NRS exhibits excellent validity and can be readily interpreted with an MCID in patients with IBS. These data support the use of the NRS in IBS clinical trials. PMID:19751360

More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS - a case-control study in primary care

OpenAIRE

Grodzinsky, Ewa; Walter, Susanna; Viktorsson, Lisa; Carlsson, Ann-Kristin; Jones, Michael P.; Olsen Faresjö, Ashild

2015-01-01

Background Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder,that affects approximately 10% of the general population and the majority are diagnosed  in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to  investigate the psychosocial constructs of self-esteem and sense of...

Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome (IBS: an evidence-based review

Directory of Open Access Journals (Sweden)

Max Schmulson

2014-04-01

Conclusions: Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non PI-IBS. Rifaximin has shown itself to be an effective treatment for IBS, regardless of prior factors.

The role of stress in IBS symptom severity

Directory of Open Access Journals (Sweden)

Sanda Pletikosic

2016-04-01

Full Text Available Irritable bowel syndrome is regarded as a biopsychosocial disorder, the result of a complex combination of predisposing, precipitating and perpetuating factors. Personality traits, affective status and stress are some of the relevant factors contributing to lower quality of life and symptom exacerbation in IBS patients. In order to examine the role of stress in IBS symptom exacerbation, the aims of this study were to explore the relationship of daily stressful events and symptom severity in a prospective manner and to explore the roles of neuroticism, anxiety, depression and stress in the vicious circle of symptom perpetuation. A total of 49 patients with IBS reported their symptom severity and daily stressful events intensity each day for 14 consecutive days. They also completed the Big five personality inventory, the Beck Depression Inventory and the State-trait anxiety inventory. Cross-correlation analyses were performed on the time series data for daily stress and symptom severity for each participant separately. Four different patterns of relationships were found in different subgroups of participants: positive cross-correlations of symptom severity and stress intensity on the same day; higher symptom severity on days following stressful days; lower symptom severity on days following stressful days; and lower stress intensity on days following severe symptoms. Using average scores for daily stress and symptom severity, as well as scores for neuroticism, anxiety and depression, we performed a path analysis to test a model of symptom exacerbation. It showed that, on the group level, average stress intensity predicts average symptom severity. Neuroticism and anxiety were not significant predictors of symptom severity, while depression showed a marginally significant relationship with symptom severity, mediated by stress intensity. In conclusion, depression and daily stress seem to be important contributors to the vicious circle of IBS symptom

Politics and Pedagogy: Discursive Constructions in the IB "Theory of Knowledge--Guide"

Science.gov (United States)

Smith, Nigel V.; Morgan, Mandy

2010-01-01

The International Baccalaureate (IB) curriculum is increasingly popular in both national and international secondary education settings. The "Theory of knowledge" (TOK) course is cast as the prime example of the international globalised values the IB Diploma represents. This article argues that such a positioning is contested within the TOK…

Steep Dose-Response Relationship for Stage I Non-Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

International Nuclear Information System (INIS)

Onimaru, Rikiya; Fujino, Masaharu; Yamazaki, Koichi; Onodera, Yuya; Taguchi, Hiroshi; Katoh, Norio; Hommura, Fumihiro; Oizumi, Satoshi; Nishimura, Masaharu; Shirato, Hiroki

2008-01-01

Purpose: To investigate the clinical outcomes of patients with pathologically proven, peripherally located, Stage I non-small-cell lung cancer who had undergone stereotactic body radiotherapy using real-time tumor tracking radiotherapy during the developmental period. Methods and Materials: A total of 41 patients (25 with Stage T1 and 16 with Stage T2) were admitted to the study between February 2000 and June 2005. A 5-mm planning target volume margin was added to the clinical target volume determined with computed tomography at the end of the expiratory phase. The gating window ranged from ±2 to 3 mm. The dose fractionation schedule was 40 or 48 Gy in four fractions within 1 week. The dose was prescribed at the center of the planning target volume, giving more than an 80% dose at the planning target volume periphery. Results: For 28 patients treated with 48 Gy in four fractions, the overall actuarial survival rate at 3 years was 82% for those with Stage IA and 32% for those with Stage IB. For patients treated with 40 Gy in four fractions within 1 week, the overall actuarial survival rate at 3 years was 50% for those with Stage IA and 0% for those with Stage IB. A significant difference was found in local control between those with Stage IB who received 40 Gy vs. 48 Gy (p = 0.0015) but not in those with Stage IA (p = 0.5811). No serious radiation morbidity was observed with either dose schedule. Conclusion: The results of our study have shown that 48 Gy in four fractions within 1 week is a safe and effective treatment for peripherally located, Stage IA non-small-cell lung cancer. A steep dose-response curve between 40 and 48 Gy using a daily dose of 12 Gy delivered within 1 week was identified for Stage IB non-small-cell lung cancer in stereotactic body radiotherapy using real-time tumor tracking radiotherapy

Critical Success Factors for Lean Thinking in the Application of Industrialised Building System (IBS)

Science.gov (United States)

Yunus, Riduan; Noor, Siti Rahimah Mohd; Halid Abdullah, Abd; Nagapan, Sasitharan; Hamid, Abdul Rahim Abdul; Tajudin, Saiful Azhar Ahmad; Rohani Mat Jusof, Siti

2017-08-01

Productivity in the manufacturing process of building components can be increased by optimising each advantage that is available in each activity. Identification of critical success factors (CSFs) for lean thinking in the Industrialised Building System (IBS) will be able to minimise cost and reduce time needed to complete a project. The focus of lean thinking in construction is on the production process and the client’s requirement. In developing countries such as Malaysia, the integration of lean thinking in IBS applications is still low and there is a shortage of comprehensive strategies to integrate lean thinking. As key stakeholders, feedback from contractors, manufacturers, developers and the local authority will be able to help the identification of CSFs in integrating lean thinking in IBS applications. The data was collected through a questionnaire survey and analysed quantitatively. There are 31 CSFs for lean thinking in IBS which have been identified in this study. A conceptual model was developed to assist researchers in investigating the influences of CSFs for lean thinking in IBS applications. This study will assist construction players to improvise their manufacturing process in the implementation of IBS to eliminate unnecessary activities and focus instead on significant processes without generating physical and non-physical waste.

A Preliminary Review on Economies of Scale (EOS Towards Industrialized Building System (IBS Manufacturer

Directory of Open Access Journals (Sweden)

Tajul Ariffin Syazwana

2017-01-01

Full Text Available Industrialized Building System (IBS is a potential technology to improve productivity of construction industry. Controlled production and minimum generation of construction waste are some of the benefits that can be achieved by replacing conventional construction with IBS. In business, IBS is giving a huge opportunity for manufacturer and supplier to expand their business while contributing to construction development. However, bad strategies will put the company in high risk due to higher initial capital for machines and equipment. Therefore, strategic planning for company’s growth, profit maximization, and enhancement of productivity is undeniable to ensure the success of business in construction industry. This preliminary paper is exploring associated factors that affect Economy of Scale (EOS and their relationships in catalyzing the IBS manufacturer especially precast concrete as the scope of study to continue their business in the construction industry. Thus, a framework of EOS is proposed to assist IBS manufacturers to ensure their company’s growth and stability, competitiveness in term of monopoly or an oligopoly, increasing productivity, leading constant returns to scale, and finally increasing the firm’s efficiency. The refined EOS’s conceptual framework is an important turning point to support the development of decision making tools for IBS manufacturer towards their stability and survival in this highly competitive industry.

The communication in industrialised building system (IBS) construction project: Virtual environment

Science.gov (United States)

Pozin, Mohd Affendi Ahmad; Nawi, Mohd Nasrun Mohd

2017-10-01

Large portion of numbers team organization in the IBS construction sector is known are being fragmented. That is contributed from a segregation of construction activity thus create team working in virtually. Virtual team are the nature when teams are working in distributed area, across culture and time. Therefore, teams can be respond to the task without relocating to the site project and settle down a problem through information and communication technology (ICT). The emergence of virtual team are carry out by advancements in communication technologies as a medium to improve project team communication in project delivery process on IBS construction. Based on literature review from previous study and data collected from interviewing, this paper aim to identified communication challenges among project team members according to current project development practices in IBS construction project. Hence, in attempt to develop effective communication through the advantages of virtual team approach for IBS construction project. In order to ensure the data is gathered comprehensively and accurately, the data was collected from project managers by using semi structured interview method. It was found that virtual team approach could be enable competitive challenges on complexity in the construction project management process.

Condutividade e difusividade térmica do figo (Ficus carica L. "Roxo de Valinhos" Conductivity and thermal diffusivity of fig fruit (Ficus carica L. "Roxo de Valinhos"

Directory of Open Access Journals (Sweden)

Saul D. Sarria

2004-04-01

Full Text Available O resfriamento e/ou congelamento de produtos hortícolas, depois da colheita, é realizado com o objetivo de retirar o calor desses produtos, permitindo-lhes, em função disso, um tempo maior de conservação. Portanto, o conhecimento das propriedades físicas que envolvem transferência de calor do figo "Roxo de Valinhos" é útil para o cálculo de projetos e a análise de sistemas de engenharia de alimentos em geral, assim como para o emprego em equações de modelos matemáticos termodinâmicos. Neste trabalho, foram determinadas, experimentalmente, a condutividade e a difusividade térmica do figo inteiro no estádio rami e, a partir desses valores, foi determinado o calor específico. Foi utilizado o método transiente da Fonte Linear de Calor. Foi introduzida nas frutas uma sonda que contém resistência elétrica e termopares. Para manter constante a temperatura da fruta, montou-se um sistema de resfriamento a água. Encontrou-se que o figo rami apresentou um valor de condutividade térmica de 0,52 W m-1 °C, difusividade térmica de 1,56 x 10-7 m² s-1, massa específica do figo de 815,6 kg m-3 e calor específico de 4,07 kJ kg-1 °C.The post harvest cooling and/or freezing processes for horticultural products have been carried out with the objective of removing the heat from these products, allowing them a bigger period of conservation. Therefore, the knowledge of the physical properties that involve heat transference in the fig fruit "Roxo de Valinhos" is useful for calculating projects and systems of food engineering in general, as well as, for using in equations of thermodynamic mathematical models. The values of conductivity and thermal diffusivity of the whole fig fruit-rami index were determined, and from these values it was determined the value of the specific heat. For these determination it was used the transient method of the Line Heat Source. The results shown that the fig fruit has a thermal conductivity of 0.52 W m-1�

Integrated Baseline System (IBS) Version 2.0: Models guide

Energy Technology Data Exchange (ETDEWEB)

1994-03-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool being developed under the direction of the US Army Nuclear and Chemical Agency. This Models Guide summarizes the IBS use of several computer models for predicting the results of emergency situations. These include models for predicting dispersion/doses of airborne contaminants, traffic evacuation, explosion effects, heat radiation from a fire, and siren sound transmission. The guide references additional technical documentation on the models when such documentation is available from other sources. The audience for this manual is chiefly emergency management planners and analysts, but also data managers and system managers.

Rendimientos del colágeno, poliornitinas (tipos: IB, IIB y IC) y colágeno mas poliornitina IB, como substratos para el cultivo de ganglios ciliares disociados de embrión de pollo

OpenAIRE

Bustos Ruiz, M.; Alcaín Tejada, F.J.; Padilla-Alvarez, F.

1981-01-01

Dissociated ciliary ganglia of 8 days embryos were cultured in heart conditioned medium, employing differents substrata types: collagen, po¬lyornithines (types: IB,IIB and IC) and collagen plus polyornithine IB. The results from neuron survival (with and without prolongations) and non neuronal cells it obtained graphically. The polyornithines mollecular weights are discussed respect inductor factors binding for conditioned medium. The type IB is better than others types (IIB y IC), but collag...

Generating a robust prediction model for stage I lung adenocarcinoma recurrence after surgical resection.

Science.gov (United States)

Wu, Yu-Chung; Wei, Nien-Chih; Hung, Jung-Jyh; Yeh, Yi-Chen; Su, Li-Jen; Hsu, Wen-Hu; Chou, Teh-Ying

2017-10-03

Lung cancer mortality remains high even after successful resection. Adjuvant treatment benefits stage II and III patients, but not stage I patients, and most studies fail to predict recurrence in stage I patients. Our study included 211 lung adenocarcinoma patients (stages I-IIIA; 81% stage I) who received curative resections at Taipei Veterans General Hospital between January 2001 and December 2012. We generated a prediction model using 153 samples, with validation using an additional 58 clinical outcome-blinded samples. Gene expression profiles were generated using formalin-fixed, paraffin-embedded tissue samples and microarrays. Data analysis was performed using a supervised clustering method. The prediction model generated from mixed stage samples successfully separated patients at high vs. low risk for recurrence. The validation tests hazard ratio (HR = 4.38) was similar to that of the training tests (HR = 4.53), indicating a robust training process. Our prediction model successfully distinguished high- from low-risk stage IA and IB patients, with a difference in 5-year disease-free survival between high- and low-risk patients of 42% for stage IA and 45% for stage IB ( p model for identifying lung adenocarcinoma patients at high risk for recurrence who may benefit from adjuvant therapy. Our prediction performance of the difference in disease free survival between high risk and low risk groups demonstrates more than two fold improvement over earlier published results.

Purification, crystallization and preliminary X-ray analysis of Enterococcus faecium aminoglycoside-2′′-phosphotransferase-Ib [APH(2′′)-Ib

Energy Technology Data Exchange (ETDEWEB)

Walanj, Rupa; Young, Paul; Baker, Heather M.; Baker, Edward N.; Metcalf, Peter [Laboratory of Structural Biology, School of Biological Sciences, University of Auckland, Auckland (New Zealand); Chow, Joseph W.; Lerner, Stephen [Division of Infectious Diseases, Wayne State University School of Medicine and VA Medical Center, Detroit, Michigan 48201 (United States); Vakulenko, Sergei [Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556 (United States); Smith, Clyde A., E-mail: csmith@slac.stanford.edu [Stanford Synchrotron Radiation Laboratory, Stanford University, Menlo Park, CA 94025 (United States); Laboratory of Structural Biology, School of Biological Sciences, University of Auckland, Auckland (New Zealand)

2005-04-01

APH(2′′)-Ib is an enzyme responsible for high-level gentamicin resistance in E. faecium isolates. Native crystals of this enzyme have been prepared and preliminary X-ray diffraction experiments have been undertaken. Bacterial resistance to the aminoglycoside antibiotics is primarily the result of deactivation of the drugs. Three families of enzymes are responsible for this activity, with one such family being the aminoglycoside phosphotransferases (APHs). The gene encoding one of these enzymes, APH(2′′)-Ib, has been cloned and the protein (comprising 299 amino-acid residues) expressed in Escherichia coli, purified and crystallized in the presence of 16%(w/v) PEG 3350 and gentamicin. The crystals belong to the monoclinic space group P2{sub 1}, with approximate unit-cell parameters a = 79.7, b = 58.8, c = 81.4 Å, β = 98.4°, and preliminary X-ray diffraction analysis is consistent with the presence of two molecules in the asymmetric unit. Synchrotron diffraction data to approximately 2.65 Å resolution were collected from a native APH(2′′)-Ib crystal at beamline BL9-2 at SSRL (Stanford, CA, USA). Selenium-substituted crystals have also been produced and structure determination is proceeding.

The Significance of Coordination for Industrialised Building System (IBS) Precast Concrete in Construction Industry

OpenAIRE

Fitri Othman Mohd Khairul; Wan Muhammad Wan Mohd Nurdden; Abd Hadi Nurulhudaya; Azman Mohd Azrai

2017-01-01

IBS precast concrete is construction system which is meant to improve the conventional construction process. However IBS precast concrete projects are suffering from serious problems such as cost overrun, delays and less quality of the end product. The absence of coordination is perceived as the reason for this issue. The purpose of this paper is to review the significance of coordination for IBS precast concrete in the construction industry. It if found that the fragmentation which occurs in...

Advantages and Setbacks of Industrialized Building System (IBS) Implementation: A Case Study in Sarawak

OpenAIRE

Sing Sing Wong; Ling Kung Lau

2015-01-01

Industrialized Building System (IBS) is an innovative technique adopted to increase the efficiency, quality and productivity of projects. However, these advantages are proven mainly for projects located in urban areas only. IBS is not a common practice for projects located in rural areas. Although there were studies about IBS in Malaysia about its advantages and setbacks, these studies were focusing on projects located in urban areas located in West Malaysia only. Hence, this paper aids to cl...

FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial.

Science.gov (United States)

McIntosh, Keith; Reed, David E; Schneider, Theresa; Dang, Frances; Keshteli, Ammar H; De Palma, Giada; Madsen, Karen; Bercik, Premysl; Vanner, Stephen

2017-07-01

To gain mechanistic insights, we compared effects of low fermentable oligosaccharides, disaccharides and monosaccharides and polyols (FODMAP) and high FODMAP diets on symptoms, the metabolome and the microbiome of patients with IBS. We performed a controlled, single blind study of patients with IBS (Rome III criteria) randomised to a low (n=20) or high (n=20) FODMAP diet for 3 weeks. Symptoms were assessed using the IBS symptom severity scoring (IBS-SSS). The metabolome was evaluated using the lactulose breath test (LBT) and metabolic profiling in urine using mass spectrometry. Stool microbiota composition was analysed by 16S rRNA gene profiling. Thirty-seven patients (19 low FODMAP; 18 high FODMAP) completed the 3-week diet. The IBS-SSS was reduced in the low FODMAP diet group (pmetabolome. In subsets of patients, FODMAPs modulate histamine levels and the microbiota, both of which could alter symptoms. NCT01829932. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

Science.gov (United States)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

Studying the Physical Function and Quality of Life Before and After Surgery in Patients With Stage I Cervical Cancer

Science.gov (United States)

2018-02-14

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Lymphedema; Sexual Dysfunction and Infertility; Stage IA1 Cervical Cancer AJCC v6 and v7; Stage IA2 Cervical Cancer AJCC v6 and v7; Stage IB1 Cervical Cancer AJCC v6 and v7

Topoisomerase IB of Deinococcus radiodurans resolves guanine ...

Indian Academy of Sciences (India)

2015-11-28

Nov 28, 2015 ... All the oligonucleotides men- tioned here were ... further reactions with DraTopoIB were carried out at 37°C ... of G4 DNA moves faster than unfolded and intermolecular .... for its action on intramolecular G4 DNA structure was.

FIGO IVB (Para-aortic lymph adenopathy) squamous cell carcinoma of uterine cervix associated with a left pelvic kidney: a therapeutic challenge

International Nuclear Information System (INIS)

Ali, N.; Karsan, F.; Abbasi, A.N.; Khan, Z.R.

2012-01-01

The standard of care for locally advanced carcinoma of uterine cervix is concurrent chemoradiation therapy followed by intracavitary brachytherapy, when there is para-aortic lymphadenopathy, radiation field needs to be extended to para-aortic region. In the latter case dose limiting organs are spinal cord, kidneys and small intestine. We present a challenging case of FIGO IVB squamous cell carcinoma of cervix and a pelvic kidney. This patient received chemoradiation to pelvis and para-aortic field, brachytherapy was not performed as patient already had undergone attempted hysterectomy. Treatment, outcome and challenges encountered in this case are presented and literature is reviewed. (author)

SYMPOSIUM REPORT: An Evidence-Based Approach to IBS and CIC: Applying New Advances to Daily Practice

Science.gov (United States)

Chey, William D.

2017-01-01

Many nonpharmacologic and pharmacologic therapies are available to manage irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC). The American College of Gastroenterology (ACG) regularly publishes reviews on IBS and CIC therapies. The most recent of these reviews was published by the ACG Task Force on the Management of Functional Bowel Disorders in 2014. The key objective of this review was to evaluate the efficacy of therapies for IBS or CIC compared with placebo or no treatment in randomized controlled trials. Evidence-based approaches to managing diarrhea-predominant IBS include dietary measures, such as a diet low in gluten and fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs); loperamide; antispasmodics; peppermint oil; probiotics; tricyclic antidepressants; alosetron; eluxadoline, and rifaximin. Evidence-based approaches to managing constipation-predominant IBS and CIC include fiber, stimulant laxatives, polyethylene glycol, selective serotonin reuptake inhibitors, lubiprostone, and guanylate cyclase agonists. With the growing evidence base for IBS and CIC therapies, it has become increasingly important for clinicians to assess the quality of evidence and understand how to apply it to the care of individual patients. PMID:28729815

The sweet potato IbMYB1 gene as a potential visible marker for sweet potato intragenic vector system.

Science.gov (United States)

Kim, Cha Young; Ahn, Young Ock; Kim, Sun Ha; Kim, Yun-Hee; Lee, Haeng-Soon; Catanach, Andrew S; Jacobs, Jeanne M E; Conner, Anthony J; Kwak, Sang-Soo

2010-07-01

MYB transcription factors play important roles in transcriptional regulation of many secondary metabolites including anthocyanins. We cloned the R2R3-MYB type IbMYB1 complementary DNAs from the purple-fleshed sweet potato (Ipomoea batatas L. cv Sinzami) and investigated the expression patterns of IbMYB1 gene with IbMYB1a and IbMYB1b splice variants in leaf and root tissues of various sweet potato cultivars by reverse transcription-polymerase chain reaction. The transcripts of IbMYB1 were predominantly expressed in the purple-fleshed storage roots and they were also detectable in the leaf tissues accumulating anthocyanin pigments. In addition, transcript levels of IbMYB1 gene were up-regulated by treatment with methyl jasmonate or salicylic acid in leaf and root tissues of cv. White Star. To set up the intragenic vector system in sweet potato, we first evaluated the utilization of the IbMYB1 gene as a visible selectable marker. The IbMYB1a was transiently expressed in tobacco leaves under the control of a constitutive cauliflower mosaic virus 35S promoter, a root-specific and sucrose-inducible sporamin promoter, and an oxidative stress-inducible sweet potato anionic peroxidase2 promoter. We also showed that overexpression of IbMYB1a induced massive anthocyanin pigmentation in tobacco leaves and up-regulated the transcript levels of the structural genes in anthocyanin biosynthetic pathway. Furthermore, high-performance liquid chromatography analysis revealed that the expression of IbMYB1a led to production of cyanidin as a major core molecule of anthocyanidins in tobacco leaves. These results suggest that the IbMYB1 gene can be applicable to a visible marker for sweet potato transformation with intragenic vectors, as well as the production of anthocyanin as important nutritive value in other plant species.

Assessment of Parametrial Response by Growth Pattern in Patients With International Federation of Gynecology and Obstetrics Stage IIB and IIIB Cervical Cancer: Analysis of Patients From a Prospective, Multicenter Trial (EMBRACE)

Energy Technology Data Exchange (ETDEWEB)

Yoshida, Kenji [Medical University of Vienna, Comprehensive Cancer Center, Vienna (Austria); Kobe University Graduate School of Medicine, Kobe (Japan); Jastaniyah, Noha [Medical University of Vienna, Comprehensive Cancer Center, Vienna (Austria); King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Sturdza, Alina, E-mail: alina.sturdza@akhwien.at [Medical University of Vienna, Comprehensive Cancer Center, Vienna (Austria); Lindegaard, Jacob [Aarhus University Hospital, Aarhus (Denmark); Segedin, Barbara [Institute of Oncology Ljubljana, Ljubljana (Slovenia); Mahantshetty, Umesh [Tata Memorial Hospital, Mumbai (India); Rai, Bhavana [Post Graduate Institute of Medical Education and Research, Chandigarh (India); Jürgenliemk-Schulz, Ina [University Medical Center, Utrecht (Netherlands); Haie-Meder, Christine [Institut Gustave Roussy, Paris (France); Sasaki, Ryohei [Kobe University Graduate School of Medicine, Kobe (Japan); Pötter, Richard [Medical University of Vienna, Comprehensive Cancer Center, Vienna (Austria)

2015-11-15

Purpose: To assess disease response along the parametrial space according to tumor morphology in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB and IIIB cervical cancer at the time of image-guided adaptive brachytherapy. Methods and Materials: Patients with FIGO stage IIB and IIIB cervical cancer registered as of November 2013 in the EMBRACE study were evaluated. Tumors were stratified according to morphologic subtype on magnetic resonance imaging (expansive and infiltrative), and the characteristics of those subtypes were analyzed. Parametrial involvement at diagnosis and at brachytherapy was evaluated, and the response to chemo-radiotherapy was classified as good, moderate, or poor. The response grade was compared between the 2 groups and analyzed with regard to tumor volumes, and dosimetric parameters. Results: A total of 452 patients were evaluated, of whom 186 had expansive growth type and 266 had infiltrative morphology. Patients with infiltrative tumors had more extensive disease, as indicated by a higher rate of FIGO stage IIIB disease, as well as radiologic evidence of extension into the distal parametrial space and to the pelvic side wall on magnetic resonance imaging. Cervical necrosis was more common in the infiltrative group. Good response was more common in the expansive group (34% vs 24%; P=.02), and poor response was more common in the infiltrative group (11% and 19%; P=.02). Mean gross tumor volume at diagnosis was equal in both groups (51.7 cm{sup 3}). The high-risk clinical target volume was larger in infiltrative tumors (37.9 cm{sup 3} vs 33.3 cm{sup 3}, P=.005). The mean high-risk clinical target volume D{sub 90} was slightly higher in expansive tumors (92.7 Gy and 89.4 Gy, P<.001). Conclusion: Infiltrative tumors are more advanced at presentation and respond less favorably to chemo-radiotherapy when compared with expansive tumors that are more or less equivalent in size. The use of image

The ties that bind: perceived social support, stress, and IBS in severely affected patients.

Science.gov (United States)

Lackner, J M; Brasel, A M; Quigley, B M; Keefer, L; Krasner, S S; Powell, C; Katz, L A; Sitrin, M D

2010-08-01

This study assessed the association between social support and the severity of irritable bowel syndrome (IBS) symptoms in a sample of severely affected IBS patients recruited to an NIH-funded clinical trial. In addition, we examined if the effects of social support on IBS pain are mediated through the effects on stress. Subjects were 105 Rome II diagnosed IBS patients (F = 85%) who completed seven questionnaires which were collected as part of a pretreatment baseline assessment. Partial correlations were conducted to clarify the relationships between social support and clinically relevant variables with baseline levels of psychopathology, holding constant number of comorbid medical diseases, age, gender, marital status, ethnicity, and education. Analyses indicated that social support was inversely related to IBS symptom severity. Social support was positively related with less severe pain. A similar pattern of data was found for perceived stress but not quality of life impairment. Regression analyses examined if the effects of social support on pain are mediated by stress. The effects of social support on bodily pain were mediated by stress such that the greater the social support the less stress and the less pain. This effect did not hold for symptom severity, quality of life, or psychological distress. This study links the perceived adequacy of social support to the global severity of symptoms of IBS and its cardinal symptom (pain). It also suggests that the mechanism by which social support alleviates pain is through a reduction in stress levels.

The Significance of Coordination for Industrialised Building System (IBS Precast Concrete in Construction Industry

Directory of Open Access Journals (Sweden)

Fitri Othman Mohd Khairul

2017-01-01

Full Text Available IBS precast concrete is construction system which is meant to improve the conventional construction process. However IBS precast concrete projects are suffering from serious problems such as cost overrun, delays and less quality of the end product. The absence of coordination is perceived as the reason for this issue. The purpose of this paper is to review the significance of coordination for IBS precast concrete in the construction industry. It if found that the fragmentation which occurs in the construction industry requires continuity of coordination due to the construction activities are intertwined in nature. Coordination is designated to assist stakeholders in completing and complementing each other with the paramount focus of achieving the objective. Proper coordination is required in delivering the desired construction product at the ideal time, cost and quality. As for the findings, the significance of coordination for IBS precast concrete can be seen through the precast concrete construction phases which consist of planning; design; manufacturing; transportation and installation/construction. These phases are meant to complement construction process with the purpose to reduce issues of fragmentation and enhance IBS precast concrete project delivery.

Critical ICT-Inhibiting Factors on IBS Production Management Processes in the Malaysia Construction Industry

Science.gov (United States)

Ern, Peniel Ang Soon; Kasim, Narimah; Hamid, Zuhairi Abd; Chen, Goh Kai

2017-10-01

Industrialized Building System (IBS) is one of the approaches that had been introduced as an alternative to conventional building method where it becomes the new strategy of enhancing the sustainable construction in current industries while spearheading a huge advancement of benefits with green constructions into the existing industries. The IBS approach is actively promoted through several strategies and incentives as an alternative to conventional building methods. Extensive uptakes of modern Information Communication Technology (ICT) applications are able to support the different IBS processes for effective production. However, it is argued that ICT uptake at the organisational level is still in its infancy. This raises the importance to identify critical inhibitors which are inhibing the effective uptake of ICT in the IBS production management process. Critical inhibitors to ICT uptake were identified through questionnaire survey with the IBS industry stakeholders. The mean index and critical t-values are generated with the use of the quantitative tool, Statistical Package for Social Sciences (SPSS). The top ten priority ranked inhibitors reflect the Cost, People and Process elements to ICT uptake. High costs in acquiring the technologies and resistance to change were some main concerns from the findings.

Klinefelter's Syndrome with Seizure, Pseudohypoparathyroidism Type Ib and Multiple Endocrine Dysfunctions

Directory of Open Access Journals (Sweden)

Chwen-Yi Yang

2005-12-01

Full Text Available Klinefelter's syndrome is rarely associated with hypocalcemia, especially pseudohypoparathyroidism (PHP type Ib. We describe a case of Klinefelter's syndrome associated with seizure, PHP type Ib and multiple endocrine dysfunctions. A 19-year-old Taiwanese male was admitted due to seizures with loss of consciousness. He had been diagnosed with Klinefelter's syndrome with seizure disorder and hypocalcemia 3 months previously. Physical examination revealed eunuchoidism but no osteodystrophy, while laboratory data revealed severe hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone. Chromosomal study showed 47, XXY. Osteoporosis was found on chest and abdominal radiography. Dense calcification in the cerebrum and cerebellum was shown on brain computed tomography and magnetic resonance imaging. Elevation of the patient's serum calcium level was noted after vitamin D and calcium carbonate supplements were given. Klinefelter's syndrome is rarely associated with PHP type Ib; our patient's hypocalcemia improved after long-term aggressive treatment.

SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients

DEFF Research Database (Denmark)

Antonsen, Sofie Leisby; Loft, Annika; Fisker, Rune Vincents

2013-01-01

OBJECTIVE: To evaluate SUVmax in the assessment of endometrial cancer preoperatively with particular focus on myometrial invasion (MI), cervical invasion (CI), FIGO stage, risk-stratification and lymph node metastases (LNM). METHODS: A total of 268 women with endometrial cancer or atypical...... endometrial hyperplasia underwent FDG PET/CT imaging before surgical treatment. SUVmax of the primary tumour was compared with histological prognostic factors. RESULTS: SUVmax was significantly higher in patients with high FIGO stages (p...

How the Change in IBS Criteria From Rome III to Rome IV Impacts on Clinical Characteristics and Key Pathophysiological Factors.

Science.gov (United States)

Aziz, Imran; Törnblom, Hans; Palsson, Olafur S; Whitehead, William E; Simrén, Magnus

2018-06-08

The diagnostic criteria for irritable bowel syndrome (IBS) have recently been updated from Rome III to Rome IV. Whereas in Rome III a diagnosis of IBS entailed chronic abdominal pain or discomfort at least 3 days per month, in Rome IV the term discomfort has been removed and the frequency of abdominal pain increased to at least 1 day per week. We examined how this change in IBS criteria impacts on clinical characteristics and pathophysiological factors. A total of 542 Swedish subjects with Rome III IBS completed a baseline questionnaire enquiring for the number of abdominal pain days in the last 10 days; this was subsequently used as a surrogate marker to identify Rome IV IBS, in that (a) those with 0 or 1 day of pain were classed as Rome IV-negative, and (b) those with ≥2 days of pain were classed as Rome IV-positive. Comparisons were made between Rome IV-positive and -negative IBS groups for demographics, IBS subtype, gastrointestinal and psychological symptoms, somatisation, fatigue, disease-specific quality of life, rectal sensitivity, and oro-anal transit time. Overall, 85% of Rome III IBS patients fulfilled the Rome IV criteria for IBS, but 15% did not. Rome IV-positive subjects were significantly more likely to be female, have poorer quality of life, greater pain severity, bloating, somatisation, fatigue, and rectal sensitivity than Rome IV-negative subjects. There were no differences in severity of anxiety or depression, IBS subtypes, bowel habit dissatisfaction, or oro-anal transit time. Finally, increasing number of pain days correlated positively with symptoms and visceral hypersensitivity. Most Rome III-positive IBS patients seeking healthcare fulfil the Rome IV IBS criteria. They constitute a more severe group than those who lose their IBS diagnosis.

Anatomic study of the pelvis in carcinoma of the uterine cervix as related to the box technique

International Nuclear Information System (INIS)

Zunino, Silvia; Rosato, Otilio; Lucino, Sergio; Jauregui, Esteban; Rossi, Luis; Venencia, Daniel

1999-01-01

Purpose: To review the radiation therapy 'box' technique for cancer of the cervix by means of magnetic resonance imaging (MRI), lymphangiography, and anatomic studies on cadavers. Methods and Materials: From 1993 to 1996, the anatomic borders of the 'box' technique used at our Radiation Oncology Department--the superior border of the AP-PA fields at the inferior edge of L4; the inferior border at the inferior edge of the ischium; the lateral borders placed 2.5 cm outside of the bony pelvis rim; the anterior border of the lateral fields over the anterior edge of the pubic symphysis; and the posterior at the S2-S3 interspace - were reviewed in 35 sagittal MRI and 10 lymphangiographies of patients with FIGO IB (6), IIA (6), IIB (19), IIIB (3), and IVA (1). An anatomic revision was conducted on 30 cadavers to identify aortic bifurcation, lymphatic nodes, and uterus flexion. Results: In 50% of the patients with FIGO IB, the posterior border of the lateral field was inadequate to encompass the planning target volume (PTV), and in 67% with Stage IIA. In IIB, the anterior border was inadequate in 1 patient, and the posterior in 8 (42%). In IIB and IVA patients, the PTV was not encompassed. When correlating the anterior and posterior borders of the lateral field and the treatment volume in the 35 sagittal MRIs, the posterior border of the lateral field was inadequate in 49%, and the anterior border in 9% of the cases. According to the lymphangiography, the portals encompassed the external iliac nodes. Dissected female pelvises revealed that the aortic bifurcation occurred at the level of the inferior L4 edge in 80% of the cadavers. There was no correlation between uterus flexion in MRIs and in cadavers. Conclusion: The design of the lateral fields of the four-field technique for the irradiation of the uterine cervix based on anatomic bone references failed to encompass the planning-target volume in a significant number of patients

Strong Prognostic Value of Tumor-infiltrating Neutrophils and Lymphocytes Assessed by Automated Digital Image Analysis in Early Stage Cervical Cancer

DEFF Research Database (Denmark)

Carus, Andreas; Donskov, Frede; Switten Nielsen, Patricia

2014-01-01

INTRODUCTION Manual observer-assisted stereological (OAS) assessments of tumor-infiltrating neutrophils and lymphocytes are prognostic, accurate, but cumbersome. We assessed the applicability of automated digital image analysis (DIA). METHODS Visiomorph software was used to obtain DIA densities...... with the prognostically strongest manual OAS assessments in the peritumoral compartment. In multivariate analysis, CD66b and CD8 densities, assessed by DIA, and regional lymph node metastases were independent predictors of RFS, while CD163 density and FIGO stage were not. The CD66b/CD8 tumorassociated neutrophil...

Value of Magnetic Resonance Imaging Without or With Applicator in Place for Target Definition in Cervix Cancer Brachytherapy

International Nuclear Information System (INIS)

Pötter, Richard; Federico, Mario; Sturdza, Alina; Fotina, Irina; Hegazy, Neamat; Schmid, Maximilian; Kirisits, Christian; Nesvacil, Nicole

2016-01-01

Purpose: To define, in the setting of cervical cancer, to what extent information from additional pretreatment magnetic resonance imaging (MRI) without the brachytherapy applicator improves conformity of CT-based high-risk clinical target volume (CTV_H_R) contours, compared with the MRI for various tumor stages (International Federation of Gynecology and Obstetrics [FIGO] stages I-IVA). Methods and Materials: The CTV_H_R was contoured in 39 patients with cervical cancer (FIGO stages I-IVA) (1) on CT images based on clinical information (CTV_H_R-CT_C_l_i_n_i_c_a_l) alone; and (2) using an additional MRI before brachytherapy, without the applicator (CTV_H_R-CT_p_r_e_-_B_T _M_R_I). The CT contours were compared with reference contours on MRI with the applicator in place (CTV_H_R-MRI_r_e_f). Width, height, thickness, volumes, and topography were analyzed. Results: The CT-MRI_r_e_f differences hardly varied in stage I tumors (n=8). In limited-volume stage IIB and IIIB tumors (n=19), CTV_H_R-CT_p_r_e_-_B_T _M_R_I–MRI_r_e_f volume differences (2.6 cm"3 [IIB], 7.3 cm"3 [IIIB]) were superior to CTV_H_R-CT_C_l_i_n_i_c_a_l–MRI_r_e_f (11.8 cm"3 [IIB], 22.9 cm"3 [IIIB]), owing to significant improvement of height and width (P<.05). In advanced disease (n=12), improved agreement with MR volume, width, and height was achieved for CTV_H_R-CT_p_r_e_-_B_T _M_R_I. In 5 of 12 cases, MRI_r_e_f contours were partly missed on CT. Conclusions: Pre-BT MRI helps to define CTV_H_R before BT implantation appropriately, if only CT images with the applicator in place are available for BT planning. Significant improvement is achievable in limited-volume stage IIB and IIIB tumors. In more advanced disease (extensive IIB to IVA), improvement of conformity is possible but may be associated with geographic misses. Limited impact on precision of CTV_H_R-CT is expected in stage IB tumors.

Value of Magnetic Resonance Imaging Without or With Applicator in Place for Target Definition in Cervix Cancer Brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Pötter, Richard [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Federico, Mario [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Department of Radiation Oncology, Gran Canaria University Hospital, Las Palmas de Gran Canaria (Spain); Sturdza, Alina [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Fotina, Irina [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Institute of Physics and Technology, Tomsk Polytechnic University, Tomsk Oblast (Russian Federation); Hegazy, Neamat [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Department of Clinical Oncology, Medical University of Alexandria, Alexandria (Egypt); Schmid, Maximilian; Kirisits, Christian [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Nesvacil, Nicole, E-mail: nicole.nesvacil@meduniwien.ac.at [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)

2016-03-01

Purpose: To define, in the setting of cervical cancer, to what extent information from additional pretreatment magnetic resonance imaging (MRI) without the brachytherapy applicator improves conformity of CT-based high-risk clinical target volume (CTV{sub HR}) contours, compared with the MRI for various tumor stages (International Federation of Gynecology and Obstetrics [FIGO] stages I-IVA). Methods and Materials: The CTV{sub HR} was contoured in 39 patients with cervical cancer (FIGO stages I-IVA) (1) on CT images based on clinical information (CTV{sub HR}-CT{sub Clinical}) alone; and (2) using an additional MRI before brachytherapy, without the applicator (CTV{sub HR}-CT{sub pre-BT} {sub MRI}). The CT contours were compared with reference contours on MRI with the applicator in place (CTV{sub HR}-MRI{sub ref}). Width, height, thickness, volumes, and topography were analyzed. Results: The CT-MRI{sub ref} differences hardly varied in stage I tumors (n=8). In limited-volume stage IIB and IIIB tumors (n=19), CTV{sub HR}-CT{sub pre-BT} {sub MRI}–MRI{sub ref} volume differences (2.6 cm{sup 3} [IIB], 7.3 cm{sup 3} [IIIB]) were superior to CTV{sub HR}-CT{sub Clinical}–MRI{sub ref} (11.8 cm{sup 3} [IIB], 22.9 cm{sup 3} [IIIB]), owing to significant improvement of height and width (P<.05). In advanced disease (n=12), improved agreement with MR volume, width, and height was achieved for CTV{sub HR}-CT{sub pre-BT} {sub MRI}. In 5 of 12 cases, MRI{sub ref} contours were partly missed on CT. Conclusions: Pre-BT MRI helps to define CTV{sub HR} before BT implantation appropriately, if only CT images with the applicator in place are available for BT planning. Significant improvement is achievable in limited-volume stage IIB and IIIB tumors. In more advanced disease (extensive IIB to IVA), improvement of conformity is possible but may be associated with geographic misses. Limited impact on precision of CTV{sub HR}-CT is expected in stage IB tumors.

Constitutive STAT5 Activation Correlates With Better Survival in Cervical Cancer Patients Treated With Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Chen, Helen H.W. [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Chou, Cheng-Yang [Department of Obstetrics and Gynecology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Wu, Yuan-Hua; Hsueh, Wei-Ting; Hsu, Chiung-Hui [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Guo, How-Ran [Department of Environmental and Occupational Health, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Lee, Wen-Ying, E-mail: 7707@so-net.net.tw [Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan (China) and Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Su, Wu-Chou, E-mail: sunnysu@mail.ncku.edu.tw [Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China)

2012-02-01

Purpose: Constitutively activated signal transducers and activators of transcription (STAT) factors, in particular STAT1, STAT3, and STAT5, have been detected in a wide variety of human primary tumors and have been demonstrated to directly contribute to oncogenesis. However, the expression pattern of these STATs in cervical carcinoma is still unknown, as is whether or not they have prognostic significance. This study investigated the expression patterns of STAT1, STAT3, and STAT5 in cervical cancer and their associations with clinical outcomes in patients treated with radical radiation therapy. Methods and Materials: A total of 165 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) Stages IB to IVA cervical cancer underwent radical radiation therapy, including external beam and/or high-dose-rate brachytherapy between 1989 and 2002. Immunohistochemical studies of their formalin-fixed, paraffin-embedded tissues were performed. Univariate and multivariate analyses were performed to identify and to evaluate the effects of these factors affecting patient survival. Results: Constitutive activations of STAT1, STAT3, and STAT5 were observed in 11%, 22%, and 61% of the participants, respectively. While STAT5 activation was associated with significantly better metastasis-free survival (p < 0.01) and overall survival (p = 0.04), STAT1 and STAT3 activation were not. Multivariate analyses showed that STAT5 activation, bulky tumor ({>=}4 cm), advanced stage (FIGO Stages III and IV), and brachytherapy (yes vs. no) were independent prognostic factors for cause-specific overall survival. None of the STATs was associated with local relapse. STAT5 activation (odds ratio = 0.29, 95% confidence interval = 0.13-0.63) and advanced stage (odds ratio = 2.54; 95% confidence interval = 1.03-6.26) were independent predictors of distant metastasis. Conclusions: This is the first report to provide the overall expression patterns and prognostic significance of

Development of a Rhizoctonia solani AG1-IB Specific Gene Model Enables Comparative Genome Analyses between Phytopathogenic R. solani AG1-IA, AG1-IB, AG3 and AG8 Isolates.

Directory of Open Access Journals (Sweden)

Daniel Wibberg

Full Text Available Rhizoctonia solani, a soil-born plant pathogenic basidiomycetous fungus, affects various economically important agricultural and horticultural crops. The draft genome sequence for the R. solani AG1-IB isolate 7/3/14 as well as a corresponding transcriptome dataset (Expressed Sequence Tags--ESTs were established previously. Development of a specific R. solani AG1-IB gene model based on GMAP transcript mapping within the eukaryotic gene prediction platform AUGUSTUS allowed detection of new genes and provided insights into the gene structure of this fungus. In total, 12,616 genes were recognized in the genome of the AG1-IB isolate. Analysis of predicted genes by means of different bioinformatics tools revealed new genes whose products potentially are involved in degradation of plant cell wall components, melanin formation and synthesis of secondary metabolites. Comparative genome analyses between members of different R. solani anastomosis groups, namely AG1-IA, AG3 and AG8 and the newly annotated R. solani AG1-IB genome were performed within the comparative genomics platform EDGAR. It appeared that only 21 to 28% of all genes encoded in the draft genomes of the different strains were identified as core genes. Based on Average Nucleotide Identity (ANI and Average Amino-acid Identity (AAI analyses, considerable sequence differences between isolates representing different anastomosis groups were identified. However, R. solani isolates form a distinct cluster in relation to other fungi of the phylum Basidiomycota. The isolate representing AG1-IB encodes significant more genes featuring predictable functions in secondary metabolite production compared to other completely sequenced R. solani strains. The newly established R. solani AG1-IB 7/3/14 gene layout now provides a reliable basis for post-genomics studies.

BUSINESS STRATEGY OF LARGE CONTRACTORS IN ADOPTING INDUSTRIALISED BUILDING SYSTEM (IBS: THE MALAYSIAN CASE

Directory of Open Access Journals (Sweden)

FRANKY AMBON

2012-12-01

Full Text Available Industrialised Building System (IBS is the term coined by the government and industry in Malaysia to represent the construction industry and the application of prefabrication method in building construction. The purpose of this exploratory research paper is to highlight business strategy being pursued by large Malaysian contractors in adopting IBS. The paper uses case study as research method. The analysis is based primarily on cross-case analysis and pattern matching technique. The paper observes contractors which involved in IBS are part of larger holding companies in a corporate set-up include design and manufacturing subsidiaries. The companies positioned themselves as one-stop total solution provider for IBS and offer a wider range of services from design, production, and installation to clients. To become competitive and able to create total solution, contractors need to establish cluster and consortium of integrated project team by creating a partnership when and where it is needed. A vendor development programme modelled along the lines of the development of automotive industry should also be established. Future empirical studies should extensively examine these areas, especially the development of business model for contractors. The availability of this model could help to accelerate the uptake of IBS among contractors.

Definitive radiotherapy for primary vaginal cancer. Correlation between treatment patterns and recurrence rate

International Nuclear Information System (INIS)

Kanayama, Naoyuki; Isohashi, Fumiaki; Yoshioka, Yasuo

2015-01-01

The purpose of this study was to determine the outcomes and optimal practice patterns of definitive radiotherapy for primary vaginal cancer. Between 1993 and 2012, 49 patients were treated with definitive radiotherapy for primary vaginal cancer in three hospitals. Of these, 15 patients (31%) had clinically positive regional lymph node metastasis. A total of 34 patients (70%) received external beam radiotherapy with high-dose-rate brachytherapy (interstitial or intracavitary), and 8 (16%) (with small superficial Stage I tumors) were treated with local radiotherapy. The median follow-up was 33 months (range: 1–169 months). The 3-year overall survival (OS), disease-free survival (DFS), and loco-regional control (LRC) rates were 83%, 59% and 71%, respectively. In multivariate analysis, the histological type (P = 0.044) was significant risk factors for LRC. In Federation of Gynecology and Obstetrics (FIGO) Stage I cases, 3 of 8 patients (38%) who did not undergo prophylactic lymph node irradiation had lymph node recurrence, compared with 2 of 12 patients (17%) who underwent prophylactic pelvic irradiation. For Stage III–IV tumors, the local recurrence rate was 50% and the lymph node recurrence rate was 40%. Patients with FIGO Stage I/II or clinical Stage N1 had a higher recurrence rate with treatment using a single modality compared with the recurrence rate using combined modalities. In conclusion, our treatment outcomes for vaginal cancer were acceptable, but external beam radiotherapy with brachytherapy (interstitial or intracavitary) was needed regardless of FIGO stage. Improvement of treatment outcomes in cases of FIGO Stage III or IV remains a significant challenge. (author)

Carcinoma invasor de cérvix en Las Palmas : tipificación del virus del papiloma humano (VPH) y factores pronósticos

OpenAIRE

Arencibia Sánchez, Octavio

2015-01-01

Programa de doctorado: Patología Quirúrgica, Reproducción humana y factores psicológicos y el proceso de enfermar [ES]Estudio retrospectivo destinado a estudiar los carcinomas infiltrantes de cérvix (estadio FIGO IB y superiores) registrados en la Unidad de Ginecología Oncológica del Complejo Hospitalario Universitario Materno Infantil entre los años 1996 y 2013. El tamaño muestral final fue de 561 pacientes, de las que se contaba con material disponible...

Pharmacological and safety evaluation of CIGB-300, a casein kinase 2 inhibitor peptide, administered intralesionally to patients with cervical cancer stage IB2/II

Directory of Open Access Journals (Sweden)

Soriano-García JL

2013-08-01

Full Text Available CIGB-300 is a pro-apoptotic casein kinase 2 inhibitor peptide with potential anticancer action. An open-label and dose scaling Phase I trial was carried out to investigate the peptide tumor uptake, pharmacokinetics, toxicity, and levels of a CIGB-300 response biomarker in patients with cervical cancer stage IB2/II. Fourteen patients were included; six of them received 35 mg, 6 received 70 mg and the two remaining patients received 245 mg of CIGB-300 prior chemoradiotherapy. CIGB-300 was applied by intratumor injections during 5-consecutive days. For pharmacokinetic and biodistribution studies, the peptide was radiolabeled with 99mTc in the first administration and whole body gammagraphy and plasma testing were done during 48 h. Data showed that the maximum tolerated dose was 70 mg for CIGB-300 in this clinical setting. Furthermore, an allergic-like syndrome was identified as the dose limiting toxicity, which was well-correlated with plasmatic histamine levels. Importantly, the mean tumor uptake was 14.9 mg and 10.4 mg for CIGB-300 doses of 35 and 70 mg, respectively. Also, the kidneys were the main target organ for drug elimination. Finally, treatment with CIGB-300 significantly reduced the B23/nucleophosmin levels in tumor specimens. CIGB-300 meets potentialities to be tested in future trials in a neoadjuvant setting prior to chemoradiotherapy in cervical cancer.

Distribution of causes of abnormal uterine bleeding using the new FIGO classification system

International Nuclear Information System (INIS)

Qureshi, F.U.; Yusuf, A.W.

2013-01-01

Objective: To categorise all women with Abnormal Uterine Bleeding attending a tertiary care centre according to new classification system by the International Federation of Gynaecology and Obstetrics (FIGO). Methods: The descriptive cross-sectional study comprised all non-gravid women of reproductive age with unpredictable, excessive duration, abnormal volume, and/or abnormal frequency of menses for at least 3 months coming to the outpatient department of Lady Willingdon Hospital, Lahore, from August 2010 to July 2011. The subjects underwent structured history, physical examination and pelvic ultrasonography. Endometrium and hysterectomy specimen were obtained for histopathology where applicable. Possible underlying causes were categorised according to the new classification system. Results: A total of 2109 women comprised 19.6% of total of the 10712 woman who visited the gynecological outpatients clinic, 2109(19.6%) had abnormal uterine bleeding. PALM-COEIN categorization done in 991(47%) cases that showed 30(3%) polyp, 15(15%) adenomyosis, 250(25%) leiomyoma, 66(6.6%) malignancy and hyperplasia, 3(0.3%) coagulopathy, 236(24%) ovulatory dysfunction, 48(5%) endometritis, and 53(6%) iatrogenic. The remaining 155(15%) cases were uncategorised. Conclusion: The classification should facilitate multi-institutional investigation into the epidemiology, etiology and treatment of women with Abnormal Uterine Bleeding. (author)

Towards Integrated Team Practice: A Case of Malaysian Industrialised Building System (IBS Construction Projects

Directory of Open Access Journals (Sweden)

Mohd Nawi Mohd Nasrun

2014-01-01

Full Text Available Problems associated with fragmentation in the traditional construction process, such as isolation of professionals, lack of co-ordination between design and construction, and the sequential manner of its processes, has impacted on construction performance leading to a lack of integration, wastage, low productivity and efficiency. Integrated team practice is perceived as paramount. Unfortunately, there has a limitation of study focus on the dimension of fully integrated team especially for Malaysian Industrialised Building System (IBS projects. Accordingly, this research paper explores and identifies the dimension of fully integrated team from the traditional approach and conduct a validation process for implementing it in Malaysian IBS projects. The research presented uses interviews case study to obtain qualitative data. It was found that the dimension of fully integrated team from the traditional construction process could apply to the Malaysian IBS projects. Suggestions on how an integrated team practice in IBS design and construction process in order to minimise the fragmentation gaps will be concluded.

Travel Tips Help IBS Sufferers Enjoy Their Vacations

Science.gov (United States)

... can feel more in control when traveling." IFFGD's travel tips include: Allow enough time in the morning to get to the airport ... Heartache 2004-0929 Norton Honored 2004-0525 IBS Travel Tips ... Real World 2001-1119 Heartburn or Heart Attack Commentary ...

Recurrence in skeletal muscle from squamous cell carcinoma of the uterine cervix: a case report and review of the literature

International Nuclear Information System (INIS)

Ferrandina, Gabriella; Salutari, Vanda; Testa, Antonia; Zannoni, Gian Franco; Petrillo, Marco; Scambia, Giovanni

2006-01-01

The occurrence of skeletal muscle metastases is a very rare event. Only two cases of late skeletal muscle recurrence from cervical cancer have been documented until now. A 38-year old patient, submitted to radical hysterectomy and pelvic lymphadenectomy for a squamous FIGO stage IB1 cervical carcinoma, presented after 76 months with a palpable, and painless swelling on the left hemithorax. MRI showed a nodule located in the context of the intercostal muscles. Pathology revealed the presence of metastasis of squamous cell carcinoma of similar morphology as the primary. On the basis of FDG-PET findings, which excluded other sites of disease, surgical excision of the lesion was performed. The patient was triaged to chemotherapy plus external radiotherapy. A case of skeletal muscle recurrence from cervical cancer after a very long interval from primary diagnosis is reported. Muscular pain or weakness, or just a palpable mass in a patient with a history of cancer has always to raise the suspicion of muscle metastasis

Comparison of optimised endovaginal vs external array coil T2-weighted and diffusion-weighted imaging techniques for detecting suspected early stage (IA/IB1) uterine cervical cancer

Energy Technology Data Exchange (ETDEWEB)

Downey, Kate; Morgan, Veronica A.; Giles, Sharon L.; MacDonald, A.; DeSouza, Nandita M. [The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, CRUK Cancer Imaging Centre, Surrey (United Kingdom); Attygalle, Ayoma D. [The Royal Marsden NHS Foundation Trust, Department of Histopathology, London (United Kingdom); Davis, M. [Kingston Hospital, Department of Gynaecology, Kingston-upon-Thames, Surrey (United Kingdom); Ind, Thomas E.J.; Shepherd, John H. [The Royal Marsden NHS Foundation Trust, Gynecology Unit, London (United Kingdom)

2016-04-15

To compare sensitivity and specificity of endovaginal versus external-array coil T2-W and T2-W + DWI for detecting and staging small cervical tumours. Optimised endovaginal and external array coil MRI at 3.0-T was done prospectively in 48 consecutive patients with stage Ia/Ib1 cervical cancer. Sensitivity/specificity for detecting tumour and parametrial extension against histopathology for a reading radiologist were determined on coronal T2-W and T2W + DW images. An independent radiologist also scored T2-W images without and with addition of DWI for the external-array and endovaginal coils on separate occasions >2 weeks apart. Cohen's kappa assessed inter- and intra-observer agreement. Median tumour volume in 19/38 cases positive on subsequent histology was 1.75 cm{sup 3}. Sensitivity, specificity, PPV, NPV were: reading radiologist 91.3 %, 89.5 %, 91.3 %, 89.5 %, respectively; independent radiologist T2-W 82.6 %, 73.7 %, 79.1 %, 77.8 % for endovaginal, 73.9 %, 89.5 %, 89.5 %, 73.9 % for external-array coil. Adding DWI improved sensitivity and specificity of endovaginal imaging (78.2 %, 89.5 %); adding DWI to external-array imaging improved specificity (94.7 %) but reduced sensitivity (66.7 %). Inter- and intra-observer agreement on T2-W + DWI was good (kappa = 0.67 and 0.62, respectively). Endovaginal coil T2-W MRI is more sensitive than external-array coil for detecting tumours <2 cm{sup 3}; adding DWI improves specificity of endovaginal imaging but reduces sensitivity of external-array imaging. (orig.)

Radiotherapy for carcinoma of the vagina. Immunocytochemical and cytofluorometric analysis of prognostic factors

Energy Technology Data Exchange (ETDEWEB)

Blecharz, P. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Gynecological Oncology; Reinfuss, M.; Jakubowicz, J. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Radiation Oncology; Rys, J. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Tumor Pathology Oncology; Skotnicki, P.; Wysocki, W. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Oncological Surgery

2013-05-15

Background and purpose: The aim of this study was to assess the potential prognostic factors in patients with primary invasive vaginal carcinoma (PIVC) treated with radical irradiation. Patients and methods: The analysis was performed on 77 patients with PIVC treated between 1985 and 2005 in the Maria Sklodowska-Curie Memorial Institute of Oncology, Cancer Center in Krakow. A total of 36 patients (46.8 %) survived 5 years with no evidence of disease (NED). The following groups of factors were assessed for potential prognostic value: population-based (age), clinical (Karnofsky Performance Score [KPS], hemoglobin level, primary location of the vaginal lesion, macroscopic type, length of the involved vaginal wall, FIGO stage), microscopic (microscopic type, grade, mitotic index, presence of atypical mitoses, lymphatic vessels invasion, lymphocytes/plasmocytes infiltration, focal necrosis, VAIN-3), immunohistochemical (protein p53 expression, MIB-1 index), cytofluorometric (ploidity, index DI, S-phase fraction, proliferation index SG2M) factors. Results: Significantly better 5-year NED was observed in patients: < 60 years, KPS {<=} 80, FIGO stage I and II, grade G1-2, MIB-1 index < 70, S-phase fraction < 10, and proliferation index < 25. Independent factors for better prognosis in the multivariate Cox analysis were age < 60 years, FIGO stage I or II, and MIB-1 index < 70. Conclusion: Independent prognostic factors in the radically irradiated PIVC patients were as follows: age, FIGO stage, MIB-1 index. (orig.)

Early stage cervical cancer of the uterine

International Nuclear Information System (INIS)

Kaneyasu, Yuuko; Fujiwara, Hisaya

2011-01-01

This paper describes the present state of radiotherapy (RT) of early stage cervical cancer involving the history, outcomes of clinical trials, procedure for each stage, irradiation methods, concurrent chemo-RT (CCRT), late adverse events, and QOL after RT. It has a history of >100 years from the brachytherapy with radium, but is not yet completely established even now. There are many RT trials hitherto. Retrospectively, no significant difference is seen in outcomes of radical RT and surgery: 80-90% efficacy for stage I and 60-80% for II in the former, respectively, and 80-96% and 65-80%, in the latter. Between RT and surgery, there is a report of randomized comparative study in Italy. In Japan, reported are comparative outcomes based on patients' choice for therapy, retrospective studies including authors' one, prospective multi-institutional cooperative trials by Japanese Radiation Oncology Study Group, and Treatment Guidelines for Cervical Cancer (2007). RT procedure depends on the stage defined by FIGO (International Federation of Gynecology and Obstetrics) and at stages I-II, intracavitary RT is major with optimal dose 29 Gy/5 fractions for I, and 23/4 Gy with external total pelvic radiation 50 Gy for II. In external radiation, the planning target volume includes the whole pelvic field with 1.8-2 Gy/5 weeks and optionally, the extended field when metastasis suspicious. Intracavitary RT with application device in the uterine is of significance for the cancer as 50% complete cure even in stage III is reported. CCRT brings about good prognosis, which is shown in a Japanese trial to compare postoperative RT alone and CCRT with CDDP and 5-FU. The late adverse events are seen mainly in the large bowel and studies of QOL, an important factor for choice of treatment, are now in progress. (T.T.)

Co-expression of CD147 and GLUT-1 indicates radiation resistance and poor prognosis in cervical squamous cell carcinoma.

Science.gov (United States)

Huang, Xin-Qiong; Chen, Xiang; Xie, Xiao-Xue; Zhou, Qin; Li, Kai; Li, Shan; Shen, Liang-Fang; Su, Juan

2014-01-01

The aim of this study was to investigate the association of CD147 and GLUT-1, which play important roles in glycolysis in response to radiotherapy and clinical outcomes in patients with locally advanced cervical squamous cell carcinoma (LACSCC). The records of 132 female patients who received primary radiation therapy to treat LACSCC at FIGO stages IB-IVA were retrospectively reviewed. Forty-seven patients with PFS (progression-free survival) of less than 36 months were regarded as radiation-resistant. Eighty-five patients with PFS longer than 36 months were regarded as radiation-sensitive. Using pretreatment paraffin-embedded tissues, we evaluated CD147 and GLUT-1 expression by immunohistochemistry. Overexpression of CD147, GLUT-1, and CD147 and GLUT-1 combined were 44.7%, 52.9% and 36.5%, respectively, in the radiation-sensitive group, and 91.5%, 89.4% and 83.0%, respectively, in the radiation-resistant group. The 5-year progress free survival (PFS) rates in the CD147-low, CD147-high, GLUT-1-low, GLUT-1-high, CD147- and/or GLUT-1-low and CD147- and GLUT-1- dual high expression groups were 66.79%, 87.10%, 52.78%, 85.82%, 55.94%, 82.90% and 50.82%, respectively. CD147 and GLUT-1 co-expression, FIGO stage and tumor diameter were independent poor prognostic factors for patients with LACSCC in multivariate Cox regression analysis. Patients with high expression of CD147 alone, GLUT-1 alone or co-expression of CD147 and GLUT-1 showed greater resistance to radiotherapy and a shorter PFS than those with low expression. In particular, co-expression of CD147 and GLUT-1 can be considered as a negative independent prognostic factor.

Effects of gut-directed hypnotherapy on IBS in different clinical settings-results from two randomized, controlled trials.

Science.gov (United States)

Lindfors, Perjohan; Unge, Peter; Arvidsson, Patrik; Nyhlin, Henry; Björnsson, Einar; Abrahamsson, Hasse; Simrén, Magnus

2012-02-01

Gut-directed hypnotherapy has been found to be effective in irritable bowel syndrome (IBS). However, randomized, controlled studies are rare and few have been performed outside highly specialized research centers. The objective of this study was to study the effect of gut-directed hypnotherapy in IBS in different clinical settings outside the traditional research units. The study population included IBS patients refractory to standard management. In study 1, patients were randomized to receive gut-directed hypnotherapy (12 sessions, 1 h/week) in psychology private practices or supportive therapy, whereas patients were randomized to receive gut-directed hypnotherapy in a small county hospital or to serve as waiting list controls in study 2. Gastrointestinal symptom severity and quality of life were evaluated at baseline, at 3 months follow-up and after 1 year. We randomized 138 IBS patients refractory to standard management, 90 in study 1 and 48 in study 2. In both the studies, IBS-related symptoms were improved at 3 months in the gut-directed hypnotherapy groups (Phypnotherapy group than in the control group (Phypnotherapy is an effective treatment alternative for patients with refractory IBS, but the effectiveness is lower when the therapy is given outside the highly specialized research centers.

Genetic recombination and Cryptosporidium hominis virulent subtype IbA10G2.

Science.gov (United States)

Li, Na; Xiao, Lihua; Cama, Vitaliano A; Ortega, Ynes; Gilman, Robert H; Guo, Meijin; Feng, Yaoyu

2013-10-01

Little is known about the emergence and spread of virulent subtypes of Cryptosporidium hominis, the predominant species responsible for human cryptosporidiosis. We conducted sequence analyses of 32 genetic loci of 53 C. hominis specimens isolated from a longitudinally followed cohort of children living in a small community. We identified by linkage disequilibrium and recombination analyses only limited genetic recombination, which occurred exclusively within the 60-kDa glycoprotein gene subtype IbA10G2, a predominant subtype for outbreaks in industrialized nations and a virulent subtype in the study community. Intensive transmission of virulent subtype IbA10G2 in the study area might have resulted in genetic recombination with other subtypes. Moreover, we identified selection for IbA10G2 at a 129-kb region around the 60-kDa glycoprotein gene in chromosome 6. These findings improve our understanding of the origin and evolution of C. hominis subtypes and the spread of virulent subtypes.

Validity, reliability, and factor analysis of Persian version of quality of life questionnaire for irritable bowel syndrome (IBS-QOL-34

Directory of Open Access Journals (Sweden)

Nasrine Masaeli

2013-01-01

Full Text Available Background: Quality of life (QOL improvement is the main objective of treating patients with irritable bowel syndrome (IBS. This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. Materials and Methods: Two hundred and forty patients with IBS (based on gastroenterologists′ diagnosis according to ROM III criteria were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36 and IBS severity index (IBSSI questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach′s alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS software, version 18. Results: Total reliability of the questionnaire was reported by using Cronbach′s alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in −0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. Conclusion: According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

Streptococcus sanguinis class Ib ribonucleotide reductase: high activity with both iron and manganese cofactors and structural insights.

Science.gov (United States)

Makhlynets, Olga; Boal, Amie K; Rhodes, Delacy V; Kitten, Todd; Rosenzweig, Amy C; Stubbe, JoAnne

2014-02-28

Streptococcus sanguinis is a causative agent of infective endocarditis. Deletion of SsaB, a manganese transporter, drastically reduces S. sanguinis virulence. Many pathogenic organisms require class Ib ribonucleotide reductase (RNR) to catalyze the conversion of nucleotides to deoxynucleotides under aerobic conditions, and recent studies demonstrate that this enzyme uses a dimanganese-tyrosyl radical (Mn(III)2-Y(•)) cofactor in vivo. The proteins required for S. sanguinis ribonucleotide reduction (NrdE and NrdF, α and β subunits of RNR; NrdH and TrxR, a glutaredoxin-like thioredoxin and a thioredoxin reductase; and NrdI, a flavodoxin essential for assembly of the RNR metallo-cofactor) have been identified and characterized. Apo-NrdF with Fe(II) and O2 can self-assemble a diferric-tyrosyl radical (Fe(III)2-Y(•)) cofactor (1.2 Y(•)/β2) and with the help of NrdI can assemble a Mn(III)2-Y(•) cofactor (0.9 Y(•)/β2). The activity of RNR with its endogenous reductants, NrdH and TrxR, is 5,000 and 1,500 units/mg for the Mn- and Fe-NrdFs (Fe-loaded NrdF), respectively. X-ray structures of S. sanguinis NrdIox and Mn(II)2-NrdF are reported and provide a possible rationale for the weak affinity (2.9 μM) between them. These streptococcal proteins form a structurally distinct subclass relative to other Ib proteins with unique features likely important in cluster assembly, including a long and negatively charged loop near the NrdI flavin and a bulky residue (Thr) at a constriction in the oxidant channel to the NrdI interface. These studies set the stage for identifying the active form of S. sanguinis class Ib RNR in an animal model for infective endocarditis and establishing whether the manganese requirement for pathogenesis is associated with RNR.

Detergent-Resistant Membrane Microdomains Facilitate Ib Oligomer Formation and Biological Activity of Clostridium perfringens Iota-Toxin

National Research Council Canada - National Science Library

Hale, Martha

2004-01-01

...) were extracted with cold Triton X-100. Western blotting revealed that Ib oligomers localized in DRMs extracted from Vero, but not MRC-5, cells while monomeric Ib was detected in the detergent-soluble fractions of both cell types...

Expression of the sweetpotato R2R3-type IbMYB1a gene induces anthocyanin accumulation in Arabidopsis.

Science.gov (United States)

Chu, Hyosub; Jeong, Jae Cheol; Kim, Wook-Jin; Chung, Dong Min; Jeon, Hyo Kon; Ahn, Young Ock; Kim, Sun Ha; Lee, Haeng-Soon; Kwak, Sang-Soo; Kim, Cha Young

2013-06-01

R2R3-type MYB transcription factors (TFs) play important roles in transcriptional regulation of anthocyanins. The R2R3-type IbMYB1 is known to be a key regulator of anthocyanin biosynthesis in the storage roots of sweetpotato. We previously showed that transient expression of IbMYB1a led to anthocyanin pigmentation in tobacco leaves. In this article, we generated transgenic Arabidopsis plants expressing the IbMYB1a gene under the control of CaMV 35S promoter, and the sweetpotato SPO and SWPA2 promoters. Overexpression of IbMYBa in transgenic Arabidopsis produced strong anthocyanin pigmentation in seedlings and generated a deep purple color in leaves, stems and seeds. Reverse transcription-polymerase chain reaction analysis showed that IbMYB1a expression induced upregulation of several structural genes in the anthocyanin biosynthetic pathway, including 4CL, CHI, F3'H, DFR, AGT, AAT and GST. Furthermore, overexpression of IbMYB1a led to enhanced expression of the AtTT8 (bHLH) and PAP1/AtMYB75 genes. high-performance liquid chromatography analysis revealed that IbMYB1a expression led to the production of cyanidin as a major core molecule of anthocyanidins in Arabidopsis, as occurs in the purple leaves of sweetpotato (cv. Sinzami). This result shows that the IbMYB1a TF is sufficient to induce anthocyanin accumulation in seedlings, leaves, stems and seeds of Arabidopsis plants. Copyright © Physiologia Plantarum 2012.

TRPA1 is functionally expressed primarily by IB4-binding, non-peptidergic mouse and rat sensory neurons.

Directory of Open Access Journals (Sweden)

Marie E Barabas

Full Text Available Subpopulations of somatosensory neurons are characterized by functional properties and expression of receptor proteins and surface markers. CGRP expression and IB4-binding are commonly used to define peptidergic and non-peptidergic subpopulations. TRPA1 is a polymodal, plasma membrane ion channel that contributes to mechanical and cold hypersensitivity during tissue injury, making it a key target for pain therapeutics. Some studies have shown that TRPA1 is predominantly expressed by peptidergic sensory neurons, but others indicate that TRPA1 is expressed extensively within non-peptidergic, IB4-binding neurons. We used FURA-2 calcium imaging to define the functional distribution of TRPA1 among peptidergic and non-peptidergic adult mouse (C57BL/6J DRG neurons. Approximately 80% of all small-diameter (<27 µm neurons from lumbar 1-6 DRGs that responded to TRPA1 agonists allyl isothiocyanate (AITC; 79% or cinnamaldehyde (84% were IB4-positive. Retrograde labeling via plantar hind paw injection of WGA-Alexafluor594 showed similarly that most (81% cutaneous neurons responding to TRPA1 agonists were IB4-positive. Additionally, we cultured DRG neurons from a novel CGRP-GFP mouse where GFP expression is driven by the CGRPα promoter, enabling identification of CGRP-expressing live neurons. Interestingly, 78% of TRPA1-responsive neurons were CGRP-negative. Co-labeling with IB4 revealed that the majority (66% of TRPA1 agonist responders were IB4-positive but CGRP-negative. Among TRPA1-null DRGs, few small neurons (2-4% responded to either TRPA1 agonist, indicating that both cinnamaldehyde and AITC specifically target TRPA1. Additionally, few large neurons (≥27 µm diameter responded to AITC (6% or cinnamaldehyde (4%, confirming that most large-diameter somata lack functional TRPA1. Comparison of mouse and rat DRGs showed that the majority of TRPA1-responsive neurons in both species were IB4-positive. Together, these data demonstrate that TRPA1 is

TRPA1 Is Functionally Expressed Primarily by IB4-Binding, Non-Peptidergic Mouse and Rat Sensory Neurons

Science.gov (United States)

Stucky, Cheryl L.

2012-01-01

Subpopulations of somatosensory neurons are characterized by functional properties and expression of receptor proteins and surface markers. CGRP expression and IB4-binding are commonly used to define peptidergic and non-peptidergic subpopulations. TRPA1 is a polymodal, plasma membrane ion channel that contributes to mechanical and cold hypersensitivity during tissue injury, making it a key target for pain therapeutics. Some studies have shown that TRPA1 is predominantly expressed by peptidergic sensory neurons, but others indicate that TRPA1 is expressed extensively within non-peptidergic, IB4-binding neurons. We used FURA-2 calcium imaging to define the functional distribution of TRPA1 among peptidergic and non-peptidergic adult mouse (C57BL/6J) DRG neurons. Approximately 80% of all small-diameter (neurons from lumbar 1–6 DRGs that responded to TRPA1 agonists allyl isothiocyanate (AITC; 79%) or cinnamaldehyde (84%) were IB4-positive. Retrograde labeling via plantar hind paw injection of WGA-Alexafluor594 showed similarly that most (81%) cutaneous neurons responding to TRPA1 agonists were IB4-positive. Additionally, we cultured DRG neurons from a novel CGRP-GFP mouse where GFP expression is driven by the CGRPα promoter, enabling identification of CGRP-expressing live neurons. Interestingly, 78% of TRPA1-responsive neurons were CGRP-negative. Co-labeling with IB4 revealed that the majority (66%) of TRPA1 agonist responders were IB4-positive but CGRP-negative. Among TRPA1-null DRGs, few small neurons (2–4%) responded to either TRPA1 agonist, indicating that both cinnamaldehyde and AITC specifically target TRPA1. Additionally, few large neurons (≥27 µm diameter) responded to AITC (6%) or cinnamaldehyde (4%), confirming that most large-diameter somata lack functional TRPA1. Comparison of mouse and rat DRGs showed that the majority of TRPA1-responsive neurons in both species were IB4-positive. Together, these data demonstrate that TRPA1 is functionally expressed

Learning Negotiation Policies Using IB3 and Bayesian Networks

Science.gov (United States)

Nalepa, Gislaine M.; Ávila, Bráulio C.; Enembreck, Fabrício; Scalabrin, Edson E.

This paper presents an intelligent offer policy in a negotiation environment, in which each agent involved learns the preferences of its opponent in order to improve its own performance. Each agent must also be able to detect drifts in the opponent's preferences so as to quickly adjust itself to their new offer policy. For this purpose, two simple learning techniques were first evaluated: (i) based on instances (IB3) and (ii) based on Bayesian Networks. Additionally, as its known that in theory group learning produces better results than individual/single learning, the efficiency of IB3 and Bayesian classifier groups were also analyzed. Finally, each decision model was evaluated in moments of concept drift, being the drift gradual, moderate or abrupt. Results showed that both groups of classifiers were able to effectively detect drifts in the opponent's preferences.

Adjuvant treatment and outcomes of stage III endometrial carcinoma

International Nuclear Information System (INIS)

Connell, C.; Ludbrook, J.; Davy, M.; Yeoh, E

2003-01-01

Surgery with staging using FIGO (1988) classification is accepted management for stage III endometrial carcinoma. The delivery of adjuvant therapy is controversial and tends to be individualised. Retrospective review of stage III endometrial carcinoma patients who underwent radical surgery at the Royal Adelaide and Queen Elizabeth Hospitals from 1984 to 2003 was carried out. Medical records were reviewed for details of patient characteristics, surgery, histopathology, adjuvant therapy and recurrence/survival. Sixty-six patients with a median age of 69 (37-97), had a median follow-up of 26 months (1-188 ). For all stage III patients, the actuarial 5-year disease-free and overall survivals were 50 and 43% respectively. Thirty-five patients received pelvic +/- paraaortic radiotherapy, 5 whole abdominal radiotherapy, 14 vaginal brachytherapy boost, 10 chemotherapy and 13 adjuvant hormones. Forty-six percent of patients recurred in a median time of 13 months (0-95). For these patients, the sites of first recurrence were pelvis in 27%, pelvis and abdomen in 23%, abdomen alone in 13%, distant alone in 27%, distant and abdominal in 7% and all three sites in 3%. On univariate analysis disease-free survival was impacted by; age, grade, parametrial involvement, number of extrauterine sites, lymphovascular invasion, adjuvant radiotherapy to the pelvis alone and postoperative macroscopic residual disease. Lymphovascular invasion, post-operative residual disease and adjuvant pelvic radiotherapy remained significant on multivariate analysis. These outcomes for stage III endometrial carcinoma are comparable to the current literature. Ongoing research is required to establish the most appropriate adjuvant therapy in these high risk patients

Primary invasive squamous carcinoma of the vagina

International Nuclear Information System (INIS)

Pride, G.L.; Schultz, A.E.; Chuprevich, T.W.; Buchler, D.A.

1979-01-01

Forty-three cases of primary vaginal squamous cell cancer were treated at the University of Wisconsin Hospital between 1956 and 1971. These cases comprised of 1.2% of patients admitted to the University Hospital with female genital tract cancer. Evidence is presented to support a modification of the currently accepted FIGO staging system for vaginal carcinoma (Stage II disease). Radiation therapy using both external beam and brachyradium equivalents or interstitial implantation of suitable isotopes was an effective method for the treatment of patients having early and locally advanced invasive vaginal cancer. The 5-year absolute survival rate for the entire series was 37.2%. Absolute survival rate by modified FIGO clinical staging was 66% for Stages I and IIA, 31% for Stage IIB, 25% for Stage III, and 0% for Stage IV

Reduced responses of submucous neurons from irritable bowel syndrome patients to a cocktail containing histamine, serotonin, TNFα and tryptase (IBS-cocktail

Directory of Open Access Journals (Sweden)

Daniela eOstertag

2015-12-01

Full Text Available Background & Aims:Malfunctions of enteric neurons are believed to play an important role in the pathophysiology of irritable bowel syndrome (IBS. Our aim was to investigate whether neuronal activity in biopsies from IBS patients is altered in comparison to healthy controls (HC.Methods:Activity of human submucous neurons in response to electrical nerve stimulation and local application of nicotine or a mixture of histamine, serotonin, tryptase and TNF-α (IBS-cocktail was recorded in biopsies from 17 HC and 35 IBS patients with the calcium-sensitive-dye Fluo-4 AM. The concentrations of the mediators resembeled those found in biopsy supernatants or blood. Neuronal activity in guinea-pig submucous neurons was studied with the voltage-sensitive-dye di-8-ANEPPS. Results:Activity in submucous ganglia in response to nicotine or electrical nerve stimulation was not different between HC and IBS patients (P=0.097 or P=0.448. However, the neuronal response after application of the IBS-cocktail was significantly decreased (P=0.039 independent of whether diarrhea (n=12, constipation (n=5 or bloating (n=5 was the predominant symptom. In agreement with this we found that responses of submucous ganglia conditioned by overnight incubation with IBS mucosal biopsy supernatant to spritz application of this supernatant was significantly reduced (P=0.019 when compared to incubation with HC supernatant.Conclusion:We demonstrated for the first time reduced neuronal responses in mucosal IBS biopsies to an IBS mediator cocktail. While excitability to classical stimuli of enteric neurons was comparable to HC, the activation by the IBS-cocktail was decreased. This was very likely due to desensitization to mediators constantly released by mucosal and immune cells in the gut wall of IBS patients.

A new method using insert-based systems (IBS) to improve cell behavior study on flexible and rigid biomaterials.

Science.gov (United States)

Grenade, Charlotte; Moniotte, Nicolas; Rompen, Eric; Vanheusden, Alain; Mainjot, Amélie; De Pauw-Gillet, Marie-Claire

2016-12-01

In vitro studies about biomaterials biological properties are essential screening tests. Yet cell cultures encounter difficulties related to cell retention on material surface or to the observation of both faces of permeable materials. The objective of the present study was to develop a reliable in vitro method to study cell behavior on rigid and flexible/permeable biomaterials elaborating two specific insert-based systems (IBS-R and IBS-F respectively). IBS-R was designed as a specific cylindrical polytetrafluoroethylene (PTFE) system to evaluate attachment, proliferation and morphology of human gingival fibroblasts (HGFs) on grade V titanium and lithium disilicate glass-ceramic discs characteristics of dental prostheses. The number of cells, their covering on discs and their morphology were determined from MTS assays and microscopic fluorescent images after 24, 48 and 72 h. IBS-F was developed as a two components system to study HGFs behavior on guided bone regeneration polyester membranes. The viability and the membrane barrier effect were evaluated by metabolic MTS assays and by scanning electron microscopy. IBS-R and IBS-F were shown to promote (1) easy and rapid handling; (2) cell retention on biomaterial surface; (3) accurate evaluation of the cellular proliferation, spreading and viability; (4) use of non-toxic material. Moreover IBS-F allowed the study of the cell migration through degradable membranes, with an access to both faces of the biomaterial and to the bottom of culture wells for medium changing.

The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS).

Science.gov (United States)

Kanuri, N; Cassell, B; Bruce, S E; White, K S; Gott, B M; Gyawali, C P; Sayuk, G S

2016-10-01

Irritable bowel syndrome (IBS) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS. While abuse relates to mood disorders (depression and anxiety) also common in IBS, the influence of abuse on gastrointestinal (GI) symptoms and health-related quality of life (HRQOL) and its independence from psychological symptom comorbidity has not been studied. Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life-Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms (PHQ-12), and HRQOL (SF-36). Current GI symptom severity and bother were assessed using 10-cm Visual Analog Scales. 272 ROME-defined IBS (47.6 ± 0.9 years, 81% female) and 246 non-FGID (51.6 ± 1.0 years, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse (p IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood. Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances. © 2016 John Wiley & Sons Ltd.

Adjuvant sequential chemo and radiotherapy improves the oncological outcome in high risk endometrial cancer

Science.gov (United States)

Signorelli, Mauro; Lissoni, Andrea Alberto; De Ponti, Elena; Grassi, Tommaso; Ponti, Serena

2015-01-01

Objective Evaluation of the impact of sequential chemoradiotherapy in high risk endometrial cancer (EC). Methods Two hundred fifty-four women with stage IB grade 3, II and III EC (2009 FIGO staging), were included in this retrospective study. Results Stage I, II, and III was 24%, 28.7%, and 47.3%, respectively. Grade 3 tumor was 53.2% and 71.3% had deep myometrial invasion. One hundred sixty-five women (65%) underwent pelvic (+/- aortic) lymphadenectomy and 58 (22.8%) had nodal metastases. Ninety-eight women (38.6%) underwent radiotherapy, 59 (23.2%) chemotherapy, 42 (16.5%) sequential chemoradiotherapy, and 55 (21.7%) were only observed. After a median follow-up of 101 months, 78 women (30.7%) relapsed and 91 women (35.8%) died. Sequential chemoradiotherapy improved survival rates in women who did not undergo nodal evaluation (disease-free survival [DFS], p=0.040; overall survival [OS], p=0.024) or pelvic (+/- aortic) lymphadenectomy (DFS, p=0.008; OS, p=0.021). Sequential chemoradiotherapy improved both DFS (p=0.015) and OS (p=0.014) in stage III, while only a trend was found for DFS (p=0.210) and OS (p=0.102) in stage I-II EC. In the multivariate analysis, only age (≤65 years) and sequential chemoradiotherapy were statistically related to the prognosis. Conclusion Sequential chemoradiotherapy improves survival rates in high risk EC compared with chemotherapy or radiotherapy alone, in particular in stage III. PMID:26197768

Expression of CD44v6 and Its Association with Prognosis in Epithelial Ovarian Carcinomas

Directory of Open Access Journals (Sweden)

Dang-xia Zhou

2012-01-01

Full Text Available The aim of this study was to evaluate CD44v6 protein expression and its prognostic value of CD44v6 in ovarian carcinoma. The expression of CD44v6 was analyzed in 62 patients with ovarian carcinoma by immunohistochemical method. The data obtained were analyzed by univariate and multivariate analyses. The present study clearly demonstrates that tumor tissues from 41 (66.1% patients showed positive expression with CD44v6. The expression of CD44v6 was significantly correlated with histological type, FIGO stage and histological grade of ovarian carcinomas. Concerning the prognosis, the survival period of patients with CD44v6 positive was shorter than that of patients with CD44v6 negative (36.6% versus 66.7%, 5-year survival, P<0.05. Univariate analysis showed that CD44v6 expression, histological type, FIGO stage and histological grade were associated with 5-year survival, and CD44v6 expression was associated with histological type, FIGO stage and histological grade and 5-year survival. In multivariate analysis, using the COX-regression model, CD44v6 expression was important prognostic factor. In conclusion, these results suggest that CD44v6 may be related to histological type, FIGO stage and histological grade of ovarian carcinomas, and CD44v6 may be an important molecular marker for poor prognosis in ovarian carcinomas.

Postoperative vaginal cuff irradiation using high dose rate remote afterloading: a Phase II clinical protocol

International Nuclear Information System (INIS)

Noyes, William R.; Bastin, Kenneth; Edwards, Scott A.; Buchler, Dolores A.; Stitt, Judith A.; Thomadsen, Bruce R.; Fowler, Jack F.; Kinsella, Timothy J.

1995-01-01

Purpose: In September 1989, a postoperative Phase II high dose rate (HDR) brachytherapy protocol was started for International Federation of Gynecology and Obstetrics (FIGO) Stage I endometrial adenocarcinoma. This review reports the overall survival, local control, and complication rates for the initial 63 patients treated in this Phase II study. Methods and Materials: High dose rate brachytherapy was delivered using an Iridium-192 HDR remote afterloader. Sixty-three patients were entered into the Phase II protocol, each receiving two vaginal cuff treatments 1 week apart (range 4-12 days) with vaginal ovoids (diameter 2.0-3.0 cm). No patient received adjuvant external beam radiation. A dose of 32.4 Gy in two fractions was prescribed to the ovoid surface in 63 patients. The first three patients treated at our institution received 15, 16.2, and 29 Gy, respectively, to determine acute effects. Results: At a median follow-up of 1.6 years (range 0.75-4.3 years) no patient has developed a vaginal cuff recurrence. One regional recurrence (1.6%) occurred at 1.2 years at the pelvic side wall. This patient is alive and without evidence of disease 7 months after completion of salvage irradiation, which resulted in the only vaginal stenosis (1.6%). Fourteen patients (22%) experienced vaginal apex fibrosis by physical exam, which was clinically symptomatic in four patients. Two patients reported stress incontinence; however, these symptoms were noted prior to their HDR therapy. One patient died 2.4 years after HDR therapy due to cardiovascular disease without evidence of cancer at autopsy. Conclusion: Preliminary results of our phase II HDR vaginal cuff protocol for postoperative FIGO Stage IA, Grade 3 or Stage IB, Grade 1-2 patients demonstrate that 32.4 Gy in two fractions is well tolerated by the vaginal cuff mucosa. Local control appears comparable to our prior experience and others with low dose rate (LDR) brachytherapy. Additional patient accrual and further follow

Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women.

Science.gov (United States)

Mykletun, Arnstein; Jacka, Felice; Williams, Lana; Pasco, Julie; Henry, Margaret; Nicholson, Geoffrey C; Kotowicz, Mark A; Berk, Michael

2010-08-05

Irritable bowel syndrome (IBS) is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising self-report screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview. Data were derived from a population-based epidemiological study (n = 1077). Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) and the General Health Questionnaire (GHQ-12). Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health. Current IBS (n = 69, 6.4%) was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 - 4.60). Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12) followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity. IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.

Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS. An epidemiological population based study of women

Directory of Open Access Journals (Sweden)

Mykletun Arnstein

2010-08-01

Full Text Available Abstract Background Irritable bowel syndrome (IBS is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising self-report screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview. Methods Data were derived from a population-based epidemiological study (n = 1077. Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP and the General Health Questionnaire (GHQ-12. Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health. Results Current IBS (n = 69, 6.4% was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 - 4.60. Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12 followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity. Conclusions IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.

[Synthesis of exo-β-glucosaminidase BY FUNGUS Penicillium sp. IB-37-2].

Science.gov (United States)

Aktuganov, G E; Galimzyanova, N F; Teregulova, G A; Melentjev, A I

2016-01-01

A new strain Penicillium sp. IB-37-2, which actively hydrolyzes chitosan (SD ∼80–85%) but possesses low activity against colloidal chitin, was isolated. The fungus was observed to have a high level chitosanase biosynthesis (1.5–3.0 U/mL) during submerged cultivation at 28°C, with a pH of 3.5–7.0 and 220 rpm in nutrient media containing chitosan or chitin from shells of crabs. Purification of the chitosanase enzyme complex from Penicillium sp. IB-37-2 by ultrafiltration and hydrophobic chromatography, followed by denaturing electrophoresis, revealed two predominant proteins with molecular weights of 89 and 41 kDa. The purified enzyme complex demonstrated maximal activity (maximal rate of hydrolysis of dissolved chitosan) and stability at 50–55°C and a pH of 3.5–4.0. The enzyme preparation also hydrolyzed laminarin, β-(1,3)-(1,4)-glycan, and colloidal chitin. Exohydrolysis of chitosan by the preparation isolated from Penicillium sp. IB-37-2 resulted in the formation of single product, D-glucosamine.

Carcinoma invasor de cérvix en Las Palmas : tipificación del virus del papiloma humano (VPH) y factores pronósticos

OpenAIRE

Arencibia Sánchez, Octavio

2015-01-01

Programa de doctorado: Patología Quirúrgica, Reproducción humana y factores psicológicos y el proceso de enfermar Estudio retrospectivo destinado a estudiar los carcinomas infiltrantes de cérvix (estadio FIGO IB y superiores) registrados en la Unidad de Ginecología Oncológica del Complejo Hospitalario Universitario Materno Infantil entre los años 1996 y 2013. El tamaño muestral final fue de 561 pacientes, de las que se contaba con material disponible para el genotipado viral, lo que supon...

Al-Shāṭibīs sufismekritik:

DEFF Research Database (Denmark)

Riexinger, Martin Thomas

2016-01-01

The faqīh (Islamic legal scholar) al-Shāṭibī (d. 1388) from Granada is primarily known for his innovative approach within the field of legal theory (uṣūl al-fiqh). However, he dedicated much attention to the criticism of sufism. But like other Islamic scholars who opposed Sufism he did...

Radiation therapy for early stage Hodgkin's disease: Australasian patterns of care

Energy Technology Data Exchange (ETDEWEB)

Barton, Michael; Boyages, John; Crennan, Elizabeth; Davis, Sidney; Fisher, Richard J; Hook, Carolyn; Johnson, Neva; Joseph, David; Liew, Kuen H; Morgan, Graeme; O' Brien, Peter; Pendlebury, Sue; Pratt, Gary; Quong, George; Thornton, Deborah; Walker, Quenten; Wallington, Margaret; Trotter, Grant

1995-01-15

Purpose: Analysis of treatment outcome for Stage I-IIA supradiaphragmatic Hodgkin's disease treated solely by irradiation in Australia and New Zealand. Methods and Materials: Patients with supradiaphragmatic Hodgkin's disease only who were treated by irradiation alone with curative intent between 1969 to 1988 were retrospectively reviewed. Ten radiation oncology departments in Australia and New Zealand contributed patient data to the study. Patient, tumor, and treatment variables were recorded. Disease-free interval, survival, and complications were analyzed. Results: Eight hundred and twenty patients were reviewed. The median age was 29 years. There were 437 men and 383 women. The distribution of 310 clinically staged patients was 170 stage IA, 5 IB, and 135 IIA. Five hundred and ten patients received laparotomies, and pathologic staging was as follows: IA 214, IB 13, IIA 283. The 10-year acturial disease-free rate was 69% and overall survival rate was 79%. Increasing age, male sex, higher number of involved sites, the use of involved field irradiation, no staging laparotomy, and earlier year of treatment were significantly associated with an increased risk of relapse and lower survival. Actuarial 10-year survival following recurrence was 48%. Acute complications requiring interruption to treatment occurred in 46 patients (6%), but < 1% had their treatment permanently suspended. Actuarial complication rates at 10 years were: cardiac 2%, pulmonary 3% and thyroid 5%. There were 44 second malignancies including 10 non-Hodgkin's lymphomas, 3 leukemias, 7 lung, and 6 breast cancers. Mean delay to the development of a second cancer was 6 years. The 10-year actuarial rate of second malignancy was 5%. Conclusions: The Australasian experience of early stage Hodgkin's disease is consistent with the results in the published literature and confirms that irradiation produces a high cure rate with minimal toxicity.

Radiation therapy for early stage Hodgkin's disease: Australasian patterns of care

International Nuclear Information System (INIS)

Barton, Michael; Boyages, John; Crennan, Elizabeth; Davis, Sidney; Fisher, Richard J.; Hook, Carolyn; Johnson, Neva; Joseph, David; Liew, Kuen H.; Morgan, Graeme; O'Brien, Peter; Pendlebury, Sue; Pratt, Gary; Quong, George; Thornton, Deborah; Walker, Quenten; Wallington, Margaret; Trotter, Grant

1995-01-01

Purpose: Analysis of treatment outcome for Stage I-IIA supradiaphragmatic Hodgkin's disease treated solely by irradiation in Australia and New Zealand. Methods and Materials: Patients with supradiaphragmatic Hodgkin's disease only who were treated by irradiation alone with curative intent between 1969 to 1988 were retrospectively reviewed. Ten radiation oncology departments in Australia and New Zealand contributed patient data to the study. Patient, tumor, and treatment variables were recorded. Disease-free interval, survival, and complications were analyzed. Results: Eight hundred and twenty patients were reviewed. The median age was 29 years. There were 437 men and 383 women. The distribution of 310 clinically staged patients was 170 stage IA, 5 IB, and 135 IIA. Five hundred and ten patients received laparotomies, and pathologic staging was as follows: IA 214, IB 13, IIA 283. The 10-year acturial disease-free rate was 69% and overall survival rate was 79%. Increasing age, male sex, higher number of involved sites, the use of involved field irradiation, no staging laparotomy, and earlier year of treatment were significantly associated with an increased risk of relapse and lower survival. Actuarial 10-year survival following recurrence was 48%. Acute complications requiring interruption to treatment occurred in 46 patients (6%), but < 1% had their treatment permanently suspended. Actuarial complication rates at 10 years were: cardiac 2%, pulmonary 3% and thyroid 5%. There were 44 second malignancies including 10 non-Hodgkin's lymphomas, 3 leukemias, 7 lung, and 6 breast cancers. Mean delay to the development of a second cancer was 6 years. The 10-year actuarial rate of second malignancy was 5%. Conclusions: The Australasian experience of early stage Hodgkin's disease is consistent with the results in the published literature and confirms that irradiation produces a high cure rate with minimal toxicity

BK polyomavirus genotypes Ia and Ib1 exhibit different biological properties in renal transplant recipients.

Science.gov (United States)

Varella, Rafael B; Zalona, Ana Carolina J; Diaz, Nuria C; Zalis, Mariano G; Santoro-Lopes, Guilherme

2018-01-02

BK polyomavirus (BKV) is an opportunist agent associated with nephropathy (BKVAN) in 1-10% of kidney transplant recipients. BKV is classified into genotypes or subgroups according to minor nucleotidic variations with unknown biological implications. Studies assessing the possible association between genotypes and the risk of BKVAN in kidney transplant patients have presented conflicting results. In these studies, genotype Ia, which is highly prevalent in Brazil, was less frequently found and, thus, comparative data on the biological properties of this genotype are lacking. In this study, BKV Ia and Ib1 genotypes were compared according to their viral load, genetic evolution (VP1 and NCCR) - in a cohort of renal transplant recipients. The patients infected with Ia (13/23; 56.5%) genotype exhibited higher viral loads in urine [>1.4 log over Ib1 (10/23; 43.5%); p=0.025]. In addition, genotype Ia was associated with diverse mutations at VP1 loops and sites under positive selection outside loops, which were totally absent in Ib1. Although the number of viremic patients was similar, the three patients who had BK nephropathy (BKVAN) were infected with Ia genotype. NCCR architecture (ww or rr) were not distinctive between Ia and Ib1 genotypes. Ia genotype, which is rare in other published BKV cohorts, presented some diverse biological properties in transplanted recipients in comparison to Ib1. Copyright © 2017 Elsevier B.V. All rights reserved.

Differential protective effects of immune lymphoid cells against transplanted line Ib leukemia and immune polioencephalomyelitis

International Nuclear Information System (INIS)

Duffey, P.S.; Lukasewycz, O.A.; Olson, D.S.; Murphy, W.H.

1978-01-01

The capacity of immune cells obtained from the major lymphoid compartments to protect C58 mice from transplanted line Ib leukemia, and from an age-dependent autoimmune CNS disease (immune polioencephalomyelitis = IPE) elicited by immunizing old C58 mice with inactivated Ib cells was quantified. Cells used for comparative adoptive protection tests were harvested from the major lymphoid compartments 14 to 15 days after young C58 mice were immunized with inactivated Ib cell preparations. Regression curves were plotted from survival data and the log 10 PD 50 values were determined. Immune spleen (ISC) and peritoneal cells (IPEC) were significantly more protective against transplanted Ib cells than immune lymph node (ILNC), thymic (ITC), and marrow cells (IMC). In contrast, IPEC and IMC were not protective against IPE and ITC were only marginally protective. ILNC afforded significant protection to transplantable leukemia but were only marginally protective to IPE. When ISC were treated with anti-thy 1.2 serum and complement, protection against transplanted leukemia and IPE was reduced > 99%. When donors of immune lymphoid cells were treated with 12.5 mg of cortisone acetate daily for 2 days before lymphoid cells were harvested, protection against transplanted Ib cells by ISC was reduced by approximately 90% whereas protection against IPE was totally eliminated. Considered together, these results indicate that the protective mechanisms to transplantable leukemia and IPE differ significantly in the same indicator mouse strain

Primary radiotherapy of stage IIA/B-IIIB cervical carcinoma. A comparison of continuous versus sequential regimens

International Nuclear Information System (INIS)

Mayer, A.; Nemeskeri, C.; Petnehazi, C.; Varga, S.; Naszaly, A.; Borgulya, G.

2004-01-01

Background: comprehensive literature on cervical cancer demonstrates, even today, the need for optimization of the timing of external-beam radiotherapy (EBRT) and high-dose-rate brachytherapy (HDR-BT) in the treatment of stage IIA/B-IIIB cervical carcinoma. Patients and methods: 210 patients with carcinoma of the cervix were treated in the Municipal Center of Oncoradiology between January 1991 and December 1996 (FIGO IIA: n = 10, FIGO IIB: n = 113, and FIGO IIIB: n = 87). Two regimens were compared: sequential radiation therapy (SRT) with 4 x 8 Gy HDR-BT to point A followed by EBRT, and continuous radiation therapy (CRT) in which 5 x 6 Gy HDR-BT to point A, one session per week, was integrated into the EBRT. A total dose of 68-70 Gy to point A and 52-54 Gy to point B was given in EBRT with SRT, five fractions per week were applied. Four fractions per week were applied in CRT, i.e., no EBRT was performed on the day of HDR-BT. Total doses to points A and B were identical in both regimens. Overall treatment time (OTT) amounted to 56 days for SRT and 35 days for CRT. Median follow-up time was 3.4 (2.5-4.2) years. Results: progression-free 5-year-survival (PFS) was 71% in the CRT and 56% in the SRT group. Nevertheless, this difference was not statistically significant (p = 1.00), and the same was found in a subgroup analysis of the different tumor stages, showing, however, an unequivocal trend. Late bladder and rectal injuries occurred in 13% and 25%, respectively. Late rectal injuries were significantly more frequent with SRT than CRT (35 patients in the SRT and 18 patients in the CRT group; p = 0.037). This was due to the higher doses per fraction of HDR-BT in the SRT group. No difference was found regarding late bladder injuries (p = 0.837). Conclusion: for the patients included in this study, no advantage has been found so far in using CRT, i.e., shortening the OTT by weekly integration of HDR-BT into EBRT. Nevertheless, an obvious trend exists. The dose of 8 Gy per

Ação de fungos entomopatogênicos em larvas e adultos da mosca do figo Zaprionus indianus (Diptera: Drosophilidae Action of entomopathogenic fungi on the larvae and adults of the fig fly Zaprionus indianus (Diptera: Drosophilidae

Directory of Open Access Journals (Sweden)

Virgínia Michelle Svedese

2012-11-01

Full Text Available A mosca do figo, Zaprionus indianus, vem se disseminando no Brasil e causou nos últimos anos perdas de até 50% na produção de figos. Uma alternativa viável de controle desta mosca pode ser a utilização de fungos entomopatogênicos. Este trabalho foi conduzido em laboratório (27±1°C, UR 70±10% e fotoperíodo de 12h para avaliar a suscetibilidade dos estágios de larva e adulto de Z. indianus a cinco concentrações (10(8 a 10(4 conídios mL-1 de B. bassiana (URM2915; ESALQ447 e M. anisopliae (URM3349; URM4403. Não houve mortalidade larval e o período de pré-pupa não sofreu alteração em relação ao grupo controle, já o estágio de pupa foi aumentado em até três dias quando se utilizou B. bassiana. A emergência de adultos diminuiu em relação ao grupo controle: 10,6% quando as larvas foram tratadas com a maior concentração de B. bassiana URM2916 e 2,0% com M. anisopliae URM4403. No bioensaio com adultos, a mortalidade máxima atingiu 98,7% com B. bassiana e 100,0% com M. anisopliae. Os menores valores da CL50 foram de 1,09x10(5 conídios mL-1 para B. bassiana URM2916 e de 1,94x10(4 conídios mL-1 para M. anisopliae URM4403. O tempo letal médio (TL50 variou de 4,5 a 6,12 dias. Os resultados demonstraram que ambos os fungos são eficientes e mostram ser promissores agentes biocontroladores da mosca do figo, com destaque para M. anisopliae URM4403.The "fig fly", Zaprionus indianus, has spread by in Brazil and in recent years and has caused losses of up to 50% in the production of figs. A viable alternative to control this fly may be the use of entomopathogenic fungi such. The present study was developed in laboratory (27±1°C, RH 70±10% and 12h photoperiod, to assess the susceptibility of larval and adult stages of Z. indianus to five concentrations (10(8 to 10(4 conidia mL-1 of B. bassiana (URM2915; ESALQ447 and M. anisopliae (URM3349; URM4403. There was no larval mortality and the pre-pupal period did not change compared

A new method using insert-based systems (IBS) to improve cell behavior study on flexible and rigid biomaterials

OpenAIRE

Grenade, Charlotte; Moniotte, Nicolas; Rompen, Eric; Vanheusden, Alain; Mainjot, Amélie; De Pauw-Gillet, Marie-Claire

2016-01-01

In vitro studies about biomaterials biological properties are essential screening tests. Yet cell cultures encounter difficulties related to cell retention on material surface or to the observation of both faces of permeable materials. The objective of the present study was to develop a reliable in vitro method to study cell behavior on rigid and flexible/permeable biomaterials elaborating two specific insert-based systems (IBS-R and IBS-F respectively). IBS-R was designed as a specific cylin...

Platelet apoptosis by cld-induced glycoportein Ibα clustering

DEFF Research Database (Denmark)

van der Wal, Dianne E; Du, V X; Lo, KS

2010-01-01

Summary Background:  Cold-storage of platelets followed by rewarming induces changes in Glycoprotein (GP) Ibα-distribution indicative of receptor clustering and initiates thromboxane A2-formation. GPIbα is associated with 14-3-3 proteins, which contribute to GPIbα-signaling and in nucleated cells...

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Directory of Open Access Journals (Sweden)

Yijie Li

2017-01-01

Conclusion: These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation, cell growth, apoptosis, stress granule formation, immune activation, loss of epithelial cell integrity, and visceral hypersensitivity.

MiR-144 Increases Intestinal Permeability in IBS-D Rats by Targeting OCLN and ZO1

Directory of Open Access Journals (Sweden)

Qiuke Hou

2017-12-01

Full Text Available Background/Aims: Irritable bowel syndrome with diarrhoea (IBS-D is a chronic, functional bowel disorder characterized by abdominal pain or diarrhoea and altered bowel habits, which correlate with intestinal hyperpermeability. MicroRNAs (miRNAs are involved in regulating intestinal permeability in IBS-D. However, the role of miRNAs in regulating intestinal permeability and protecting the epithelial barrier remains unclear. Our goals were to (i identify differential expression of miRNAs and their targets in the distal colon of IBS-D rats; (ii verify in vitro whether occludin (OCLN and zonula occludens 1 (ZO1/TJP1 were direct targets of miR-144 and were down-regulated in IBS-D rats; and (iii determine whether down-regulation of miR-144 in vitro could reverse the pathological hallmarks of intestinal hyperpermeability via targeting OCLN and ZO1. Methods: The IBS-D rat model was established using 4% acetic acid and evaluated by haematoxylin-eosin (HE staining. The distal colon was obtained in order to perform miRNA microarray analysis and to isolate and culture colonic epithelial cells. When differential expression of miRNA was found, the results were verified by qRT-PCR, and the target genes were further explored by bioinformatics analysis. Correlation analyses were carried out to compare the expression of miRNA and target genes. Then, mutants, miRNA mimics and inhibitors of the target genes were constructed and transfected to colonic epithelial cells. qRT-PCR, western blotting, enzyme-linked immunosorbent assays (ELISAs and dual-luciferase assays were used to investigate the expression of miR-144 and OCLN, ZO1 in IBS-D rats. Results: There were 8 up-regulated and 18 down-regulated miRNAs identified in the IBS-D rat model. Of these, miR-144 was markedly up-regulated and resulted in the down-regulation of OCLN and ZO1 expression. Overexpression of miR-144 by transfection of miR-144 precursor markedly inhibited the expression of OCLN and ZO1. Further

EVALUATION OF LOW URINARY TRACT SYMPTOMS AND ERECTILE FUNCTION IN MEN WITH IRRITABLE BOWEL SYNDROME(IBS

Directory of Open Access Journals (Sweden)

Dogan Atilgan

2014-06-01

Conclusion: IBS, is a major health problem with serious psychosocial side effects and significantly reduces patients quality of life. LUTS and ED may be seen frequently in patients with IBS. Therefore, during menagement of these patients multydiciplinary assesment should be kept in mind. [J Contemp Med 2014; 4(2.000: 64-68

Radiotherapy Results of Early Uterine Cervix Cancer

International Nuclear Information System (INIS)

Choi, Doo Ho; Huh, Seung Jae

1996-01-01

Purpose : This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. Methods and Materials : Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months. and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy. Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. Results : Overall 5 year survival rate and relapse free survival rate were 72.3%, and 72.8% respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months. Late complication rate of bladder and rectum were 8.8%, 15% respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. Conclusion : These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients, To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed

A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D.

Science.gov (United States)

Eswaran, Shanti L; Chey, William D; Han-Markey, Theresa; Ball, Sarah; Jackson, Kenya

2016-12-01

There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients. This was a single-center, randomized-controlled trial of adult patients with IBS-D (Rome III) which compared 2 diet interventions. After a 2-week screening period, eligible patients were randomized to a low FODMAP or mNICE diet for 4 weeks. The primary end point was the proportion of patients reporting adequate relief of IBS-D symptoms ≥50% of intervention weeks 3-4. Secondary outcomes included a composite end point which required response in both abdominal pain (≥30% reduction in mean daily pain score compared with baseline) and stool consistency (decrease in mean daily Bristol Stool Form of ≥1 compared with baseline), abdominal pain and stool consistency responders, and other key individual IBS symptoms assessed using daily questionnaires. After screening, 92 subjects (65 women, median age 42.6 years) were randomized. Eighty-four patients completed the study (45 low FODMAP, 39 mNICE). Baseline demographics, symptom severity, and nutrient intake were similar between groups. Fifty-two percent of the low FODMAP vs. 41% of the mNICE group reported adequate relief of their IBS-D symptoms (P=0.31). Though there was no significant difference in the proportion of composite end point responders (P=0.13), the low FODMAP diet resulted in a higher proportion of abdominal pain responders compared with the mNICE group (51% vs. 23%, P=0.008). Compared with baseline scores, the low FODMAP diet led to greater reductions in average daily scores of abdominal pain, bloating

Myasthenia gravis in a patient affected by glycogen storage disease type Ib: a further manifestation of an increased risk for autoimmune disorders?

Science.gov (United States)

Melis, D; Balivo, F; Della Casa, R; Romano, A; Taurisano, R; Capaldo, B; Riccardi, G; Monsurrò, M R; Parenti, G; Andria, G

2008-12-01

Glycogen storage disease type Ib (GSD Ib, OMIM 232220) is an inborn disorder of glucose metabolism, caused by mutations in the G6PT gene, encoding a glucose 6-phosphate transporter (G6PT). GSD Ib is mainly associated with fasting hypoglycaemia and hepatomegaly. Most GSD Ib patients also show neutropenia and neutrophil dysfunction and therefore are at risk of developing severe infections and inflammatory bowel disease (IBD). An increased risk for autoimmune disorders, such as thyroid autoimmunity and Crohn-like disease, has also been demonstrated, but no systematic study on the prevalence of autoimmune disorders in GSD Ib patients has ever been performed. We describe a 25-year-old patient affected by GSD Ib who developed 'seronegative' myasthenia gravis (MG), presenting with bilateral eyelid ptosis, diplopia, dysarthria, severe dysphagia, dyspnoea and fatigue. The repetitive stimulation of peripheral nerves test showed signs of exhaustion of neuromuscular transmission, particularly evident in the cranial area. Even in the absence of identifiable anti-acetylcholine receptor antibodies, seronegative MG is considered an autoimmune disorder and may be related to the disturbed immune function observed in GSD Ib patients.

Isolated port site recurrence of node-negative clinical stage IB1 cervical adenocarcinoma

Directory of Open Access Journals (Sweden)

Uma Deshmukh

2017-05-01

Conclusion: This is the first case report describing an isolated port site recurrence in a patient who underwent robotic-assisted laparoscopic surgery for early-stage cervical adenocarcinoma with negative margins and negative lymph nodes. The mechanism underlying this isolated recurrence remains unknown.

Severe radiation morbidity in carcinoma of the cervix: impact of pretherapy surgical staging and previous surgery

International Nuclear Information System (INIS)

Fine, Bruce A.; Hempling, Ronald E.; Piver, M. Steven; Baker, Trudy R.; McAuley, Michael; Driscoll, Deborah

1995-01-01

Purpose: The purpose of this study is to delineate the factors which (a) contribute to an increase in the severe, radiation induced complication rate and (b) have a significant effect on survival in patients with International Federation of Gynecologists and Obstetricians (FIGO) Stage I-IVA cervical cancer undergoing pretherapy surgical staging. Methods and Materials: From 1971-1991, 189 patients underwent pretherapy surgical staging via a retroperitoneal approach (67) or transperitoneal approach (122). Seventy-nine patients had previously experienced a laparotomy. Patients subsequently received a median of 85 Gy to point A. In patients receiving paraaortic radiation, a median of 45 Gy was administered. One hundred and thirty-two (69.8%) patients received hydroxyurea as a radiation sensitizer. Results: Pretherapy surgical evaluation revealed that 21 of 89 (23.6%) Stage II patients and 32 of 85 (37.6%) Stage III patients had paraaortic lymph node metastases. Multivariate logistic regression analysis detailed the significant factors favorably influencing the radiation-induced complication rate to be a retroperitoneal approach of pretherapy surgical staging and no previous laparotomy. Survival was significantly prolonged in patients receiving hydroxyurea, evaluated via a retroperitoneal incision, with negative paraaortic lymph nodes, and with an early stage of disease. Conclusion: A retroperitoneal approach to pretherapy surgical staging and absence of previous surgery reduced the incidence of subsequent radiation-induced complications. Despite improvements in the detection of occult disease, prolonged survival is impaired when the therapeutic measures currently available are used

Investigation of the feasibility of elective irradiation to neck level Ib using intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma: a retrospective analysis

International Nuclear Information System (INIS)

Zhang, Fan; Cheng, Yi-Kan; Li, Wen-Fei; Guo, Rui; Chen, Lei; Sun, Ying; Mao, Yan-Ping; Zhou, Guan-Qun; Liu, Xu; Liu, Li-Zhi; Lin, Ai-Hua; Tang, Ling-Long; Ma, Jun

2015-01-01

To assess the feasibility of elective neck irradiation to level Ib in nasopharyngeal carcinoma (NPC) using intensity-modulated radiation therapy (IMRT). We retrospectively analyzed 1438 patients with newly-diagnosed, non-metastatic and biopsy-proven NPC treated with IMRT. Greatest dimension of level IIa LNs (DLN-IIa) ≥ 20 mm and/or level IIa LNs with extracapsular spread (ES), oropharynx involvement and positive bilateral cervical lymph nodes (CLNs) were independently significantly associated with metastasis to level Ib LN at diagnosis. No recurrence at level Ib was observed in the 904 patients without these characteristics (median follow-up, 38.7 months; range, 1.3–57.8 months), these patients were classified as low risk. Level Ib irradiation was not an independent risk factor for locoregional failure-free survival, distant failure-free survival, failure-free survival or overall survival in low risk patients. The frequency of grade ≥ 2 subjective xerostomia at 12 months after radiotherapy was not significantly different between low risk patients who received level Ib-sparing, unilateral level Ib-covering or bilateral level Ib-covering IMRT. Level Ib-sparing IMRT should be safe and feasible for patients without a DLN-IIa ≥ 20 mm and/or level IIa LNs with ES, positive bilateral CLNs or oropharynx involvement at diagnosis. Further investigations based on specific criteria for dose constraints for the submandibular glands are warranted to confirm the benefit of elective level Ib irradiation

Recurrence in skeletal muscle from squamous cell carcinoma of the uterine cervix: a case report and review of the literature

Directory of Open Access Journals (Sweden)

Zannoni Gian

2006-06-01

Full Text Available Abstract Background The occurrence of skeletal muscle metastases is a very rare event. Only two cases of late skeletal muscle recurrence from cervical cancer have been documented until now. Case presentation A 38-year old patient, submitted to radical hysterectomy and pelvic lymphadenectomy for a squamous FIGO stage IB1 cervical carcinoma, presented after 76 months with a palpable, and painless swelling on the left hemithorax. MRI showed a nodule located in the context of the intercostal muscles. Pathology revealed the presence of metastasis of squamous cell carcinoma of similar morphology as the primary. On the basis of FDG-PET findings, which excluded other sites of disease, surgical excision of the lesion was performed. The patient was triaged to chemotherapy plus external radiotherapy. Conclusion A case of skeletal muscle recurrence from cervical cancer after a very long interval from primary diagnosis is reported. Muscular pain or weakness, or just a palpable mass in a patient with a history of cancer has always to raise the suspicion of muscle metastasis.

A Measure of Suffering in relation to Anxiety and Quality of Life in IBS Patients: Preliminary Results

Directory of Open Access Journals (Sweden)

Sanda Pletikosić Tončić

2017-01-01

Full Text Available Irritable bowel syndrome (IBS is a chronic gastrointestinal (GI disorder with a severe impact on quality of life (QoL. We explored the relationship of a visual measure of suffering, the PRISM-RII, with quality of life (QoL and anxiety measures in IBS patients. Participants were 44 IBS patients who completed several questionnaires and kept a symptom diary for two weeks. The measures used were PRISM-RII (self-illness separation (SIS; illness perception measure (IPM; IBS-36 (IBS health related QoL; SF-36 (physical and mental health related QoL; State-Trait Anxiety Inventory (STAI-T; Visceral Sensitivity Index (VSI; GI-specific anxiety; and a symptom diary. SIS was negatively correlated to VSI, while IPM was negatively correlated to SIS and the physical component of SF-36 and positively to VSI and symptom severity. We found significant differences between participants who perceive their illness as small and those who perceive it as medium in SIS, symptom severity, VSI, and the mental component of SF-36. Participants, who perceived their illness as small, represented their illness as more distant, showed lower average symptom severity, and had lower GI-specific anxiety and higher QoL. The results indicate that IPM and SIS can be useful in discriminating patients with more prominent psychological difficulties and QoL impairment.

More Accurate Definition of Clinical Target Volume Based on the Measurement of Microscopic Extensions of the Primary Tumor Toward the Uterus Body in International Federation of Gynecology and Obstetrics Ib-IIa Squamous Cell Carcinoma of the Cervix

Energy Technology Data Exchange (ETDEWEB)

Xie, Wen-Jia [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Wu, Xiao [Department of Pathology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Xue, Ren-Liang; Lin, Xiang-Ying [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Kidd, Elizabeth A. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Yan, Shu-Mei [Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province (China); Zhang, Yao-Hong [Department of Radiation Oncology, Chaozhou Hospital of Chaozhou City, Guangdong Province (China); Zhai, Tian-Tian; Lu, Jia-Yang; Wu, Li-Li; Zhang, Hao [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Huang, Hai-Hua [Department of Pathology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Chen, Zhi-Jian; Li, De-Rui [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Xie, Liang-Xi, E-mail: xieliangxi1@qq.com [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China)

2015-01-01

Purpose: To more accurately define clinical target volume for cervical cancer radiation treatment planning by evaluating tumor microscopic extension toward the uterus body (METU) in International Federation of Gynecology and Obstetrics stage Ib-IIa squamous cell carcinoma of the cervix (SCCC). Patients and Methods: In this multicenter study, surgical resection specimens from 318 cases of stage Ib-IIa SCCC that underwent radical hysterectomy were included. Patients who had undergone preoperative chemotherapy, radiation, or both were excluded from this study. Microscopic extension of primary tumor toward the uterus body was measured. The association between other pathologic factors and METU was analyzed. Results: Microscopic extension toward the uterus body was not common, with only 12.3% of patients (39 of 318) demonstrating METU. The mean (±SD) distance of METU was 0.32 ± 1.079 mm (range, 0-10 mm). Lymphovascular space invasion was associated with METU distance and occurrence rate. A margin of 5 mm added to gross tumor would adequately cover 99.4% and 99% of the METU in the whole group and in patients with lymphovascular space invasion, respectively. Conclusion: According to our analysis of 318 SCCC specimens for METU, using a 5-mm gross tumor volume to clinical target volume margin in the direction of the uterus should be adequate for International Federation of Gynecology and Obstetrics stage Ib-IIa SCCC. Considering the discrepancy between imaging and pathologic methods in determining gross tumor volume extent, we recommend a safer 10-mm margin in the uterine direction as the standard for clinical practice when using MRI for contouring tumor volume.

Nereididae (Annelida, Polychaeta colectados en las campañas “Fauna II, III, IV” (Proyecto “Fauna Ibérica” y catálogo de las especies conocidas para el ámbito ibérico

Directory of Open Access Journals (Sweden)

Núñez, Jorge

2002-06-01

Full Text Available A check-list of 19 polychaetes species belonging to the family Nereididae is made, from the material collected during the Cruises “Fauna Ibérica II, III and IV”. Of these, data on the sampling stations are given. As a result of the identification of nereidid specimens, three new records for the Iberian Peninsula were found, Ceratonereis vittata Langerhans, 1884, Neanthes rubicunda (Ehlers, 1864 and Nereis perivisceralis Claparède, 1864. An updated catalogue is also presented, with the 36 nereidid species known for the Iberian Peninsula.

Se confecciona una lista de 19 especies de poliquetos pertenecientes a la familia Nereididae, a partir del material colectado en las campañas oceanográficas “Fauna Ibérica II, III y IV”. De éstas, se aportan datos sobre las estaciones de muestreo. De todo el material identificado son nuevas citas para la Península Ibérica tres especies: Ceratonereis vittata Langerhans, 1884, Neanthes rubicunda (Ehlers, 1864 y Nereis perivisceralis Claparède, 1864. También se aporta un catálogo actualizado de los neréididos conocidos para la Península Ibérica compuesto por 36 especies.

Reports of "satisfactory relief" by IBS patients receiving usual medical care are confounded by baseline symptom severity and do not accurately reflect symptom improvement.

Science.gov (United States)

Whitehead, William E; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; VonKorff, Michael; Turner, Marsha

2006-05-01

Treatment trials for irritable bowel syndrome (IBS) usually define a responder as a patient who reports satisfactory relief or adequate relief of symptoms at the end of the trial. However, these measures have not been adequately validated. (1) Compare a binary satisfactory relief measure to alternative ways of defining a treatment responder. (2) Determine whether baseline IBS symptom severity or psychological distress influence the sensitivity of these outcome measures. A total of 350 patients (81% females, average age 50 yr) who had a medical diagnosis of IBS and satisfied Rome II criteria, were recruited from Group Health Cooperative of Puget Sound. At baseline the Irritable Bowel Severity Scale (IBSS) was used to assess symptom severity and to classify patients as mild, moderate, or severe. Psychological distress and IBS-specific quality of life (IBS-QOL) were also assessed. After 6 months treatment with standard medical care, IBSS and IBS-QOL were reassessed, and patients were asked whether they had experienced satisfactory relief and whether they were somewhat or markedly better. Initial severity of IBS significantly affected the proportion who reported satisfactory relief (mild, 72%; moderate, 53%; severe, 44%) and the proportion who were somewhat or markedly better (mild, 62%; moderate, 44%; severe, 38%), but did not affect the proportion with a 50% reduction in symptoms (mild, 26%; moderate, 25%; severe, 23%). Although mild patients were the most likely to report satisfactory relief, they showed no average decrease in symptom severity or improvement in IBS-QOL. Conversely, severe patients, who were the least likely to report satisfactory relief, had the largest reductions in IBS symptom severity and the largest improvements in IBS-QOL. Psychological distress had no significant effect on the responder rate after adjusting for IBS symptom severity. These data from a descriptive study suggest that satisfactory relief is confounded with initial IBS symptom

Loss-of-heterozygosity on chromosome 19q in early-stage serous ovarian cancer is associated with recurrent disease

Directory of Open Access Journals (Sweden)

Skirnisdottir Ingiridur

2012-09-01

Full Text Available Abstract Background Ovarian cancer is a heterogeneous disease and prognosis for apparently similar cases of ovarian cancer varies. Recurrence of the disease in early stage (FIGO-stages I-II serous ovarian cancer results in survival that is comparable to those with recurrent advanced-stage disease. The aim of this study was to investigate if there are specific genomic aberrations that may explain recurrence and clinical outcome. Methods Fifty-one women with early stage serous ovarian cancer were included in the study. DNA was extracted from formalin fixed samples containing tumor cells from ovarian tumors. Tumor samples from thirty-seven patients were analysed for allele-specific copy numbers using OncoScan single nucleotide polymorphism arrays from Affymetrix and the bioinformatic tool Tumor Aberration Prediction Suite. Genomic gains, losses, and loss-of-heterozygosity that associated with recurrent disease were identified. Results The most significant differences (p  Conclusions The results of our study indicate that presence of two aberrations in TP53 on 17p and LOH on 19q in early stage serous ovarian cancer is associated with recurrent disease. Further studies related to the findings of chromosomes 17 and 19 are needed to elucidate the molecular mechanism behind the recurring genomic aberrations and the poor clinical outcome.

Neuroimmune interactions at different intestinal sites are related to abdominal pain symptoms in children with IBS.

Science.gov (United States)

Di Nardo, G; Barbara, G; Cucchiara, S; Cremon, C; Shulman, R J; Isoldi, S; Zecchi, L; Drago, L; Oliva, S; Saulle, R; Barbaro, M R; Stronati, L

2014-02-01

Neuroimmune interactions and inflammation have been proposed as factors involved in sensory-motor dysfunction and symptom generation in adult irritable bowel syndrome (IBS) patients. In children with IBS and healthy controls, we measured ileocolonic mast cell infiltration and fecal calprotectin and evaluated the relationships between these parameters and abdominal pain symptoms and stooling pattern. Irritable bowel syndrome patients diagnosed according to Pediatric Rome III criteria and healthy controls kept a 2-week pain/stooling diary. Ileocolonic mucosal mast cells (MC) and MC in close proximity to nerve fibers (MC-NF) were identified immunohistochemically and quantified. Fecal calprotectin concentration was measured. 21 IBS patients and 10 controls were enrolled. The MC-NF count was significantly higher in the ileum (p = 0.01), right colon (p = 0.04), and left colon (p Abdominal pain intensity score correlated with ileal MC count (r(s) = 0.47, p = 0.030) and right colon MC-NF count (r(s) = 0.52, p = 0.015). In addition, children with IBS with >3 abdominal pain episodes/week had greater ileal (p = 0.002) and right colonic (p = 0.01) MC counts and greater ileal (p = 0.05) and right colonic (p = 0.016) MC-NF counts than children with less frequent pain. No relationship was found between MC and MC-NF and fecal calprotectin or stooling pattern. Mast cells-nerve fibers counts are increased in the ileocolonic mucosa of children with IBS. Mast cells and MC-NF counts are related to the intensity and frequency of abdominal pain. © 2013 John Wiley & Sons Ltd.

Phenotyping of subjects for large scale studies on patients with IBS

NARCIS (Netherlands)

Boeckxstaens, G. E.; Drug, V.; Dumitrascu, D.; Farmer, A. D.; Hammer, J.; Hausken, T.; Niesler, B.; Pohl, D.; Pojskic, L.; Polster, A.; Simren, M.; Goebel-Stengel, M.; van Oudenhove, L.; Vassallo, M.; Wensaas, K.-A.; Aziz, Q.; Houghton, L. A.

2016-01-01

Background Irritable bowel syndrome (IBS) is a complex condition with multiple factors contributing to its aetiology and pathophysiology. Aetiologically these include genetics, life-time events and environment, and physiologically, changes in motility, central processing, visceral sensitivity,

THE EFFECT OF EARLY CERVICAL CANCER DIAGNOSIS

Directory of Open Access Journals (Sweden)

Herman Haller

2018-02-01

Full Text Available Background: Treatment effectiveness and clinical outcome of patients with cervical carcinoma FIGO stage IA1 and IA2 are analyzed in three different time period at the Department of Obstetrics and Gynecology Rijeka, Croatia. Method: Retrospective analysis of the hospital chart of all cervical cancer patients between 1991 and 2005 was conducted with five-year follow up. Results: Data on cervical cancer distribution by stage and five-year survival are presented. Separately analyzed age, histology type and treatment modalities in stage FIGO IA1 and IA2 during three consecutive five-year periods are presented. Conclusions: Conservative surgical approach – conization alone in stage IA1 of the squamous cell car- cinoma is reasonable and safe treatment option for reproductive active women. During observed periods conization became the most used surgical technique applied in almost two third of FIGO IA1 cervical cancer patients. Lymph vascular space invasion in stage IA1 lead to adjunct pelvic lymphadenectomy with unclear clinical benefit. In cervical cancer patients stage IA2 simple hysterectomy and pelvic lymphadenectomy could be accepted as a standard treatment. In these patients further studies are recommended to evaluate other less radical surgical techniques – simple and radical trachelectomy with or without pelvic lymphadenectomy. Radical hysterectomy in both stages IA1 and IA2, based on personal experience and literature data represents a surgical overtreatment and should be abandoned.

STRATEGI PEMASARAN TERHADAP PENJUALAN PRODUK TABUNGAN IB HASANAH DI PT. BANK NEGARA INDONESIA SYARIAH KANTOR CABANG JAKARTA BARAT

Directory of Open Access Journals (Sweden)

Raden Ajeng Entaresmen

2017-02-01

Full Text Available BNI Syariah branch office in West Jakarta has one of funding products that Savings iB Hasanah useful for pure investment vehicles Shariah compliance, where customers can make deposits and withdrawals of cash very easily. In marketing this product, BNI Syariah use 2 pattern to implement a marketing strategy that intensification patterns for customers who already have a product BNI Syariah and extension patterns for prospective customers at other banks that have not used that product at BNI Syariah. Besides, in general BNI Syariah has some marketing strategies that include 9P is Process, People, Product, Price, Place, Promotion, Partners, Presentation, and Passion. Employees who are experts in marketing their products to barriers such as the lack of make Savings iB Hasanah customers, how to services and lack of staff was quick to respond, competition between conventional banks and Islamic banks BNI Syariah office supplies in some areas. Keywords : Marketing strategy, Savings iB Hasanah, Product marketing barriers savings iB Hasanah

The Rhizoctonia solani AG1-IB (isolate 7/3/14 transcriptome during interaction with the host plant lettuce (Lactuca sativa L..

Directory of Open Access Journals (Sweden)

Bart Verwaaijen

Full Text Available The necrotrophic pathogen Rhizoctonia solani is one of the most economically important soil-borne pathogens of crop plants. Isolates of R. solani AG1-IB are the major pathogens responsible for bottom-rot of lettuce (Lactuca sativa L. and are also responsible for diseases in other plant species. Currently, there is lack of information regarding the molecular responses in R. solani during the pathogenic interaction between the necrotrophic soil-borne pathogen and its host plant. The genome of R. solani AG1-IB (isolate 7/3/14 was recently established to obtain insights into its putative pathogenicity determinants. In this study, the transcriptional activity of R. solani AG1-IB was followed during the course of its pathogenic interaction with the host plant lettuce under controlled conditions. Based on visual observations, three distinct pathogen-host interaction zones on lettuce leaves were defined which covered different phases of disease progression on tissue inoculated with the AG1-IB (isolate 7/3/14. The zones were defined as: Zone 1-symptomless, Zone 2-light brown discoloration, and Zone 3-dark brown, necrotic lesions. Differences in R. solani hyphae structure in these three zones were investigated by microscopic observation. Transcriptional activity within these three interaction zones was used to represent the course of R. solani disease progression applying high-throughput RNA sequencing (RNA-Seq analysis of samples collected from each Zone. The resulting three transcriptome data sets were analyzed for their highest expressed genes and for differentially transcribed genes between the respective interaction zones. Among the highest expressed genes was a group of not previously described genes which were transcribed exclusively during early stages of interaction, in Zones 1 and 2. Previously described importance of up-regulation in R. solani agglutinin genes during disease progression could be further confirmed; here, the corresponding genes

The Rhizoctonia solani AG1-IB (isolate 7/3/14) transcriptome during interaction with the host plant lettuce (Lactuca sativa L.).

Science.gov (United States)

Verwaaijen, Bart; Wibberg, Daniel; Kröber, Magdalena; Winkler, Anika; Zrenner, Rita; Bednarz, Hanna; Niehaus, Karsten; Grosch, Rita; Pühler, Alfred; Schlüter, Andreas

2017-01-01

The necrotrophic pathogen Rhizoctonia solani is one of the most economically important soil-borne pathogens of crop plants. Isolates of R. solani AG1-IB are the major pathogens responsible for bottom-rot of lettuce (Lactuca sativa L.) and are also responsible for diseases in other plant species. Currently, there is lack of information regarding the molecular responses in R. solani during the pathogenic interaction between the necrotrophic soil-borne pathogen and its host plant. The genome of R. solani AG1-IB (isolate 7/3/14) was recently established to obtain insights into its putative pathogenicity determinants. In this study, the transcriptional activity of R. solani AG1-IB was followed during the course of its pathogenic interaction with the host plant lettuce under controlled conditions. Based on visual observations, three distinct pathogen-host interaction zones on lettuce leaves were defined which covered different phases of disease progression on tissue inoculated with the AG1-IB (isolate 7/3/14). The zones were defined as: Zone 1-symptomless, Zone 2-light brown discoloration, and Zone 3-dark brown, necrotic lesions. Differences in R. solani hyphae structure in these three zones were investigated by microscopic observation. Transcriptional activity within these three interaction zones was used to represent the course of R. solani disease progression applying high-throughput RNA sequencing (RNA-Seq) analysis of samples collected from each Zone. The resulting three transcriptome data sets were analyzed for their highest expressed genes and for differentially transcribed genes between the respective interaction zones. Among the highest expressed genes was a group of not previously described genes which were transcribed exclusively during early stages of interaction, in Zones 1 and 2. Previously described importance of up-regulation in R. solani agglutinin genes during disease progression could be further confirmed; here, the corresponding genes exhibited

Colm Tóibín and Post-Nationalist Ireland: Redefining Family Through Alterity

Directory of Open Access Journals (Sweden)

José Carregal-Romero

2012-03-01

Full Text Available In nationalist Ireland, definitions of family have traditionally followed a hetero-normative and sexist pattern whereby husbands and wives fulfilled deeply unequal roles. Moreover, the notion of family has been too often idealized as a site of peace and unconditional love, its members being united by unbreakable bonds of mutual affection. In Colm Tóibín’s fiction, “traditional” families tend to be dysfunctional and the relations between their members become strained because of emotional distance, regrets and distrust. However, Tóibín’s protagonists do find their sense of home and domesticity outside the traditional parameters of family. In this regard, this paper intends to analyze the manner in which Tóibín de-stabilizes canonical definitions through his revisionist agenda and his inscription of alternative forms of family. In order to shed light on these points, I shall refer to his novels The South (1990, The Heather Blazing (1992, The Blackwater Lightship (1999 and his short stories “A Long Winter” (Mothers and Sons, 2006, “Two Women” and “The Street” (The Empty Family, 2010.

Revisión de epigrafía Ibérica turolense

Directory of Open Access Journals (Sweden)

Ignacio SIMÓN CORNAGO

2012-07-01

Full Text Available El objetivo de este artículo es revisar varias inscripciones ibéricas procedentes de tres yacimientos de la provincia de Teruel: un grafito grabado sobre un adobe de San Antonio de Calaceite, recuperado en las excavaciones de Juan Cabré y que se conserva en el Museo Arqueológico de Barcelona; una posible inscripción bilingüe de Azaila, incisa sobre un pequeño canto rodado, actualmente perdido y que presenta una notable similitud con otro descubierto en La Moleta dels Frares (Castellón; y, finalmente, dos estelas de La Iglesuela del Cid, reutilizadas como material de construcción en la ermita de Nuestra Señora del Cid, donde también se conservan una tercera inscripción ibérica y un conjunto de epígrafes latinos.

Primary Carcinosarcoma of Ovary an Unusual Tumor Case Report ...

African Journals Online (AJOL)

radiotherapy and chemotherapy or chemotherapy alone.[2]. These tumors are .... stage of disease.[6]. The adverse prognostic factors as enumerated by various ... The effect of epithelial and stromal tumor components on. FIGO stages III and IV ...

Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis.

Science.gov (United States)

Chakiath, Rosemary J; Siddall, Philip J; Kellow, John E; Hush, Julia M; Jones, Mike P; Marcuzzi, Anna; Wrigley, Paul J

2015-12-10

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. While abdominal pain is a dominant symptom of IBS, many sufferers also report widespread hypersensitivity and present with other chronic pain conditions. The presence of widespread hypersensitivity and extra-intestinal pain conditions suggests central nervous dysfunction. While central nervous system dysfunction may involve the spinal cord (central sensitisation) and brain, this review will focus on one brain mechanism, descending pain modulation. We will conduct a comprehensive search for the articles indexed in the databases Ovid MEDLINE, Ovid Embase, Ovid PsycINFO and Cochrane Central Register of Controlled Trial (CENTRAL) from their inception to August 2015, that report on any aspect of descending pain modulation in irritable bowel syndrome. Two independent reviewers will screen studies for eligibility, assess risk of bias and extract relevant data. Results will be tabulated and, if possible, a meta-analysis will be carried out. The systematic review outlined in this protocol aims to summarise current knowledge regarding descending pain modulation in IBS. PROSPERO CRD42015024284.

Prognostic value of pretreatment factors in patients with locally advanced carcinoma of the uterine cervix treated by radiotherapy alone

International Nuclear Information System (INIS)

Pedersen, D.; Soegaard, H.; Overgaard, J.; Bentzen, S.M.

1995-01-01

The prognostic effect of pretreatment patient- and tumor characteristics, and the influence of radiotherapy schedule on local control, distant metastases, and crude survival were analyzed in 424 consecutive patients with FIGO stage IIB (n = 137), IIIA (n = 10), IIIB (n = 211) and IVA (n = 66) cancer of the uterine cervix. All patients were given radiotherapy alone. From 1974 and through 1977, the external and intracavitary combined radiotherapy was given continuously in 4 to 6 weeks. From 1978 and through 1983, the treatment policy was changed to split-course radiotherapy by introducing planned pauses, resulting in an overall treatment time of 10 to 12 weeks. The results were estimated by univariate actuarial- and Cox multivariate regression analyses. Multivariate analysis showed that significant adverse variables for local control were large lateral tumor diameter, young age, low hemoglobin at time of admission, many prognancies, split-course strategy, and high FIGO stage. Risk of metastases increased with decreasing hemoglobin, increasing malignancy grade and split-course treatment. Poor survival probability were related to large lateral tumor diameter, high malignancy grade and FIGO stage, low hemoglobin, split-course therapy, and adeno/adenosquamous tumor type. (orig.)

A review on the current issues and barriers of Industrialised Building System (IBS) adoption in Malaysia’s construction industry

Science.gov (United States)

Amin, M. A. Mohd; Abas, N. H.; Shahidan, S.; Rahmat, M. H.; Suhaini, N. A.; Nagapan, S.; Rahim, R. Abdul

2017-11-01

Malaysia considers the construction industry as one of the main contributors to its Gross Domestic Product (GDP). However, there are some unresolved issues arising from the ongoing and widespread adoption of the conventional method of construction such as the resultant fragmentation of the industry itself; delays in production and delivery time of unnecessary wastages and lack of sustainability practice. Malaysian Government has been continuously encouraging the industry to use, partly or if not wholly, the Industrialized Building System (IBS), which is considered to be an important part of sustainable construction initiative. IBS was introduced to Malaysia as the solution to issues related to dependencies of foreign workers, raising demand for affordable accommodations and improving image, quality and productivity of construction industry. However, the IBS adoption in Malaysia remains low. This paper presents the review of the current issues and barriers of IBS adoption in Malaysian construction industry.

Pelvic control following external beam radiation for surgical Stage I endometrial adenocarcinoma

International Nuclear Information System (INIS)

Rush, Stephen; Gal, David; Potters, Louis; Bosworth, Jay; Lovecchio, John

1995-01-01

Purpose: To determine if postoperative external pelvic radiation (EBRT), without vaginal brachytherapy, is sufficient to prevent vaginal cuff and pelvic recurrences in patients with surgical Stage I endometrial adenocarcinoma (ACA). Methods and Materials: The records of 122 patients with surgical Stage I endometrial cancer were reviewed. There were 87 patients with ACA who received EBRT alone and are the subject of this study. Their radiation records were reviewed. All patients underwent exploration, total abdominal hysterectomy, and bilateral salpingo-oophorectomy (TAH BSO), and pelvic and paraaortic lymph node sampling. They were staged according to the FIGO 1988 surgical staging system recommendations. Postoperatively, pelvic EBRT was administered by megavoltage equipment using four fields, to a total dose of 45 to 50.4 Gy. Actuarial survival and disease free survival were calculated according to Kaplan-Meier Method. Results: Twenty-seven patients with Stage IA Grade 1 or 2 ACA with less than one-third myometrial invasion, who did not receive EBRT, and eight patients with histology other than adenocarcinoma (i.e., serous papillary, mucinous, etc.) were not included in the study. For the remaining 87 patients who are in the study group, the median follow-up was 52 months (range: 12-82 months). The 5-year overall survival for these 87 patients was 92%, with a disease-free survival of 83%. There were no tumor recurrences in the upper vagina or in the pelvis. Two patients developed small bowel obstruction (no surgery required), and one patient developed chronic enteritis. Conclusion: Adjuvant external pelvic radiation, without vaginal brachytherapy, prevents pelvic and vaginal cuff recurrences in surgical Stage I endometrial ACA

Surgical staging and prognosis in serous borderline ovarian tumours (BOT): a subanalysis of the AGO ROBOT study.

Science.gov (United States)

Trillsch, F; Mahner, S; Vettorazzi, E; Woelber, L; Reuss, A; Baumann, K; Keyver-Paik, M-D; Canzler, U; Wollschlaeger, K; Forner, D; Pfisterer, J; Schroeder, W; Muenstedt, K; Richter, B; Fotopoulou, C; Schmalfeldt, B; Burges, A; Ewald-Riegler, N; de Gregorio, N; Hilpert, F; Fehm, T; Meier, W; Hillemanns, P; Hanker, L; Hasenburg, A; Strauss, H-G; Hellriegel, M; Wimberger, P; Kommoss, S; Kommoss, F; Hauptmann, S; du Bois, A

2015-02-17

Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure. Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS). For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation. Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.

In vitro activity and in vivo animal model efficacy of IB-367 alone and in combination with imipenem and colistin against Gram-negative bacteria.

Science.gov (United States)

Simonetti, Oriana; Cirioni, Oscar; Ghiselli, Roberto; Orlando, Fiorenza; Silvestri, Carmela; Mazzocato, Susanna; Kamysz, Wojciech; Kamysz, Elzbieta; Provinciali, Mauro; Giacometti, Andrea; Guerrieri, Mario; Offidani, Annamaria

2014-05-01

The aim of our study was to evaluate the in vitro activity of IB-367 and its bactericidal effect for Pseudomonas aeruginosa and Escherichia coli, associated to a synergic study to test the antibiotic combinations between the peptide and colistin or imipenem. Minimum inhibitory concentrations (MICs), the minimum bactericidal concentrations (MBCs), the synergy test and killing study were carried out to evaluate the IB-367 activity. In the in vivo model, a wound was incised through the panniculus carnosus of BALB/c mice, and then inoculated with 5 × 107 colony-forming units of P. aeruginosa and E. coli. For each strain, the study included an infected or not infected group that did not receive any treatment, and five contaminated groups treated with local IB- 367, intraperitoneal imipenem, intraperitoneal colistin, topical IB-367 local plus intraperitoneal imipenem or intraperitoneal colistin. All isolates were inhibited by IB-367 at concentrations of 4-64 mg/l. Killing by IB-367 was shown to be very rapid: its activity on all Gram-negative bacteria was completed within a 40 min exposure period at a concentration of 2 × MIC/l. Synergy was demonstrated when IB-367 was combined with colistin or imipenem. In in vivo studies, the groups treated with topical IB-367 and intraperitoneal colistin showed the best results in terms of bacterial load inhibition either for Pseudomonas or for E. coli. The good in vitro activity and in vivo efficacy, as well as, the synergic interactions with antibiotics suggest that IB-367 is a promising candidate for potential application in the treatment of wound Gram-negative infections. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of breath testing with fructose and high fructose corn syrups in health and IBS.

Science.gov (United States)

Skoog, S M; Bharucha, A E; Zinsmeister, A R

2008-05-01

Although incomplete fructose absorption has been implicated to cause gastrointestinal symptoms, foods containing high fructose corn syrup (HFCS) contain glucose. Glucose increases fructose absorption in healthy subjects. Our hypothesis was that fructose intolerance is less prevalent after HFCS consumption compared to fructose alone in healthy subjects and irritable bowel syndrome (IBS). Breath hydrogen levels and gastrointestinal symptoms were assessed after 40 g of fructose (12% solution) prepared either in water or as HFCS, administered in double-blind randomized order on 2 days in 20 healthy subjects and 30 patients with IBS. Gastrointestinal symptoms were recorded on 100-mm Visual Analogue Scales. Breath hydrogen excretion was more frequently abnormal (P fructose (68%) than HFCS (26%) in controls and patients. Fructose intolerance (i.e. abnormal breath test and symptoms) was more prevalent after fructose than HFCS in healthy subjects (25% vs. 0%, P = 0.002) and patients (40% vs. 7%, P = 0.062). Scores for several symptoms (e.g. bloating r = 0.35) were correlated (P fructose but not HFCS; in the fructose group, this association did not differ between healthy subjects and patients. Symptoms were not significantly different after fructose compared to HFCS. Fructose intolerance is more prevalent with fructose alone than with HFCS in health and in IBS. The prevalence of fructose intolerance is not significantly different between health and IBS. Current methods for identifying fructose intolerance should be modified to more closely reproduce fructose ingestion in daily life.

Short Stories, Novels and Spain. An Interview With Colm Tóibín

Directory of Open Access Journals (Sweden)

José-Francisco Fernández Sánchez

2009-03-01

Full Text Available Colm Tóibín (Enniscorthy, 1955 is the author of five novels, The South (1990, The Heather Blazing (1992, The Story of the Night (1996, The Blackwater Lightship(1999 and The Master (2004. This last novel won the IMPAC Dublin Literary Award, the Los Angeles Times Novel of the Year, the Prix du Meilleur Livre Etranger for the best foreign novel published in 2005 in France, and it was shortlisted for the Man Booker Prize. Colm Tóibín has a long career in journalism and was the editor of the magazine Magill from 1982 to 1985. He is also the author of several non-fiction books, including Homage to Barcelona (1990 and The Sign of the Cross: Travels in Catholic Europe (1994. He edited The Penguin Book of Irish Fiction (1999 and has recently published his first book of short stories,Mothers and Sons (2006. Colm Tóibín attended the 10th International Conference on the Short Story in English, held at University College Cork on 19-21 June 2008, where this interview took place.

Differential protective effects of immune lymphoid cells against transplanted line Ib leukemia and immune polioencephalomyelitis. [X radiation, mice

Energy Technology Data Exchange (ETDEWEB)

Duffey, P.S.; Lukasewycz, O.A.; Olson, D.S.; Murphy, W.H.

1978-12-01

The capacity of immune cells obtained from the major lymphoid compartments to protect C58 mice from transplanted line Ib leukemia, and from an age-dependent autoimmune CNS disease (immune polioencephalomyelitis = IPE) elicited by immunizing old C58 mice with inactivated Ib cells was quantified. Cells used for comparative adoptive protection tests were harvested from the major lymphoid compartments 14 to 15 days after young C58 mice were immunized with inactivated Ib cell preparations. Regression curves were plotted from survival data and the log/sub 10/PD/sub 50/ values were determined. Immune spleen (ISC) and peritoneal cells (IPEC) were significantly more protective against transplanted Ib cells than immune lymph node (ILNC), thymic (ITC), and marrow cells (IMC). In contrast, IPEC and IMC were not protective against IPE and ITC were only marginally protective. ILNC afforded significant protection to transplantable leukemia but were only marginally protective to IPE. When ISC were treated with anti-thy 1.2 serum and complement, protection against transplanted leukemia and IPE was reduced > 99%. When donors of immune lymphoid cells were treated with 12.5 mg of cortisone acetate daily for 2 days before lymphoid cells were harvested, protection against transplanted Ib cells by ISC was reduced by approximately 90% whereas protection against IPE was totally eliminated. Considered together, these results indicate that the protective mechanisms to transplantable leukemia and IPE differ significantly in the same indicator mouse strain.

[Abdominal spasms, meteorism, diarrhea: fructose intolerance, lactose intolerance or IBS?].

Science.gov (United States)

Litschauer-Poursadrollah, Margaritha; El-Sayad, Sabine; Wantke, Felix; Fellinger, Christina; Jarisch, Reinhart

2012-12-01

Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p intolerance (HIT). Headache (ca. 10 %), fatigue (ca. 5 %) and dizziness (ca. 3 %) may occur after the test, irrespective whether the test was positive or negative.In more than 2/3 of patients a diet reduced in fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders.

Clinical and Microbiological Effect of a Multispecies Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms: A Randomized, Double-Blind, Placebo-controlled, Multicenter Trial.

Science.gov (United States)

Francavilla, Ruggiero; Piccolo, Maria; Francavilla, Antonio; Polimeno, Lorenzo; Semeraro, Francesco; Cristofori, Fernanda; Castellaneta, Stefania; Barone, Michele; Indrio, Flavia; Gobbetti, Marco; De Angelis, Maria

2018-04-23

The goals of this study were to evaluate the efficacy and safety of a probiotic mixture in patients with celiac disease (CD) with irritable bowel syndrome (IBS)-type symptoms despite a strict gluten-free diet (GFD). About 30% of patients with CD adherent to a GFD suffer from IBS-type symptoms; a possible cause resides in the imbalances of the intestinal microbiota in CD. Probiotics may represent a potential treatment. CD patients with IBS-type symptoms entered a prospective, double-blind, randomized placebo-controlled study. A 6-week treatment period was preceded by a 2-week run-in and followed by a 6-week follow-up phase. Clinical data were monitored throughout the study by validated questionnaires: IBS Severity Scoring System (IBS-SSS); Gastrointestinal Symptom Rating Scale (GSRS); Bristol Stool Form Scale (BSFS); and IBS Quality of Life Questionnaire (IBS-QOL). The fecal microbiota were assayed using plate counts and 16S rRNA gene-based analysis. In total, 109 patients were randomized to probiotics (n=54) or placebo (n=55). IBS-SSS and GSRS decreased significantly in probiotics, as compared with placebo [(-15.9%±14.8% vs. 8.2%±25.9%; Psymptoms, in CD patients on strict GFD, and is associated with a modification of gut microbiota, characterized by an increase of bifidobacteria.

[Using a multicomponent functional food in IBS patients with constipation a comparative controlled study].

Science.gov (United States)

Pilipenko, V I; Teplyuk, D A; Shakhovskaya, A K; Isakov, V A; Vorobyova, V M; Vorobyova, I S; Sarkisyan, V A; Kochetkova, A A; Mikheeva, G A; Yudina, A V

2016-01-01

Irritable bowel syndrome (IBS) is highly prevalent functional gastrointestinal disorder associated with decrease in quality of life and a high social cost. Diet is one of several therapeutic options in IBS treatment; therefore the development and clinical evaluation of innovative functional food for IBS patients are actual. Instant drink containing 4 g inulin, 4 mg menthol and 2 mg of pyridoxine (in daily dose) has been evaluated. 49 patients 18-68 (41.5±16.5) years old fulfilling the Rome III criteria for IBS-C were randomly assigned into two groups: one received standard diet plus two drinks per day for 2 weeks and control group received standard diet. Response to therapy was recorded daily using Likert scale of abdominal pain, bloating and feeling of incomplete bowel emptying, frequency of bowel movement, Bristol stool scale, and quality of life was assessed by IBSQoL questionnaire before and after the treatment. The consumption of the drink with inulin and menthol contributed to a significant positive effect on the stool parameters (from 0.91±0.73 to 1.12±0.45 bowel movements per day in stool frequency, p=0.05, from 2.68±1.63 to 3.43±1.27 index Bristol scale, p=0.05), reduced the severity of abdominal pain (from 1.78±0.58 to 1.47?0.61 Likert scale points, p=0.05), bloating (from 2.22±0.83 to 1.53±0.71 points ofLikertscale,p= 0.01) and a sense of incomplete bowelemptying (from 2.22 ± 0.88 to 1.61± 0.81 points of Likert scale, p=0.001), as well as increased the quality of life (from 75.3± 12.0 to 83.3±6.7%, p=0.05), but a significant part of patients (10 of 25) complained the appearance of heartburn after the start of the treatment. In conclusion, the consumption of the functional drink containing inulin, menthol and pyridoxine is associated with improve in stool parameters, abdominal pain, Bristol scale index and increase in quality of life in patients with IBS-C, but produce noticeable heartburn. Changes in functional drink composition are needed to

Effects on gastrointestinal transit and antroduodenojejunal manometry after gut-directed hypnotherapy in irritable bowel syndrome (IBS).

Science.gov (United States)

Lindfors, Perjohan; Törnblom, Hans; Sadik, Riadh; Björnsson, Einar S; Abrahamsson, Hasse; Simrén, Magnus

2012-12-01

Gut-directed hypnotherapy is an effective treatment in irritable bowel syndrome (IBS) but little is known about the mechanisms of action. In this study we aimed to investigate the effects on gastrointestinal motility when treating IBS with gut-directed hypnotherapy. We randomized 90 patients with IBS, refractory to standard management to receive gut-directed hypnotherapy 1 h/week for 12 weeks or supportive treatment for the same time period. Eighty-one subjects (40 hypnotherapy, 41 controls) could be evaluated by one or more of the following investigations, both before and after the intervention: gastric emptying time, small bowel transit time, colonic transit time, and antroduodenojejunal manometry. No significant differences in gastric emptying time, small bowel transit time, or colonic transit time was found when comparing the baseline and post-intervention measurements in the hypnotherapy group or in the control group. The same was true concerning the results of the antroduodenojejunal manometry. However, there was a numerical trend toward a higher number of migrating motor complexes at manometry and an accelerated gastric emptying time after hypnotherapy that did not reach statistical significance. In this study, we were not able to find evidence for long-standing effects on gastrointestinal motility as a mediator of the effects on IBS when treating the condition with gut-directed hypnotherapy. Further research to understand the mechanism of action is needed.

Current job situation of the alumni from IBS Groningen -2017

NARCIS (Netherlands)

Liefers, Jan

2017-01-01

Our main question is: what is the current job situation of the alumni from IBS Groningen? The sub questions are: •How many students graduated in the various years? •What are the most popular jobs? •Where do alumni work and what is the career path? •What is their highest degree? •What companies

Trino IB ameliorates the oxidative stress of cryptorchidism in the rat ...

African Journals Online (AJOL)

The study examined the effect of Trino IB, a mixture of oleuropein and -lipoic acid, on the plasma concentration of g-glutamyl transpeptidase (GGT), malondialdehyde (MDA), sperm count and apoptotic degeneration of testicular germ cells in experimentally induced cryptorchidism in adult male rats. Oral administration of ...

′Belonging without Belonging′: Colm Tóibín′s Dialogue with the Past

DEFF Research Database (Denmark)

Bøss, Michael

2005-01-01

It is argued that Tóibín is not the typical 'revisionist' intellectual that some have made him into, but a humanist and a sort of in-between, making a virtue of his own ambivalences towards notions of tradition, community and nationhood. The essay makes an analysis of these ambivalences with refe......It is argued that Tóibín is not the typical 'revisionist' intellectual that some have made him into, but a humanist and a sort of in-between, making a virtue of his own ambivalences towards notions of tradition, community and nationhood. The essay makes an analysis of these ambivalences...

Armazenamento de figo-da-índia em pó Storage of the prickly pear powder

Directory of Open Access Journals (Sweden)

Cícera G. C. de Lisbôa

2012-02-01

Full Text Available Neste trabalho foram avaliadas a estabilidade do figo-da-índia em pó acondicionado em embalagens laminadas durante 100 dias de armazenamento, sob condições controladas de temperatura e umidade relativa e as amostras a cada 20 dias, por meio do teor de água, atividade de água, acidez total titulável, açúcares redutores e cor (luminosidade, intensidade de vermelho e de amarelo. Observou-se que as embalagens laminadas não evitaram a absorção de água, enquanto a atividade de água aumentou e os açúcares redutores diminuíram com o tempo; por outro lado, a acidez total titulável diminuiu mas apenas nos primeiros vinte dias; enfim, todas as amostras sofreram escurecimento durante o armazenamento.The stability of the prickly pear power packed in laminated roll for 100 days storage under controlled temperature and relative humidity was evaluated. The material was evaluated every 20 days, through the moisture content, water activity, total acidity, sugars and color (brightness, red and yellow colour intensity. It was found during storage of powder samples, that the laminated packaging did not prevent the water absorption, while water activity increased and reduced sugars decreased with time, the total acidity decreased in the first twenty days, keeping stable thereafter in all samples and there was a darkening of the powder samples stored at 40 ºC.

Radiotherapy of the solitary and multiple eosinophilic granuloma of the bone (stage I)

International Nuclear Information System (INIS)

Wiegel, T.; Sommer, K.; Baumann, M.; Kruell, A.; Huebener, K.H.; Knop, J.; Reuter, M.

1991-01-01

Between 1957 and 1990 15 patients with solitary (stage Ia by Greenberger) and 2 patients with mulitple (stage Ib) eosinophilic granuloma of the bone were treated by radiotherapy in 18 locations after previous surgery. The doses applied varied from 6 Gy to 42 Gy (median for patients under 18 years: 8 Gy, for patients over 18 years: 30 Gy). Median follow-up was 9 years (range, 0,3-33 years). Local control rate and survival were 100%. Three patients with granuloma developed a second granuloma within 13 years after primary diagnosis (two bone manifestations, one cutaneous manifestation). Long term follow-up of patients with solitary eosinophilic granuloma is neccessary. (orig.) [de

[Multiparameter magnetic resonance imaging in the diagnosis of cancer of the cervix uteri].

Science.gov (United States)

Tarachkova, E V; Strel'tsova, O N; Panov, V O; Bazaeva, I Ya; Tyurin, I E

2015-01-01

Cancer of the cervix uteri (CCU) ranks third in the incidence of malignancies in women. The choice of CCU treatment mainly depends on the extent of the tumor process, i.e., the stage of the disease. Determining the stage of CCU is based on the clinical classification of the International Federation of Gynecology and Obstetrics (FIGO) (2009) and has a number of substantial limitations in evaluating parametrial invasion, tumor spread to the pelvic wall, and involvement of regional lymph nodes and in determining the true tumor sizes. Magnetic resonance imaging (MRI) is now the method of choice in staging invasive CCU. Multiparameter MRI will be able to enhance the efficiency of diagnosing microinvasive CCU as well (FIGO 2009), to plan surgical and/or chemoradiation treatment, to evaluate its efficiency, and to diagnose locally recurrent CCU.

Challenging a dogma; AJCC 8th staging system is not sufficient to predict outcomes of patients with malignant pleural mesothelioma.

Science.gov (United States)

Abdel-Rahman, Omar

2017-11-01

The 8th edition of malignant pleural mesothelioma (MPM) American Joint Committee on Cancer (AJCC) staging system has been published. The current analysis aims to evaluate its performance in a population-based setting among patients recorded within the surveillance, epidemiology and end results (SEER) database. SEER database (2004-2013) has been accessed through SEER*Stat program and AJCC 8th edition stage groups were reconstructed. Survival analyses (overall and cancer-specific) were conducted according to 6th and 8th editions through Kaplan-Meier analysis. Cox-regression multivariate model was also utilized for pair wise comparisons between different prognostic groups for overall and cancer-specific survival. A total of 5382 patients with MPM were identified in the period from 2004 to 2013. According to the 6th edition, significant pair wise P values for overall survival included: IA vs. III (P=0.027); IA vs. IV: P<0.0001; IB vs. IV: P<0.0001; II vs. III: P<0.0001; II vs. IV: P<0.0001; III vs. IV: P<0.0001). According to the 8th edition, significant pair wise P values for overall survival included: all stages vs. IV: P<0.0001; IA vs. II: P=0.046; IA vs. IIIA: P=0.022; IA vs. IIIB: P <0.0001; IB vs. II: P<0.0001; IB vs. IIIB: P<0.0001; II vs. IIIA: P<0.0001; IIIA vs. IIIB: P<0.0001). C-index for 6th edition was 0.539 (SE: 0.008; 95% CI: 0.524-0.555); while C-index for 8th edition was 0.540 (SE: 0.008; 95% CI: 0.525-0.556). Based on the above findings, a simplified staging system was proposed and overall and cancer-specific survivals were evaluated according to the simplified system. For overall and cancer-specific survival assessment, P values for all pair wise comparisons among different stages were significant (<0.01). The prognostic performance of both the 6th and 8th AJCC editions is unsatisfactory; there is a need for a more practical and prognostically relevant staging system for MPM. Copyright © 2017 Elsevier B.V. All rights reserved.

Nomogram for suboptimal cytoreduction at primary surgery for advanced stage ovarian cancer.

Science.gov (United States)

Gerestein, Cornelis G; Eijkemans, Marinus J; Bakker, Jeanette; Elgersma, Otto E; van der Burg, Maria E L; Kooi, Geertruida S; Burger, Curt W

2011-11-01

Maximal cytoreduction to minimal residual tumor is the most important determinant of prognosis in patients with advanced stage epithelial ovarian cancer (EOC). Preoperative prediction of suboptimal cytoreduction, defined as residual tumor >1 cm, could guide treatment decisions and improve counseling. The objective of this study was to identify predictive computed tomographic (CT) scan and clinical parameters for suboptimal cytoreduction at primary cytoreductive surgery for advanced stage EOC and to generate a nomogram with the identified parameters, which would be easy to use in daily clinical practice. Between October 2005 and December 2008, all patients with primary surgery for suspected advanced stage EOC at six participating teaching hospitals in the South Western part of the Netherlands entered the study protocol. To investigate independent predictors of suboptimal cytoreduction, a Cox proportional hazard model with backward stepwise elimination was utilized. One hundred and fifteen patients with FIGO stage III/IV EOC entered the study protocol. Optimal cytoreduction was achieved in 52 (45%) patients. A suboptimal cytoreduction was predicted by preoperative blood platelet count (p=0.1990; odds ratio (OR)=1.002), diffuse peritoneal thickening (DPT) (p=0.0074; OR=3.021), and presence of ascites on at least two thirds of CT scan slices (p=0.0385; OR=2.294) with a for-optimism corrected c-statistic of 0.67. Suboptimal cytoreduction was predicted by preoperative platelet count, DPT and presence of ascites. The generated nomogram can, after external validation, be used to estimate surgical outcome and to identify those patients, who might benefit from alternative treatment approaches.

INTEGRAL FIELD SPECTROSCOPY OF SUPERNOVA EXPLOSION SITES: CONSTRAINING THE MASS AND METALLICITY OF THE PROGENITORS. I. TYPE Ib AND Ic SUPERNOVAE

Energy Technology Data Exchange (ETDEWEB)

Kuncarayakti, Hanindyo; Maeda, Keiichi [Kavli Institute for the Physics and Mathematics of the Universe (WPI), Todai Institutes for Advanced Study, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8583 (Japan); Doi, Mamoru; Morokuma, Tomoki; Hashiba, Yasuhito [Institute of Astronomy, Graduate School of Science, The University of Tokyo, 2-21-1 Osawa, Mitaka, Tokyo 181-0015 (Japan); Aldering, Greg [Physics Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Arimoto, Nobuo [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-0015 (Japan); Pereira, Rui [CNRS/IN2P3, Institut de Physique Nucleaire de Lyon, 4 Rue Enrico Fermi, F-69622 Villeurbanne Cedex (France); Usuda, Tomonori, E-mail: hanindyo.kuncarayakti@ipmu.jp [Subaru Telescope, National Astronomical Observatory of Japan, 650 North A' ohoku Place, Hilo, HI 96720 (United States)

2013-08-01

Integral field spectroscopy of 11 Type Ib/Ic supernova (SN Ib/Ic) explosion sites in nearby galaxies has been obtained using UH88/SNIFS and Gemini-N/GMOS. The use of integral field spectroscopy enables us to obtain both spatial and spectral information about the explosion site, enabling the identification of the parent stellar population of the SN progenitor star. The spectrum of the parent population provides metallicity determination via strong-line method and age estimation obtained via comparison with simple stellar population models. We adopt this information as the metallicity and age of the SN progenitor, under the assumption that it was coeval with the parent stellar population. The age of the star corresponds to its lifetime, which in turn gives the estimate of its initial mass. With this method we were able to determine both the metallicity and initial (zero-age main sequence) mass of the progenitor stars of SNe Ib and Ic. We found that on average SN Ic explosion sites are more metal-rich and younger than SN Ib sites. The initial mass of the progenitors derived from parent stellar population age suggests that SN Ic has more massive progenitors than SN Ib. In addition, we also found indication that some of our SN progenitors are less massive than {approx}25 M{sub Sun }, indicating that they may have been stars in a close binary system that have lost their outer envelope via binary interactions to produce SNe Ib/Ic, instead of single Wolf-Rayet stars. These findings support the current suggestions that both binary and single progenitor channels are in effect in producing SNe Ib/Ic. This work also demonstrates the power of integral field spectroscopy in investigating SN environments and active star-forming regions.

The Gut-Brain Axis and the Microbiome: Clues to Pathophysiology and Opportunities for Novel Management Strategies in Irritable Bowel Syndrome (IBS

Directory of Open Access Journals (Sweden)

Eamonn M.M. Quigley

2018-01-01

Full Text Available Irritable bowel syndrome (IBS is one of the most common of all medical disorders worldwide and, while for some it represents no more than a nuisance, for others it imposes significant negative impacts on daily life and activities. IBS is a heterogeneous disorder and may well have a number of causes which may lie anywhere from the external environment to the contents of the gut lumen and from the enteric neuromuscular apparatus and the gut immune system to the central nervous system. Consequently, the paradigm of the gut-brain axis, which includes the participation of these various factors, has proven a useful model to assist clinicians and patients alike in understanding the genesis of symptoms in IBS. Now, given the widespread interest in the gut microbiome in health and disease, in general, reports of disordered enteric bacterial communities in IBS, and experimental data to indicate that components of the gut microbiota can influence brain morphology and function, as well as behavior and cognition, this concept has been extended to encompass the microbiota-gut-brain axis. The implications of this novel concept to the assessment and management of IBS will be explored in this review.

Sociodemographic factors and delay in the diagnosis of cervical ...

African Journals Online (AJOL)

Background: In Morocco, cervical cancer is the second most common cancer in women. The cases of cervical cancer are diagnosed at a late stage: 43.7% presented at stage II of diagnosis (FIGO) and 38.1% in advanced stage (stage III and IV). The main objective of this study is to investigate factors associated to late the ...

Long‐Term Monitoring of a Geosynthetic Reinforced Soil Integrated Bridge System (GRS‐IBS)

Science.gov (United States)

2017-11-01

The geosynthetic reinforced soil integrated bridge system (GRS-IBS) is an innovative alternative to conventional bridge technology that utilizes closely spaced layers of geosynthetic reinforcement and compacted granular fill material to provide direc...

Radiotherapy in the management of cervical cancer in elderly patients

International Nuclear Information System (INIS)

Lindegaard, J.C.; Thranov, I.R.; Engelholm, S.A.

2000-01-01

One hundred and fourteen elderly patients (median 75.5 years, range 70.0-85.9) consecutively referred for curative radiotherapy in the period 1987-1996 were prospectively followed with regard to tumour control and complications. The importance of age, stage (FIGO), tumour size, histology, tumour fixation, haemoglobin, concurrent disease, performance status (WHO) and type of radiotherapy were assessed using univariate and multivariate analyses. Treatment was completed as planned in 68%, delayed in 29% and stopped prematurely in 3%. The frequency of grade 3 late complications was 11% and the actuarial probability at 5 years was 20%. Overall 5-year survival according to FIGO was 61% (I), 34% (II) and 25% (III). Cox multivariate analysis identified tumour size as independent prognostic factor for tumour control, disease-free survival and overall survival. FIGO stage was predictive for late grade 2 complications. We were unable to identify significant factors with respect to grade 3 complications. Age was not a significant parameter for any of the investigated endpoints. Elderly patients in good performance status with advanced cancer of the uterine may tolerate radical radiotherapy with acceptable morbidity and reasonable survival. Radiotherapy may also be a good alternative in early stage disease for surgically unfit elderly patients. (author)

Using the skin protective lotion IB1 as a substitute for chemical protective gloves.

Science.gov (United States)

Ophir, Nimrod; Milk, Nadav; Mayer, Talia; Ravfogel, Shaul; Yavnai, Nirit; Eisenkraft, Arik; Kadar, Tamar; Kassirer, Michael; Rosman, Yossi

2016-10-01

We aimed to evaluate the performance of medical personnel in using the IB1 topical protective lotion on their hands and wrists together with standard disposable medical gloves, compared to standard-issued medical chemical protective gloves. This randomized cross-over study included 144 medical personnel. Primary endpoints were time-to-completion of autoinjection; success rate, number of attempts, and time-to-achieve successful endotracheal intubation; time-to-achieve satisfactory tube fixation; time-to-draw and inject the content of an ampoule; and the total time-to-perform all medical procedures. Secondary endpoints included the subjective assessment of convenience to perform these four procedures with each protective measure. Mean time was significantly shorter using IB1 compared to chemical protective gloves for tube fixation, ampoule drawing, and the total time-to-perform all procedures (58.6±22.7 seconds vs. 71.7±29.7; 31.5±21.8 vs. 38.2±19.4; 137.4±56.1 vs. 162.5±63.6, respectively; Pgloves (Pgloves significantly shorten the time-to-perform medical procedures requiring fine motor dexterities and is subjectively more convenient than chemical protective gloves. IB1 should be considered as an appropriate alternative for medical teams in a chemical event. Copyright © 2016 Elsevier Inc. All rights reserved.

Trachelectomy for cancer of the cervix: dargent's operation. Vaginal hysterectomy for early cancer of the cervix stage IA1 and CIN III

DEFF Research Database (Denmark)

Ottosen, Christian

2011-01-01

Radical vaginal trachelectomy is today an established method of treating selected women with cervical cancer stage IA2 and IB1, with tumour size less than 2cm without precluding future childbearing. This technique has been used for more than 20 years with reassuring oncological safety and excellent...

A framework of initiatives for successful application of life cycle costing (LCC in industrialised building system (IBS in Malaysian construction industry

Directory of Open Access Journals (Sweden)

Shamsuddin Siti Mazzuana

2017-01-01

Full Text Available Industrialised Building System (IBS contributes a great shift in sustainable construction and benefits the society. Previous studies have proven in general that one of the hindrances in promoting sustainable in IBS, is a high cost for any pre-cast material specifically thus effected the overall cost. The introduction of Life Cycle Costing (LCC leads into providing a better and comprehensive cost estimation, including projecting actual cost to operate the building, hence providing a better baseline for decision making. The lacking application of LCC in IBS is still in trivial impact, therefore, this paper presents a framework which produced by expressing the successful initiatives of LCC and IBS in Malaysia construction industry. The framework developed based on findings from the extensive literature reviews, 164 responded questionnaires, and 19 expert opinions, which has three sections: Strategy Development, System Development and the last part is Decision Level. Aspects of objectivity, practicality, reliability, completeness that were likely to be implemented in the Malaysian construction industry were used. There are significant opinions on the usefulness and completeness of the proposed framework in providing a comprehensive cost estimates which helps much in deciding to carry out IBS or remain with a traditional construction method.

Clinical Significance of IGFBP-3 Methylation in Patients with Early Stage Gastric Cancer

Directory of Open Access Journals (Sweden)

Seung Tae Kim

2015-08-01

Full Text Available BACKGROUND: IGFBP-3 is a multifunctional protein that inhibits growth and induces apoptosis of cancer cells. Hypermethylation of the promoter represses expression of the IGFBP-3 gene. We undertook this study to assess the impact of IGFBP-3 methylation on survival of early stage gastric cancer patients. METHODS: Of the 482 tissue samples from gastric cancer patients who underwent curative surgery, IGFBP-3 methylation was tested in 138 patients with stage IB/II gastric cancer. We also analyzed IGFBP-3 methylation in 26 gastric cancer cell lines. IGFBP-3 methylation was evaluated by methylation-specific polymerase chain reaction (MethyLight. Statistical analyses, all two-sided, were performed to investigate the prognostic effects of methylation status of the IGFBP-3 promoter on various clinical parameters. RESULTS: Hypermethylation of IGFBP-3 was observed in 26 (19% of the 138 stage IB/II gastric cancer patients. Clinicopathological factors such as age, Lauren classification, sex, tumor infiltration, lymph node metastasis, and histologic grade did not show a statistically significant association with the methylation status of the IGFBP-3 promoter. Patients with a hypermethylated IGFBP-3 promoter had similar 8-year disease-free survival compared with those without a hypermethylated IGFBP-3 promoter (73% vs 75%, P = .78. In subgroup analyses, females, but not males, seemed to have poorer prognosis for DFS and OS in the subset of patients with IGFBP-3 methylation as compared with those without IGFBP-3 methylation (8-year DFS: 55.6% vs 71.6%, P = .3694 and 8-year overall survival: 55.6% vs 68.4%, P = .491, respectively even with no statistical significance. CONCLUSIONS: The status of IGFBP-3 methylation as measured by methylation-specific polymerase chain reaction proposed the modest role for predicting survival in specific subgroups of patients with early-stage gastric cancer who undergo curative surgery. However, this needs further investigation.

Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life.

Science.gov (United States)

Böhn, Lena; Störsrud, Stine; Törnblom, Hans; Bengtsson, Ulf; Simrén, Magnus

2013-05-01

Despite the fact that food and diet are central issues, that concern patients with irritable bowel syndrome (IBS), the current understanding about the association between the intake of certain foods/food groups and the gastrointestinal (GI) symptom pattern, psychological symptoms, and quality of life is poor. The aim of this study was to determine which food groups and specific food items IBS patients report causing GI symptoms, and to investigate the association with GI and psychological symptoms and quality of life. We included 197 IBS patients (mean age 35 (18-72) years; 142 female subjects) who completed a food questionnaire in which they specified symptoms from 56 different food items or food groups relevant to food intolerance/allergy. The patients also completed questionnaires to assess depression and general anxiety (Hospital Anxiety and Depression), GI-specific anxiety (Visceral Sensitivity Index), IBS symptoms (IBS-Severity Scoring System), somatic symptoms (Patient Health Questionnaire-15), and quality of life (Irritable Bowel Syndrome Quality of Life Questionnaire). In all, 84% of the studied population reported symptoms related to at least one of the food items surveyed. Symptoms related to intake of food items with incompletely absorbed carbohydrates were noted in 138 (70%) patients; the most common were dairy products (49%), beans/lentils (36%), apple (28%), flour (24%), and plum (23%). Of these, 58% experienced GI symptoms from foods rich in biogenic amines, such as wine/beer (31%), salami (22%), and cheese (20%). Histamine-releasing foods, such as milk (43%), wine/beer (31%), and pork (21%), were also considered causes of symptoms in IBS patients. GI symptoms were also frequently reported after intake of fried and fatty foods (52%). With increasing IBS symptom severity, patients reported more food items responsible for their GI symptoms (P=0.004), and this was also found in patients with more severe somatic symptoms (Psleep (r=-0.25; P=0

Conservação pós-colheita de figos verdes (Ficus carica L. cv. roxo de Valinhos tratados com hipoclorito de sódio e armazenados sob refrigeração em atmosfera modificada passiva Post-harvest conservation of unripe figs (Ficus carica L. cv. "roxo de Valinhos" treated with sodium hypochlorite and stored under refrigeration in passive modified atmosphere

Directory of Open Access Journals (Sweden)

Luciana Costa Lima

2005-08-01

Full Text Available Os principais causadores de perdas da qualidade de figos são: colheita e embalagens inadequadas, falta de padronização do produto na classificação e péssimas condições de transporte e armazenamento. Com este trabalho objetivou-se avaliar o efeito da imersão em hipoclorito, tipo de embalagem e refrigeração na conservação pós-colheita de figos verdes, cv. Roxo de Valinhos, mediante as características físicas, físico-químicas e químicas, durante o armazenamento. Após seleção, os figos foram imersos ou não em solução de hipoclorito de sódio a 40 ppm conforme os tratamentos, secos ao ar e embalados em filme de PVC de 50 m ou sacos plásticos. Após os tratamentos, os frutos foram submetidos a armazenamento refrigerado (1ºC e 70% de UR em BOD, por um período de 35 dias, sendo avaliados a cada 7 dias. O uso da embalagem reduziu drasticamente a perda de massa dos figos. Frutos não embalados apresentaram-se mais ácidos e com menores teores de açúcares. Com o uso da embalagem, os figos podem ser comercializados até os 35 dias de armazenamento desde que armazenados a 1ºC e 70% de UR em BOD. Já os figos não embalados, estes podem ser comercializados somente até os 2 dias de armazenamento sob refrigeração.The chief causesof quality loss in figs are inadequate harvest and packaging, lack of standardization of the product in the classification and very bad transportation and storage conditions. This work aimed to evaluate the effects of soaking in hypochlorite, and the type of packaging and refrigeration on the post-harvest conservation of unripe figs cv. "Roxo de Valinhos", through physico-chemical analyses, during storage. After selection, the figs were soaked, or not, in a 40ppm sodium hypochlorite solution, air-dried and wrapped in 50µ PVC film or plastic bags. After the treatments, the fruits were submitted to refrigerated storage (1ºC and 70% of RH for a 35-day period, being evaluated every 7 days. Use of the

Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity