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Sample records for nodal metastasis treated

  1. Nodal metastasis in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.

    1999-01-01

    The biological behavior and hence the prognosis of thyroid cancer (TC) depends among other factors on the extent of spread of the disease outside the thyroid bed. This effect is controversial, especially for nodal metastasis of well differentiated thyroid carcinoma (WDC). Nodal metastasis at the time of initial diagnosis behaves differently depending on the histology, age of the patient, presence of extrathyroidal extension, and the sex of the individual. The type of the surgery, administration of 131 I and thyroxin suppression also to some extent influence the rate of recurrence and mortality. Experience has shown that it is not as innocuous as a small intrathyroidal tumor without any invasion outside the thyroid bed and due consideration should be accorded to the management strategies for handling patients with nodal metastasis

  2. Hyoid bone chondrosarcoma with cervical nodal metastasis: A case ...

    African Journals Online (AJOL)

    Background: Hyoid bone chondrosarcoma is a very rare condition. This study presents a case report of low-grade chondrosarcoma of hyoid bone with cervical nodal metastasis. The study also presents preoperative radiological investigations, pathological examination and the follow-up of the case. Case presentation: A 42 ...

  3. Clinical investigation: Regional nodal failure patterns in breast cancer patients treated with mastectomy without radiotherapy

    International Nuclear Information System (INIS)

    Strom, Eric A.; Woodward, Wendy A.; Katz, Angela; Buchholz, Thomas A.; Perkins, George H.; Jhingran, Anuja; Theriault, Richard; Singletary, Eva; Sahin, Aysegul; McNeese, Marsha D.

    2005-01-01

    Purpose: The purpose of this study was to describe regional nodal failure patterns in patients who had undergone mastectomy with axillary dissection to define subgroups of patients who might benefit from supplemental regional nodal radiation to the axilla or supraclavicular fossa/axillary apex. Methods and Materials: The cohort consisted of 1031 patients treated with mastectomy (including a level I-II axillary dissection) and doxorubicin-based systemic therapy without radiation on five clinical trials at M.D. Anderson Cancer Center. Patient records, including pathology reports, were retrospectively reviewed. All regional recurrences (with or without distant metastasis) were recorded. Median follow-up was 116 months (range, 6-262 months). Results: Twenty-one patients recurred within the low-mid axilla (10-year actuarial rate 3%). Of these, 16 were isolated regional failures (no chest wall failure). The risk of failure in the low-mid axilla was not significantly higher for patients with increasing numbers of involved nodes, increasing percentage of involved nodes, larger nodal size or gross extranodal extension. Only 3 of 100 patients with 20% involved axillary nodes, and the presence of gross extranodal extension (10-year actuarial rates 15%, 14%, and 19%, respectively, p 20% involved axillary nodes, or gross extranodal extension are at increased risk of failure in the supraclavicular fossa/axillary apex and should receive radiation to undissected regions in addition to the chest wall

  4. Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma.

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    Yu, Marc Gregory; Atun, Jenny Maureen

    2016-01-01

    Tuberculous (TB) lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC) since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV-) PTC. Lymph node examination, however, revealed TB lymphadenitis, and the patient was given standard antimycobacterial therapy. This is the first documented case in Southeast Asia, a high TB burden region. This is also the first report involving FV-PTC, which has features between those of conventional PTC and follicular thyroid carcinoma. The case suggests that, in endemic areas, TB should be a differential in the etiology of cervical lymphadenopathy in PTC patients. In developed countries, this differential diagnosis is also valuable because of the increasing incidence of HIV and TB coinfection. Proper preoperative evaluation is important and needs to be highlighted in the formulation of local guidelines.

  5. Tuberculous Lymphadenitis Mimicking Nodal Metastasis in Follicular Variant Papillary Thyroid Carcinoma

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    Marc Gregory Yu

    2016-01-01

    Full Text Available Tuberculous (TB lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV- PTC. Lymph node examination, however, revealed TB lymphadenitis, and the patient was given standard antimycobacterial therapy. This is the first documented case in Southeast Asia, a high TB burden region. This is also the first report involving FV-PTC, which has features between those of conventional PTC and follicular thyroid carcinoma. The case suggests that, in endemic areas, TB should be a differential in the etiology of cervical lymphadenopathy in PTC patients. In developed countries, this differential diagnosis is also valuable because of the increasing incidence of HIV and TB coinfection. Proper preoperative evaluation is important and needs to be highlighted in the formulation of local guidelines.

  6. Early clinical esophageal adenocarcinoma (cT1): Utility of CT in regional nodal metastasis detection and can the clinical accuracy be improved?

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    Betancourt Cuellar, Sonia L., E-mail: slbetancourt@mdanderson.org; Sabloff, Bradley, E-mail: bsabloff@mdanderson.org; Carter, Brett W., E-mail: bcarter2@mdanderson.org; Benveniste, Marcelo F., E-mail: mfbenveniste@mdanderson.org; Correa, Arlene M., E-mail: amcorrea@mdanderson.org; Maru, Dipen M., E-mail: dmaru@mdanderson.org; Ajani, Jaffer A., E-mail: jajani@mdanderson.org; Erasmus, Jeremy J., E-mail: jerasmus@mdanderson.org; Hofstetter, Wayne L., E-mail: whofstetter@mdanderson.org

    2017-03-15

    Introduction: Treatment of early esophageal cancer depends on the extent of the primary tumor and presence of regional lymph node metastasis.(RNM). Short axis diameter >10 mm is typically used to detect RNM. However, clinical determination of RNM is inaccurate and can result in inappropriate treatment. Purpose of this study is to evaluate the accuracy of a single linear measurement (short axis > 10 mm) of regional nodes on CT in predicting nodal metastasis, in patients with early esophageal cancer and whether using a mean diameter value (short axis + long axis/2) as well as nodal shape improves cN designation. Methods: CTs of 49 patients with cT1 adenocarcinoma treated with surgical resection alone were reviewed retrospectively. Regional nodes were considered positive for malignancy when round or ovoid and mean size >5 mm adjacent to the primary tumor and >7 mm when not adjacent. Results were compared with pN status after esophagectomy. Results: 18/49 patients had pN+ at resection. Using a single short axis diameter >10 mm on CT, nodal metastasis (cN) was positive in 7/49. Only 1 of these patients was pN+ at resection (sensitivity 5%, specificity 80%, accuracy 53%). Using mean size and morphologic criteria, cN was positive in 28/49. 11 of these patients were pN+ at resection (sensitivity 61%, specificity 45%, accuracy 51%). EUS with limited FNA of regional nodes resulted in 16/49 patients with pN+ being inappropriately designated as cN0. Conclusions: Evaluation of size, shape and location of regional lymph nodes on CT improves the sensitivity of cN determination compared with a short axis measurement alone in patients with cT1 esophageal cancer, although clinical utility is limited.

  7. Unilateral cervical nodal metastasis is an independent prognostic factor for esophageal squamous cell carcinoma patients undergoing chemoradiotherapy: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Peng Zhang

    Full Text Available To determine the prognostic significance of unilateral cervical lymph nodal metastasis (CLNM in patients with inoperable thoracic esophageal squamous cell carcinoma (SCC and to identify significant prognostic factors in these patients.This retrospective study involved 395 patients with inoperable esophageal SCC treated with concurrent chemoradiotherapy. The patients were classified into three groups according to their cervical lymph node status: group A, no evidence of CLNM; group B, unilateral CLNM; group C, other distant metastases. Overall survival (OS and progression-free survival (PFS were calculated. Significant prognostic factors were identified using univariate and multivariate analyses.The 3-year OS rates in groups A, B and C were 46.7%, 33.5% and 8.3%, respectively (p<0.001, log-rank test. The corresponding PFS rates were 40.7%, 26.4% and 4.7% (p<0.001, log-rank test. Group B had a similar prognosis to that of group A and better 3-year OS (p = 0.009 and PFS (p = 0.006 rates than those of group C. Multivariate analysis demonstrated that T stage, chemotherapy regimen and cervical lymph node involvement were independent prognostic factors affecting OS and PFS.Compared to other distant metastases, unilateral CLNM is associated with longer OS in esophageal SCC and should be regarded as a regional disease. Sex, T stage, concurrent chemotherapy modality and cervical lymph node involvement are independent predictors of survival in esophageal SCC.

  8. Efficacy and prognostic analysis of chemoradiotherapy in patients with thoracic esophageal squamous carcinoma with cervical lymph nodal metastasis alone

    International Nuclear Information System (INIS)

    Zhang, Peng; Xi, Mian; Zhao, Lei; Li, Qiao-Qiao; He, Li-Ru; Liu, Shi-Liang; Shen, Jing-Xian; Liu, Meng-Zhong

    2014-01-01

    The prognostic factors of thoracic esophageal squamous carcinoma with cervical lymph nodal metastasis (CLNM) have not been specifically investigated. This study was performed to analyze the efficacy and prognostic factors of chemoradiotherapy for thoracic esophageal carcinoma with CLNM alone. From 2002 to 2011, 139 patients with inoperable esophageal cancer who underwent chemoradiotherapy at the Sun Yat-Sen University were retrospectively analyzed. Median radiation doses were 60 Gy (range: 50–68 Gy). Univariate and multivariate analyses were performed to compare overall survival (OS) and progression-free survival (PFS). The 1- and 3-year OS rates were 68.2% and 27.9%, respectively. The 1- and 3-year PFS rates were 51.9% and 20.1%, respectively. The multivariate analysis demonstrated that response to treatment, T stage, pathological grade, and laterality of cervical lymph nodal metastases were independent prognostic factors for thoracic esophageal carcinoma with CLNM. Concurrent chemoradiotherapy is an important and hopeful treatment option for patients with esophageal cancer with CLNM alone. Our study has revealed that response to treatment, T stage, pathological grade and laterality of cervical lymph nodal metastases are significant prognostic factors for long-term survival

  9. How to treat brain metastasis in 2012?

    International Nuclear Information System (INIS)

    Braccini, A.L.; Azria, D.; Mazeron, J.J.; Mornex, F.; Jacot, W.; Metellus, P.; Tallet, A.

    2012-01-01

    During the last French radiation oncology society annual congress, the therapeutic options for the management of brain metastases were presented. The indications and limits of surgery, stereotactic radiotherapy and whole brain radiotherapy, as well as their benefit in terms of overall survival, local control and improvement of the functional and neuro-cognitive status were discussed. The prognosis significance of the different phenotypes of breast cancer on the risk for BM as well as their roles in the treatment of brain metastases were also described. Surgery improves overall survival for patients with a single brain metastase and should be considered in the case of symptomatic lesions. The overall survival of patients treated with stereotactic radiotherapy do not differ from that of patients treated with surgery. These treatments should be mainly considered for patients with good performance status, one to three small brain metastases (< 3 cm) and limited extracranial disease. Whole brain radiotherapy is more and more discussed in adjuvant setting due to potential late neuro-cognitive toxicity. This toxicity could be improved with the development of techniques sparing the hippocampus. HER2+ and triple-negative breast cancer patients are at increased risk for brain metastases. Prognosis of these patients differs as the overall survival of HER2+ patients has improved with anti-HER2 therapies. The optimal combination of local and systemic therapies remain to be determined. (authors)

  10. PTK 7 is a transforming gene and prognostic marker for breast cancer and nodal metastasis involvement.

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    Silvia Gärtner

    Full Text Available Protein Tyrosin Kinase 7 (PTK7 is upregulated in several human cancers; however, its clinical implication in breast cancer (BC and lymph node (LN is still unclear. In order to investigate the function of PTK7 in mediating BC cell motility and invasivity, PTK7 expression in BC cell lines was determined. PTK7 signaling in highly invasive breast cancer cells was inhibited by a dominant-negative PTK7 mutant, an antibody against the extracellular domain of PTK7, and siRNA knockdown of PTK7. This resulted in decreased motility and invasivity of BC cells. We further examined PTK7 expression in BC and LN tissue of 128 BC patients by RT-PCR and its correlation with BC related genes like HER2, HER3, PAI1, MMP1, K19, and CD44. Expression profiling in BC cell lines and primary tumors showed association of PTK7 with ER/PR/HER2-negative (TNBC-triple negative BC cancer. Oncomine data analysis confirmed this observation and classified PTK7 in a cluster with genes associated with agressive behavior of primary BC. Furthermore PTK7 expression was significantly different with respect to tumor size (ANOVA, p = 0.033 in BC and nodal involvement (ANOVA, p = 0.007 in LN. PTK7 expression in metastatic LN was related to shorter DFS (Cox Regression, p = 0.041. Our observations confirmed the transforming potential of PTK7, as well as its involvement in motility and invasivity of BC cells. PTK7 is highly expressed in TNBC cell lines. It represents a novel prognostic marker for BC patients and has potential therapeutic significance.

  11. PTK 7 is a transforming gene and prognostic marker for breast cancer and nodal metastasis involvement.

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    Gärtner, Silvia; Gunesch, Angela; Knyazeva, Tatiana; Wolf, Petra; Högel, Bernhard; Eiermann, Wolfgang; Ullrich, Axel; Knyazev, Pjotr; Ataseven, Beyhan

    2014-01-01

    Protein Tyrosin Kinase 7 (PTK7) is upregulated in several human cancers; however, its clinical implication in breast cancer (BC) and lymph node (LN) is still unclear. In order to investigate the function of PTK7 in mediating BC cell motility and invasivity, PTK7 expression in BC cell lines was determined. PTK7 signaling in highly invasive breast cancer cells was inhibited by a dominant-negative PTK7 mutant, an antibody against the extracellular domain of PTK7, and siRNA knockdown of PTK7. This resulted in decreased motility and invasivity of BC cells. We further examined PTK7 expression in BC and LN tissue of 128 BC patients by RT-PCR and its correlation with BC related genes like HER2, HER3, PAI1, MMP1, K19, and CD44. Expression profiling in BC cell lines and primary tumors showed association of PTK7 with ER/PR/HER2-negative (TNBC-triple negative BC) cancer. Oncomine data analysis confirmed this observation and classified PTK7 in a cluster with genes associated with agressive behavior of primary BC. Furthermore PTK7 expression was significantly different with respect to tumor size (ANOVA, p = 0.033) in BC and nodal involvement (ANOVA, p = 0.007) in LN. PTK7 expression in metastatic LN was related to shorter DFS (Cox Regression, p = 0.041). Our observations confirmed the transforming potential of PTK7, as well as its involvement in motility and invasivity of BC cells. PTK7 is highly expressed in TNBC cell lines. It represents a novel prognostic marker for BC patients and has potential therapeutic significance.

  12. A Web-based nomogram predicting para-aortic nodal metastasis in incompletely staged patients with endometrial cancer: a Korean Multicenter Study.

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    Kang, Sokbom; Lee, Jong-Min; Lee, Jae-Kwan; Kim, Jae-Weon; Cho, Chi-Heum; Kim, Seok-Mo; Park, Sang-Yoon; Park, Chan-Yong; Kim, Ki-Tae

    2014-03-01

    The purpose of this study is to develop a Web-based nomogram for predicting the individualized risk of para-aortic nodal metastasis in incompletely staged patients with endometrial cancer. From 8 institutions, the medical records of 397 patients who underwent pelvic and para-aortic lymphadenectomy as a surgical staging procedure were retrospectively reviewed. A multivariate logistic regression model was created and internally validated by rigorous bootstrap resampling methods. Finally, the model was transformed into a user-friendly Web-based nomogram (http://http://www.kgog.org/nomogram/empa001.html). The rate of para-aortic nodal metastasis was 14.4% (57/397 patients). Using a stepwise variable selection, 4 variables including deep myometrial invasion, non-endometrioid subtype, lymphovascular space invasion, and log-transformed CA-125 levels were finally adopted. After 1000 repetitions of bootstrapping, all of these 4 variables retained a significant association with para-aortic nodal metastasis in the multivariate analysis-deep myometrial invasion (P = 0.001), non-endometrioid histologic subtype (P = 0.034), lymphovascular space invasion (P = 0.003), and log-transformed serum CA-125 levels (P = 0.004). The model showed good discrimination (C statistics = 0.87; 95% confidence interval, 0.82-0.92) and accurate calibration (Hosmer-Lemeshow P = 0.74). This nomogram showed good performance in predicting para-aortic metastasis in patients with endometrial cancer. The tool may be useful in determining the extent of lymphadenectomy after incomplete surgery.

  13. Amplification and protein overexpression of cyclin D1: Predictor of occult nodal metastasis in early oral cancer.

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    Noorlag, Rob; Boeve, Koos; Witjes, Max J H; Koole, Ronald; Peeters, Ton L M; Schuuring, Ed; Willems, Stefan M; van Es, Robert J J

    2017-02-01

    Accurate nodal staging is pivotal for treatment planning in early (stage I-II) oral cancer. Unfortunately, current imaging modalities lack sensitivity to detect occult nodal metastases. Chromosomal region 11q13, including genes CCND1, Fas-associated death domain (FADD), and CTTN, is often amplified in oral cancer with nodal metastases. However, evidence in predicting occult nodal metastases is limited. In 158 patients with early tongue and floor of mouth (FOM) squamous cell carcinomas, both CCND1 amplification and cyclin D1, FADD, and cortactin protein expression were correlated with occult nodal metastases. CCND1 amplification and cyclin D1 expression correlated with occult nodal metastases. Cyclin D1 expression was validated in an independent multicenter cohort, confirming the correlation with occult nodal metastases in early FOM cancers. Cyclin D1 is a predictive biomarker for occult nodal metastases in early FOM cancers. Prospective research on biopsy material should confirm these results before implementing its use in routine clinical practice. © 2016 Wiley Periodicals, Inc. Head Neck 39: 326-333, 2017. © 2016 Wiley Periodicals, Inc.

  14. Incidental Prophylactic Nodal Irradiation and Patterns of Nodal Relapse in Inoperable Early Stage NSCLC Patients Treated With SBRT: A Case-Matched Analysis

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    Lao, Louis [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Auckland City Hospital, Auckland (New Zealand); Hope, Andrew J. [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Maganti, Manjula [Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Brade, Anthony; Bezjak, Andrea; Saibishkumar, Elantholi P.; Giuliani, Meredith; Sun, Alexander [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Cho, B. C. John, E-mail: john.cho@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada)

    2014-09-01

    Purpose: Reported rates of non-small cell lung cancer (NSCLC) nodal failure following stereotactic body radiation therapy (SBRT) are lower than those reported in the surgical series when matched for stage. We hypothesized that this effect was due to incidental prophylactic nodal irradiation. Methods and Materials: A prospectively collected group of medically inoperable early stage NSCLC patients from 2004 to 2010 was used to identify cases with nodal relapses. Controls were matched to cases, 2:1, controlling for tumor volume (ie, same or greater) and tumor location (ie, same lobe). Reference (normalized to equivalent dose for 2-Gy fractions [EQD2]) point doses at the ipsilateral hilum and carina, demographic data, and clinical outcomes were extracted from the medical records. Univariate conditional logistical regression analyses were performed with variables of interest. Results: Cases and controls were well matched except for size. The controls, as expected, had larger gross tumor volumes (P=.02). The mean ipsilateral hilar doses were 9.6 Gy and 22.4 Gy for cases and controls, respectively (P=.014). The mean carinal doses were 7.0 Gy and 9.2 Gy, respectively (P=.13). Mediastinal nodal relapses, with and without ipsilateral hilar relapse, were associated with mean ipsilateral hilar doses of 3.6 Gy and 19.8 Gy, respectively (P=.01). The conditional density plot appears to demonstrate an inverse dose-effect relationship between ipsilateral hilar normalized total dose and risk of ipsilateral hilar relapse. Conclusions: Incidental hilar dose greater than 20 Gy is significantly associated with fewer ipsilateral hilar relapses in inoperable early stage NSCLC patients treated with SBRT.

  15. Incidental Prophylactic Nodal Irradiation and Patterns of Nodal Relapse in Inoperable Early Stage NSCLC Patients Treated With SBRT: A Case-Matched Analysis

    International Nuclear Information System (INIS)

    Lao, Louis; Hope, Andrew J.; Maganti, Manjula; Brade, Anthony; Bezjak, Andrea; Saibishkumar, Elantholi P.; Giuliani, Meredith; Sun, Alexander; Cho, B. C. John

    2014-01-01

    Purpose: Reported rates of non-small cell lung cancer (NSCLC) nodal failure following stereotactic body radiation therapy (SBRT) are lower than those reported in the surgical series when matched for stage. We hypothesized that this effect was due to incidental prophylactic nodal irradiation. Methods and Materials: A prospectively collected group of medically inoperable early stage NSCLC patients from 2004 to 2010 was used to identify cases with nodal relapses. Controls were matched to cases, 2:1, controlling for tumor volume (ie, same or greater) and tumor location (ie, same lobe). Reference (normalized to equivalent dose for 2-Gy fractions [EQD2]) point doses at the ipsilateral hilum and carina, demographic data, and clinical outcomes were extracted from the medical records. Univariate conditional logistical regression analyses were performed with variables of interest. Results: Cases and controls were well matched except for size. The controls, as expected, had larger gross tumor volumes (P=.02). The mean ipsilateral hilar doses were 9.6 Gy and 22.4 Gy for cases and controls, respectively (P=.014). The mean carinal doses were 7.0 Gy and 9.2 Gy, respectively (P=.13). Mediastinal nodal relapses, with and without ipsilateral hilar relapse, were associated with mean ipsilateral hilar doses of 3.6 Gy and 19.8 Gy, respectively (P=.01). The conditional density plot appears to demonstrate an inverse dose-effect relationship between ipsilateral hilar normalized total dose and risk of ipsilateral hilar relapse. Conclusions: Incidental hilar dose greater than 20 Gy is significantly associated with fewer ipsilateral hilar relapses in inoperable early stage NSCLC patients treated with SBRT

  16. Histogram Analysis of Apparent Diffusion Coefficients for Occult Tonsil Cancer in Patients with Cervical Nodal Metastasis from an Unknown Primary Site at Presentation.

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    Choi, Young Jun; Lee, Jeong Hyun; Kim, Hye Ok; Kim, Dae Yoon; Yoon, Ra Gyoung; Cho, So Hyun; Koh, Myeong Ju; Kim, Namkug; Kim, Sang Yoon; Baek, Jung Hwan

    2016-01-01

    To explore the added value of histogram analysis of apparent diffusion coefficient (ADC) values over magnetic resonance (MR) imaging and fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for the detection of occult palatine tonsil squamous cell carcinoma (SCC) in patients with cervical nodal metastasis from a cancer of an unknown primary site. The institutional review board approved this retrospective study, and the requirement for informed consent was waived. Differences in the bimodal histogram parameters of the ADC values were assessed among occult palatine tonsil SCC (n = 19), overt palatine tonsil SCC (n = 20), and normal palatine tonsils (n = 20). One-way analysis of variance was used to analyze differences among the three groups. Receiver operating characteristic curve analysis was used to determine the best differentiating parameters. The increased sensitivity of histogram analysis over MR imaging and (18)F-FDG PET/CT for the detection of occult palatine tonsil SCC was evaluated as added value. Histogram analysis showed statistically significant differences in the mean, standard deviation, and 50th and 90th percentile ADC values among the three groups (P histogram analysis was 52.6% over MR imaging alone and 15.8% over combined conventional MR imaging and (18)F-FDG PET/CT. Adding ADC histogram analysis to conventional MR imaging can improve the detection sensitivity for occult palatine tonsil SCC in patients with a cervical nodal metastasis originating from a cancer of an unknown primary site. © RSNA, 2015.

  17. A Case Report of Intraocular Metastasis Treated with Radiotherapy

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    Kim, Ok Bae; Byun, Sang Jun; Kim, Kwang Soo; Kim, Jin Hee [Keimyung University School of Medicine, Daegu (Korea, Republic of); Lee, Ho Jun [Daegu Catholic University School of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    Intraocular metastasis is the most common malignancy of the eye. The frequency of intraocular metastasis in all the patients dying of cancer is about 12% and ocular metastases will be detected more frequently in the future because the patients with malignant tumor are now living longer. Intraocular metastasis can cause a serious clinical problem such as blindness. The early recognition and treatment of intraocular metastasis are very important clinical oncologic issues to maintain vision and to maximize the quality of life. However, significance of intraocular metastasis is still under-evaluated for practicing oncologists. External beam radiotherapy is a safe, effective palliative treatment in terms of preserving both the vision and the eye globe.

  18. Treatment results of Stage I and II oral tongue cancer with interstitial brachytherapy: maximum tumor thickness is prognostic of nodal metastasis

    International Nuclear Information System (INIS)

    Matsuura, Kanji; Hirokawa, Yutaka; Fujita, Minoru; Akagi, Yukio; Ito, Katsuhide

    1998-01-01

    Purpose: To evaluate the prognostic importance of T classification and maximum tumor thickness (MTT) on the treatment results of Stage I and II oral tongue cancer treated with interstitial brachytherapy. Methods and Materials: Between January 1981 and December 1993, 173 cases were eligible for this retrospective analysis. Of 173 patients, 75 were classified as Stage I and 98 as Stage II: maximum tumor length ranged from 6 to 40 mm. MTT, which ranged from 2 to 38 mm, was measured with ultrasonography and/or palpation. Brachytherapy was performed with iridium hairpins or radium needles following external irradiation in 66 patients, or exclusively in 107 patients. Results: The 5-year local recurrence rates were Stage I, 7%; Stage II, 22%; MTT < 8 mm, 8%; and MTT ≥ 8 mm, 28%. The 5-year regional recurrence rates were Stage I, 15%; Stage II, 29%; MTT < 8 mm, 18%; and MTT ≥ 8 mm, 31%, respectively. The 5-year local recurrence rates of the patients with Stage I and MTT < 8 mm of the brachytherapy only group were significantly better than those of Stage II and MTT ≥ 8 mm (5% and 6% vs. 16% and 24%). The 5-year regional recurrence rates of the patients with Stage I and MTT < 8 mm of the brachytherapy-only group were significantly better than those of Stage II and MTT ≥ 8 mm (14% and 16% vs. 34% and 46%). There was no significant difference in the 5-year regional recurrence rates between the two groups of Stage I and Stage II, MTT < 8 mm. However, there was a significant difference in the 5-year regional recurrence rates between the two groups of MTT ≥ 8 mm (p < 0.005). Conclusions: For patients with Stage I and II oral tongue cancer, tumor thickness as well as T classification were prognostic for nodal metastasis and prognosis. Patients with MTT ≥ 8 mm are more likely to fail in the neck region. These findings suggest that MTT should be considered along with T stage in determining strategies for Stage I and II oral tongue cancer

  19. Experience of treating late cerebral lungcancer metastasis using photodynamic therapy

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    A. I. Ryabova

    2013-01-01

    Full Text Available Treatment outcomes for a patient with solitary brain metastasis after long-term relapse-free follow-up of invasive lung carcinoma were presented. Brain metastasis without other signs of disease progression was diagnosed 10 years after combined modality treatment for stage II lung cancer. Removal of intracerebral metastasis with intraoperative photodynamic therapy was performed. Histology microspecimens of the primary tumor and metastasis were similar. No signs of disease progression in the brain 9 months after surgery were found. This case demonstrates that it is important to increase cancer suspicion for patients with long-term relapse-free follow-up. The use of intraoperative photodynamic therapy with photoditazine as a sensitizer in the treatment of cerebral metastases results in a favorable anti-tumor effect, thus improving life quality of patients

  20. Detection of lymph node metastasis in patients with nodal prostate cancer relapse using (18)F/(11)C-choline positron emission tomography/computerized tomography.

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    Jilg, Cordula A; Schultze-Seemann, Wolfgang; Drendel, Vanessa; Vach, Werner; Wieser, Gesche; Krauss, Tobias; Jandausch, Anett; Hölz, Stefanie; Henne, Karl; Reske, Sven N; Grosu, Anca-L; Weber, Wolfgang A; Rischke, H Christian

    2014-07-01

    We evaluated the diagnostic accuracy of choline positron emission tomography/computerized tomography for nodal relapse of prostate cancer according to topographical site and tumor infiltration size in lymph nodes. A total of 72 patients with nodal prostate cancer relapse after primary therapy underwent pelvic and/or retroperitoneal salvage lymph node dissection. Salvage was done after whole body positron emission tomography/computerized tomography with (11)C-choline or (18)F-fluoroethylcholine showed positron emission tomography positive lymph nodes but no other detectable metastasis. Diagnostic accuracy was evaluated in 160 dissected lymph node regions (pelvic left/right and retroperitoneal), 498 subregions (common, external and internal iliac, obturator, presacral, aortic bifurcation, aortal, vena caval and interaortocaval) and 2,122 lymph nodes. Lymph node metastasis was present in 32% of resected lymph nodes (681 of 2,122), resulting in 238 positive subregions and 111 positive regions. Positron emission tomography/computerized tomography was positive for 110 regions and 209 subregions. Sensitivity, specificity, positive and negative predictive values, and accuracy were 91.9%, 83.7%, 92.7%, 82.0% and 89.4% (region based), 80.7%, 93.5%, 91.9%, 84.1% and 87.3% (subregion based), and 57.0%, 98.4%, 94.5%, 82.6% and 84.9% (lesion based), respectively. Of 393 positive lymph node metastases detected by this method 278 (70.7%) were in lymph nodes with a less than 10 mm short axis diameter. Imaging sensitivity was 13.3%, 57.4% and 82.8% for a tumor infiltration depth of 2 or greater to less than 3 mm, 5 or greater to less than 6 mm and 10 or greater to less than 11 mm, respectively. Lymph node metastasis site and the radiotracer ((11)C-choline/(18)F-fluoroethylcholine) had no substantial impact on diagnostic accuracy. Choline positron emission tomography/computerized tomography detects affected lymph node regions (pelvic left/right and retroperitoneal) in patients with

  1. Long-term outcomes of patients with lymph node metastasis treated with radical prostatectomy without adjuvant androgen-deprivation therapy.

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    Touijer, Karim A; Mazzola, Clarisse R; Sjoberg, Daniel D; Scardino, Peter T; Eastham, James A

    2014-01-01

    The presence of lymph node metastasis (LNM) at radical prostatectomy (RP) is associated with poor outcome, and optimal treatment remains undefined. An understanding of the natural history of node-positive prostate cancer (PCa) and identifying prognostic factors is needed. To assess outcomes for patients with LNM treated with RP and lymph node dissection (LND) alone. We analyzed data from a consecutive cohort of 369 men with LNM treated at a single institution from 1988 to 2010. RP and extended LND. Our primary aim was to model overall survival, PCa-specific survival, metastasis-free progression, and freedom from biochemical recurrence (BCR). We used univariate Cox proportional hazard regression models for survival outcomes. Multivariable Cox proportional hazard regression models were used for freedom from metastasis and freedom from BCR, with prostate-specific antigen, Gleason score, extraprostatic extension, seminal vesical invasion, surgical margin status, and number of positive nodes as predictors. Sixty-four patients with LNM died, 37 from disease. Seventy patients developed metastasis, and 201 experienced BCR. The predicted 10-yr overall survival and cancer-specific survival were 60% (95% confidence interval [CI], 49-69) and 72% (95% CI, 61-80), respectively. The 10-yr probability of freedom from distant metastasis and freedom from BCR were 65% (95% CI, 56-73) and 28% (95% CI, 21-36), respectively. Higher pathologic Gleason score (>7 compared with ≤ 7; hazard ratio [HR]: 2.23; 95% CI, 1.64-3.04; p < 0.0001) and three or more positive lymph nodes (HR: 2.61; 95% CI, 1.81-3.76; p < 0.0001) were significantly associated with increased risk of BCR on multivariable analysis. The retrospective nature and single-center source of data are study limitations. A considerable subset of men with LNM remained free of disease 10 yr after RP and extended LND alone. Patients with pathologic Gleason score <8 and low nodal metastatic burden represent a favorable group. Our data

  2. Facilitation of nodal metastasis from a non-immunogenic murine carcinoma by previous whole-body irradiation of tumour recipients

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    Hewitt, H.B.; Blake, E.R.

    1977-01-01

    Of 193 CBA mice kept under prolonged observation after excision of small intradermal transplants of a non-immunogenic tumour (CBA Carcinoma NT), 27 (14%) presented with local recurrence, 19 (10%) with regional lymphnodal metastasis (RNM) and 72 (37%), with pulmonary metastasis +- other systemic metastases. When mice were exposed to sublethal whole-body irradiation (WBI) before tumour transplantation, the incidence of RNM rose to approximately 80% and the latent period was reduced from approximately 60 days to approximately 40 days after tumour transplantation. This enhancement of RNM by WBI was undiminished when the interval between WBI and tumour transplantation was increased from 1 to 90 days. An explanation for this effect in terms of immunosuppression by the WBI is unlikely for the following reasons: the tumour was non-immunogenic by standard quantitative tests; the effect persisted long after the expected time for recovery of immune reactivity; and i.v. injection of normal marrow and lymphoid cells after WBI failed to reduce the effect. That the effect was systemic was proved by failure of local pre-irradiation of the tumour bed or regional node to enhance RNM. The effect was not observed when WBI was given 4 days after excision of tumours. These and other experiments failed to indicate the mechanism of the effect of WBI, but its long persistence suggests that it may relate to stored lethal radiation damage in migrating cells of slow turnover tissues. (author)

  3. Predictors of survival in surgically treated patients of spinal metastasis

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    Pravin Padalkar

    2011-01-01

    Full Text Available Background: The spinal metastasis occurs in up to 40% of cancer patient. We compared the Tokuhashi and Tomita scoring systems, two commonly used scoring systems for prognosis in spinal metastases. We also assessed the different variables separately with respect to their value in predicting postsurgical life expectancy. Finally, we suggest criteria for selecting patients for surgery based on the postoperative survival pattern. Materials and Methods: We retrospectively analyzed 102 patients who had been operated for metastatic disease of the spine. Predictive scoring was done according to the scoring systems proposed by Tokuhashi and Tomita. Overall survival was assessed using Kaplan-Meier survival analysis. Using the log rank test and Cox regression model we assessed the value of the individual components of each scoring system for predicting survival in these patients. Result: The factors that were most significantly associated with survival were the general condition score (Karnofsky Performance Scale (P=.000, log rank test, metastasis to internal organs (P=.0002 log rank test, and number of extraspinal bone metastases (P=.0058. Type of primary tumor was not found to be significantly associated with survival according to the revised Tokuhashi scoring system (P=.9131, log rank test. Stepwise logistic regression revealed that the Tomita score correlated more closely with survival than the Tokuhashi score. Conclusion: The patient′s performance status, extent of visceral metastasis, and extent of bone metastases are significant predictors of survival in patients with metastatic disease. Both revised Tokuhashi and Tomita scores were significantly correlated with survival. A revised Tokuhashi score of 7 or more and a Tomita score of 6 or less indicated >50% chance of surviving 6 months postoperatively. We recommend that the Tomita score be used for prognostication in patients who are contemplating surgery, as it is simpler to score and has a higher

  4. Prostate-Derived Ets Transcription Factor Overexpression is Associated with Nodal Metastasis, Hormone Receptor Positivity in Invasive Breast Cancer

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    Simon Turcotte

    2007-10-01

    Full Text Available Prostate-derived Ets transcription factor (PDEF has recently been associated with invasive breast cancer, but no expression profile has been defined in clinical specimens. We undertook a comprehensive PDEF transcriptional expression study of 86 breast cancer clinical specimens, several cell lines, normal tissues. PDEF expression profile was analyzed according to standard clinicopathologic parameters, compared with hormonal receptor, HER-2/neu status, to the expression of the new tumor biomarker Dikkopf-1 (DKK1. Wide ranging PDEF overexpression was observed in 74% of tested tumors, at higher levels than the average expression found in normal breasts. High PDEF expression was associated with hormone receptor positivity (P < .001, moderate to good differentiation (less than grade III, P = .01, dissemination to axillary lymph nodes (P = .002. PDEF was an independent risk factor for nodal involvement (multivariate analysis, odds ratio 1.250, P = .002. It was expressed in a different subgroup compared to DKK1-expressing tumors (P < .001. Our data imply that PDEF mRNA expression could be useful in breast cancer molecular staging. Further insights into PDEF functions at the protein level, possible links with hormone receptors biology, bear great potential for new therapeutic avenues.

  5. Risk of isolated nodal failure for non-small cell lung cancer (NSCLC) treated with the elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT) techniques - A retrospective analysis

    International Nuclear Information System (INIS)

    Kepka, Lucyna; Bujko, Krzysztof; Zolciak-Siwinska, Agnieszka

    2008-01-01

    Purpose. To estimate retrospectively the rate of isolated nodal failures (INF) in NSCLC patients treated with the elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT). Materials/methods. One hundred and eighty-five patients with I-IIIB stage treated with 3D-CRT in consecutive clinical trials differing in an extent of the ENI were analyzed. According to the extent of the ENI, two groups were distinguished: extended (n=124) and limited (n=61) ENI. INF was defined as regional nodal failure occurring without local progression. Cumulative Incidence of INF (CIINF) was evaluated by univariate and multivariate analysis with regard to prognostic factors. Results. With a median follow up of 30 months, the two-year actuarial overall survival was 35%. The two-year CIINF rate was 12%. There were 16 (9%) INF, eight (6%) for extended and eight (13%) for limited ENI. In the univariate analysis bulky mediastinal disease (BMD), left side, higher N stage, and partial response to RT had a significant negative impact on the CIINF. BMD was the only independent predictor of the risk of incidence of the INF (p=0.001). Conclusions. INF is more likely to occur in case of more advanced nodal status

  6. Risk of isolated nodal failure for non-small cell lung cancer (NSCLC) treated with the elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT) techniques--a retrospective analysis.

    Science.gov (United States)

    Kepka, Lucyna; Bujko, Krzysztof; Zolciak-Siwinska, Agnieszka

    2008-01-01

    To estimate retrospectively the rate of isolated nodal failures (INF) in NSCLC patients treated with the elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT). One hundred and eighty-five patients with I-IIIB stage treated with 3D-CRT in consecutive clinical trials differing in an extent of the ENI were analyzed. According to the extent of the ENI, two groups were distinguished: extended (n = 124) and limited (n = 61) ENI. INF was defined as regional nodal failure occurring without local progression. Cumulative Incidence of INF (CIINF) was evaluated by univariate and multivariate analysis with regard to prognostic factors. With a median follow up of 30 months, the two-year actuarial overall survival was 35%. The two-year CIINF rate was 12%. There were 16 (9%) INF, eight (6%) for extended and eight (13%) for limited ENI. In the univariate analysis bulky mediastinal disease (BMD), left side, higher N stage, and partial response to RT had a significant negative impact on the CIINF. BMD was the only independent predictor of the risk of incidence of the INF (p = 0.001). INF is more likely to occur in case of more advanced nodal status.

  7. Effect of interfractional shoulder motion on low neck nodal targets for patients treated using volume modulated arc therapy (VMAT

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    Kevin Casey

    2014-03-01

    Full Text Available Purpose: To quantify the dosimetric impact of interfractional shoulder motion on targets in the low neck for head and neck patients treated with volume modulated arc therapy (VMAT.Methods: Three patients with head and neck cancer were selected. All three required treatment to nodal regions in the low neck in addition to the primary tumor site. The patients were immobilized during simulation and treatment with a custom thermoplastic mask covering the head and shoulders. One VMAT plan was created for each patient utilizing two full 360° arcs and a second plan was created consisting of two superior VMAT arcs matched to an inferior static AP supraclavicular field. A CT-on-rails alignment verification was performed weekly during each patient’s treatment course. The weekly CT images were registered to the simulation CT and the target contours were deformed and applied to the weekly CT. The two VMAT plans were copied to the weekly CT datasets and recalculated to obtain the dose to the deformed low neck contours.Results: The average observed shoulder position shift in any single dimension relative to simulation was 2.5 mm. The maximum shoulder shift observed in a single dimension was 25.7 mm. Low neck target mean doses, normalized to simulation and averaged across all weekly recalculations were 0.996, 0.991, and 1.033 (Full VMAT plan and 0.986, 0.995, and 0.990 (Half-Beam VMAT plan for the three patients, respectively. The maximum observed deviation in target mean dose for any individual weekly recalculation was 6.5%, occurring with the Full VMAT plan for Patient 3.Conclusion: Interfractional variation in dose to low neck nodal regions was quantified for three head and neck patients treated with VMAT. Mean dose was 3.3% higher than planned for one patient using a Full VMAT plan. A Half-Beam technique is likely a safer choice when treating the supraclavicular region with VMAT.-------------------------------------------Cite this article as: Casey K

  8. Incidentally Detected Inoperable Malignant Pheochromocytoma with Hepatic Metastasis Treated by Transcatheter Arterial Chemoembolization

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    Joong Keun Kim

    2014-12-01

    Full Text Available Malignant pheochromocytoma (PCC is a rare condition. Although the liver is the second most frequent site of metastasis in malignant PCC, no definite treatments have been established. Herein, we report a case of liver metastasis of PCC that was successfully treated by transcatheter arterial chemoembolization (TACE. A 69-year-old man was admitted to the Department of Gastroenterology for evaluation of an incidental hepatic mass in August 2013. He had undergone right adrenalectomy in May 2005 and PCC had been confirmed on the basis of histopathological findings. Liver biopsy was performed, and metastatic PCC was diagnosed. The lesion appeared inoperable because of invasion of the portal vein and metastases in the lymph nodes along the hepatoduodenal ligament. Thus, TACE was performed instead. After TACE, symptoms including dizziness and cold sweating improved, and the patient's serum catecholamine levels decreased. On the basis of this case, we believe that TACE may be a useful treatment for liver metastasis in malignant PCC.

  9. Histologic assessment of tumor budding in preoperative biopsies to predict nodal metastasis in squamous cell carcinoma of the tongue and floor of the mouth.

    Science.gov (United States)

    Seki, Mai; Sano, Takaaki; Yokoo, Satoshi; Oyama, Tetsunari

    2016-04-01

    In squamous cell carcinoma (SCC) of the tongue and the floor of the mouth (FOM), it is important to predict lymph node metastasis, including occult metastasis, before operating. The purpose of this study was for us to determine practical histopathologic parameters as predictive factors for lymph node metastasis in preoperative SCC biopsy specimens. We examined 91 cases of SCC for conventional histopathologic assessment and a new factor, tumor budding, and their relationship with lymph node metastasis. Significant factors via univariate analysis (p factoring into the decision as to whether neck dissection is indicated. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1582-E1590, 2016. © 2015 Wiley Periodicals, Inc.

  10. Dose-Volume Relationships for Acute Bowel Toxicity in Patients Treated With Pelvic Nodal Irradiation for Prostate Cancer

    International Nuclear Information System (INIS)

    Fiorino, Claudio; Alongi, Filippo; Perna, Lucia; Broggi, Sara; Cattaneo, Giovanni Mauro; Cozzarini, Cesare; Di Muzio, Nadia; Fazio, Ferruccio; Calandrino, Riccardo

    2009-01-01

    Purpose: To find correlation between dose-volume histograms (DVHs) of the intestinal cavity (IC) and moderate-severe acute bowel toxicity in men with prostate cancer treated with pelvic nodal irradiation. Methods and Materials: The study group consisted of 191 patients with localized prostate cancer who underwent whole-pelvis radiotherapy with radical or adjuvant/salvage intent during January 2004 to November 2007. Complete planning/clinical data were available in 175 of these men, 91 of whom were treated with a conventional four-field technique (50.4 Gy, 1.8 Gy/fraction) and 84 of whom were treated with IMRT using conventional Linac (n = 26, 50.4 Gy, 1.8 Gy/fraction) or Helical TomoTherapy (n = 58, 50-54 Gy, 1.8-2 Gy/fraction). The IC outside the planning target volume (PTV) was contoured and the DVH for the first 6 weeks of treatment was recovered in all patients. The correlation between a number of clinical and DVH (V10-V55) variables and toxicity was investigated in univariate and multivariate analyses. The correlation between DVHs for the IC outside the PTV and DVHs for the whole IC was also assessed. Results: Twenty-two patients experienced toxicity (3/22 in the IMRT/tomotherapy group). Univariate analyses showed a significant correlation between V20-V50 and toxicity (p = 0.0002-0.001), with a higher predictive value observed for V40-V50. Previous prostatectomy (p = 0.066) and abdominal/pelvic surgery (p = 0.12) also correlated with toxicity. Multivariate analysis that included V45, abdominal/pelvic surgery, and prostatectomy showed that the most predictive parameters were V45 (p = 0.002) and abdominal/pelvic surgery (p = 0.05, HR = 2.4) Conclusions: Our avoidance IMRT approach drastically reduces the incidence of acute bowel toxicity. V40-V50 of IC and, secondarily, previous abdominal/pelvic surgery were the main predictors of acute bowel toxicity.

  11. Lymph node metastasis in maxillary sinus carcinoma

    International Nuclear Information System (INIS)

    Le, Q.-T.; Fu, Karen K.; Kaplan, Michael J.; Terris, David J.; Fee, Willard E.; Goffinet, Don R.

    2000-01-01

    Purpose: To evaluate the incidence and prognostic significance of lymph node metastasis in maxillary sinus carcinoma. Methods and Materials: We reviewed the records of 97 patients treated for maxillary sinus carcinoma with radiotherapy at Stanford University and at the University of California, San Francisco between 1959 and 1996. Fifty-eight patients had squamous cell carcinoma (SCC), 4 had adenocarcinoma (ADE), 16 had undifferentiated carcinoma (UC), and 19 had adenoid cystic carcinoma (AC). Eight patients had T2, 36 had T3, and 53 had T4 tumors according to the 1997 AJCC staging system. Eleven patients had nodal involvement at diagnosis: 9 with SCC, 1 with UC, and 1 with AC. The most common sites of nodal involvement were ipsilateral level 1 and 2 lymph nodes. Thirty-six patients were treated with definitive radiotherapy alone, and 61 received a combination of surgical and radiation treatment. Thirty-six patients had neck irradiation, 25 of whom received elective neck irradiation (ENI) for N0 necks. The median follow-up for alive patients was 78 months. Results: The median survival for all patients was 22 months (range: 2.4-356 months). The 5- and 10-year actuarial survivals were 34% and 31%, respectively. Ten patients relapsed in the neck, with a 5-year actuarial risk of nodal relapse of 12%. The 5-year risk of neck relapse was 14% for SCC, 25% for ADE, and 7% for both UC and ACC. The overall risk of nodal involvement at either diagnosis or on follow-up was 28% for SCC, 25% for ADE, 12% for UC, and 10% for AC. All patients with nodal involvement had T3-4, and none had T2 tumors. ENI effectively prevented nodal relapse in patients with SCC and N0 neck; the 5-year actuarial risk of nodal relapse was 20% for patients without ENI and 0% for those with elective neck therapy. There was no correlation between neck relapse and primary tumor control or tumor extension into areas containing a rich lymphatic network. The most common sites of nodal relapse were in the

  12. Nonfunctional pancreatic neuroendocrine tumors <2 cm on preoperative imaging are associated with a low incidence of nodal metastasis and an excellent overall survival.

    Science.gov (United States)

    Toste, Paul A; Kadera, Brian E; Tatishchev, Sergei F; Dawson, David W; Clerkin, Barbara M; Muthusamy, Raman; Watson, Rabindra; Tomlinson, James S; Hines, Oscar J; Reber, Howard A; Donahue, Timothy R

    2013-12-01

    The optimal surgical management of small nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) remains controversial. We sought to identify (1) clinicopathologic factors associated with survival in NF-PNETs and (2) preoperative tumor characteristics that can be used to determine which lesions require resection and lymph node (LN) harvest. The records of all 116 patients who underwent resection for NF-PNETs between 1989 and 2012 were reviewed retrospectively. Preoperative factors, operative data, pathology, surgical morbidity, and survival were analyzed. The overall 5- and 10-year survival rates were 83.9 and 72.8 %, respectively. Negative LNs (p = 0.005), G1 or G2 histology (p = 0.033), and age <60 years (p = 0.002) correlated with better survival on multivariate analysis. The 10-year survival rate was 86.6 % for LN-negative patients (n = 73) and 34.1 % for LN-positive patients (n = 32). Tumor size ≥2 cm on preoperative imaging predicted nodal positivity with a sensitivity of 93.8 %. Positive LNs were found in 38.5 % of tumors ≥2 cm compared to only 7.4 % of tumors <2 cm. LN status, a marker of systemic disease, was a highly significant predictor of survival in this series. Tumor size on preoperative imaging was predictive of nodal disease. Thus, it is reasonable to consider parenchyma-sparing resection or even close observation for NF-PNETs <2 cm.

  13. Isolated Late Metastasis of a Renal Cell Cancer Treated by Radical Distal Pancreatectomy

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    J. P. Barras

    1996-01-01

    Full Text Available A 53–year-old man underwent right nephrectomy for a locally advanced renal cell carcinoma with concomitant resection of a solitary metastasis in the right lung. Ten years later, he presented with haematochezia caused by a tumour in the tail of pancreas, invading the transverse colon and the greater curvature of the stomach. The tumour was radically resected, and histological examination revealed a solitary metastasis of the previous renal cell carcinoma. This case illustrates a rare indication for pancreatic resection because of pancreatic metastasis.

  14. Pancreatic Metastasis in a Child Suffering with Treated Stage 4 Neuroblastoma

    International Nuclear Information System (INIS)

    Kim, Eun Young; Yoo, So Young; Kim, Ji Hye; Sung, Ki Woong

    2008-01-01

    Neuroblastoma is the most common extracranial solid tumor of childhood, and its metastasis to distant organs such as bone, bone marrow and liver is well documented. However, pancreatic metastasis of neuroblastoma has not yet been reported in the medical literature. We report here on a 4-year old boy who had a metastatic relapse in his pancreas, combined with pancreatitis, after remission of stage 4 neuroblastoma. In conclusion, we present here a very rare case of neuroblastoma that metastasized to the pancreas in a 4- year-old boy. Pancreatic metastasis should be taken into consideration for those patients who are found to have pancreatic nodules concurrent with neuroblastoma

  15. Peritoneal metastasis from pancreatic cancer treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC)

    DEFF Research Database (Denmark)

    Graversen, Martin; Detlefsen, Sönke; Bjerregaard, Jon Kroll

    2017-01-01

    Patients with peritoneal metastasis (PM) from pancreatic cancer have a short life expectancy. Systemic combination chemotherapy leads to a median overall survival of 7–8 months. Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) is a treatment alternative, where studies in patients with PM...... activity of PIPAC with low-dose cisplatin and doxorubicin in pretreated peritoneal metastasis of pancreatic origin. This should now be evaluated in prospective studies....

  16. Analysis of Incidental Radiation Dose to Uninvolved Mediastinal/Supraclavicular Lymph Nodes in Patients with Limited-Stage Small Cell Lung Cancer Treated Without Elective Nodal Irradiation

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    Ahmed, Irfan; DeMarco, Marylou; Stevens, Craig W. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL (United States); Fulp, William J. [Biostatistics Core, H. Lee Moffitt Cancer Center, Tampa, FL (United States); Dilling, Thomas J., E-mail: Thomas.Dilling@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL (United States)

    2011-01-01

    Classic teaching states that treatment of limited-stage small cell lung cancer (L-SCLC) requires large treatment fields covering the entire mediastinum. However, a trend in modern thoracic radiotherapy is toward more conformal fields, employing positron emission tomography/computed tomography (PET/CT) scans to determine the gross tumor volume (GTV). This analysis evaluates the dosimetric results when using selective nodal irradiation (SNI) to treat a patient with L-SCLC, quantitatively comparing the results to standard Intergroup treatment fields. Sixteen consecutive patients with L-SCLC and central mediastinal disease who also underwent pretherapy PET/CT scans were studied in this analysis. For each patient, we created SNI treatment volumes, based on the PET/CT-based criteria for malignancy. We also created 2 ENI plans, the first without heterogeneity corrections, as per the Intergroup 0096 study (ENI{sub off}) and the second with heterogeneity corrections while maintaining constant the number of MUs delivered between these latter 2 plans (ENI{sub on}). Nodal stations were contoured using published guidelines, then placed into 4 'bins' (treated nodes, 1 echelon away, >1 echelon away within the mediastinum, contralateral hilar/supraclavicular). These were aggregated across the patients in the study. Dose to these nodal bins and to tumor/normal structures were compared among these plans using pairwise t-tests. The ENI{sub on} plans demonstrated a statistically significant degradation in dose coverage compared with the ENI{sub off} plans. ENI and SNI both created a dose gradient to the lymph nodes across the mediastinum. Overall, the gradient was larger for the SNI plans, although the maximum dose to the '1 echelon away' nodes was not statistically different. Coverage of the GTV and planning target volume (PTV) were improved with SNI, while simultaneously reducing esophageal and spinal cord dose though at the expense of modestly reduced dose to

  17. Analysis of incidental radiation dose to uninvolved mediastinal/supraclavicular lymph nodes in patients with limited-stage small cell lung cancer treated without elective nodal irradiation.

    Science.gov (United States)

    Ahmed, Irfan; DeMarco, Marylou; Stevens, Craig W; Fulp, William J; Dilling, Thomas J

    2011-01-01

    Classic teaching states that treatment of limited-stage small cell lung cancer (L-SCLC) requires large treatment fields covering the entire mediastinum. However, a trend in modern thoracic radiotherapy is toward more conformal fields, employing positron emission tomography/computed tomography (PET/CT) scans to determine the gross tumor volume (GTV). This analysis evaluates the dosimetric results when using selective nodal irradiation (SNI) to treat a patient with L-SCLC, quantitatively comparing the results to standard Intergroup treatment fields. Sixteen consecutive patients with L-SCLC and central mediastinal disease who also underwent pretherapy PET/CT scans were studied in this analysis. For each patient, we created SNI treatment volumes, based on the PET/CT-based criteria for malignancy. We also created 2 ENI plans, the first without heterogeneity corrections, as per the Intergroup 0096 study (ENI(off)) and the second with heterogeneity corrections while maintaining constant the number of MUs delivered between these latter 2 plans (ENI(on)). Nodal stations were contoured using published guidelines, then placed into 4 "bins" (treated nodes, 1 echelon away, >1 echelon away within the mediastinum, contralateral hilar/supraclavicular). These were aggregated across the patients in the study. Dose to these nodal bins and to tumor/normal structures were compared among these plans using pairwise t-tests. The ENI(on) plans demonstrated a statistically significant degradation in dose coverage compared with the ENI(off) plans. ENI and SNI both created a dose gradient to the lymph nodes across the mediastinum. Overall, the gradient was larger for the SNI plans, although the maximum dose to the "1 echelon away" nodes was not statistically different. Coverage of the GTV and planning target volume (PTV) were improved with SNI, while simultaneously reducing esophageal and spinal cord dose though at the expense of modestly reduced dose to anatomically distant lymph nodes

  18. Diet Modulation is an Effective Complementary Agent in Preventing and Treating Breast Cancer Lung Metastasis

    Science.gov (United States)

    Zhao, Xiangmin; Rezonzew, Gabriel; Wang, Dezhi; Siegal, Gene P.; Hardy, Robert W.

    2014-01-01

    A significant percentage of breast cancer victims will suffer from metastases indicating that new approaches to preventing breast cancer metastasis are thus needed. Dietary stearate and chemotherapy have been shown to reduce breast cancer metastasis. We tested the complementary use of dietary stearate with a taxol-based chemotherapy which work through separate mechanisms to reduce breast cancer metastasis. We therefore carried out a prevention study in which diets were initiated prior to human MDA-MB-435 cancer cells being injected into the host and a treatment study in which diets were combined with paclitaxel (PTX). Using an orthotopic athymic nude mouse model and three diets (corn oil control diet/CO, low fat /LF or stearate/ST) the prevention study demonstrated that the ST diet decreased the incidence of lung metastasis by 50% compared to both the LF and CO diets. The ST diet also reduced the number and size of metastatic lung nodules compared to the LF diet. Results of the treatment study indicated that both the CO and ST diets decreased the number of mice with lung metastasis compared to the LF diet. Both CO and ST also decreased the number of lung metastases per mouse compared to the LF diet however only the ST diet cohort was significant. Histomorphometric analysis of the lung tumor tissue indicated that the ST diet plus PTX decreased angiogenesis compared to the LF diet plus PTX. In conclusion these results support combining diet with chemotherapy in both treatment and prevention settings. PMID:24832758

  19. Determination and delineation of nodal target volumes for head-and-neck cancer based on patterns of failure in patients receiving definitive and postoperative IMRT

    International Nuclear Information System (INIS)

    Chao, K.S. Clifford; Wippold, Franz J.; Ozyigit, Gokhan; Tran, Binh N.; Dempsey, James F.

    2002-01-01

    Purpose: We present the guidelines for target volume determination and delineation of head-and-neck lymph nodes based on the analysis of the patterns of nodal failure in patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Data pertaining to the natural course of nodal metastasis for each head-and-neck cancer subsite were reviewed. A system was established to provide guidance for nodal target volume determination and delineation. Following these guidelines, 126 patients (52 definitive, 74 postoperative) were treated between February 1997 and December 2000 with IMRT for head-and-neck cancer. The median follow-up was 26 months (range 12-55), and the patterns of nodal failure were analyzed. Results: These guidelines define the nodal target volume based on the location of the primary tumor and the probability of microscopic metastasis to the ipsilateral and contralateral (Level I-V) nodal regions. Following these guidelines, persistent or recurrent nodal disease was found in 6 (12%) of 52 patients receiving definitive IMRT, and 7 (9%) of 74 patients receiving postoperative IMRT had failure in the nodal region. Conclusion: On the basis of our clinical experience in implementing inverse-planning IMRT for head-and-neck cancer, we present guidelines using a simplified, but clinically relevant, method for nodal target volume determination and delineation. The intention was to provide a foundation that enables different institutions to exchange clinical experiences in head-and-neck IMRT. These guidelines will be subject to future refinement when the clinical experience in head-and-neck IMRT advances

  20. Combined-modality therapy for patients with regional nodal metastases from melanoma

    International Nuclear Information System (INIS)

    Ballo, Matthew T.; Ross, Merrick I.; Cormier, Janice N.; Myers, Jeffrey N.; Lee, Jeffrey E.; Gershenwald, Jeffrey E.; Hwu, Patrick; Zagars, Gunar K.

    2006-01-01

    Purpose: To evaluate the outcome and patterns of failure for patients with nodal metastases from melanoma treated with combined-modality therapy. Methods and Materials: Between 1983 and 2003, 466 patients with nodal metastases from melanoma were managed with lymphadenectomy and radiation, with or without systemic therapy. Surgery was a therapeutic procedure for clinically apparent nodal disease in 434 patients (regionally advanced nodal disease). Adjuvant radiation was generally delivered with a hypofractionated regimen. Adjuvant systemic therapy was delivered to 154 patients. Results: With a median follow-up of 4.2 years, 252 patients relapsed and 203 patients died of progressive disease. The actuarial 5-year disease-specific, disease-free, and distant metastasis-free survival rates were 49%, 42%, and 44%, respectively. By multivariate analysis, increasing number of involved lymph nodes and primary ulceration were associated with an inferior 5-year actuarial disease-specific and distant metastasis-free survival. Also, the number of involved lymph nodes was associated with the development of brain metastases, whereas thickness was associated with lung metastases, and primary ulceration was associated with liver metastases. The actuarial 5-year regional (in-basin) control rate for all patients was 89%, and on multivariate analysis there were no patient or disease characteristics associated with inferior regional control. The risk of lymphedema was highest for those patients with groin lymph node metastases. Conclusions: Although regional nodal disease can be satisfactorily controlled with lymphadenectomy and radiation, the risk of distant metastases and melanoma death remains high. A management approach to these patients that accounts for the competing risks of distant metastases, regional failure, and long-term toxicity is needed

  1. Radiotherapy for esthesioneuroblastoma: is elective nodal irradiation warranted in the multimodality treatment approach?

    Science.gov (United States)

    Noh, O Kyu; Lee, Sang-wook; Yoon, Sang Min; Kim, Sung Bae; Kim, Sang Yoon; Kim, Chang Jin; Jo, Kyung Ja; Choi, Eun Kyung; Song, Si Yeol; Kim, Jong Hoon; Ahn, Seung Do

    2011-02-01

    The role of elective nodal irradiation (ENI) in radiotherapy for esthesioneuroblastoma (ENB) has not been clearly defined. We analyzed treatment outcomes of patients with ENB and the frequency of cervical nodal failure in the absence of ENI. Between August 1996 and December 2007, we consulted with 19 patients with ENB regarding radiotherapy. Initial treatment consisted of surgery alone in 2 patients; surgery and postoperative radiotherapy in 4; surgery and adjuvant chemotherapy in 1; surgery, postoperative radiotherapy, and chemotherapy in 3; and chemotherapy followed by radiotherapy or concurrent chemoradiotherapy in 5. Five patients did not receive planned radiotherapy because of disease progression. Including 2 patients who received salvage radiotherapy, 14 patients were treated with radiotherapy. Elective nodal irradiation was performed in 4 patients with high-risk factors, including 3 with cervical lymph node metastasis at presentation. Fourteen patients were analyzable, with a median follow-up of 27 months (range, 7-64 months). The overall 3-year survival rate was 73.4%. Local failure occurred in 3 patients (21.4%), regional cervical failure in 3 (21.4%), and distant failure in 2 (14.3%). No cervical nodal failure occurred in patients treated with combined systemic chemotherapy regardless of ENI. Three cervical failures occurred in the 4 patients treated with ENI or neck dissection (75%), none of whom received systemic chemotherapy. ENI during radiotherapy for ENB seems to play a limited role in preventing cervical nodal failure. Omitting ENI may be an option if patients are treated with a combination of radiotherapy and chemotherapy. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Radiotherapy for Esthesioneuroblastoma: Is Elective Nodal Irradiation Warranted in the Multimodality Treatment Approach?

    International Nuclear Information System (INIS)

    Noh, O Kyu; Lee, Sang-wook; Yoon, Sang Min; Kim, Sung Bae; Kim, Sang Yoon; Kim, Chang Jin; Jo, Kyung Ja; Choi, Eun Kyung; Song, Si Yeol; Kim, Jong Hoon; Ahn, Seung Do

    2011-01-01

    Purpose: The role of elective nodal irradiation (ENI) in radiotherapy for esthesioneuroblastoma (ENB) has not been clearly defined. We analyzed treatment outcomes of patients with ENB and the frequency of cervical nodal failure in the absence of ENI. Methods and Materials: Between August 1996 and December 2007, we consulted with 19 patients with ENB regarding radiotherapy. Initial treatment consisted of surgery alone in 2 patients; surgery and postoperative radiotherapy in 4; surgery and adjuvant chemotherapy in 1; surgery, postoperative radiotherapy, and chemotherapy in 3; and chemotherapy followed by radiotherapy or concurrent chemoradiotherapy in 5. Five patients did not receive planned radiotherapy because of disease progression. Including 2 patients who received salvage radiotherapy, 14 patients were treated with radiotherapy. Elective nodal irradiation was performed in 4 patients with high-risk factors, including 3 with cervical lymph node metastasis at presentation. Results: Fourteen patients were analyzable, with a median follow-up of 27 months (range, 7-64 months). The overall 3-year survival rate was 73.4%. Local failure occurred in 3 patients (21.4%), regional cervical failure in 3 (21.4%), and distant failure in 2 (14.3%). No cervical nodal failure occurred in patients treated with combined systemic chemotherapy regardless of ENI. Three cervical failures occurred in the 4 patients treated with ENI or neck dissection (75%), none of whom received systemic chemotherapy. Conclusions: ENI during radiotherapy for ENB seems to play a limited role in preventing cervical nodal failure. Omitting ENI may be an option if patients are treated with a combination of radiotherapy and chemotherapy.

  3. KEK NODAL user's guide

    International Nuclear Information System (INIS)

    Akiyama, Atsuyoshi; Katoh, Tadahiko; Kikutani, Eiji; Koiso, Haruyo; Kurokawa, Shin-ichi; Oide, Katsunobu.

    1984-06-01

    NODAL is an interpreter language for accelerator control developed at CERN SPS and has been used successfully since 1974. At present NODAL or NODAL-like languages are used at DESY PETRA and CERN CPS. At KEK, we have also adopted NODAL for the control of TRISTAN, a 30 GeV x 30 GeV electron-positron colliding beam facility. The KEK version of NODAL has the following improvements on the SPS NODAL: (1) the fast execution speed due to the compiler-interpreter scheme, and (2) the full-screen editing facility. This manual explains how to use the KEK NODAL. It is based on the manual of the SPS NODAL, THE NODAL SYSTEM FOR THE SPS, by M.C. Crowley-Milling and G.C. Shering, CERN 78-07. We have made some additions and modifications to make the manual more appropriate for the KEK NODAL system, paying attention to retaining the good features of the original SPS NODAL manual. We acknowledge Professor M.C. Crowley-Milling, Dr G.C. Shering and CERN for their kind permission for this modification. (author)

  4. KEK NODAL system

    International Nuclear Information System (INIS)

    Kurokawa, S.; Abe, K.; Akiyama, A.; Katoh, T.; Kikutani, E.; Koiso, H.; Kurihara, N.; Oide, K.; Shinomoto, M.

    1985-01-01

    The KEK NODAL system, which is based on the NODAL devised at the CERN SPS, works on an optical-fiber token ring network of twenty-four minicomputers (Hitachi HIDIC 80's) to control the TRISTAN accelerator complex, now being constructed at KEK. KEK NODAL retains main features of the original NODAL: the interpreting scheme, the multi-computer programming facility, and the data-module concept. In addition, it has the following characteristics: fast execution due to the compiler-interpreter method, a multicomputer file system, a full-screen editing facility, and a dynamic linkage scheme of data modules and NODAL functions. The structure of the KEK NODAL system under PMS, a real-time multitasking operating system of HIDIC 80, is described; the NODAL file system is also explained

  5. Implantation port-catheter permanent indwelling of pulmonary artery in treating lung metastasis from HCC

    International Nuclear Information System (INIS)

    Cheng Jiemin; Wang Jianhua; Yan Zhiping; Wang Xiaolin; Gong Gaoquan; Liu Qingxin

    2000-01-01

    Objective: To observe the efficacy of a percutaneous implantation port-catheter permanent indwelling pulmonary artery for regional chemotherapy of the metastatic lung cancer from HCC. Methods: Between 1995 and 1999, 62 patients (42 males, 20 females; mean age 46 years) suffering from the metastatic lung cancer from HCC underwent percutaneous implantation of port-catheter permanent indwelling pulmonary artery using the right subclavian vein. In 19 patients with metastatic tumor located on one side of the lung, an indwelling catheter was placed into the ipsilateral side pulmonary artery. With metastasis of both sides, the catheter was inserted into the main trunk of pulmonary artery. The regimens of the chemotherapy were 5-FU + CDDP + MMC(FDM) or 5-FU + CDDP + MMC(FDA). Results: The interventional procedure was successfully completed in all 62 cases (100%). The complications occurred in 8% cases, including infections (3.2%), unhealed wound (1.6%) and pneumothorax (3.2%). The treatment effects of 3-months after the procedure were as follows: the obvious decrease of lung tumor size was 35.5%; stable disease (SD) 32.3% and progressive disease (PD) 32.3%. 6 months follow-up: 12 patients were dead (12/62) and the others are still doing well. The response rates were 22.6%, partial response (PR) 32.3%; stable disease (SD) 25.8% and progressive disease (PD) 32.3%. Conclusions: The percutaneous implantation techniques of pulmonary arterial port-catheter could be a good method in the treatment of metastatic lung cancer from HCC because of it is simple, with few complications and positive effect

  6. Influence of low-dose daily cisplatin on the distant metastasis-free survival of patients with locally advanced nonmetastatic head and neck cancer treated with radiation therapy

    International Nuclear Information System (INIS)

    Jeremic, Branislav; Milicic, Biljana

    2008-01-01

    We investigated the impact of low dose daily cisplatin on distant metastasis-free survival (DMFS) in locally advanced head and neck cancer treated with hyperfractionated radiotherapy (77 Gy in 70 fractions in 35 treatment days). In locally controlled tumors cisplatin led to better DMFS (p = 0.0272); Cisplatin may have acted independently of micrometastasis in locally advanced H and N cancer

  7. Maternal Nodal inversely affects NODAL and STOX1 expression in the fetal placenta

    Directory of Open Access Journals (Sweden)

    Hari Krishna Thulluru

    2013-08-01

    Full Text Available Nodal, a secreted signaling protein from the TGFβ-super family plays a vital role during early embryonic development. Recently, it was found that maternal decidua-specific Nodal knockout mice show intrauterine growth restriction (IUGR and preterm birth. As the chromosomal location of NODAL is in the same linkage area as the susceptibility gene STOX1, associated with the familial form of early-onset, IUGR-complicated pre-eclampsia, their potential maternal-fetal interaction was investigated. Pre-eclamptic mothers with children who carried the STOX1 susceptibility allele themselves all carried the NODAL H165R SNP, which causes a 50% reduced activity. Surprisingly, in decidua Nodal knockout mice the fetal placenta showed up-regulation of STOX1 and NODAL expression. Conditioned media of human first trimester decidua and a human endometrial stromal cell line (T-HESC treated with siRNAs against NODAL or carrying the H165R SNP were also able to induce NODAL and STOX1 expression when added to SGHPL-5 first trimester extravillous trophoblast cells. Finally, a human TGFß-BMP-Signaling-Pathway PCR-Array on decidua and the T-HESC cell line with Nodal knockdown revealed upregulation of Activin-A, which was confirmed in conditioned media by ELISA. We show that maternal decidua Nodal knockdown gives upregulation of NODAL and STOX1 mRNA expression in fetal extravillous trophoblast cells, potentially via upregulation of Activin-A in the maternal decidua. As both Activin-A and Nodal have been implicated in pre-eclampsia, being increased in serum of pre-eclamptic women and upregulated in pre-eclamptic placentas respectively, this interaction at the maternal-fetal interface might play a substantial role in the development of pre-eclampsia.

  8. Nasopharyngeal carcinoma with pericardial metastasis

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    Shang-Wen Chen

    2011-07-01

    Full Text Available Nasopharyngeal carcinoma (NPC is prevalent in Taiwan and is characterized by a high frequency of nodal metastasis. The most common organs with distal metastases are the bones, lungs, and liver, with extremely rare cases to the pericardium. Herein, we report a rare case with NPC who presented with dyspnea and orthopnea. Serial studies, including pericardial biopsy, revealed NPC with pericardial metastasis and pericardial effusion. The tumor cells of both the original and metastatic tumors were positive for Epstein–Barr virus by in situ hybridization. This is the first histologically confirmed case of NPC with pericardial metastasis.

  9. Prognostic value and staging classification of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy.

    Directory of Open Access Journals (Sweden)

    Ling-Long Tang

    Full Text Available BACKGROUND: The development of intensity-modulated radiotherapy (IMRT has revolutionized the management of nasopharyngeal carcinoma (NPC. The purpose of this study was to evaluate the prognostic value and classification of TNM stage system for retropharyngeal lymph node (RLN metastasis in NPC in the IMRT era. MATERIAL AND METHODS: We retrospectively reviewed data from 749 patients with biopsy-proven, non-metastatic NPC. All patients received IMRT as the primary treatment. Chemotherapy was administered to 86.2% (424/492 of the patients with stage III or IV disease. RESULTS: The incidence of RLN metastasis was 64.2% (481/749. Significant differences were observed in the 5-year disease-free survival (DFS; 70.6% vs. 85.4%, P<0.001 and distant metastasis-free survival (DMFS; 79.2% vs. 90.1%, P<0.001 rates of patients with and without RLN metastasis. In multivariate analysis, RLN metastasis was an independent prognostic factor for disease failure and distant failure (P = 0.005 and P = 0.026, respectively, but not for locoregional recurrence. Necrotic RLN metastases have a negative effect on disease failure, distant failure and locoregional recurrence in NPC with RLN metastasis (P = 0.003, P = 0.018 and P = 0.005, respectively. Survival curves demonstrated a significant difference in DFS between patients with N0 disease and N1 disease with only RLN metastasis (P = 0.020, and marginally statistically significant differences in DMFS and DFS between N1 disease with only RLN metastasis and other N1 disease (P = 0.058 and P = 0.091, respectively. In N1 disease, no significant differences in DFS were observed between unilateral and bilateral RLN metastasis (P = 0.994. CONCLUSIONS: In the IMRT era, RLN metastasis remains an independent prognostic factor for DFS and DMFS in NPC. It is still reasonable for RLN metastasis to be classified in the N1 disease, regardless of laterality. However, there is a need to investigate the feasibility of classifying RLN

  10. Nodal lymphomas of the abdomen

    International Nuclear Information System (INIS)

    Bruneton, J.N.; Caramella, E.; Manzino, J.J.

    1986-01-01

    Modern imaging modalities have greatly contributed to current knowledge about intra-abdominal nodal lymphomas. Since both intra and retroperitoneal node involvement can be demonstrated by computed tomography (CT) and ultrasonography, it seems legitimate to treat these two sites together in the same chapter, particularly since the older separation between intraperitoneal and retroperitoneal nodal disease was based to a large degree on the limitations of lymphography. Hodgkin's disease (HD) has benefited less from recent technological advances. The diversity in the incidence of nodal involvement between HD and NHL, the diagnostic capabilities of modern imaging techniques, and the histopathological features of lymphomatous non-Hodgkin and Hodgkin nodes, justify adoption of an investigatory approach which takes all of these factors into account. Details of this investigative strategy are discussed in this paper following a review of available imaging modalities. In current practice, the four main methods for the exploration of abdominal lymph nodes are lymphography, ultrasonography, CT, and radionuclide studies. The first three techniques are also utilized to guide biopsies for staging purposes and for the evaluation of response to treatment

  11. Risk factors of distant metastasis in patients with squamous cell carcinoma of the uterine cervix treated with postoperative irradiation

    International Nuclear Information System (INIS)

    Yokoyama, Takashi; Beppu, Michiko; Kawakami, Yousuke; Nogawa, Takayoshi; Chiba, Take; Hiura, Masamichi

    2000-01-01

    This paper reports the results of a study of risk factors for recurrence in non-irradiated sites in patients with squamous cell carcinoma of the uterine cervix who received postoperative irradiation. It also discusses clinical experience with such patients, particularly those with a poor prognosis, based on a review of the literature. The study was conducted at the National Shikoku Cancer Center in 62 patients with squamous cell carcinoma of the uterine cervix (mean age=50.5, range=30-66) who received 10 MeV postoperative irradiation with a Linac between 1981 and 1990. An analysis was performed in terms of sites and times of recurrence, risk factors for distant metastasis, and groups at high risk for distant metastasis. Based on the results of the study as well as the review of the literature, it was concluded that squamous cell carcinoma of the uterine cervix is sensitive to radiation therapy and that the clinical outcome of local treatment is satisfactory. However, systemic chemotherapy should be considered for patients who are suspected of having minute distant metastasis at the time of surgical operation, i.e., those with moderate to severe vascular space invasion, multiple lymph node metastasis, parametrium infiltration, and/or endometrial infiltration. (K.H.)

  12. [A case of rectal cancer with brain metastasis successfully treated with combined modality therapy - a case report].

    Science.gov (United States)

    Nishimura, Junya; Noda, Eiji; Kitayama, Kishu; Nomura, Shinya; Teraoka, Hitoshi; Nishino, Hiroji; Hirakawa, Kosei

    2014-11-01

    The authors report their experience in a patient with brain metastasis from rectal cancer who has survived without recurrence after multidisciplinary treatment. A 60-year-old man presented to the Department of Neurosurgery with the primary complaint of spasm of the left side of the face. Examination revealed a tumor 2 cm in diameter in the right frontal lobe. The tumor was suspected to be metastatic, and brain metastasis from rectal cancer was diagnosed. The brain tumor was removed by a neurosurgeon, and the patient was transferred to the Department of Surgery. Removal of the primary lesion in the rectum was attempted, but only colostomy could be performed due to extensive anterior invasion. Postoperatively, 5 courses of capecitabine and oxaliplatin (XELOX) + bevacizumab were administered. The rectal tumor shrank in size, while another mass, suspected to be a lung metastasis, remained unchanged. Therefore, a second surgery on the rectum was scheduled, and abdominoperineal resection of the rectum and lateral lymphadenectomy were performed. Postoperatively, 4 courses of XE LOX therapy were administered. The patient is currently alive without recurrence at 1 year after surgery. Treatment (including timing) for brain metastasis from rectal cancer has not been established and prognosis is poor. However, multidisciplinary treatment may provide the possibility of cure.

  13. Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery

    International Nuclear Information System (INIS)

    Flannery, Todd W.; Suntharalingam, Mohan; Regine, William F.; Chin, Lawrence S.; Krasna, Mark J.; Shehata, Michael K.; Edelman, Martin J.; Kremer, Marnie; Patchell, Roy A.; Kwok, Young

    2008-01-01

    Purpose: To report the outcome of patients with synchronous, solitary brain metastasis from non-small-cell lung cancer (NSCLC) treated with gamma knife stereotactic radiosurgery (GKSRS). Patients and Methods: Forty-two patients diagnosed with synchronous, solitary brain metastasis from NSCLC were treated with GKSRS between 1993 and 2006. The median Karnofsky performance status (KPS) was 90. Patients had thoracic Stage I-III disease (American Joint Committee on Cancer 2002 guidelines). Definitive thoracic therapy was delivered to 26/42 (62%) patients; 9 patients underwent chemotherapy and radiation, 12 patients had surgical resection, and 5 patients underwent preoperative chemoradiation and surgical resection. Results: The median overall survival (OS) was 18 months. The 1-, 2-, and 5-year actuarial OS rates were 71.3%, 34.1%, and 21%, respectively. For patients who underwent definitive thoracic therapy, the median OS was 26.4 months compared with 13.1 months for those who had nondefinitive therapy, and the 5-year actuarial OS was 34.6% vs. 0% (p < 0.0001). Median OS was significantly longer for patients with a KPS ≥90 vs. KPS < 90 (27.8 months vs. 13.1 months, p < 0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001). Conclusions: This is one of the largest series of patients diagnosed with synchronous, solitary brain metastasis from NSCLC treated with GKSRS. Definitive thoracic therapy and KPS significantly impacted OS. The 5-year OS of 21% demonstrates the potential for long-term survival in patients treated with GKSRS; therefore, patients with good KPS should be considered for definitive thoracic therapy

  14. Evaluation of the pain and local tenderness in bone metastasis treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS)

    Science.gov (United States)

    Namba, Hirofumi; Kawasaki, Motohiro; Kato, Tomonari; Tani, Toshikazu; Ushida, Takahiro; Koizumi, Norihiro

    2017-03-01

    It has been reported that MRgFUS has pain palliative effects on the local pain in patients with bone metastasis. In general, a severity of pain has been evaluated using only subjective method with numerical rating scale (NRS) or visual analogue scale (VAS). It is important to evaluate local pain-palliative effects of MRgFUS treatment with objective and quantitative method. The aim of this study is to investigate changes in the severity of local pain of bone metastasis before and after MRgFUS treatments, measuring pressure pain threshold (PPT) using pressure algometer, and pain intensity using electrical stimulation device (the Pain Vision system) at most painful site of bone metastasis. We have conducted MRgFUS for pain palliation of bone metastasis for 8 patients, and evaluated the local tenderness quantitatively for 8 patients, and evaluated local pain intensity for 7 patients. Before the treatments, PPTs were 106.3kPa [40.0-431.5] at metastatic site and 344.8 kPa [206.0-667.0] at normal control site, which showed a significant difference. The PPTs at metastatic site shows a significant increase from 106.3 kPa [40.0-431.5] at the baseline to 270.5 kPa [93.5-533.5] at 3 months after the treatment. The NRS score shows a significant decrease from 6.0 [4-8] at baseline to 1 [0-3] at 3 months after the treatment. Similarly, the pain intensity shows a significant decrease 245 [96.3-888.7] at baseline to 55.9 [2.8-292] at 3 months after the treatment. The results of our study illustrate the pain-relieving effects of MRgFUS for the treatment of painful bone metastasis. PPT might be a useful parameter not only for assessing a treatment's effect, but also for the decision of the painful area to treat with MRgFUS. Pain Vision seems to be useful for quantitative and objective evaluation of local pain of painful bone metastasis.

  15. [A Case of Transverse Colon Cancer with Liver Metastasis and Tumor Thrombosis of Portal Vein Effectively Treated with Chemotherapy].

    Science.gov (United States)

    Aida, Toshiaki; Shiobara, Masayuki; Wakatsuki, Kazuo; Arai, Shuka; Suda, Kosuke; Miyazawa, Kotaro; Miyoshi, Tetsutaro; Takahashi, Yoshihisa; Yoshioka, Shigeru

    2018-02-01

    The patient was a 70-year-old man. He was diagnosed with advanced transverse colon cancer. A computed tomography (CT)revealed liver metastasis and tumor thrombosis of portal vein. We started combination chemotherapy with capecita- bine/oxaliplatin(CapeOX). Perforation of the tumor was observed 5 days after CapeOX therapy was started. Treatment with abscess drainage and ileostmy, infection was controlled and general condition was improved. After 9 courses of CapeOX, we changed chemotherapy regimen to irinotecan/tegafur-gimeracil-oteracilpotassium (IRIS)due to strong side effects. In CT and FDG-PET examination after 8 courses of IRIS, the tumor of transverse colon, liver metastasis, and the tumor thrombosis of portalvein became unclear. A year and 6 months have passed since chemotherapy was started, recurrence was not observed. For the patients with unresectable colorectal cancer, it is necessary to consider multidisciplinary treatments including chemotherapy while considering the general condition of them.

  16. Late (> 5 years) regional lymph node metastasis of oral squamous cell carcinoma (SCC), proven by p53 mutation analysis

    NARCIS (Netherlands)

    Kummer, J. Alain; Van Es, Robert J. J.; Hoekstra, J.W.M.

    2008-01-01

    Background: A late (>5 years) neck nodal metastasis of oral cancer, poses a problem to the clinician: is it a late metastasis or a metastasis of a (unknown) second primary tumour? Methods: A 50-year-old male was seen with a contralateral lymph node metastasis, 51/2 years after treatment of a pT2N1M0

  17. ABCB1 and ABCC2 and the risk of distant metastasis in Thai breast cancer patients treated with tamoxifen

    Directory of Open Access Journals (Sweden)

    Sensorn I

    2016-04-01

    Full Text Available Insee Sensorn,1,* Chonlaphat Sukasem,2,* Ekaphop Sirachainan,3 Montri Chamnanphon,2 Ekawat Pasomsub,4 Narumol Trachu,5 Porntip Supavilai,1 Darawan Pinthong,1 Sansanee Wongwaisayawan6 1Department of Pharmacology, Faculty of Science, Mahidol University, 2Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 3Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 4Division of Virology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 5Research Center, Faculty of Medicine, Ramathibodi Hospital, 6Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand *These authors contributed equally to this work Background: Genetic polymorphisms of drug-metabolizing enzymes and transporters have been extensively studied with regard to tamoxifen treatment outcomes. However, the results are inconclusive. Analysis of organ-specific metastasis may reveal the association of these pharmacogenetic factors. The aim of this study is to investigate the impact of CYP3A5, CYP2D6, ABCB1, and ABCC2 polymorphisms on the risk of all distant and organ-specific metastases in Thai patients who received tamoxifen adjuvant therapy. Methods: Genomic DNA was extracted from blood samples of 73 patients with breast cancer who received tamoxifen adjuvant therapy. CYP3A5 (6986A>G, CYP2D6 (100C>T, ABCB1 (3435C>T, and ABCC2 (-24C>T were genotyped using allelic discrimination real-time polymerase chain reaction assays. The impacts of prognostic clinical factors and genetic variants on disease-free survival were analyzed using the Kaplan–Meier method and Cox regression analysis. Results: In the univariate analysis, primary tumor size >5 cm was significantly associated with increased risk of distant metastasis (P=0

  18. Nodal-chain metals.

    Science.gov (United States)

    Bzdušek, Tomáš; Wu, QuanSheng; Rüegg, Andreas; Sigrist, Manfred; Soluyanov, Alexey A

    2016-10-06

    The band theory of solids is arguably the most successful theory of condensed-matter physics, providing a description of the electronic energy levels in various materials. Electronic wavefunctions obtained from the band theory enable a topological characterization of metals for which the electronic spectrum may host robust, topologically protected, fermionic quasiparticles. Many of these quasiparticles are analogues of the elementary particles of the Standard Model, but others do not have a counterpart in relativistic high-energy theories. A complete list of possible quasiparticles in solids is lacking, even in the non-interacting case. Here we describe the possible existence of a hitherto unrecognized type of fermionic excitation in metals. This excitation forms a nodal chain-a chain of connected loops in momentum space-along which conduction and valence bands touch. We prove that the nodal chain is topologically distinct from previously reported excitations. We discuss the symmetry requirements for the appearance of this excitation and predict that it is realized in an existing material, iridium tetrafluoride (IrF 4 ), as well as in other compounds of this class of materials. Using IrF 4 as an example, we provide a discussion of the topological surface states associated with the nodal chain. We argue that the presence of the nodal-chain fermions will result in anomalous magnetotransport properties, distinct from those of materials exhibiting previously known excitations.

  19. Superior metastasis-free survival for patients with high-risk prostate cancer treated with definitive radiation therapy compared to radical prostatectomy: A propensity score-matched analysis

    Directory of Open Access Journals (Sweden)

    Stephanie Markovina, MD, PhD

    2018-04-01

    Full Text Available Purpose: For high-risk prostate cancer (HR-PCa in men with a life expectancy of at least 10 years, the National Comprehensive Cancer Network recommends radiation therapy (RT plus androgen deprivation therapy (ADT with category 1 evidence or radical prostatectomy (RP as an acceptable initial therapy. Randomized evidence regarding which therapy is optimal for disease control is lacking for men with HR-PCa. We performed a propensity-score-matched comparison of outcomes for men with localized HR-PCa treated with primary RT or RP. Methods and materials: The medical records of patients with localized HR-PCa who were treated at our institution between 2002 and 2011 were reviewed. Patient and disease characteristics, treatment details, and outcomes were collected. A combination of nearest-neighbor propensity score matching on age, Adult Comorbidity Evaluation-27 comorbidity index, prostate-specific antigen, biopsy Gleason scores, and clinical T-stage as well as exact matching on prostate-specific antigen, biopsy Gleason scores, and clinical T-stage was performed. Outcomes were measured from diagnosis. Multivariate Cox proportional hazards regression was used to compare metastasis-free and overall survival. Results: A total of 246 patients were identified with 62 propensity-score-matched pairs. ADT was administered to 6.5% and 80.6% of patients receiving RP and RT, respectively. Five-year rates of metastasis for RP and RT were 33% and 8.9%, respectively (P = .003. Overall survival was not different. Delay of salvage therapy was longer for patients undergoing primary RT (P < .001. Findings were similar when only those patients who did not receive ADT were compared. Conclusions: At our institution, treatment with primary RT resulted in superior metastasis-free survival over RP. This was not accompanied by an improvement in OS.

  20. [A case of breast cancer with multiple hepatic metastasis successfully treated with S-1/PTX and S-1 chemotherapy].

    Science.gov (United States)

    Hashimoto, Masakazu; Moriyuki, Toshio; Kuranishi, Fumito; Niitsu, Hiroaki; Fujikuni, Nobuaki; Iwako, Hiroshi; Kuroda, Yoshinori

    2010-06-01

    The case is a woman in her 50's. A total glandectomy was performed for her breast cancer on August 8, 1998, and subsequently chemotherapy(5'-DFUR, CMF, uracil.tegafur, CEF, and docetaxel)as well as radiation therapy and surgical resection have been performed for local recurrence. With multiple hepatic metastasis recognized in September, 2007, chemotherapy combined with S-1/paclitaxel(PTX)has been performed. In view of the side effects such as reduction in appetite and leukocyte, the dosage has been reduced as of the second course of treatment. With the disappearance of hepatic metastasis on CT, 6 courses of S-1monotherapy have been performed after completing 6 courses of chemotherapy combined with S-1/ PTX. As of March, 2009, the therapeutic effect shows that continuous CR and outpatient follow-up have been performed while maintaining QOL. Since any chemotherapy after thirdline treatment for recurrent breast cancer has not been established yet, chemotherapy combined with S-1/PTX is considered to be one of the regimens and therefore, the second and thirdphase clinical tests ahead are expected to bring better outcomes.

  1. Experimental discovery of nodal chains

    Science.gov (United States)

    Yan, Qinghui; Liu, Rongjuan; Yan, Zhongbo; Liu, Boyuan; Chen, Hongsheng; Wang, Zhong; Lu, Ling

    2018-05-01

    Three-dimensional Weyl and Dirac nodal points1 have attracted widespread interest across multiple disciplines and in many platforms but allow for few structural variations. In contrast, nodal lines2-4 can have numerous topological configurations in momentum space, forming nodal rings5-9, nodal chains10-15, nodal links16-20 and nodal knots21,22. However, nodal lines are much less explored because of the lack of an ideal experimental realization23-25. For example, in condensed-matter systems, nodal lines are often fragile to spin-orbit coupling, located away from the Fermi level, coexist with energy-degenerate trivial bands or have a degeneracy line that disperses strongly in energy. Here, overcoming all these difficulties, we theoretically predict and experimentally observe nodal chains in a metallic-mesh photonic crystal having frequency-isolated linear band-touching rings chained across the entire Brillouin zone. These nodal chains are protected by mirror symmetry and have a frequency variation of less than 1%. We use angle-resolved transmission measurements to probe the projected bulk dispersion and perform Fourier-transformed field scans to map out the dispersion of the drumhead surface state. Our results establish an ideal nodal-line material for further study of topological line degeneracies with non-trivial connectivity and consequent wave dynamics that are richer than those in Weyl and Dirac materials.

  2. Exclusion of elective nodal irradiation is associated with minimal elective nodal failure in non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Cox James D

    2009-01-01

    Full Text Available Abstract Background Controversy still exists regarding the long-term outcome of patients whose uninvolved lymph node stations are not prophylactically irradiated for non-small cell lung cancer (NSCLC treated with definitive radiotherapy. To determine the frequency of elective nodal failure (ENF and in-field failure (IFF, we examined a large cohort of patients with NSCLC staged with positron emission tomography (PET/computed tomography (CT and treated with 3-dimensional conformal radiotherapy (3D-CRT that excluded uninvolved lymph node stations. Methods We retrospectively reviewed the records of 115 patients with non-small cell lung cancer treated at our institution with definitive radiation therapy with or without concurrent chemotherapy (CHT. All patients were treated with 3D-CRT, including nodal regions determined by CT or PET to be disease involved. Concurrent platinum-based CHT was administered for locally advanced disease. Patients were analyzed in follow-up for survival, local regional recurrence, and distant metastases (DM. Results The median follow-up time was 18 months (3 to 44 months among all patients and 27 months (6 to 44 months among survivors. The median overall survival, 2-year actuarial overall survival and disease-free survival were 19 months, 38%, and 28%, respectively. The majority of patients died from DM, the overall rate of which was 36%. Of the 31 patients with local regional failure, 26 (22.6% had IFF, 5 (4.3% had ENF and 2 (1.7% had isolated ENF. For 88 patients with stage IIIA/B, the frequencies of IFF, any ENF, isolated ENF, and DM were 23 (26%, 3 (9%, 1 (1.1% and 36 (40.9%, respectively. The comparable rates for the 22 patients with early stage node-negative disease (stage IA/IB were 3 (13.6%, 1(4.5%, 0 (0%, and 5 (22.7%, respectively. Conclusion We observed only a 4.3% recurrence of any ENF and a 1.7% recurrence of isolated ENF in patients with NSCLC treated with definitive 3D-CRT without prophylactic irradiation of

  3. Exclusion of elective nodal irradiation is associated with minimal elective nodal failure in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Sulman, Erik P; Komaki, Ritsuko; Klopp, Ann H; Cox, James D; Chang, Joe Y

    2009-01-01

    Controversy still exists regarding the long-term outcome of patients whose uninvolved lymph node stations are not prophylactically irradiated for non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. To determine the frequency of elective nodal failure (ENF) and in-field failure (IFF), we examined a large cohort of patients with NSCLC staged with positron emission tomography (PET)/computed tomography (CT) and treated with 3-dimensional conformal radiotherapy (3D-CRT) that excluded uninvolved lymph node stations. We retrospectively reviewed the records of 115 patients with non-small cell lung cancer treated at our institution with definitive radiation therapy with or without concurrent chemotherapy (CHT). All patients were treated with 3D-CRT, including nodal regions determined by CT or PET to be disease involved. Concurrent platinum-based CHT was administered for locally advanced disease. Patients were analyzed in follow-up for survival, local regional recurrence, and distant metastases (DM). The median follow-up time was 18 months (3 to 44 months) among all patients and 27 months (6 to 44 months) among survivors. The median overall survival, 2-year actuarial overall survival and disease-free survival were 19 months, 38%, and 28%, respectively. The majority of patients died from DM, the overall rate of which was 36%. Of the 31 patients with local regional failure, 26 (22.6%) had IFF, 5 (4.3%) had ENF and 2 (1.7%) had isolated ENF. For 88 patients with stage IIIA/B, the frequencies of IFF, any ENF, isolated ENF, and DM were 23 (26%), 3 (9%), 1 (1.1%) and 36 (40.9%), respectively. The comparable rates for the 22 patients with early stage node-negative disease (stage IA/IB) were 3 (13.6%), 1(4.5%), 0 (0%), and 5 (22.7%), respectively. We observed only a 4.3% recurrence of any ENF and a 1.7% recurrence of isolated ENF in patients with NSCLC treated with definitive 3D-CRT without prophylactic irradiation of uninvolved lymph node stations. Thus

  4. A case of recurrent gastric cancer with recurrent celiac lymph node metastasis successfully treated with chemoradiotherapy and CPT-11 plus CDDP therapy

    International Nuclear Information System (INIS)

    Takachi, Ko; Oshima, Satoshi; Nishioka, Kiyonori; Takemoto, Hiroyoshi; Tsujimura, Naoto; Iijima, Shohei; Uemura, Yoshio

    2016-01-01

    Chemotherapy is performed for the recurrence of gastric cancer in many cases. We report a case of recurrent lymph node metastasis successfully treated with chemoradiotherapy and chemotherapy. A man in his 60s underwent total gastrectomy and D2 dissection in 2009. The pathological diagnosis was poorly differentiated adenocarcinoma, T4a, int, INF, β, ly2, v2, LN no.2: 2/3, no.3: 1/4, no.7, 8, and 9: 3/4, stage IIIB. Although we administered S-1/UFT as postoperative adjuvant chemotherapy, a strong rash appeared and the patient ceased chemotherapy. Eight months later, the rash had disappeared. We started chemotherapy with paclitaxel (PAC). CT performed 1 year postoperatively showed celiac lymph node (no.9) metastasis. Chemoradiotherapy (RT+PAC) and additional CPT-11 (98 mg) and CDDP (49 mg) treatment were administered. The lymph node (no.9) was cicatrized after 8 cycles. Forty-two months after the end of treatment, the patient has had no recurrence. It is thought that chemoradiotherapy is an effective cure for local recurrence of gastric cancer. (author)

  5. Avoided intersections of nodal lines

    International Nuclear Information System (INIS)

    Monastra, Alejandro G; Smilansky, Uzy; Gnutzmann, Sven

    2003-01-01

    We consider real eigenfunctions of the Schroedinger operator in 2D. The nodal lines of separable systems form a regular grid, and the number of nodal crossings equals the number of nodal domains. In contrast, for wavefunctions of non-integrable systems nodal intersections are rare, and for random waves, the expected number of intersections in any finite area vanishes. However, nodal lines display characteristic avoided crossings which we study in this work. We define a measure for the avoidance range and compute its distribution for the random wave ensemble. We show that the avoidance range distribution of wavefunctions of chaotic systems follows the expected random wave distributions, whereas for wavefunctions of classically integrable but quantum non-separable systems, the distribution is quite different. Thus, the study of the avoidance distribution provides more support to the conjecture that nodal structures of chaotic systems are reproduced by the predictions of the random wave ensemble

  6. Long-Term Survival of a Patient with Brainstem and Recurrent Brain Metastasis from Stage IV Nonsmall Cell Lung Cancer Treated with Multiple Gamma Knife Radiosurgeries and Craniotomies: A Case Report and Review of the Literature

    Science.gov (United States)

    Lamm, Andrew F.; Elaimy, Ameer L.; Mackay, Alexander R.; Fairbanks, Robert K.; Demakas, John J.; Cooke, Barton S.; Lee, Christopher M.; Taylor, Blake S.; Lamoreaux, Wayne T.

    2012-01-01

    The prognosis of patients diagnosed with stage IV nonsmall cell lung cancer that have brain and brainstem metastasis is very poor, with less than a third surviving a year past their initial date of diagnosis. We present the rare case of a 57-year-old man who is a long-term survivor of brainstem and recurrent brain metastasis, after aggressive treatment. He is now five and a half years out from diagnosis and continues to live a highly functional life without evidence of disease. Four separate Gamma Knife stereotactic radiosurgeries in conjunction with two craniotomies were utilized since his initial diagnosis to treat recurrent brain metastasis while chemoradiation therapy and thoracic surgery were used to treat his primary disease in the right upper lung. In his situation, Gamma Knife radiosurgery proved to be a valuable, safe, and effective tool for the treatment of multiply recurrent brain metastases within critical normal structures. PMID:23056973

  7. Pathologic Nodal Classification Is the Most Discriminating Prognostic Factor for Disease-Free Survival in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy and Curative Resection

    International Nuclear Information System (INIS)

    Kim, Tae Hyun; Chang, Hee Jin; Kim, Dae Yong

    2010-01-01

    Purpose: We retrospectively evaluated the effects of clinical and pathologic factors on disease-free survival (DFS) with the aim of identifying the most discriminating factor predicting DFS in rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection. Methods and Materials: The study involved 420 patients who underwent preoperative CRT and curative resection between August 2001 and October 2006. Gender, age, distance from the anal verge, histologic type, histologic grade, pretreatment carcinoembryonic antigen (CEA) level, cT, cN, cStage, circumferential resection margin, type of surgery, preoperative chemotherapy, adjuvant chemotherapy, ypT, ypN, ypStage, and tumor regression grade (TRG) were analyzed to identify prognostic factors associated with DFS. To compare the discriminatory prognostic ability of four tumor response-related pathologic factors (ypT, ypN, ypStage, and TRG), the Akaike information criteria were calculated. Results: The 5-year DFS rate was 75.4%. On univariate analysis, distance from the anal verge, histologic type, histologic grade, pretreatment CEA level, cT, circumferential resection margin, type of surgery, preoperative chemotherapeutic regimen, ypT, ypN, ypStage, and TRG were significantly associated with DFS. Multivariate analysis showed that the four parameters ypT, ypN, ypStage, and TRG were, consistently, significant prognostic factors for DFS. The ypN showed the lowest Akaike information criteria value for DFS, followed by ypStage, ypT, and TRG, in that order. Conclusion: In our study, ypT, ypN, ypStage, and TRG were important prognostic factors for DFS, and ypN was the most discriminating factor.

  8. Brain metastasis from colorectal cancer

    International Nuclear Information System (INIS)

    Bamba, Yoshiko; Itabashi, Michio; Hirosawa, Tomoichiro; Ogawa, Shinpei; Noguchi, Eiichiro; Takemoto, Kaori; Shirotani, Noriyasu; Kameoka, Shingo

    2007-01-01

    The present study was performed to clarify the clinical characteristics of brain metastasis from colorectal cancer. Five patients with brain metastasis from colorectal cancer treated at our institute between 2001 and 2005 were included in the study. Clinical findings and survival time were determined and an appropriate system for follow-up in such cases was considered. Brain metastasis was found after surgery for colorectal cancer in 4 cases. In addition, colorectal cancer was found after diagnosis of brain metastasis in 1 case. At the time of diagnosis of brain metastasis, all patients had lung metastasis and 3 had liver metastasis. The mean periods between surgery for colorectal cancer and lung and brain metastases were 19.5 and 38.2 months, respectively. In all cases, brain metastasis was diagnosed by imaging after the appearance of neurological symptoms. Brain metastases were multiple in 1 case and focal in 4 cases. We performed gamma knife radiation therapy, and the symptoms disappeared or decreased in all cases. Mean survival time after brain metastasis was 3.0 months. Prognosis after brain metastasis is poor, but gamma knife radiation therapy contributed to patients' quality of life. (author)

  9. The SINTRAN III NODAL system

    International Nuclear Information System (INIS)

    Skaali, T.B.

    1980-10-01

    NODAL is a high level programming language based on FOCAL and SNOBOL4, with some influence from BASIC. The language was developed to operate on the computer network controlling the SPS accelerator at CERN. NODAL is an interpretive language designed for interactive use. This is the most important aspect of the language, and is reflected in its structure. The interactive facilities make it possible to write, debug and modify programs much faster than with compiler based languages like FORTRAN and ALGOL. Apart from a few minor modifications, the basic part of the Oslo University NODAL system does not differ from the CERN version. However, the Oslo University implementation has been expanded with new functions which enable the user to execute many of the SINTRAN III monitor calls from the NODAL level. In particular the most important RT monitor calls have been implemented in this way, a property which renders possible the use of NODAL as a RT program administrator. (JIW)

  10. Local recurrence and distant metastasis of supratentorial primitive neuro-ectodermal tumor in an adult patient successfully treated with intensive induction chemotherapy and maintenance temozolomide

    NARCIS (Netherlands)

    Terheggen, F.; Troost, D.; Majoie, C. B.; Leenstra, S.; Richel, D. J.

    2007-01-01

    Supratentorial primitive neuro-ectodermal tumors (PNET) in adults are very rare. Extraneural metastasis are unusual and the optimal palliative chemotherapy regimen is not established. We present a 26-year-old patient with local recurrence and distant metastasis of supratentorial PNET successfully

  11. Intrabiliary growth of recurrent tumor after percutaneous RF ablation for treating liver metastasis from colon cancer: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Youn Kyung; Kim, Seung Kwon; Hong, Hyun Pyo [Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-12-15

    A 64-year-old man who underwent right hemicolectomy 3.5 years ago for ascending colon cancer and then RF ablation for two metastatic nodules in the liver was admitted to our hospital with a new metastatic nodule in the S6/7 segment of the liver. The CT scan showed a low attenuating metastatic nodule 2.2 cm in diameter in the S6/7 segment of the liver, and the liver showed peripheral bile duct dilatation. This nodule was treated with percutaneous RF ablation. A follow-up CT seven months after RF ablation showed the presence of a viable tumor in the RF ablation zone, with tumor extension along the dilated bile duct. These findings were confirmed on the resected specimen.

  12. Hyoid bone chondrosarcoma with cervical nodal metastasis: A case ...

    African Journals Online (AJOL)

    Hisham Mostafa Abdel-Fattah

    2015-11-18

    Nov 18, 2015 ... Case presentation: A 42 years old female had a hard mass in the left submandibular region of the neck. ... material incorporating numerous islands of chondroid tissue ... Postoperative radiation does not have a specific role in.

  13. Local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer.

    Science.gov (United States)

    Kimoto, Takuya; Yamazaki, Hideya; Suzuki, Gen; Aibe, Norihiro; Masui, Koji; Tatekawa, Kotoha; Sasaki, Naomi; Fujiwara, Hitoshi; Shiozaki, Atsushi; Konishi, Hirotaka; Nakamura, Satoaki; Yamada, Kei

    2017-09-01

    Radiotherapy is an effective treatment for the postoperative loco-regional recurrence of esophageal cancer; however, the optimal treatment field remains controversial. This study aims to evaluate the outcome of local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer. We retrospectively investigated 35 patients treated for a postoperative loco-regional recurrence of esophageal cancer with local field radiotherapy between December 2008 and March 2016. The median irradiation dose was 60 Gy (range: 50-67.5 Gy). Thirty-one (88.6%) patients received concurrent chemotherapy. The median follow-up period was 18 months (range: 5-94 months). The 2-year overall survival was 55.7%, with a median survival time of 29.9 months. In the univariate analysis, the maximal diameter ≤20 mm (P = 0.0383), solitary lesion (P = 0.0352), and the complete remission after treatment (P = 0.00411) had a significantly better prognosis. A total of 27 of 35 patients (77.1%) had progressive disease (loco-regional failure [n = 9], distant metastasis [n = 7], and both loco-regional failure and distant metastasis [n = 11]). No patients had Grade 3 or greater mucositis. Local field radiotherapy is a considerable treatment option for postoperative loco-regional recurrence of esophageal cancer. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. NODAL interpreter for CP/M

    International Nuclear Information System (INIS)

    Oide, Katsunobu.

    1982-11-01

    A NODAL interpreter which works under CP/M operating system is made for microcomputers. This interpreter language named NODAL-80 has a similar structure to the NODAL of SPS, but its commands, variables, and expressions are modified to increase the flexibility of programming. NODAL-80 also uses a simple intermediate code to make the execution speed fast without imposing any restriction on the dynamic feature of NODAL language. (author)

  15. Hypophyseal metastasis

    International Nuclear Information System (INIS)

    Yanes Quesada, Miguel Angel; Yanes Quesada, Marelys; Lopez Arbolay, Omar; Lima Perez, Mayte; Hernandez Yero, Arturo

    2009-01-01

    Metastatic tumors of hypophyseal gland are infrequent. Most are silent lesions discovered accidentally in necropsy. Appearance of symptomatic metastasis is however, exceptional. We describe here clinical and radiological findings in a female patient aged 69, presenting with a non-differential carcinoma of lung, diagnosed two years a half ago, starting with headache and visual disorders without hypopituitarism and insipidus diabetes. We made a nuclear magnetic resonance and diagnosis was a hypophyseal lesion operated on by trans-esphenoidal route, and Pathological Anatomy Service reports a metastasis of lung carcinoma. (Author)

  16. A proposal for combined MRI and PET/CT interpretation criteria for preoperative nodal staging in non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Kim, Yoo Na; Yi, Chin A.; Lee, Kyung Soo; Lee, Ho Yun; Kim, Tae Sung; Chung, Myung Jin; Kwon, O.Jung; Chung, Man Pyo; Kim, Byung-Tae; Choi, Joon Young; Kim, Seon Woo; Han, Joungho; Shim, Young Mog

    2012-01-01

    To determine the positive reading criteria for malignant nodes when interpreting combined MRI and PET/CT images for preoperative nodal staging in non-small-cell lung cancer (NSCLC). Forty-nine patients with biopsy-proven NSCLC underwent both PET/CT and thoracic MRI [diffusion weighted imaging (DWI)]. Each nodal station was evaluated for the presence of metastasis by applying either inclusive (positive if either one read positive) or exclusive (positive if both read positive) criteria in the combined interpretation of PET/CT and MRI. Nodal stage was confirmed pathologically. The combined diagnostic accuracy of PET/CT and MRI was determined on per-nodal station and per-patient bases and compared with that of PET/CT alone. In 49 patients, 39 (19%) of 206 nodal stations harboured malignant cells. Out of 206 nodal stations, 186 (90%) had concordant readings, while the rest (10%) had discordant readings. Inclusive criteria of combined PET/CT and MRI helped increase sensitivity for detecting nodal metastasis (69%) compared with PET/CT alone (46%; P = 0.003), while specificity was not significantly decreased. Inclusive criteria in combined MRI and PET/CT readings help improve significantly the sensitivity for detecting nodal metastasis compared with PET/CT alone and may decrease unnecessary open thoracotomy. (orig.)

  17. An Unusual Metastasis of a Transglottic Squamous Cell Carcinoma to the Forearm

    Directory of Open Access Journals (Sweden)

    Abdullah Dafir Albeyatti

    2013-01-01

    Full Text Available Introduction. Each year around 2,200 people in the UK are diagnosed with laryngeal SCC (Office of National Statistics 2009. Compared to pharyngeal carcinoma, it is a highly curable disease with a survival rate of around 60% for all stages and all forms of treatment. Case Presentation. We present the case of a 60-year-old man with a previously treated T4 N2c transglottic squamous cell carcinoma (SCC, who developed an isolated swelling in the extensor compartment of his right forearm at 6 months after radical laryngectomy with bilateral neck dissection. Fine needle aspiration of the forearm lesion revealed SCC consistent with a metastasis from the laryngeal primary. MRI revealed that the lesion was confined to the muscle. Initial staging CT showed no distant metastases or signs of advanced disease, including no evidence of axillary nodal involvement. Conclusion. This case is therefore unusual, as one of only 2 cases reported in the scientific literature of isolated distant muscular metastasis from a laryngeal squamous cell carcinoma. We conclude that any muscular swelling, in the setting of previous head and neck malignancy, should be treated with a high degree of suspicion for metastasis and investigated promptly.

  18. The adjoint variational nodal method

    International Nuclear Information System (INIS)

    Laurin-Kovitz, K.; Lewis, E.E.

    1993-01-01

    The widespread use of nodal methods for reactor core calculations in both diffusion and transport approximations has created a demand for the corresponding adjoint solutions as a prerequisite for performing perturbation calculations. With some computational methods, however, the solution of the adjoint problem presents a difficulty; the physical adjoint obtained by discretizing the adjoint equation is not the same as the mathematical adjoint obtained by taking the transpose of the coefficient matrix, which results from the discretization of the forward equation. This difficulty arises, in particular, when interface current nodal methods based on quasi-one-dimensional solution of the diffusion or transport equation are employed. The mathematical adjoint is needed to perform perturbation calculations. The utilization of existing nodal computational algorithms, however, requires the physical adjoint. As a result, similarity transforms or related techniques must be utilized to relate physical and mathematical adjoints. Thus far, such techniques have been developed only for diffusion theory

  19. Investigation on generalized Variational Nodal Methods for heterogeneous nodes

    International Nuclear Information System (INIS)

    Wang, Yongping; Wu, Hongchun; Li, Yunzhao; Cao, Liangzhi; Shen, Wei

    2017-01-01

    Highlights: • We developed two heterogeneous nodal methods based on the Variational Nodal Method. • Four problems were solved to evaluate the two heterogeneous nodal methods. • The function expansion method is good at treating continuous-changing heterogeneity. • The finite sub-element method is good at treating discontinuous-changing heterogeneity. - Abstract: The Variational Nodal Method (VNM) is generalized for heterogeneous nodes and applied to four kinds of problems including Molten Salt Reactor (MSR) core problem with continuous cross section profile, Pressurized Water Reactor (PWR) control rod cusping effect problem, PWR whole-core pin-by-pin problem, and heterogeneous PWR core problem without fuel-coolant homogenization in each pin cell. Two approaches have been investigated for the treatment of the nodal heterogeneity in this paper. To concentrate on spatial heterogeneity, diffusion approximation was adopted for the angular variable in neutron transport equation. To provide demonstrative numerical results, the codes in this paper were developed in slab geometry. The first method, named as function expansion (FE) method, expands nodal flux by orthogonal polynomials and the nodal cross sections are also expressed as spatial depended functions. The second path, named as finite sub-element (FS) method, takes advantage of the finite-element method by dividing each node into numbers of homogeneous sub-elements and expanding nodal flux into the combination of linear sub-element trial functions. Numerical tests have been carried out to evaluate the ability of the two nodal (coarse-mesh) heterogeneous VNMs by comparing with the fine-mesh homogeneous VNM. It has been demonstrated that both heterogeneous approaches can handle heterogeneous nodes. The FE method is good at continuous-changing heterogeneity as in the MSR core problem, while the FS method is good at discontinuous-changing heterogeneity such as the PWR pin-by-pin problem and heterogeneous PWR core

  20. Nodal in computerized control systems of accelerators

    International Nuclear Information System (INIS)

    Kagarmanov, A.A.; Koval'tsov, V.I.; Korobov, S.A.

    1994-01-01

    Brief description of the Nodal language programming structure is presented. Its possibilities as high-level programming language for accelerator control systems are considered. The status of the Nodal language in the HEPI is discussed. 3 refs

  1. Esophageal Metastasis from Rectal Cancer Successfully Treated with Fluorouracil-Based Chemotherapy with Bevacizumab: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sho Watanabe

    2017-05-01

    Full Text Available Esophageal metastasis from colorectal carcinoma is uncommon, and diagnosis of esophageal metastasis is difficult. We report a case of a 54-year-old woman with postoperative recurrence of rectal cancer metastasizing to the esophagus. She underwent rectectomy and adjuvant chemotherapy with fluorouracil, leucovorin plus oxaliplatin for stage IIIB rectal cancer. Three years later, she presented with dysphagia and cough. Computed tomography showed thickening of the esophagus wall, enlargement of the lymph nodes in the mediastinum and abdomen, and ground-glass opacities in the right lung. Endoscopy revealed a submucosal tumor of the midthoracic esophagus. Histopathological analysis of the tumor biopsy showed infiltration of adenocarcinoma cells into the stroma of the esophagus; tumor cells were positive for caudal type homeobox 2 and negative for thyroid transcription factor 1. A transbronchial biopsy indicated pulmonary lymphangitic carcinomatosis of rectal adenocarcinoma. Based on those findings, she was diagnosed with recurrent rectal cancer. She received fluorouracil-based chemotherapy plus bevacizumab, which ameliorated her symptoms and induced a durable response without severe adverse events. Diagnosis of esophageal metastasis from rectal cancer can thus be made by repeated biopsy. Furthermore, aggressive systemic treatment with fluorouracil-containing chemotherapy and bevacizumab is a treatment option for colorectal cancer patients with esophageal metastasis.

  2. A variational synthesis nodal discrete ordinates method

    International Nuclear Information System (INIS)

    Favorite, J.A.; Stacey, W.M.

    1999-01-01

    A self-consistent nodal approximation method for computing discrete ordinates neutron flux distributions has been developed from a variational functional for neutron transport theory. The advantage of the new nodal method formulation is that it is self-consistent in its definition of the homogenized nodal parameters, the construction of the global nodal equations, and the reconstruction of the detailed flux distribution. The efficacy of the method is demonstrated by two-dimensional test problems

  3. Mapping of nodal disease in locally advanced prostate cancer: Rethinking the clinical target volume for pelvic nodal irradiation based on vascular rather than bony anatomy

    International Nuclear Information System (INIS)

    Shih, Helen A.; Harisinghani, Mukesh; Zietman, Anthony L.; Wolfgang, John A.; Saksena, Mansi; Weissleder, Ralph

    2005-01-01

    Purpose: Toxicity from pelvic irradiation could be reduced if fields were limited to likely areas of nodal involvement rather than using the standard 'four-field box.' We employed a novel magnetic resonance lymphangiographic technique to highlight the likely sites of occult nodal metastasis from prostate cancer. Methods and Materials: Eighteen prostate cancer patients with pathologically confirmed node-positive disease had a total of 69 pathologic nodes identifiable by lymphotropic nanoparticle-enhanced MRI and semiquantitative nodal analysis. Fourteen of these nodes were in the para-aortic region, and 55 were in the pelvis. The position of each of these malignant nodes was mapped to a common template based on its relation to skeletal or vascular anatomy. Results: Relative to skeletal anatomy, nodes covered a diffuse volume from the mid lumbar spine to the superior pubic ramus and along the sacrum and pelvic side walls. In contrast, the nodal metastases mapped much more tightly relative to the large pelvic vessels. A proposed pelvic clinical target volume to encompass the region at greatest risk of containing occult nodal metastases would include a 2.0-cm radial expansion volume around the distal common iliac and proximal external and internal iliac vessels that would encompass 94.5% of the pelvic nodes at risk as defined by our node-positive prostate cancer patient cohort. Conclusions: Nodal metastases from prostate cancer are largely localized along the major pelvic vasculature. Defining nodal radiation treatment portals based on vascular rather than bony anatomy may allow for a significant decrease in normal pelvic tissue irradiation and its associated toxicities

  4. SU-E-J-256: Predicting Metastasis-Free Survival of Rectal Cancer Patients Treated with Neoadjuvant Chemo-Radiotherapy by Data-Mining of CT Texture Features of Primary Lesions

    International Nuclear Information System (INIS)

    Zhong, H; Wang, J; Shen, L; Hu, W; Wan, J; Zhou, Z; Zhang, Z

    2015-01-01

    Purpose: The purpose of this study is to investigate the relationship between computed tomographic (CT) texture features of primary lesions and metastasis-free survival for rectal cancer patients; and to develop a datamining prediction model using texture features. Methods: A total of 220 rectal cancer patients treated with neoadjuvant chemo-radiotherapy (CRT) were enrolled in this study. All patients underwent CT scans before CRT. The primary lesions on the CT images were delineated by two experienced oncologists. The CT images were filtered by Laplacian of Gaussian (LoG) filters with different filter values (1.0–2.5: from fine to coarse). Both filtered and unfiltered images were analyzed using Gray-level Co-occurrence Matrix (GLCM) texture analysis with different directions (transversal, sagittal, and coronal). Totally, 270 texture features with different species, directions and filter values were extracted. Texture features were examined with Student’s t-test for selecting predictive features. Principal Component Analysis (PCA) was performed upon the selected features to reduce the feature collinearity. Artificial neural network (ANN) and logistic regression were applied to establish metastasis prediction models. Results: Forty-six of 220 patients developed metastasis with a follow-up time of more than 2 years. Sixtyseven texture features were significantly different in t-test (p<0.05) between patients with and without metastasis, and 12 of them were extremely significant (p<0.001). The Area-under-the-curve (AUC) of ANN was 0.72, and the concordance index (CI) of logistic regression was 0.71. The predictability of ANN was slightly better than logistic regression. Conclusion: CT texture features of primary lesions are related to metastasisfree survival of rectal cancer patients. Both ANN and logistic regression based models can be developed for prediction

  5. NESTLE: A nodal kinetics code

    International Nuclear Information System (INIS)

    Al-Chalabi, R.M.; Turinsky, P.J.; Faure, F.-X.; Sarsour, H.N.; Engrand, P.R.

    1993-01-01

    The NESTLE nodal kinetics code has been developed for utilization as a stand-alone code for steady-state and transient reactor neutronic analysis and for incorporation into system transient codes, such as TRAC and RELAP. The latter is desirable to increase the simulation fidelity over that obtained from currently employed zero- and one-dimensional neutronic models and now feasible due to advances in computer performance and efficiency of nodal methods. As a stand-alone code, requirements are that it operate on a range of computing platforms from memory-limited personal computers (PCs) to supercomputers with vector processors. This paper summarizes the features of NESTLE that reflect the utilization and requirements just noted

  6. Older Age Predicts Decreased Metastasis and Prostate Cancer-Specific Death for Men Treated With Radiation Therapy: Meta-Analysis of Radiation Therapy Oncology Group Trials

    Energy Technology Data Exchange (ETDEWEB)

    Hamstra, Daniel A., E-mail: dhamm@umich.edu [University of Michigan, Ann Arbor, Michigan (United States); Bae, Kyounghwa [Radiation Therapy Oncology Group, Philadelphia, Pennsylvania (United States); Pilepich, Miljenko V. [UCLA Medical Center, Los Angeles, California (United States); Hanks, Gerald E. [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Grignon, David J. [Indiana University-Purdue University Indianapolis, Indiana (United States); McGowan, David G. [Cross Cancer Institute, Edmonton, Alberta (Canada); Roach, Mack [UCSF, San Francisco, California (United States); Lawton, Colleen [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Lee, R. Jeffrey [Intermountain Medical Center, Salt Lake City, Utah (United States); Sandler, Howard [Cedars-Sinai Medical Center, Los Angeles, California (United States)

    2011-12-01

    Purpose: The impact of age on prostate cancer (PCa) outcome has been controversial; therefore, we analyzed the effect of age on overall survival (OS), distant metastasis, prostate cancer-specific death (PCSD), and nonprostate cancer death (NPCD) on patients with locally advanced PCa. Methods and Materials: Patients who participated in four Radiation Therapy Oncology Group (RTOG) phase III trials, 8531, 8610, 9202, and 9413, were studied. Cox proportional hazards regression was used for OS analysis, and cumulative events analysis with Fine and Gray's regression was used for analyses of metastasis, PCSD, and NPCD. Results: Median follow-up of 4,128 patients with median age of 70 (range, 43-88 years) was 7.3 years. Most patients had high-risk disease: cT3 to cT4 (54%) and Gleason scores (GS) of 7 (45%) and 8 to 10 (27%). Older age ({<=}70 vs. >70 years) predicted for decreased OS (10-year rate, 55% vs. 41%, respectively; p < 0.0001) and increased NPCD (10-year rate, 28% vs. 46%, respectively; p < 0.0001) but decreased metastasis (10-year rate, 27% vs. 20%, respectively; p < 0.0001) and PCSD (10-year rate, 18% vs. 14%, respectively; p < 0.0001). To account for competing risks, outcomes were analyzed in 2-year intervals, and age-dependent differences in metastasis and PCSD persisted, even in the earliest time periods. When adjusted for other covariates, an age of >70 years remained associated with decreased OS (hazard ratio [HR], 1.56 [95% confidence interval [CI], 1.43-1.70] p < 0.0001) but with decreased metastasis (HR, 0.72 [95% CI, 0.63-0.83] p < 0.0001) and PCSD (HR, 0.78 [95% CI, 0.66-0.92] p < 0.0001). Finally, the impact of the duration of androgen deprivation therapy as a function of age was evaluated. Conclusions: These data support less aggressive PCa in older men, independent of other clinical features. While the biological underpinning of this finding remains unknown, stratification by age in future trials appears to be warranted.

  7. Nodal imaging in the neck: recent advances in US, CT and MR imaging of metastatic nodes

    International Nuclear Information System (INIS)

    Nakamura, Takashi; Sumi, Misa

    2007-01-01

    The presence of lymph node metastasis in the neck in patients with head and neck cancer is an important prognostic determinant in staging cancers and in planning surgery and chemo- and radiotherapy for the cancer patients. Therefore, metastatic nodes should be effectively differentiated from benign lymphadenopathies and nodal lymphomas. Here, we review recent advances in the diagnostic imaging of metastatic nodes in the neck, with emphasis placed on the diagnostic performance of MR imaging, Doppler sonography, and CT. (orig.)

  8. Regional Nodal Irradiation in Early-Stage Breast Cancer.

    Science.gov (United States)

    Whelan, Timothy J; Olivotto, Ivo A; Parulekar, Wendy R; Ackerman, Ida; Chua, Boon H; Nabid, Abdenour; Vallis, Katherine A; White, Julia R; Rousseau, Pierre; Fortin, Andre; Pierce, Lori J; Manchul, Lee; Chafe, Susan; Nolan, Maureen C; Craighead, Peter; Bowen, Julie; McCready, David R; Pritchard, Kathleen I; Gelmon, Karen; Murray, Yvonne; Chapman, Judy-Anne W; Chen, Bingshu E; Levine, Mark N

    2015-07-23

    Most women with breast cancer who undergo breast-conserving surgery receive whole-breast irradiation. We examined whether the addition of regional nodal irradiation to whole-breast irradiation improved outcomes. We randomly assigned women with node-positive or high-risk node-negative breast cancer who were treated with breast-conserving surgery and adjuvant systemic therapy to undergo either whole-breast irradiation plus regional nodal irradiation (including internal mammary, supraclavicular, and axillary lymph nodes) (nodal-irradiation group) or whole-breast irradiation alone (control group). The primary outcome was overall survival. Secondary outcomes were disease-free survival, isolated locoregional disease-free survival, and distant disease-free survival. Between March 2000 and February 2007, a total of 1832 women were assigned to the nodal-irradiation group or the control group (916 women in each group). The median follow-up was 9.5 years. At the 10-year follow-up, there was no significant between-group difference in survival, with a rate of 82.8% in the nodal-irradiation group and 81.8% in the control group (hazard ratio, 0.91; 95% confidence interval [CI], 0.72 to 1.13; P=0.38). The rates of disease-free survival were 82.0% in the nodal-irradiation group and 77.0% in the control group (hazard ratio, 0.76; 95% CI, 0.61 to 0.94; P=0.01). Patients in the nodal-irradiation group had higher rates of grade 2 or greater acute pneumonitis (1.2% vs. 0.2%, P=0.01) and lymphedema (8.4% vs. 4.5%, P=0.001). Among women with node-positive or high-risk node-negative breast cancer, the addition of regional nodal irradiation to whole-breast irradiation did not improve overall survival but reduced the rate of breast-cancer recurrence. (Funded by the Canadian Cancer Society Research Institute and others; MA.20 ClinicalTrials.gov number, NCT00005957.).

  9. Creation of a Prognostic Index for Spine Metastasis to Stratify Survival in Patients Treated With Spinal Stereotactic Radiosurgery: Secondary Analysis of Mature Prospective Trials

    International Nuclear Information System (INIS)

    Tang, Chad; Hess, Kenneth; Bishop, Andrew J.; Pan, Hubert Y.; Christensen, Eva N.; Yang, James N.; Tannir, Nizar; Amini, Behrang; Tatsui, Claudio; Rhines, Laurence; Brown, Paul; Ghia, Amol

    2015-01-01

    Purpose: There exists uncertainty in the prognosis of patients following spinal metastasis treatment. We sought to create a scoring system that stratifies patients based on overall survival. Methods and Materials: Patients enrolled in 2 prospective trials investigating stereotactic spine radiation surgery (SSRS) for spinal metastasis with ≥3-year follow-up were analyzed. A multivariate Cox regression model was used to create a survival model. Pretreatment variables included were race, sex, age, performance status, tumor histology, extent of vertebrae involvement, previous therapy at the SSRS site, disease burden, and timing of diagnosis and metastasis. Four survival groups were generated based on the model-derived survival score. Results: Median follow-up in the 206 patients included in this analysis was 70 months (range: 37-133 months). Seven variables were selected: female sex (hazard ratio [HR] = 0.7, P=.02), Karnofsky performance score (HR = 0.8 per 10-point increase above 60, P=.007), previous surgery at the SSRS site (HR = 0.7, P=.02), previous radiation at the SSRS site (HR = 1.8, P=.001), the SSRS site as the only site of metastatic disease (HR = 0.5, P=.01), number of organ systems involved outside of bone (HR = 1.4 per involved system, P<.001), and >5 year interval from initial diagnosis to detection of spine metastasis (HR = 0.5, P<.001). The median survival among all patients was 25.5 months and was significantly different among survival groups (in group 1 [excellent prognosis], median survival was not reached; group 2 reached 32.4 months; group 3 reached 22.2 months; and group 4 [poor prognosis] reached 9.1 months; P<.001). Pretreatment symptom burden was significantly higher in the patient group with poor survival than in the group with excellent survival (all metrics, P<.05). Conclusions: We developed the prognostic index for spinal metastases (PRISM) model, a new model that identified patient subgroups with poor and excellent prognoses

  10. Creation of a Prognostic Index for Spine Metastasis to Stratify Survival in Patients Treated With Spinal Stereotactic Radiosurgery: Secondary Analysis of Mature Prospective Trials

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Chad [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hess, Kenneth [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Bishop, Andrew J.; Pan, Hubert Y.; Christensen, Eva N. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Yang, James N. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tannir, Nizar [Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Amini, Behrang [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tatsui, Claudio; Rhines, Laurence [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Brown, Paul [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ghia, Amol, E-mail: ajghia@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: There exists uncertainty in the prognosis of patients following spinal metastasis treatment. We sought to create a scoring system that stratifies patients based on overall survival. Methods and Materials: Patients enrolled in 2 prospective trials investigating stereotactic spine radiation surgery (SSRS) for spinal metastasis with ≥3-year follow-up were analyzed. A multivariate Cox regression model was used to create a survival model. Pretreatment variables included were race, sex, age, performance status, tumor histology, extent of vertebrae involvement, previous therapy at the SSRS site, disease burden, and timing of diagnosis and metastasis. Four survival groups were generated based on the model-derived survival score. Results: Median follow-up in the 206 patients included in this analysis was 70 months (range: 37-133 months). Seven variables were selected: female sex (hazard ratio [HR] = 0.7, P=.02), Karnofsky performance score (HR = 0.8 per 10-point increase above 60, P=.007), previous surgery at the SSRS site (HR = 0.7, P=.02), previous radiation at the SSRS site (HR = 1.8, P=.001), the SSRS site as the only site of metastatic disease (HR = 0.5, P=.01), number of organ systems involved outside of bone (HR = 1.4 per involved system, P<.001), and >5 year interval from initial diagnosis to detection of spine metastasis (HR = 0.5, P<.001). The median survival among all patients was 25.5 months and was significantly different among survival groups (in group 1 [excellent prognosis], median survival was not reached; group 2 reached 32.4 months; group 3 reached 22.2 months; and group 4 [poor prognosis] reached 9.1 months; P<.001). Pretreatment symptom burden was significantly higher in the patient group with poor survival than in the group with excellent survival (all metrics, P<.05). Conclusions: We developed the prognostic index for spinal metastases (PRISM) model, a new model that identified patient subgroups with poor and excellent prognoses.

  11. Development of nodal interface conditions for a PN approximation nodal model

    International Nuclear Information System (INIS)

    Feiz, M.

    1993-01-01

    A relation was developed for approximating higher order odd-moments from lower order odd-moments at the nodal interfaces of a Legendre polynomial nodal model. Two sample problems were tested using different order P N expansions in adjacent nodes. The developed relation proved to be adequate and matched the nodal interface flux accurately. The development allows the use of different order expansions in adjacent nodes, and will be used in a hybrid diffusion-transport nodal model. (author)

  12. Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer.

    Directory of Open Access Journals (Sweden)

    Sura Aziz

    Full Text Available Presence of lymph node (LN metastasis is a strong prognostic factor in breast cancer, whereas the importance of extra-nodal extension and other nodal tumor features have not yet been fully recognized. Here, we examined microscopic features of lymph node metastases and their prognostic value in a population-based cohort of node positive breast cancer (n = 218, as part of the prospective Norwegian Breast Cancer Screening Program NBCSP (1996-2009. Sections were reviewed for the largest metastatic tumor diameter (TD-MET, nodal afferent and efferent vascular invasion (AVI and EVI, extra-nodal extension (ENE, number of ENE foci, as well as circumferential (CD-ENE and perpendicular (PD-ENE diameter of extra-nodal growth. Number of positive lymph nodes, EVI, and PD-ENE were significantly increased with larger primary tumor (PT diameter. Univariate survival analysis showed that several features of nodal metastases were associated with disease-free (DFS or breast cancer specific survival (BCSS. Multivariate analysis demonstrated an independent prognostic value of PD-ENE (with 3 mm as cut-off value in predicting DFS and BCSS, along with number of positive nodes and histologic grade of the primary tumor (for DFS: P = 0.01, P = 0.02, P = 0.01, respectively; for BCSS: P = 0.02, P = 0.008, P = 0.02, respectively. To conclude, the extent of ENE by its perpendicular diameter was independently prognostic and should be considered in line with nodal tumor burden in treatment decisions of node positive breast cancer.

  13. Hepatocellular Carcinoma Metastasis to the Orbit in a Coinfected HIV+ HBV+ Patient Previously Treated with Orthotopic Liver Transplantation: A Case Report

    Directory of Open Access Journals (Sweden)

    S. Guerriero

    2011-01-01

    Full Text Available Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient.

  14. Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer?

    Science.gov (United States)

    Evans, Andrew; Rauchhaus, Petra; Whelehan, Patsy; Thomson, Kim; Purdie, Colin A; Jordan, Lee B; Michie, Caroline O; Thompson, Alastair; Vinnicombe, Sarah

    2014-01-01

    Shear wave elastography (SWE) shows promise as an adjunct to greyscale ultrasound examination in assessing breast masses. In breast cancer, higher lesion stiffness on SWE has been shown to be associated with features of poor prognosis. The purpose of this study was to assess whether lesion stiffness at SWE is an independent predictor of lymph node involvement. Patients with invasive breast cancer treated by primary surgery, who had undergone SWE examination were eligible. Data were retrospectively analysed from 396 consecutive patients. The mean stiffness values were obtained using the Aixplorer® ultrasound machine from SuperSonic Imagine Ltd. Measurements were taken from a region of interest positioned over the stiffest part of the abnormality. The average of the mean stiffness value obtained from each of two orthogonal image planes was used for analysis. Associations between lymph node involvement and mean lesion stiffness, invasive cancer size, histologic grade, tumour type, ER expression, HER-2 status and vascular invasion were assessed using univariate and multivariate logistic regression. At univariate analysis, invasive size, histologic grade, HER-2 status, vascular invasion, tumour type and mean stiffness were significantly associated with nodal involvement. Nodal involvement rates ranged from 7 % for tumours with mean stiffness 150 kPa. At multivariate analysis, invasive size, tumour type, vascular invasion, and mean stiffness maintained independent significance. Mean stiffness at SWE is an independent predictor of lymph node metastasis and thus can confer prognostic information additional to that provided by conventional preoperative tumour assessment and staging.

  15. The Nudo, Rollo, Melon codes and nodal correlations

    International Nuclear Information System (INIS)

    Perlado, J.M.; Aragones, J.M.; Minguez, E.; Pena, J.

    1975-01-01

    Analysis of nodal calculation and checking results by the reference reactor experimental data. Nudo code description, adapting experimental data to nodal calculations. Rollo, Melon codes as improvement in the cycle life calculations of albedos, mixing parameters and nodal correlations. (author)

  16. Delphian node metastasis in head and neck cancers--oracle or myth?

    Science.gov (United States)

    Iyer, N Gopalakrishna; Shaha, Ashok R; Ferlito, Alfio; Thomas Robbins, K; Medina, Jesus E; Silver, Carl E; Rinaldo, Alessandra; Takes, Robert P; Suárez, Carlos; Rodrigo, Juan P; Bradley, Patrick J; Werner, Jochen A

    2010-09-15

    Delphian node (DN) refers to the pre-laryngeal or pre-cricoid nodal tissue often identified during laryngeal or thyroid surgery. The original nomenclature is based on the assumption that metastasis to this node was predictive of aggressive disease and poor outcome for patients. In this article, we review the existing literature on the topic to determine the significance of DN metastasis in laryngeal, hypopharyngeal and thyroid cancers. (c) 2010 Wiley-Liss, Inc.

  17. Heterogeneous treatment in the variational nodal method

    International Nuclear Information System (INIS)

    Fanning, T.H.

    1995-01-01

    The variational nodal transport method is reduced to its diffusion form and generalized for the treatment of heterogeneous nodes while maintaining nodal balances. Adapting variational methods to heterogeneous nodes requires the ability to integrate over a node with discontinuous cross sections. In this work, integrals are evaluated using composite gaussian quadrature rules, which permit accurate integration while minimizing computing time. Allowing structure within a nodal solution scheme avoids some of the necessity of cross section homogenization, and more accurately defines the intra-nodal flux shape. Ideally, any desired heterogeneity can be constructed within the node; but in reality, the finite set of basis functions limits the practical resolution to which fine detail can be defined within the node. Preliminary comparison tests show that the heterogeneous variational nodal method provides satisfactory results even if some improvements are needed for very difficult, configurations

  18. [A case of gastric cancer with N2 lymph node metastasis and pancreatic invasion effectively treated with docetax-el/S-1 as a neoadjuvant chemotherapy].

    Science.gov (United States)

    Omori, Keita; Wakabayashi, Kazuhiko; Ishibashi, Yuji; Ito, Yutaka

    2014-08-01

    A 74-year-old man was diagnosed with advanced gastric cancer(cStage III B). Laparotomy showed N2 lymph node metastasis and pancreatic invasion. Radical resection appeared impossible and was thus not performed. Chemotherapy consisting of a combination of S-1(80mg/m 2, 2-week administration and 1-week rest), and docetaxel(40mg/m2day 1)was administered with the expectation of tumor downstaging. A partial response(PR)was obtained after five courses of this regimen in which the primary lesion and lymph node swelling remarkably improved. Total gastrectomy, splenectomy, partial colectomy, and D2 lymph node dissection were then performed. Pathological analysis revealed very few cancer cells in the primary lesion and that the lymph nodes had become scarred and fibrotic. The histological appearance was judged to be grade 2 and the final diagnosis was T1N0H0P0CY0M0, fStage I A, curability A. Currently, more than 6 years and 4 months after the operation, the patient is alive without any evidence of recurrence. Thus, docetaxel/S-1 combination therapy was an effective neoadjuvant chemotherapy for this case of advanced gastric cancer.

  19. The variational nodal method: history and recent accomplishments

    International Nuclear Information System (INIS)

    Lewis, E.E.

    2004-01-01

    The variational nodal method combines spherical harmonics expansions in angle with hybrid finite element techniques is space to obtain multigroup transport response matrix algorithms applicable to both deep penetration and reactor core physics problems. This survey briefly recounts the method's history and reviews its capabilities. The variational basis for the approach is presented and two methods for obtaining discretized equations in the form of response matrices are detailed. The first is that contained the widely used VARIANT code, while the second incorporates newly developed integral transport techniques into the variational nodal framework. The two approaches are combined with a finite sub element formulation to treat heterogeneous nodes. Applications are presented for both a deep penetration problem and to an OECD benchmark consisting of LWR MOX fuel assemblies. Ongoing work is discussed. (Author)

  20. Ischemic stroke associated with radio frequency ablation for nodal reentry

    International Nuclear Information System (INIS)

    Diaz M, Juan C; Duran R, Carlos E; Perafan B, Pablo; Pava M, Luis F

    2010-01-01

    Atrioventricular nodal reentry tachycardia is the most common type of paroxysmal supraventricular tachycardia. In those patients in whom drug therapy is not effective or not desired, radio frequency ablation is an excellent therapeutic method. Although overall these procedures are fast and safe, several complications among which ischemic stroke stands out, have been reported. We present the case of a 41 year old female patient with repetitive episodes of tachycardia due to nodal reentry who was treated with radiofrequency ablation. Immediately after the procedure she presented focal neurologic deficit consistent with ischemic stroke in the right medial cerebral artery territory. Angiography with angioplastia and abxicimab was performed and then tissue plasminogen activator (rtPA) was locally infused, with appropriate clinical and angiographic outcome.

  1. The variational nodal method: some history and recent activity

    International Nuclear Information System (INIS)

    Lewis, E.E.; Smith, M.A.; Palmiotti, G.

    2005-01-01

    The variational nodal method combines spherical harmonics expansions in angle with hybrid finite element techniques in space to obtain multigroup transport response matrix algorithms applicable to a wide variety of reactor physics problems. This survey briefly recounts the method's history and reviews its capabilities. Two methods for obtaining discretized equations in the form of response matrices are compared. The first is that contained the widely used VARIANT code, while the second incorporates more recently developed integral transport techniques into the variational nodal framework. The two approaches are combined with a finite sub-element formulation to treat heterogeneous nodes. Results are presented for application to a deep penetration problem and to an OECD benchmark consisting of LWR Mox fuel assemblies. Ongoing work is discussed. (authors)

  2. Nodal pricing in a coupled electricity market

    OpenAIRE

    Bjørndal, Endre; Bjørndal, Mette; Cai, Hong

    2014-01-01

    This paper investigates a pricing model for an electricity market with a hybrid congestion management method, i.e. part of the system applies a nodal pricing scheme and the rest applies a zonal pricing scheme. The model clears the zonal and nodal pricing areas simultaneously. The nodal pricing area is affected by the changes in the zonal pricing area since it is directly connected to the zonal pricing area by commercial trading. The model is tested on a 13-node power system. Within the area t...

  3. A comparison of two nodal codes : Advanced nodal code (ANC) and analytic function expansion nodal (AFEN) code

    International Nuclear Information System (INIS)

    Chung, S.K.; Hah, C.J.; Lee, H.C.; Kim, Y.H.; Cho, N.Z.

    1996-01-01

    Modern nodal methods usually employs the transverse integration technique in order to reduce a multi-dimensional diffusion equation to one-dimensional diffusion equations. The use of the transverse integration technique requires two major approximations such as a transverse leakage approximation and a one-dimensional flux approximation. Both the transverse leakage and the one-dimensional flux are approximated by polynomials. ANC (Advanced Nodal Code) developed by Westinghouse employs a modern nodal expansion method for the flux calculation, the equivalence theory for the homogenization error reduction and a group theory for pin power recovery. Unlike the conventional modern nodal methods, AFEN (Analytic Function Expansion Nodal) method expands homogeneous flux distributions within a node into non-separable analytic basis functions, which eliminate two major approximations of the modern nodal methods. A comparison study of AFEN with ANC has been performed to see the applicability of AFEN to commercial PWR and different types of reactors such as MOX fueled reactor. The qualification comparison results demonstrate that AFEN methodology is accurate enough to apply for commercial PWR analysis. The results show that AFEN provides very accurate results (core multiplication factor and assembly power distribution) for cores that exhibit strong flux gradients as in a MOX loaded core. (author)

  4. NOMAD: a nodal microscopic analysis method for nuclear fuel depletion

    International Nuclear Information System (INIS)

    Rajic, H.L.; Ougouag, A.M.

    1987-01-01

    Recently developed assembly homogenization techniques made possible very efficient global burnup calculations based on modern nodal methods. There are two possible ways of modeling the global depletion process: macroscopic and microscopic depletion models. Using a microscopic global depletion approach NOMAD (NOdal Microscopic Analysis Method for Nuclear Fuel Depletion), a multigroup, two- and three-dimensional, multicycle depletion code was devised. The code uses the ILLICO nodal diffusion model. The formalism of the ILLICO methodology is extended to treat changes in the macroscopic cross sections during a depletion cycle without recomputing the coupling coefficients. This results in a computationally very efficient method. The code was tested against a well-known depletion benchmark problem. In this problem a two-dimensional pressurized water reactor is depleted through two cycles. Both cycles were run with 1 x 1 and 2 x 2 nodes per assembly. It is obvious that the one node per assembly solution gives unacceptable results while the 2 x 2 solution gives relative power errors consistently below 2%

  5. Quantum oscillations in nodal line systems

    Science.gov (United States)

    Yang, Hui; Moessner, Roderich; Lim, Lih-King

    2018-04-01

    We study signatures of magnetic quantum oscillations in three-dimensional nodal line semimetals at zero temperature. The extended nature of the degenerate bands can result in a Fermi surface geometry with topological genus one, as well as a Fermi surface of electron and hole pockets encapsulating the nodal line. Moreover, the underlying two-band model to describe a nodal line is not unique, in that there are two classes of Hamiltonian with distinct band topology giving rise to the same Fermi-surface geometry. After identifying the extremal cyclotron orbits in various magnetic field directions, we study their concomitant Landau levels and resulting quantum oscillation signatures. By Landau-fan-diagram analyses, we extract the nontrivial π Berry phase signature for extremal orbits linking the nodal line.

  6. Sensitivity of SBLOCA analysis to model nodalization

    International Nuclear Information System (INIS)

    Lee, C.; Ito, T.; Abramson, P.B.

    1983-01-01

    The recent Semiscale test S-UT-8 indicates the possibility for primary liquid to hang up in the steam generators during a SBLOCA, permitting core uncovery prior to loop-seal clearance. In analysis of Small Break Loss of Coolant Accidents with RELAP5, it is found that resultant transient behavior is quite sensitive to the selection of nodalization for the steam generators. Although global parameters such as integrated mass loss, primary inventory and primary pressure are relatively insensitive to the nodalization, it is found that the predicted distribution of inventory around the primary is significantly affected by nodalization. More detailed nodalization predicts that more of the inventory tends to remain in the steam generators, resulting in less inventory in the reactor vessel and therefore causing earlier and more severe core uncovery

  7. Twisted Vector Bundles on Pointed Nodal Curves

    Indian Academy of Sciences (India)

    Abstract. Motivated by the quest for a good compactification of the moduli space of -bundles on a nodal curve we establish a striking relationship between Abramovich's and Vistoli's twisted bundles and Gieseker vector bundles.

  8. The NODAL system for the SPS

    International Nuclear Information System (INIS)

    Crowley-Milling, M.C.; Shering, G.C.

    1978-01-01

    A comprehensive description is given of the NODAL system used for computer control of the CERN Super-Proton Synchrotron. Details are given of NODAL, a high-level programming language based on FOCAL and SNOBOL4, designed for interactive use. It is shown how this interpretive language is used with a network of computers and how it can be extended by adding machine-code modules. The report updates and replaces an earlier one published in 1974. (Auth.)

  9. Nodal coupling by response matrix principles

    International Nuclear Information System (INIS)

    Ancona, A.; Becker, M.; Beg, M.D.; Harris, D.R.; Menezes, A.D.; VerPlanck, D.M.; Pilat, E.

    1977-01-01

    The response matrix approach has been used in viewing a reactor node in isolation and in characterizing the node by reflection and trans-emission factors. These are then used to generate invariant imbedding parameters, which in turn are used in a nodal reactor simulator code to compute core power distributions in two and three dimensions. Various nodal techniques are analyzed and converted into a single invariant imbedding formalism

  10. Isolated splenic metastasis from a thymic carcinoma: A case report.

    Science.gov (United States)

    Chen, Dongmei; Meng, Xiangying; Zhao, Yaowei; Wu, Shikai

    2016-09-01

    Thymic carcinomas are rare tumors that arise in the anterior mediastinum. Most of these malignancies develop local metastases limited in the thorax. Splenic metastases from thymic carcinomas are extremely rare. Here we report a case of isolated splenic metastasis from a 38-year-old female patient with Stage IV thymic carcinoma, who was treated with chemoradiotherapy. At twenty-2 months follow-up, the patient was found to have an isolated spleen metastasis, which was treated by Cyberknife with a reduced size of the metastasis, representing a partial response. Although splenic metastasis is a rare phenomenon, physicians need to be aware of the possibility of such metastases.

  11. Magnonic triply-degenerate nodal points

    Science.gov (United States)

    Owerre, S. A.

    2017-12-01

    We generalize the concept of triply-degenerate nodal points to non-collinear antiferromagnets. Here, we introduce this concept to insulating quantum antiferromagnets on the decorated honeycomb lattice, with spin-1 bosonic quasiparticle excitations known as magnons. We demonstrate the existence of magnonic surface states with constant energy contours that form pairs of magnonic arcs connecting the surface projection of the magnonic triple nodal points. The quasiparticle excitations near the triple nodal points represent three-component bosons beyond that of magnonic Dirac, Weyl, and nodal-line cases. They can be regarded as a direct reflection of the intrinsic spin carried by magnons. Furthermore, we show that the magnonic triple nodal points can split into magnonic Weyl points, as the system transits from a non-collinear spin structure to a non-coplanar one with a non-zero scalar spin chirality. Our results not only apply to insulating antiferromagnets, but also provide a platform to seek for triple nodal points in metallic antiferromagnets.

  12. Efficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp

    OpenAIRE

    Wray, Justin; Amdur, Robert J.; Morris, Christopher G.; Werning, John; Mendenhall, William M.

    2015-01-01

    Background In patients at high risk for regional node metastasis from squamous cell carcinoma (SCC) of the skin of the face, ear, or scalp, radiotherapy to the regional nodes is an alternative to parotid or neck surgery. Data on the efficacy of elective nodal radiotherapy in this setting are scarce such that there is no publication specifically addressing the subject. The purpose of our study is to fill this void in the skin cancer literature. Methods This is a single-institution study of out...

  13. Unusual metachronous isolated inguinal lymph node metastasis from adenocarcinoma of the sigmoid colon

    Directory of Open Access Journals (Sweden)

    Parodo Giuseppina

    2011-10-01

    Full Text Available Abstract This study aimed to describe an unusual case of metachronous isolated inguinal lymph nodes metastasis from sigmoid carcinoma. A 62-year-old man was referred to our department because of an obstructing sigmoid carcinoma. Colonoscopy showed the obstructing lesion at 30 cm from the anal verge and abdominal CT revealed a sigmoid lesion infiltrating the left lateral abdominal wall. The patient underwent a colonic resection extended to the abdominal wall. Histology showed an adenocarcinoma of the colon infiltrating the abdominal wall with iuxtacolic nodal involvement. Thirty three months after surgery abdominal CT and PET scan revealed a metastatic left inguinal lymph node involvement. The metastatic lymph node was found strictly adherent to the left iliac-femoral artery and encompassing the origin of the left inferior epigastric artery. Histology showed a metachronous nodal metastasis from colonic adenocarcinoma. Despite metastastic involvement of inguinal lymph node from rectal cancer is a rare but well known clinical entity, to the best of our knowledge, this is the first report of inguinal metastasis from a carcinoma of the left colon. Literature review shows only three other similar reported cases: two cases of inguinal metastasis secondary to adenocarcinoma of the cecum and one case of axillary metastasis from left colonic carcinoma. A metastatic pathway through superficial abdominal wall lymphatic vessels could be possible through the route along the left inferior epigastric artery. The solitary inguinal nodal involvement from rectal carcinoma could have a more favorable prognosis. In the case of nodal metastasis to the body surface lymph nodes from colonic carcinoma, following the small number of such cases reported in the literature, no definitive conclusions can be drawn.

  14. The impact of nodal tumour burden on lymphoscintigraphic imaging in patients with melanomas

    Energy Technology Data Exchange (ETDEWEB)

    Kretschmer, Lutz; Bertsch, Hans Peter; Hellriegel, Simin; Thoms, Kai-Martin; Schoen, Michael Peter [Georg August University of Goettingen, Department of Dermatology, Venereology and Allergology, Goettingen (Germany); Bardzik, Pawel; Meller, Johannes; Sahlmann, Carsten Oliver [Georg-August-University of Goettingen, Department of Nuclear Medicine, Goettingen (Germany)

    2014-10-15

    To retrospectively study the influence of nodal tumour burden on lymphoscintigraphic imaging in 509 consecutive patients with melanomas. Bidirectional lymphatic drainage, the clear depiction of an afferent lymphatic vessel, time to depiction of the first sentinel lymph node (SLN) and number of depicted and excised nodes were recorded. Nodal tumour load was classified as SLN-negative, SLN micrometastases or macrometastases. In the overall population, using multivariate regression analysis, a short SLN depiction time was significantly associated with the depiction of a greater number of radioactive nodes, a short distance between the primary tumour site and the nodal basin, younger age and lower nodal tumour burden. The proportion of patients with clear depiction of an afferent lymphatic vessel depended on the nodal tumour load (46 % in SLN-negative patients, 57 % in SLN positive patients, and 69 % in patients with macrometastases; P = 0.009). Macrometastasis was significantly associated with delayed depiction of the first radioactive node and a greater number of depicted hotspots. In patients with clinically nonsuspicious nodes, i.e. the classical target group for SLN biopsy, clear depiction of an afferent vessel was significantly associated with a higher number of SLNs during dynamic acquisition, SLN micrometastasis and a higher overall number of metastatic lymph nodes after SLN biopsy plus completion lymphadenectomy. The excision of more than two SLNs did not increase the metastasis detection rate. In patients with bidirectional or tridirectional lymphatic drainage, the SLN positivity rates for the first, second and third basin were 25.4 %, 11.7 % and 0.0 %, respectively (P = 0.002). In patients with clinically nonsuspicious lymph nodes, clear depiction of an afferent lymph vessel may be a sign of micrometastasis. Macrometastasis is associated with prominent afferent vessels, delayed depiction of the first radioactive node and a higher number of depicted hotspots

  15. The analytic nodal method in cylindrical geometry

    International Nuclear Information System (INIS)

    Prinsloo, Rian H.; Tomasevic, Djordje I.

    2008-01-01

    Nodal diffusion methods have been used extensively in nuclear reactor calculations, specifically for their performance advantage, but also for their superior accuracy. More specifically, the Analytic Nodal Method (ANM), utilising the transverse integration principle, has been applied to numerous reactor problems with much success. In this work, a nodal diffusion method is developed for cylindrical geometry. Application of this method to three-dimensional (3D) cylindrical geometry has never been satisfactorily addressed and we propose a solution which entails the use of conformal mapping. A set of 1D-equations with an adjusted, geometrically dependent, inhomogeneous source, is obtained. This work describes the development of the method and associated test code, as well as its application to realistic reactor problems. Numerical results are given for the PBMR-400 MW benchmark problem, as well as for a 'cylindrisized' version of the well-known 3D LWR IAEA benchmark. Results highlight the improved accuracy and performance over finite-difference core solutions and investigate the applicability of nodal methods to 3D PBMR type problems. Results indicate that cylindrical nodal methods definitely have a place within PBMR applications, yielding performance advantage factors of 10 and 20 for 2D and 3D calculations, respectively, and advantage factors of the order of 1000 in the case of the LWR problem

  16. Encapsulation of nodal segments of lobelia chinensis

    Directory of Open Access Journals (Sweden)

    Weng Hing Thong

    2015-04-01

    Full Text Available Lobelia chinensis served as an important herb in traditional chinese medicine. It is rare in the field and infected by some pathogens. Therefore, encapsulation of axillary buds has been developed for in vitro propagation of L. chinensis. Nodal explants of L. chinensis were used as inclusion materials for encapsulation. Various combinations of calcium chloride and sodium alginate were tested. Encapsulation beads produced by mixing 50 mM calcium chloride and 3.5% sodium alginate supported the optimal in vitro conversion potential. The number of multiple shoots formed by encapsulated nodal segments was not significantly different from the average of shoots produced by non-encapsulated nodal segments. The encapsulated nodal segments regenerated in vitro on different medium. The optimal germination and regeneration medium was Murashige-Skoog medium. Plantlets regenerated from the encapsulated nodal segments were hardened, acclimatized and established well in the field, showing similar morphology with parent plants. This encapsulation technology would serve as an alternative in vitro regeneration system for L. chinensis.

  17. Isolated cutaneous involvement in a child with nodal anaplastic large cell lymphoma

    Directory of Open Access Journals (Sweden)

    Vibhu Mendiratta

    2016-01-01

    Full Text Available Non-Hodgkin lymphoma is a common childhood T-cell and B-cell neoplasm that originates primarily from lymphoid tissue. Cutaneous involvement can be in the form of a primary extranodal lymphoma, or secondary to metastasis from a non-cutaneous location. The latter is uncommon, and isolated cutaneous involvement is rarely reported. We report a case of isolated secondary cutaneous involvement from nodal anaplastic large cell lymphoma (CD30 + and ALK + in a 7-year-old boy who was on chemotherapy. This case is reported for its unusual clinical presentation as an acute febrile, generalized papulonodular eruption that mimicked deep fungal infection, with the absence of other foci of systemic metastasis.

  18. Accuracy of EUS for estimating the depth of tumor invasion and for diagnosing lymph node metastasis and recurrence in patients with m3 and sm esophageal carcinomas

    International Nuclear Information System (INIS)

    Arima, Miwako; Tada, Masahiro; Tanaka, Youichi; Arima, Hideaki

    2006-01-01

    Esophagus-preserving therapy has been increasingly used to treat esophageal cancer invading the m 3 and sm, thereby avoiding radical surgery. However, many problems remain to be solved, including the diagnosis of lymph node metastasis and recurrence and the assessment of long-term outcomes. We studied 132 patients who had esophageal cancer with m 3 and sm invasion. Clinical course after esophagus-preserving therapy, and the accuracy and roles of endoscopic ultrasonography (EUS) for diagnosing the depth of tumor invasion, lymph node metastasis, and recurrence were assessed. EUS can be used to examine the cervical, thoracic, and abdominal regions, without being affected by heat beats. Therefore, EUS can more clearly depict lymph nodes than CT or US. The accuracy of EUS was 86.4% for estimating the depth of tumor invasion and 82% for diagnosing lymph node metastasis. All cases of nodal recurrence were diagnosed by EUS. Among patients who received chemoradiotherapy, enlarged lymph nodes often appeared around 3 years after treatment, and recurrence was diagnosed slightly later than that in patients who underwent endoscopic mucosal resection. Endoscopic ultrasound-guided fine-needle aspiration biopsy was sometimes performed to determine the treatment policy. Patients who receive chemoradiotherapy should undergo regular long-term follow-up by CT, US, and EUS. EUS is essential for the earlier detection of recurrence. (author)

  19. Cavitary pulmonar metastasis

    International Nuclear Information System (INIS)

    Marchiori, E.; Matushita, J.P.K.; Azevedo, C.M. de

    1984-01-01

    Seven cases of cavitary lung metastasis, four from head and neck neoplasma, two from uterine carcinoma and one from hepatoma are reported. The physiopathology and the most common sites of this kind of lesion are discussed. The rarity of the solitary excavated metastasis from hepatoma, not reported previously in the literature reviewed, is emphasized. (Author) [pt

  20. Complex models of nodal nuclear data

    International Nuclear Information System (INIS)

    Dufek, Jan

    2011-01-01

    During the core simulations, nuclear data are required at various nodal thermal-hydraulic and fuel burnup conditions. The nodal data are also partially affected by thermal-hydraulic and fuel burnup conditions in surrounding nodes as these change the neutron energy spectrum in the node. Therefore, the nodal data are functions of many parameters (state variables), and the more state variables are considered by the nodal data models the more accurate and flexible the models get. The existing table and polynomial regression models, however, cannot reflect the data dependences on many state variables. As for the table models, the number of mesh points (and necessary lattice calculations) grows exponentially with the number of variables. As for the polynomial regression models, the number of possible multivariate polynomials exceeds the limits of existing selection algorithms that should identify a few dozens of the most important polynomials. Also, the standard scheme of lattice calculations is not convenient for modelling the data dependences on various burnup conditions since it performs only a single or few burnup calculations at fixed nominal conditions. We suggest a new efficient algorithm for selecting the most important multivariate polynomials for the polynomial regression models so that dependences on many state variables can be considered. We also present a new scheme for lattice calculations where a large number of burnup histories are accomplished at varied nodal conditions. The number of lattice calculations being performed and the number of polynomials being analysed are controlled and minimised while building the nodal data models of a required accuracy. (author)

  1. Hybrid nodal methods in the solution of the diffusion equations in X Y geometry; Metodos nodales hibridos en la solucion de las ecuaciones de difusion en geometria XY

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez M, N. [CFE, Carretera Cardel-Nautla Km. 43.5, 91680 Veracruz (Mexico); Alonso V, G.; Valle G, E. del [IPN-ESFM, 07738 Mexico D.F. (Mexico)]. e-mail: nhmiranda@mexico.com

    2003-07-01

    In 1979, Hennart and collaborators applied several schemes of classic finite element in the numerical solution of the diffusion equations in X Y geometry and stationary state. Almost two decades then, in 1996, himself and other collaborators carried out a similar work but using nodal schemes type finite element. Continuing in this last direction, in this work a group it is described a set of several Hybrid Nodal schemes denominated (NH) as well as their application to solve the diffusion equations in multigroup in stationary state and X Y geometry. The term hybrid nodal it means that such schemes interpolate not only Legendre moments of face and of cell but also the values of the scalar flow of neutrons in the four corners of each cell or element of the spatial discretization of the domain of interest. All the schemes here considered are polynomials like they were it their predecessors. Particularly, its have developed and applied eight different hybrid nodal schemes that its are very nearby related with those developed by Hennart and collaborators in the past. It is treated of schemes in those that nevertheless that decreases the number of interpolation parameters it is conserved the accurate in relation to the bi-quadratic and bi-cubic schemes. Of these eight, three were described and applied in a previous work. It is the bi-lineal classic scheme as well as the hybrid nodal schemes, bi-quadratic and bi-cubic for that here only are described the other 5 hybrid nodal schemes although they are provided numerical results for several test problems with all them. (Author)

  2. Nodal Structure of the Electronic Wigner Function

    DEFF Research Database (Denmark)

    Schmider, Hartmut; Dahl, Jens Peder

    1996-01-01

    On the example of several atomic and small molecular systems, the regular behavior of nodal patterns in the electronic one-particle reduced Wigner function is demonstrated. An expression found earlier relates the nodal pattern solely to the dot-product of the position and the momentum vector......, if both arguments are large. An argument analogous to the ``bond-oscillatory principle'' for momentum densities links the nuclear framework in a molecule to an additional oscillatory term in momenta parallel to bonds. It is shown that these are visible in the Wigner function in terms of characteristic...

  3. [Parahisian atrial tachycardia or atrioventricular nodal reentrant tachycardia with tendon of Todaro breakthrough?].

    Science.gov (United States)

    Orczykowski, Michał; Jaworska-Wilczyńska, Maria; Urbanek, Piotr; Bodalski, Robert; Derejko, Paweł; Gajek, Jacek; Hryniewiecki, Tomasz; Szumowski, Lukasz; Walczak, Franciszek

    2010-08-01

    We present a case of a 61 year-old woman with tachycardia originating close to the His bundle where radiofrequency (RF) ablation may bear potential risk of atrioventricular (AV) block. In this case report we discuss the possibility of a AV nodal reciprocating tachycardia with tendon of Todaro breakthrough. Patient was safely and effectively treated with RF catheter ablation.

  4. Comparison of five systems for staging lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Yu, W; Choi, G S; Whang, I; Suh, I S

    1997-09-01

    There are several systems for staging lymph node metastasis in gastric cancer. Their relative merits are not clear. In this retrospective analysis, the nodal status was classified according to the Union Internacional Contra la Cancrum (UICC) and Japanese staging systems, the number and frequency of lymph node metastasis, and the level of involved nodes. Each staging system was scored as good (+1), fair (0) or poor (-1) with respect to prognostic value, theoretical value, convenience, reproducibility and surgical applicability. There were no differences between the five staging systems in predicting survival. The Japanese staging system was most arbitrary owing to the complexity of the system, although it had an advantage in surgical application. The same disadvantage was found in the UICC system and the level system. Determination of the number and frequency of involved nodes was convenient and reproducible, but the number of lymph nodes dissected must be considered when the number of positive nodes is used for staging. The classification of metastasis to the regional lymph nodes as N0 (no nodal metastasis), N1 (metastasis in 1-25 per cent of dissected nodes) and N2 (metastasis in more than 25 per cent of dissected nodes) would be a simple, convenient, reproducible staging system with an ability to predict surgical results.

  5. The use of genetic programming in the analysis of quantitative gene expression profiles for identification of nodal status in bladder cancer

    International Nuclear Information System (INIS)

    Mitra, Anirban P; Almal, Arpit A; George, Ben; Fry, David W; Lenehan, Peter F; Pagliarulo, Vincenzo; Cote, Richard J; Datar, Ram H; Worzel, William P

    2006-01-01

    Previous studies on bladder cancer have shown nodal involvement to be an independent indicator of prognosis and survival. This study aimed at developing an objective method for detection of nodal metastasis from molecular profiles of primary urothelial carcinoma tissues. The study included primary bladder tumor tissues from 60 patients across different stages and 5 control tissues of normal urothelium. The entire cohort was divided into training and validation sets comprised of node positive and node negative subjects. Quantitative expression profiling was performed for a panel of 70 genes using standardized competitive RT-PCR and the expression values of the training set samples were run through an iterative machine learning process called genetic programming that employed an N-fold cross validation technique to generate classifier rules of limited complexity. These were then used in a voting algorithm to classify the validation set samples into those associated with or without nodal metastasis. The generated classifier rules using 70 genes demonstrated 81% accuracy on the validation set when compared to the pathological nodal status. The rules showed a strong predilection for ICAM1, MAP2K6 and KDR resulting in gene expression motifs that cumulatively suggested a pattern ICAM1>MAP2K6>KDR for node positive cases. Additionally, the motifs showed CDK8 to be lower relative to ICAM1, and ANXA5 to be relatively high by itself in node positive tumors. Rules generated using only ICAM1, MAP2K6 and KDR were comparably robust, with a single representative rule producing an accuracy of 90% when used by itself on the validation set, suggesting a crucial role for these genes in nodal metastasis. Our study demonstrates the use of standardized quantitative gene expression values from primary bladder tumor tissues as inputs in a genetic programming system to generate classifier rules for determining the nodal status. Our method also suggests the involvement of ICAM1, MAP2K6, KDR

  6. Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation.

    Science.gov (United States)

    Komatsu, Tetsuya; Kunieda, Etsuo; Kitahara, Tadashi; Akiba, Takeshi; Nagao, Ryuta; Fukuzawa, Tsuyoshi

    2016-01-01

    More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V20 of the lung, D(1cm3) of the spinal cord, D(1cm3) and D(10cm3) of the esophagus and D(10cm3) of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible. © The Author 2015. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  7. Status on development and verification of reactivity initiated accident analysis code for PWR (NODAL3)

    International Nuclear Information System (INIS)

    Peng Hong Liem; Surian Pinem; Tagor Malem Sembiring; Tran Hoai Nam

    2015-01-01

    A coupled neutronics thermal-hydraulics code NODAL3 has been developed based on the nodal few-group neutron diffusion theory in 3-dimensional Cartesian geometry for a typical pressurized water reactor (PWR) static and transient analyses, especially for reactivity initiated accidents (RIA). The spatial variables are treated by using a polynomial nodal method (PNM) while for the neutron dynamic solver the adiabatic and improved quasi-static methods are adopted. A simple single channel thermal-hydraulics module and its steam table is implemented into the code. Verification works on static and transient benchmarks are being conducting to assess the accuracy of the code. For the static benchmark verification, the IAEA-2D, IAEA-3D, BIBLIS and KOEBERG light water reactor (LWR) benchmark problems were selected, while for the transient benchmark verification, the OECD NEACRP 3-D LWR Core Transient Benchmark and NEA-NSC 3-D/1-D PWR Core Transient Benchmark (Uncontrolled Withdrawal of Control Rods at Zero Power). Excellent agreement of the NODAL3 results with the reference solutions and other validated nodal codes was confirmed. (author)

  8. Isospectral graphs with identical nodal counts

    International Nuclear Information System (INIS)

    Oren, Idan; Band, Ram

    2012-01-01

    According to a recent conjecture, isospectral objects have different nodal count sequences (Gnutzmann et al 2005 J. Phys. A: Math. Gen. 38 8921–33). We study generalized Laplacians on discrete graphs, and use them to construct the first non-trivial counterexamples to this conjecture. In addition, these examples demonstrate a surprising connection between isospectral discrete and quantum graphs. (paper)

  9. Comparison of neutronic transport equation resolution nodal methods

    International Nuclear Information System (INIS)

    Zamonsky, O.M.; Gho, C.J.

    1990-01-01

    In this work, some transport equation resolution nodal methods are comparatively studied: the constant-constant (CC), linear-nodal (LN) and the constant-quadratic (CQ). A nodal scheme equivalent to finite differences has been used for its programming, permitting its inclusion in existing codes. Some bidimensional problems have been solved, showing that linear-nodal (LN) are, in general, obtained with accuracy in CPU shorter times. (Author) [es

  10. Symptomatic spinal metastasis: A systematic literature review of the preoperative prognostic factors for survival, neurological, functional and quality of life in surgically treated patients and methodological recommendations for prognostic studies.

    Directory of Open Access Journals (Sweden)

    Anick Nater

    Full Text Available While several clinical prediction rules (CPRs of survival exist for patients with symptomatic spinal metastasis (SSM, these have variable prognostic ability and there is no recognized CPR for health related quality of life (HRQoL. We undertook a critical appraisal of the literature to identify key preoperative prognostic factors of clinical outcomes in patients with SSM who were treated surgically. The results of this study could be used to modify existing or develop new CPRs.Seven electronic databases were searched (1990-2015, without language restriction, to identify studies that performed multivariate analysis of preoperative predictors of survival, neurological, functional and HRQoL outcomes in surgical patients with SSM. Individual studies were assessed for class of evidence. The strength of the overall body of evidence was evaluated using GRADE for each predictor.Among 4,818 unique citations, 17 were included; all were in English, rated Class III and focused on survival, revealing a total of 46 predictors. The strength of the overall body of evidence was very low for 39 and low for 7 predictors. Due to considerable heterogeneity in patient samples and prognostic factors investigated as well as several methodological issues, our results had a moderately high risk of bias and were difficult to interpret.The quality of evidence for predictors of survival was, at best, low. We failed to identify studies that evaluated preoperative prognostic factors for neurological, functional, or HRQoL outcomes in surgical patients with SSM. We formulated methodological recommendations for prognostic studies to promote acquiring high-quality evidence to better estimate predictor effect sizes to improve patient education, surgical decision-making and development of CPRs.

  11. SU-E-J-254: Evaluating the Role of Mid-Treatment and Post-Treatment FDG-PET/CT in Predicting Progression-Free Survival and Distant Metastasis of Anal Cancer Patients Treated with Chemoradiotherapy

    International Nuclear Information System (INIS)

    Zhang, H; Wang, J; Chuong, M; D’Souza, W; Choi, W; Lu, W; Latifi, K; Hoffe, S; Moros, E; Saeed, Nadia; Tan, S; Shridhar, R

    2015-01-01

    Purpose: To evaluate the role of mid-treatment and post-treatment FDG-PET/CT in predicting progression-free survival (PFS) and distant metastasis (DM) of anal cancer patients treated with chemoradiotherapy (CRT). Methods: 17 anal cancer patients treated with CRT were retrospectively studied. The median prescription dose was 56 Gy (range, 50–62.5 Gy). All patients underwent FDG-PET/CT scans before and after CRT. 16 of the 17 patients had an additional FDG-PET/CT image at 3–5 weeks into the treatment (denoted as mid-treatment FDG-PET/CT). 750 features were extracted from these three sets of scans, which included both traditional PET/CT measures (SUVmax, SUVpeak, tumor diameters, etc.) and spatialtemporal PET/CT features (comprehensively quantify a tumor’s FDG uptake intensity and distribution, spatial variation (texture), geometric property and their temporal changes relative to baseline). 26 clinical parameters (age, gender, TNM stage, histology, GTV dose, etc.) were also analyzed. Advanced analytics including methods to select an optimal set of predictors and a model selection engine, which identifies the most accurate machine learning algorithm for predictive analysis was developed. Results: Comparing baseline + mid-treatment PET/CT set to baseline + posttreatment PET/CT set, 14 predictors were selected from each feature group. Same three clinical parameters (tumor size, T stage and whether 5-FU was held during any cycle of chemotherapy) and two traditional measures (pre- CRT SUVmin and SUVmedian) were selected by both predictor groups. Different mix of spatial-temporal PET/CT features was selected. Using the 14 predictors and Naive Bayes, mid-treatment PET/CT set achieved 87.5% accuracy (2 PFS patients misclassified, all local recurrence and DM patients correctly classified). Post-treatment PET/CT set achieved 94.0% accuracy (all PFS and DM patients correctly predicted, 1 local recurrence patient misclassified) with logistic regression, neural network or

  12. SU-E-J-254: Evaluating the Role of Mid-Treatment and Post-Treatment FDG-PET/CT in Predicting Progression-Free Survival and Distant Metastasis of Anal Cancer Patients Treated with Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, H; Wang, J; Chuong, M; D’Souza, W; Choi, W; Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States); Latifi, K; Hoffe, S; Moros, E [Moffitt Cancer Center, Tampa, FL (United States); Saeed, Nadia [Brwon University, Providence, RI (United States); Tan, S [Huazhong University of Science & Technology, Wuhan (China); Shridhar, R [Florida Hospital, Orlando, FL (United States)

    2015-06-15

    Purpose: To evaluate the role of mid-treatment and post-treatment FDG-PET/CT in predicting progression-free survival (PFS) and distant metastasis (DM) of anal cancer patients treated with chemoradiotherapy (CRT). Methods: 17 anal cancer patients treated with CRT were retrospectively studied. The median prescription dose was 56 Gy (range, 50–62.5 Gy). All patients underwent FDG-PET/CT scans before and after CRT. 16 of the 17 patients had an additional FDG-PET/CT image at 3–5 weeks into the treatment (denoted as mid-treatment FDG-PET/CT). 750 features were extracted from these three sets of scans, which included both traditional PET/CT measures (SUVmax, SUVpeak, tumor diameters, etc.) and spatialtemporal PET/CT features (comprehensively quantify a tumor’s FDG uptake intensity and distribution, spatial variation (texture), geometric property and their temporal changes relative to baseline). 26 clinical parameters (age, gender, TNM stage, histology, GTV dose, etc.) were also analyzed. Advanced analytics including methods to select an optimal set of predictors and a model selection engine, which identifies the most accurate machine learning algorithm for predictive analysis was developed. Results: Comparing baseline + mid-treatment PET/CT set to baseline + posttreatment PET/CT set, 14 predictors were selected from each feature group. Same three clinical parameters (tumor size, T stage and whether 5-FU was held during any cycle of chemotherapy) and two traditional measures (pre- CRT SUVmin and SUVmedian) were selected by both predictor groups. Different mix of spatial-temporal PET/CT features was selected. Using the 14 predictors and Naive Bayes, mid-treatment PET/CT set achieved 87.5% accuracy (2 PFS patients misclassified, all local recurrence and DM patients correctly classified). Post-treatment PET/CT set achieved 94.0% accuracy (all PFS and DM patients correctly predicted, 1 local recurrence patient misclassified) with logistic regression, neural network or

  13. Nodal Diffusion Burnable Poison Treatment for Prismatic Reactor Cores

    International Nuclear Information System (INIS)

    Ougouag, A.M.; Ferrer, R.M.

    2010-01-01

    The prismatic block version of the High Temperature Reactor (HTR) considered as a candidate Very High Temperature Reactor (VHTR)design may use burnable poison pins in locations at some corners of the fuel blocks (i.e., assembly equivalent structures). The presence of any highly absorbing materials, such as these burnable poisons, within fuel blocks for hexagonal geometry, graphite-moderated High Temperature Reactors (HTRs) causes a local inter-block flux depression that most nodal diffusion-based method have failed to properly model or otherwise represent. The location of these burnable poisons near vertices results in an asymmetry in the morphology of the assemblies (or blocks). Hence the resulting inadequacy of traditional homogenization methods, as these 'spread' the actually local effect of the burnable poisons throughout the assembly. Furthermore, the actual effect of the burnable poison is primarily local with influence in its immediate vicinity, which happens to include a small region within the same assembly as well as similar regions in the adjacent assemblies. Traditional homogenization methods miss this artifact entirely. This paper presents a novel method for treating the local effect of the burnable poison explicitly in the context of a modern nodal method.

  14. Parotid metastasis--an independent prognostic factor for head and neck cutaneous squamous cell carcinoma.

    Science.gov (United States)

    Ch'ng, S; Maitra, A; Lea, R; Brasch, H; Tan, S T

    2006-01-01

    Metastatic parotid cutaneous squamous cell carcinoma (SCC) is the most common parotid gland malignancy in New Zealand and Australia. The current AJCC TNM staging system does not account for the extent of nodal metastasis. A staging system that separates parotid (P stage) from neck disease (N stage) has been proposed recently. To review the outcome of patients with metastatic head and neck cutaneous SCC treated at our multidisciplinary Head and Neck Service using the proposed staging system. Consecutive patients were culled from our Head and Neck/Skull Base Database, 1990-2004. These patients were restaged according to the proposed staging system: P stage: P0 = no disease in the parotid (i.e., neck disease only); P1 = metastatic node P2=metastatic node > 3 cm and 6 cm, or disease involving the facial nerve or skull base. N stage: N0=no disease in the neck (i.e., parotid disease only); N1 = single ipsilateral metastatic node 3 cm, or contralateral neck involvement. Loco-regional recurrence and disease-specific survival were calculated using the Kaplan-Meier method and comparison of graphs made with the log-rank test. Multivariate analysis using the Cox regression model was carried out to assess the impact of various parameters. Sixty-seven patients with metastatic head and neck cutaneous SCC were identified. Thirty-seven patients had parotid metastasis (of whom 13 also had neck disease) while 21 had neck metastasis alone. Nine patients had dermal or soft tissue metastasis. These nine patients were excluded from this series, and data analysis was carried out on the remaining 58 (46 men, 12 women, mean age 71 years) patients. Sixty-seven percent of the patients underwent post-operative adjuvant radiotherapy. The five-year disease-specific survival rate was 54%. Among 56 patients followed up to disease recurrence or for a minimum period of 18 months, the loco-regional recurrence rate was 52%. The presence of parotid disease was an independent prognostic factor on

  15. Hybrid nodal methods in the solution of the diffusion equations in X Y geometry

    International Nuclear Information System (INIS)

    Hernandez M, N.; Alonso V, G.; Valle G, E. del

    2003-01-01

    In 1979, Hennart and collaborators applied several schemes of classic finite element in the numerical solution of the diffusion equations in X Y geometry and stationary state. Almost two decades then, in 1996, himself and other collaborators carried out a similar work but using nodal schemes type finite element. Continuing in this last direction, in this work a group it is described a set of several Hybrid Nodal schemes denominated (NH) as well as their application to solve the diffusion equations in multigroup in stationary state and X Y geometry. The term hybrid nodal it means that such schemes interpolate not only Legendre moments of face and of cell but also the values of the scalar flow of neutrons in the four corners of each cell or element of the spatial discretization of the domain of interest. All the schemes here considered are polynomials like they were it their predecessors. Particularly, its have developed and applied eight different hybrid nodal schemes that its are very nearby related with those developed by Hennart and collaborators in the past. It is treated of schemes in those that nevertheless that decreases the number of interpolation parameters it is conserved the accurate in relation to the bi-quadratic and bi-cubic schemes. Of these eight, three were described and applied in a previous work. It is the bi-lineal classic scheme as well as the hybrid nodal schemes, bi-quadratic and bi-cubic for that here only are described the other 5 hybrid nodal schemes although they are provided numerical results for several test problems with all them. (Author)

  16. Pathology of nodal marginal zone lymphomas.

    Science.gov (United States)

    Pileri, Stefano; Ponzoni, Maurilio

    Nodal marginal zone B cell lymphomas (NMZLs) are a rare group of lymphoid disorders part of the spectrum of marginal zone B-cell lymphomas, which encompass splenic marginal one B-cell lymphoma (SMZL) and extra nodal marginal zone of B-cell lymphoma (EMZL), often of MALT-type. Two clinicopathological forms of NMZL are recognized: adult-type and pediatric-type, respectively. NMZLs show overlapping features with other types of MZ, but distinctive features as well. In this review, we will focus on the salient distinguishing features of NMZL mostly under morphological/immunophenotypical/molecular perspectives in views of the recent acquisitions and forthcoming updated 2016 WHO classification of lymphoid malignancies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Quantum anomalies in nodal line semimetals

    Science.gov (United States)

    Burkov, A. A.

    2018-04-01

    Topological semimetals are a new class of condensed matter systems with nontrivial electronic structure topology. Their unusual observable properties may often be understood in terms of quantum anomalies. In particular, Weyl and Dirac semimetals, which have point band-touching nodes, are characterized by the chiral anomaly, which leads to the Fermi arc surface states, anomalous Hall effect, negative longitudinal magnetoresistance, and planar Hall effect. In this paper, we explore analogous phenomena in nodal line semimetals. We demonstrate that such semimetals realize a three-dimensional analog of the parity anomaly, which is a known property of two-dimensional Dirac semimetals arising, for example, on the surface of a three-dimensional topological insulator. We relate one of the characteristic properties of nodal line semimetals, namely, the drumhead surface states, to this anomaly, and derive the field theory, which encodes the corresponding anomalous response.

  18. Temporal quadratic expansion nodal Green's function method

    International Nuclear Information System (INIS)

    Liu Cong; Jing Xingqing; Xu Xiaolin

    2000-01-01

    A new approach is presented to efficiently solve the three-dimensional space-time reactor dynamics equation which overcomes the disadvantages of current methods. In the Temporal Quadratic Expansion Nodal Green's Function Method (TQE/NGFM), the Quadratic Expansion Method (QEM) is used for the temporal solution with the Nodal Green's Function Method (NGFM) employed for the spatial solution. Test calculational results using TQE/NGFM show that its time step size can be 5-20 times larger than that of the Fully Implicit Method (FIM) for similar precision. Additionally, the spatial mesh size with NGFM can be nearly 20 times larger than that using the finite difference method. So, TQE/NGFM is proved to be an efficient reactor dynamics analysis method

  19. Acceleration of the FERM nodal program

    International Nuclear Information System (INIS)

    Nakata, H.

    1985-01-01

    It was tested three acceleration methods trying to reduce the number of outer iterations in the FERM nodal program. The results obtained indicated that the Chebychev polynomial acceleration method with variable degree results in a economy of 50% in the computer time. Otherwise, the acceleration method by source asymptotic extrapolation or by zonal rebalance did not result in economy of the global computer time, however some acceleration had been verified in outer iterations. (M.C.K.) [pt

  20. Acceleration of the nodal program FERM

    International Nuclear Information System (INIS)

    Nakata, H.

    1985-01-01

    Acceleration of the nodal FERM was tried by three acceleration schemes. Results of the calculations showed the best acceleration with the Tchebyshev method where the savings in the computing time were of the order of 50%. Acceleration with the Assymptotic Source Extrapoltation Method and with the Coarse-Mesh Rebalancing Method did not result in any improvement on the global computational time, although a reduction in the number of outer iterations was observed. (Author) [pt

  1. Nodal method for fast reactor analysis

    International Nuclear Information System (INIS)

    Shober, R.A.

    1979-01-01

    In this paper, a nodal method applicable to fast reactor diffusion theory analysis has been developed. This method has been shown to be accurate and efficient in comparison to highly optimized finite difference techniques. The use of an analytic solution to the diffusion equation as a means of determining accurate coupling relationships between nodes has been shown to be highly accurate and efficient in specific two-group applications, as well as in the current multigroup method

  2. Nodal methods in numerical reactor calculations

    International Nuclear Information System (INIS)

    Hennart, J.P.; Valle, E. del

    2004-01-01

    The present work describes the antecedents, developments and applications started in 1972 with Prof. Hennart who was invited to be part of the staff of the Nuclear Engineering Department at the School of Physics and Mathematics of the National Polytechnic Institute. Since that time and up to 1981, several master theses based on classical finite element methods were developed with applications in point kinetics and in the steady state as well as the time dependent multigroup diffusion equations. After this period the emphasis moved to nodal finite elements in 1, 2 and 3D cartesian geometries. All the thesis were devoted to the numerical solution of the neutron multigroup diffusion and transport equations, few of them including the time dependence, most of them related with steady state diffusion equations. The main contributions were as follows: high order nodal schemes for the primal and mixed forms of the diffusion equations, block-centered finite-differences methods, post-processing, composite nodal finite elements for hexagons, and weakly and strongly discontinuous schemes for the transport equation. Some of these are now being used by several researchers involved in nuclear fuel management. (Author)

  3. Nodal methods in numerical reactor calculations

    Energy Technology Data Exchange (ETDEWEB)

    Hennart, J P [UNAM, IIMAS, A.P. 20-726, 01000 Mexico D.F. (Mexico); Valle, E del [National Polytechnic Institute, School of Physics and Mathematics, Department of Nuclear Engineering, Mexico, D.F. (Mexico)

    2004-07-01

    The present work describes the antecedents, developments and applications started in 1972 with Prof. Hennart who was invited to be part of the staff of the Nuclear Engineering Department at the School of Physics and Mathematics of the National Polytechnic Institute. Since that time and up to 1981, several master theses based on classical finite element methods were developed with applications in point kinetics and in the steady state as well as the time dependent multigroup diffusion equations. After this period the emphasis moved to nodal finite elements in 1, 2 and 3D cartesian geometries. All the thesis were devoted to the numerical solution of the neutron multigroup diffusion and transport equations, few of them including the time dependence, most of them related with steady state diffusion equations. The main contributions were as follows: high order nodal schemes for the primal and mixed forms of the diffusion equations, block-centered finite-differences methods, post-processing, composite nodal finite elements for hexagons, and weakly and strongly discontinuous schemes for the transport equation. Some of these are now being used by several researchers involved in nuclear fuel management. (Author)

  4. Tumour thickness as a predictor of nodal metastases in oral cancer: comparison between tongue and floor of mouth subsites.

    Science.gov (United States)

    Balasubramanian, Deepak; Ebrahimi, Ardalan; Gupta, Ruta; Gao, Kan; Elliott, Michael; Palme, Carsten E; Clark, Jonathan R

    2014-12-01

    To identify whether tumour thickness as a predictor of nodal metastases in oral squamous cell carcinoma differs between tongue and floor of mouth (FOM) subsites. Retrospective review of 343 patients treated between 1987 and 2012. The neck was considered positive in the presence of pathologically proven nodal metastases on neck dissection or during follow-up. There were 222 oral tongue and 121 FOM tumours. In patients with FOM tumours 2.1-4mm thick, the rate of nodal metastases was 41.7%. In contrast, for tongue cancers of a similar thickness the rate was only 11.2%. This increased to 38.5% in patients with tongue cancers that were 4.1-6mm thick. Comparing these two subsites, FOM cancers cross the critical 20% threshold of probability for nodal metastases between 1 and 2mm whereas tongue cancers cross the 20% threshold just under 4mm thickness. On logistic regression adjusting for relevant covariates, there was a significant difference in the propensity for nodal metastases based on tumour thickness according to subsite (p=0.028). Thin FOM tumours (2.1-4mm) have a high rate of nodal metastases. Elective neck dissection is appropriate in FOM tumours ⩾2mm thick and in tongue tumours ⩾4mm thick. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. INTERMITTENT ANTIARYTHMIC THERAPY OF ARIOVENTICULAR NODAL REENTRY TACHYCARDIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Boris Djindjic

    2008-04-01

    Full Text Available Until recent advances in pharmacology and clinical cardiology regarding farmacodynamics of antiarrhythmic drugs and their efficiency in patients with refractory paroxysmal supraventricular tachycardia, chronic prophylactic therapy was the only treatment option for patients refusing catheter ablation. Another treatment option, also known by eponym “pill in pocket” have been shown to be equally useful and efficacious.The aim of our study was prospective examination of children with refractory atrioventricular nodal reentry tachycardia (AVNRT who were withdrawn from chronic antiarrhythmic prophylactic therapy and started with intermittent oral beta blocker treatment (propranolol at dosage 1 mg/kg - max 80 mg.Twelve children (8 boys and 4 girls with AVNRT were included in the study. Four children did not have arrhythmia during first six months after withdrawal and 7 were successfully treated without complication.Intermittent antiarrhythmic therapy in children with AVNRT could be very efficacious and useful treatment option which significantly improves their quality of life.

  6. Comparison of treatment outcomes between involved-field and elective nodal irradiation in limited-stage small cell lung cancer

    International Nuclear Information System (INIS)

    Han, Tae-Jin; Kim, Hak-Jae; Wu, Hong-Gyun; Heo, Dae-Seog; Kim, Young-Whan; Lee, Se-Hoon

    2012-01-01

    The present study was performed to assess the usefulness of involved-field irradiation and the impact of 18 F-fluorodeoxyglucose-positron emission tomography-based staging on treatment outcomes in limited-stage small cell lung cancer. Eighty patients who received definitive chemoradiotherapy for limited-stage small cell lung cancer were retrospectively analyzed. Fifty patients were treated with involved-field irradiation, which means that the radiotherapy portal includes only clinically identifiable tumors. The other 30 patients were irradiated with a comprehensive portal, including uninvolved mediastinal and/or supraclavicular lymph nodes, so-called elective nodal irradiation. No significant difference was seen in clinical factors between the two groups. At a median follow-up of 27 months (range, 5-75 months), no significant differences were observed in 3 year overall survival (44.6 vs. 54.1%, P=0.220) and 3 year progression-free survival (24.4 vs. 42.8%, P=0.133) between the involved-field irradiation group and the elective nodal irradiation group, respectively. For patients who did not undergo positron emission tomography scans, 3 year overall survival (29.3 vs. 56.3%, P=0.022) and 3 year progression-free survival (11.0 vs. 50.0%, P=0.040) were significantly longer in the elective nodal irradiation group. Crude incidences of isolated nodal failure were 6.0% in the involved-field irradiation group and 0% in the elective nodal irradiation group, respectively. All isolated nodal failures were developed in patients who had not undergone positron emission tomography scans in their initial work-ups. If patients did not undergo positron emission tomography-based staging, the omission of elective nodal irradiation resulted in impaired survival outcomes and raised the risk of isolated nodal failure. Therefore, involved-field irradiation for limited-stage small cell lung cancer might be reasonable only with positron emission tomography scan implementation. (author)

  7. On the non-uniqueness of the nodal mathematical adjoint

    International Nuclear Information System (INIS)

    Müller, Erwin

    2014-01-01

    Highlights: • We evaluate three CMFD schemes for computing the nodal mathematical adjoint. • The nodal mathematical adjoint is not unique and can be non-positive (nonphysical). • Adjoint and forward eigenmodes are compatible if produced by the same CMFD method. • In nodal applications the excited eigenmodes are purely mathematical entities. - Abstract: Computation of the neutron adjoint flux within the framework of modern nodal diffusion methods is often facilitated by reducing the nodal equation system for the forward flux into a simpler coarse-mesh finite-difference form and then transposing the resultant matrix equations. The solution to the transposed problem is known as the nodal mathematical adjoint. Since the coarse-mesh finite-difference reduction of a given nodal formulation can be obtained in a number of ways, different nodal mathematical adjoint solutions can be computed. This non-uniqueness of the nodal mathematical adjoint challenges the credibility of the reduction strategy and demands a verdict as to its suitability in practical applications. This is the matter under consideration in this paper. A selected number of coarse-mesh finite-difference reduction schemes are described and compared. Numerical calculations are utilised to illustrate the differences in the adjoint solutions as well as to appraise the impact on such common applications as the computation of core point kinetics parameters. Recommendations are made for the proper application of the coarse-mesh finite-difference reduction approach to the nodal mathematical adjoint problem

  8. Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck.

    Science.gov (United States)

    Agarwal, Sangeet Kumar; Arora, Sowrabh Kumar; Kumar, Gopal; Sarin, Deepak

    2016-10-01

    The incidence of occult perifacial nodal disease in oral cavity squamous cell carcinoma is not well reported. The purpose of this study was to evaluate the incidence of isolated perifacial lymph node metastasis in patients with oral squamous cell carcinoma with a clinically node-negative neck. The study will shed light on current controversies and will provide valuable clinical and pathological information in the practice of routine comprehensive removal of these lymph node pads in selective neck dissection in the node-negative neck. Prospective analysis. This study was started in August 2011 when intraoperatively we routinely separated the lymph node levels from the main specimen for evaluation of the metastatic rate to different lymph node levels in 231 patients of oral squamous cell cancer with a clinically node-negative neck. The current study demonstrated that 19 (8.22%) out of 231 patients showed ipsilateral isolated perifacial lymph node involvement. The incidence of isolated perifacial nodes did not differ significantly between the oral tongue (7.14%) and buccal mucosa (7.75%). Incidence was statistically significant in cases with lower age group (oral squamous cell carcinoma with a clinically node-negative neck. The incidence of isolated perifacial involvement is high in cases of buccal mucosal and tongue cancers. A meticulous dissection of the perifacial nodes seems prudent when treating the neck in oral cavity squamous cell carcinoma. 4 Laryngoscope, 126:2252-2256, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Breast cancer lung metastasis: Molecular biology and therapeutic implications.

    Science.gov (United States)

    Jin, Liting; Han, Bingchen; Siegel, Emily; Cui, Yukun; Giuliano, Armando; Cui, Xiaojiang

    2018-03-26

    Distant metastasis accounts for the vast majority of deaths in patients with cancer. Breast cancer exhibits a distinct metastatic pattern commonly involving bone, liver, lung, and brain. Breast cancer can be divided into different subtypes based on gene expression profiles, and different breast cancer subtypes show preference to distinct organ sites of metastasis. Luminal breast tumors tend to metastasize to bone while basal-like breast cancer (BLBC) displays a lung tropism of metastasis. However, the mechanisms underlying this organ-specific pattern of metastasis still remain to be elucidated. In this review, we will summarize the recent advances regarding the molecular signaling pathways as well as the therapeutic strategies for treating breast cancer lung metastasis.

  10. Diagnosis and treatment of brain metastasis

    International Nuclear Information System (INIS)

    Sajama, Carlos; Lorenzoni, Jose; Tagle, Patricio

    2008-01-01

    Cerebral metastasis occur in 20 to 30 percent of patients with systemic cancer and are the most common type of intracranial tumor. The median survival of untreated patients is one month with a slightly longer survival in those treated with steroids. Patients treated with whole brain radiation therapy survive between 3 to 6 months. In selected cases survival can increase to 10 to 12 months with combination of surgery and radiotherapy or stereotactic radiosurgery alone or associated to radiotherapy. Most brain metastasis arise from lung, breast and melanomas. The most important criteria for selecting patients who will benefit from surgery or stereotactic radiosurgery are a Karnofsky score of 70 or more, systemic control of the cancer and absence of leptomeningeal involvement. Surgery is indicated in patients with a single lesion located in an accessible zone and stereotactic radiosurgery is indicated for lesions up to 3 cm of diameter, and in patients with up to 3 or 4 metastasis, no matter their location. The survival benefit of chemotherapy in brain metastasis has not been demonstrated

  11. Occurrence and clinical features of brain metastasis after chemoradiotherapy for esophageal carcinoma

    International Nuclear Information System (INIS)

    Kanemoto, Ayae; Hashimoto, Takayuki; Harada, Hideyuki; Asakura, Hirofumi; Ogawa, Hirofumi; Furutani, Kazuhisa; Boku, Narikazu; Nakasu, Yoko; Nishimura, Tetsuo

    2011-01-01

    Brain metastasis from esophageal carcinoma has been considered rare and survival following esophageal carcinoma with distant metastasis is poor. The purpose of this report was to clarify cumulative incidence and risk factors for brain metastasis after chemoradiotherapy for esophageal carcinoma, and to consider recommended treatments for brain metastasis from esophageal carcinoma. We reviewed 391 patients treated with chemoradiotherapy. Median age was 65 years. Clinical stages were I, II, III, and IV in 32, 47, 150, and 162 patients, respectively. Brain imaging was performed usually when patients revealed neurological symptoms. The 3-year cumulative incidence of brain metastasis after chemoradiotherapy was 6.6%. There were 4 patients with single metastasis and 8 with multiple metastases. Initial clinical stages were II, III, and IV in 1, 2, and 9 patients, respectively. Histology included squamous cell carcinoma in 10 patients and others in 2 patients. Univariate analysis demonstrated M factor, distant lymph node relapse, and recurrent lung and liver metastasis as significant risk factors of brain metastasis (P<0.05). Median survival time after diagnosis of brain metastasis was 2.1 months. Brain metastasis was not directly related to cause of mortality. The causes were extracranial tumor deterioration in 8 patients and infection in 4 patients. Brain metastasis may increase in the future with improving survival from esophageal carcinoma. However, considering the poor survival after diagnosis of brain metastasis, short-term palliative therapy for brain metastasis appears preferable to vigorous long-term therapy. (author)

  12. Impacts of Contingency Reserve on Nodal Price and Nodal Reliability Risk in Deregulated Power Systems

    DEFF Research Database (Denmark)

    Zhao, Qian; Wang, Peng; Goel, Lalit

    2013-01-01

    The deregulation of power systems allows customers to participate in power market operation. In deregulated power systems, nodal price and nodal reliability are adopted to represent locational operation cost and reliability performance. Since contingency reserve (CR) plays an important role...... in reliable operation, the CR commitment should be considered in operational reliability analysis. In this paper, a CR model based on customer reliability requirements has been formulated and integrated into power market settlement. A two-step market clearing process has been proposed to determine generation...

  13. Lung Metastasis Mimicking Fingertip Infection

    Science.gov (United States)

    Soylemez, Salih; Demiroglu, Murat; Yayla, Mehmet Ali; Ozkan, Korhan; Alpan, Bugra; Ozger, Harzem

    2015-01-01

    Metastasis fingers (acral metastasis) are finding a poor prognosis. Past medical history should be questioned and metastasis from primary tumor should be kept in mind in patients with pain, swelling, and hyperemia in fingers. Successful surgical treatment on acral metastasis does not extend the life expectancy; however, it reduces the patient's pain during his terminal period, saves the functions of the limb, and increases life comfort. PMID:26236517

  14. Lung Metastasis Mimicking Fingertip Infection

    Directory of Open Access Journals (Sweden)

    Salih Soylemez

    2015-01-01

    Full Text Available Metastasis fingers (acral metastasis are finding a poor prognosis. Past medical history should be questioned and metastasis from primary tumor should be kept in mind in patients with pain, swelling, and hyperemia in fingers. Successful surgical treatment on acral metastasis does not extend the life expectancy; however, it reduces the patient’s pain during his terminal period, saves the functions of the limb, and increases life comfort.

  15. Development of a code in three-dimensional cylindrical geometry based on analytic function expansion nodal (AFEN) method

    International Nuclear Information System (INIS)

    Lee, Joo Hee

    2006-02-01

    There is growing interest in developing pebble bed reactors (PBRs) as a candidate of very high temperature gas-cooled reactors (VHTRs). Until now, most existing methods of nuclear design analysis for this type of reactors are base on old finite-difference solvers or on statistical methods. But for realistic analysis of PBRs, there is strong desire of making available high fidelity nodal codes in three-dimensional (r,θ,z) cylindrical geometry. Recently, the Analytic Function Expansion Nodal (AFEN) method developed quite extensively in Cartesian (x,y,z) geometry and in hexagonal-z geometry was extended to two-group (r,z) cylindrical geometry, and gave very accurate results. In this thesis, we develop a method for the full three-dimensional cylindrical (r,θ,z) geometry and implement the method into a code named TOPS. The AFEN methodology in this geometry as in hexagonal geometry is 'robus' (e.g., no occurrence of singularity), due to the unique feature of the AFEN method that it does not use the transverse integration. The transverse integration in the usual nodal methods, however, leads to an impasse, that is, failure of the azimuthal term to be transverse-integrated over r-z surface. We use 13 nodal unknowns in an outer node and 7 nodal unknowns in an innermost node. The general solution of the node can be expressed in terms of that nodal unknowns, and can be updated using the nodal balance equation and the current continuity condition. For more realistic analysis of PBRs, we implemented em Marshak boundary condition to treat the incoming current zero boundary condition and the partial current translation (PCT) method to treat voids in the core. The TOPS code was verified in the various numerical tests derived from Dodds problem and PBMR-400 benchmark problem. The results of the TOPS code show high accuracy and fast computing time than the VENTURE code that is based on finite difference method (FDM)

  16. Outcomes of breast cancer patients with triple negative receptor status treated with accelerated partial breast irradiation.

    Science.gov (United States)

    Wilkinson, J Ben; Reid, Robert E; Shaitelman, Simona F; Chen, Peter Y; Mitchell, Christine K; Wallace, Michelle F; Marvin, Kimberly S; Grills, Inga S; Margolis, Jeffrey M; Vicini, Frank A

    2011-11-01

    Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Outcomes of Breast Cancer Patients With Triple Negative Receptor Status Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Wilkinson, J. Ben; Reid, Robert E.; Shaitelman, Simona F.; Chen, Peter Y.; Mitchell, Christine K.; Wallace, Michelle F.; Marvin, Kimberly S.; Grills, Inga S.; Margolis, Jeffrey M.; Vicini, Frank A.

    2011-01-01

    Purpose: Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). Methods and Materials: We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Results: Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). Conclusions: In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer.

  18. Clinical Study of Nasopharyngeal Carcinoma Treated by Helical Tomotherapy in China: 5-Year Outcomes

    Directory of Open Access Journals (Sweden)

    Lei Du

    2014-01-01

    Full Text Available Background. To evaluate the outcomes of nasopharyngeal carcinoma (NPC patients treated with helical tomotherapy (HT. Methods. Between September 2007 and August 2012, 190 newly diagnosed NPC patients were treated with HT. Thirty-one patients were treated with radiation therapy as single modality, 129 with additional cisplatin-based chemotherapy with or without anti-EGFR monoclonal antibody therapy, and 30 with concurrent anti-EGFR monoclonal antibody therapy. Results. Acute radiation related side effects were mainly grade 1 or 2. Grade 3 and greater toxicities were rarely noted. The median followup was 32 (3–38 months. The local relapse-free survival (LRFS, nodal relapse-free survival (NRFS, distant metastasis-free survival (DMFS, and overall survival (OS were 96.1%, 98.2%, 92.0%, and 86.3%, respectively, at 3 years. Cox multivariate regression analysis showed that age and T stage were independent predictors for 3-year OS. Conclusions. Helical tomotherapy for NPC patients achieved excellent 3-year locoregional control, distant metastasis-free survival, and overall survival, with relatively minor acute and late toxicities. Age and T stage were the main prognosis factors.

  19. Topological surface states in nodal superconductors.

    Science.gov (United States)

    Schnyder, Andreas P; Brydon, Philip M R

    2015-06-24

    Topological superconductors have become a subject of intense research due to their potential use for technical applications in device fabrication and quantum information. Besides fully gapped superconductors, unconventional superconductors with point or line nodes in their order parameter can also exhibit nontrivial topological characteristics. This article reviews recent progress in the theoretical understanding of nodal topological superconductors, with a focus on Weyl and noncentrosymmetric superconductors and their protected surface states. Using selected examples, we review the bulk topological properties of these systems, study different types of topological surface states, and examine their unusual properties. Furthermore, we survey some candidate materials for topological superconductivity and discuss different experimental signatures of topological surface states.

  20. Twisted vector bundles on pointed nodal curves

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    by identifying the points p1 and p2. If m ≥ 2, let R1,...,Rm−1 be m − 1 copies of the projective line P1 and let xi,yi be two distinct points in Ri. Let R be the nodal curve which arises from the union. R0 ⊔ R1 ⊔···⊔ Rm−1 ⊔ Rm by identifying p1 ∈ R0 and p2 ∈ Rm with x1 ∈ R1 and ym−1 ∈ Rm−1 respectively and by identifying ...

  1. Long-term survival after a favorable response to anti-EGFR antibody plus chemotherapy to treat bone marrow metastasis: a case report of KRAS-wildtype rectal cancer

    Directory of Open Access Journals (Sweden)

    Nakamura S

    2017-02-01

    Full Text Available Sho Nakamura, Tadahisa Fukui, Shuhei Suzuki, Hiroyuki Takeda, Kaname Watanabe, Takashi Yoshioka Department of Clinical Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan Abstract: Bone marrow metastasis is a rare consequence of colorectal cancer that results in a poor prognosis; few reports describe a favorable response to doublet chemotherapy combined with targeted therapy, which is currently the standard treatment. We experienced a case where anti-epidermal growth factor receptor (EGFR antibody produced a marked anti-tumor response to bone marrow metastasis that led to long-term survival. A 51-year-old man was diagnosed with a primary KRAS-wildtype rectal cancer with multiple metastases, including the bone marrow. Disease control was achieved for 10.8 months following chemotherapy with a modified FOLFOX6 regimen combined with an anti-EGFR antibody. He died of cancer 22.7 and 16.6 months after disease onset and first-line chemotherapy, respectively. This case shows that early tumor shrinkage and deepness of response to the anti-EGFR antibody were observed even in a patient with bone marrow metastasis. Anti-EGFR antibody therapy should therefore be considered even when a patient’s medical condition appears to be poor owing to bone marrow metastasis. Moreover, tumors that are likely to be sensitive to chemotherapy, such as RAS-wildtype colorectal cancers, can be considered for anti-EGFR antibody therapy even if the patient is considered unfit for chemotherapy. Keywords: colorectal cancer, anti-epidermal growth factor receptor antibody, molecular targeted therapies, disseminated intravascular coagulation, standard of care

  2. Robust doubly charged nodal lines and nodal surfaces in centrosymmetric systems

    Science.gov (United States)

    Bzdušek, Tomáš; Sigrist, Manfred

    2017-10-01

    Weyl points in three spatial dimensions are characterized by a Z -valued charge—the Chern number—which makes them stable against a wide range of perturbations. A set of Weyl points can mutually annihilate only if their net charge vanishes, a property we refer to as robustness. While nodal loops are usually not robust in this sense, it has recently been shown using homotopy arguments that in the centrosymmetric extension of the AI symmetry class they nevertheless develop a Z2 charge analogous to the Chern number. Nodal loops carrying a nontrivial value of this Z2 charge are robust, i.e., they can be gapped out only by a pairwise annihilation and not on their own. As this is an additional charge independent of the Berry π -phase flowing along the band degeneracy, such nodal loops are, in fact, doubly charged. In this manuscript, we generalize the homotopy discussion to the centrosymmetric extensions of all Atland-Zirnbauer classes. We develop a tailored mathematical framework dubbed the AZ +I classification and show that in three spatial dimensions such robust and multiply charged nodes appear in four of such centrosymmetric extensions, namely, AZ +I classes CI and AI lead to doubly charged nodal lines, while D and BDI support doubly charged nodal surfaces. We remark that no further crystalline symmetries apart from the spatial inversion are necessary for their stability. We provide a description of the corresponding topological charges, and develop simple tight-binding models of various semimetallic and superconducting phases that exhibit these nodes. We also indicate how the concept of robust and multiply charged nodes generalizes to other spatial dimensions.

  3. Prediction of Metastasis Using Second Harmonic Generation

    Science.gov (United States)

    2016-07-01

    small but statistically significant difference in average F/B of treated US patients versus untreated Dutch patients. Fig. 1. Display of all...predictive ability of models incorporating F/B using a multivariate linear model, but this time applying the analysis to the entire ER+ and ER- cohort. As...AWARD NUMBER: W81XWH-15-1-0040 TITLE: Prediction of Metastasis Using Second Harmonic Generation PRINCIPAL INVESTIGATOR: Edward Brown

  4. Radiotherapy of adult nodal non Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Gamen, G.; Thirion, P.

    1999-01-01

    The role of radiotherapy in the treatment of nodal non-Hodgkin's lymphoma has been modified by the introduction of efficient chemotherapy and the development of different pathological classifications. The recommended treatment of early-stage aggressive lymphomas is primarily a combination chemotherapy. The interest of adjuvant radiotherapy remains unclear and has to be established through large prospective trials. If radiation therapy has to be delivered, the historical results of exclusive radiation therapy showed that involved-fields and a dose of 35-40 Gy (daily fraction of 1.8 Gy, 5 days a week) are the optimal schedule. The interest of radiotherapy in the treatment of advanced-stage aggressive lymphoma is yet to be proven. Further studies had to stratify localized stages according to the factors of the International Prognostic Index. For easy-stage low-grade lymphoma, radiotherapy remains the standard treatment. However, the appropriate technique to use is controversial. Involved-field irradiation at a dose of 35 Gy seems to be the optimal schedule, providing a 10 year disease-free survival rate of 50 % and no major toxicity. There is no standard indication of radiotherapy in the treatment advanced-stage low-grade lymphoma. For 'new' nodal lymphoma's types, the indication of radiotherapy cannot be established (mantle-zone lymphoma, marginal zone B-cell lymphoma) or must take into account the natural history (Burkitt's lymphoma, peripheral T-cell lymphoma) and the sensibility to others therapeutic methods. (authors)

  5. Error estimation for variational nodal calculations

    International Nuclear Information System (INIS)

    Zhang, H.; Lewis, E.E.

    1998-01-01

    Adaptive grid methods are widely employed in finite element solutions to both solid and fluid mechanics problems. Either the size of the element is reduced (h refinement) or the order of the trial function is increased (p refinement) locally to improve the accuracy of the solution without a commensurate increase in computational effort. Success of these methods requires effective local error estimates to determine those parts of the problem domain where the solution should be refined. Adaptive methods have recently been applied to the spatial variables of the discrete ordinates equations. As a first step in the development of adaptive methods that are compatible with the variational nodal method, the authors examine error estimates for use in conjunction with spatial variables. The variational nodal method lends itself well to p refinement because the space-angle trial functions are hierarchical. Here they examine an error estimator for use with spatial p refinement for the diffusion approximation. Eventually, angular refinement will also be considered using spherical harmonics approximations

  6. Application of nonlinear nodal diffusion method for a small research reactor

    International Nuclear Information System (INIS)

    Jaradat, Mustafa K.; Alawneh, Luay M.; Park, Chang Je; Lee, Byungchul

    2014-01-01

    Highlights: • We applied nonlinear unified nodal method for 10 MW IAEA MTR benchmark problem. • TRITION–NEWT system was used to obtain two-group burnup dependent cross sections. • The criticality and power distribution compared with reference (IAEA-TECDOC-233). • Comparison between different fuel materials was conducted. • Satisfactory results were provided using UNM for MTR core calculations. - Abstract: Nodal diffusion methods are usually used for LWR calculations and rarely used for research reactor calculations. A unified nodal method with an implementation of the coarse mesh finite difference acceleration was developed for use in plate type research reactor calculations. It was validated for two PWR benchmark problems and then applied for IAEA MTR benchmark problem for static calculations to check the validity and accuracy of the method. This work was conducted to investigate the unified nodal method capability to treat material testing reactor cores. A 10 MW research reactor core is considered with three calculation cases for low enriched uranium fuel depending on the core burnup status of fresh, beginning-of-life, and end-of-life cores. The validation work included criticality calculations, flux distribution, and power distribution; in addition, a comparison between different fuel materials with the same uranium content was conducted. The homogenized two-group cross sections were generated using the TRITON–NEWT system. The results were compared with a reference, which was taken from IAEA-TECDOC-233. The unified nodal method provides satisfactory results for an all-rod out case, and the three-dimensional, two-group diffusion model can be considered accurate enough for MTR core calculations

  7. Role of CT/PET in predicting nodal disease in head and neck cancers

    International Nuclear Information System (INIS)

    Singham, S.; Iyer, G.; Clark, J.

    2009-01-01

    Full text:Introduction: Pre-treatment evaluation of the presence of cervical nodal metastases is important in head and neck cancers and has major prognostic implications. In this study, we aim to determine the accuracy of CT/PET as a tool for identifying such metastases. Methods: All patients from Royal Prince Alfred and Liverpool Hospitals, who underwent CT/PET for any cancer arising from the head and neck, and who underwent subsequent surgery (which included a neck dissection) within 8 weeks of the CT/PET were included. Nodal staging was undertaken by utilising imaging-based nodal classification, and comparison with pathologic data from the surgical specimen was made. PET was considered positive if the SUV was greater than 2. Results: We identified 111 patients from the above criteria. 80 of such patients were treated for squamous cell carcinoma (SCC). CT/PET identified unsuspected metastatic disease in 6 patients. Correlation of CT/PET findings and the presence of disease at the primary site: sensitivity: 98%, specificity: 93%, positive predictive value (PPV): 98% and negative predictive value (NPV): 93%. Correlating CT/PET findings with the presence of nodal disease at any level: sensitivity: 95%, specificity: 88%, PPV: 95% and NPV: 88%. CT/PET was anatomically accurate in predicting the site of metastases in 62/74 (84%). Conclusion: PET is accurate in predicting both presence of nodal metastases and the level of involvement. CT/PET should be undertaken as a pre-operative tool to assist in planning the extent of surgery required in head and neck cancers.

  8. Pattern of Progression after Stereotactic Body Radiotherapy for Oligometastatic Prostate Cancer Nodal Recurrences.

    Science.gov (United States)

    Ost, P; Jereczek-Fossa, B A; Van As, N; Zilli, T; Tree, A; Henderson, D; Orecchia, R; Casamassima, F; Surgo, A; Miralbell, R; De Meerleer, G

    2016-09-01

    To report the relapse pattern of stereotactic body radiotherapy (SBRT) for oligorecurrent nodal prostate cancer (PCa). PCa patients with ≤3 lymph nodes (N1/M1a) at the time of recurrence were treated with SBRT. SBRT was defined as a radiotherapy dose of at least 5 Gy per fraction to a biological effective dose of at least 80 Gy to all metastatic sites. Distant progression-free survival was defined as the time interval between the first day of SBRT and appearance of new metastatic lesions, outside the high-dose region. Relapses after SBRT were recorded and compared with the initially treated site. Secondary end points were local control, time to palliative androgen deprivation therapy and toxicity scored using the Common Terminology Criteria for Adverse Events v4.0. Overall, 89 metastases were treated in 72 patients. The median distant progression-free survival was 21 months (95% confidence interval 16-25 months) with 88% of patients having ≤3 metastases at the time of progression. The median time from first SBRT to the start of palliative androgen deprivation therapy was 44 months (95% confidence interval 17-70 months). Most relapses (68%) occurred in nodal regions. Relapses after pelvic nodal SBRT (n = 36) were located in the pelvis (n = 14), retroperitoneum (n = 1), pelvis and retroperitoneum (n = 8) or in non-nodal regions (n = 13). Relapses after SBRT for extrapelvic nodes (n = 5) were located in the pelvis (n = 1) or the pelvis and retroperitoneum (n = 4). Late grade 1 and 2 toxicity was observed in 17% (n = 12) and 4% of patients (n = 3). SBRT for oligometastatic PCa nodal recurrences is safe. Most subsequent relapses are again nodal and oligometastatic. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  9. Staging Lung Cancer: Metastasis.

    Science.gov (United States)

    Shroff, Girish S; Viswanathan, Chitra; Carter, Brett W; Benveniste, Marcelo F; Truong, Mylene T; Sabloff, Bradley S

    2018-05-01

    The updated eighth edition of the tumor, node, metastasis (TNM) classification for lung cancer includes revisions to T and M descriptors. In terms of the M descriptor, the classification of intrathoracic metastatic disease as M1a is unchanged from TNM-7. Extrathoracic metastatic disease, which was classified as M1b in TNM-7, is now subdivided into M1b (single metastasis, single organ) and M1c (multiple metastases in one or multiple organs) descriptors. In this article, the rationale for changes in the M descriptors, the utility of preoperative staging with PET/computed tomography, and the treatment options available for patients with oligometastatic disease are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Torsionfree Sheaves over a Nodal Curve of Arithmetic Genus One

    Indian Academy of Sciences (India)

    We classify all isomorphism classes of stable torsionfree sheaves on an irreducible nodal curve of arithmetic genus one defined over C C . Let be a nodal curve of arithmetic genus one defined over R R , with exactly one node, such that does not have any real points apart from the node. We classify all isomorphism ...

  11. Impact of splenic hilar lymph node metastasis on prognosis in patients with advanced gastric cancer.

    Science.gov (United States)

    Son, Taeil; Kwon, In Gyu; Lee, Joong Ho; Choi, Youn Young; Kim, Hyoung-Il; Cheong, Jae-Ho; Noh, Sung Hoon; Hyung, Woo Jin

    2017-10-13

    Impact of splenic hilar LN dissection during total gastrectomy for proximal advanced gastric cancer is controversial. The objective of this study was to assess the impact on prognosis of splenic hilar lymph node(LN) metastasis compared to that of metastasis to other regional LN groups. Patients who underwent total gastrectomy with D2 LN dissection from 2000 to 2010 were reviewed retrospectively. The clinicopathologic characteristics and long-term results of patients with splenic hilar LN metastasis were compared to those of patients with only metastasis to other extraperigastric LNs (stations #8a, #9, #11, or #12a). To investigate the survival benefit of performing splenic hilar LN dissection, the estimated therapeutic index for the procedure was calculated by multiplying the incidence of metastases in the hilar region by the survival rates for individuals with nodal involvement in that region. Of 602 patients, 87(14.5%) had hilar LN metastasis. The 5-year overall and relapse-free survival rates for patients with hilar LN metastasis were 24.1% and 12.1%, respectively. These rates were similar to those for patients with metastasis to other extraperigastric LNs ( P > 0.05), with similar recurrence patterns. Overall survival in the hilar LN metastasis group was better than that for patients with distant metastasis( P hilar LN dissection was 3.5, which was similar to index values for LN dissection at other extraperigastric LNs. Dissection of splenic hilar LNs during total gastrectomy for advanced gastric cancer allows for a prognosis similar to that achieved with dissection of extraperigastric LNs.

  12. Analysis of nodal coverage utilizing image guided radiation therapy for primary gynecologic tumor volumes

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Faisal [University of Utah School of Medicine, Salt Lake City, UT (United States); Loma Linda University Medical Center, Department of Radiation Oncology, Loma Linda, CA (United States); Sarkar, Vikren; Gaffney, David K.; Salter, Bill [Department of Radiation Oncology, University of Utah, Salt Lake City, UT (United States); Poppe, Matthew M., E-mail: matthew.poppe@hci.utah.edu [Department of Radiation Oncology, University of Utah, Salt Lake City, UT (United States)

    2016-10-01

    Purpose: To evaluate radiation dose delivered to pelvic lymph nodes, if daily Image Guided Radiation Therapy (IGRT) was implemented with treatment shifts based on the primary site (primary clinical target volume [CTV]). Our secondary goal was to compare dosimetric coverage with patient outcomes. Materials and methods: A total of 10 female patients with gynecologic malignancies were evaluated retrospectively after completion of definitive intensity-modulated radiation therapy (IMRT) to their pelvic lymph nodes and primary tumor site. IGRT consisted of daily kilovoltage computed tomography (CT)-on-rails imaging fused with initial planning scans for position verification. The initial plan was created using Varian's Eclipse treatment planning software. Patients were treated with a median radiation dose of 45 Gy (range: 37.5 to 50 Gy) to the primary volume and 45 Gy (range: 45 to 64.8 Gy) to nodal structures. One IGRT scan per week was randomly selected from each patient's treatment course and re-planned on the Eclipse treatment planning station. CTVs were recreated by fusion on the IGRT image series, and the patient's treatment plan was applied to the new image set to calculate delivered dose. We evaluated the minimum, maximum, and 95% dose coverage for primary and nodal structures. Reconstructed primary tumor volumes were recreated within 4.7% of initial planning volume (0.9% to 8.6%), and reconstructed nodal volumes were recreated to within 2.9% of initial planning volume (0.01% to 5.5%). Results: Dosimetric parameters averaged less than 10% (range: 1% to 9%) of the original planned dose (45 Gy) for primary and nodal volumes on all patients (n = 10). For all patients, ≥99.3% of the primary tumor volume received ≥ 95% the prescribed dose (V95%) and the average minimum dose was 96.1% of the prescribed dose. In evaluating nodal CTV coverage, ≥ 99.8% of the volume received ≥ 95% the prescribed dose and the average minimum dose was 93%. In

  13. The Verification of Coupled Neutronics Thermal-Hydraulics Code NODAL3 in the PWR Rod Ejection Benchmark

    Directory of Open Access Journals (Sweden)

    Surian Pinem

    2014-01-01

    Full Text Available A coupled neutronics thermal-hydraulics code NODAL3 has been developed based on the few-group neutron diffusion equation in 3-dimensional geometry for typical PWR static and transient analyses. The spatial variables are treated by using a polynomial nodal method while for the neutron dynamic solver the adiabatic and improved quasistatic methods are adopted. In this paper we report the benchmark calculation results of the code against the OECD/NEA CRP PWR rod ejection cases. The objective of this work is to determine the accuracy of NODAL3 code in analysing the reactivity initiated accident due to the control rod ejection. The NEACRP PWR rod ejection cases are chosen since many organizations participated in the NEA project using various methods as well as approximations, so that, in addition to the reference solutions, the calculation results of NODAL3 code can also be compared to other codes’ results. The transient parameters to be verified are time of power peak, power peak, final power, final average Doppler temperature, maximum fuel temperature, and final coolant temperature. The results of NODAL3 code agree well with the PHANTHER reference solutions in 1993 and 1997 (revised. Comparison with other validated codes, DYN3D/R and ANCK, shows also a satisfactory agreement.

  14. A nodalization study of steam separator in real time simulation

    International Nuclear Information System (INIS)

    Horugshyang, Lein; Luh, R.T.J.; Zen-Yow, Wang

    1999-01-01

    The motive of this paper is to investigate the influence of steam separator nodalization on reactor thermohydraulics in terms of stability and level response. Three different nodalizations of steam separator are studied by using THEATRE and REMARK Code in a BWR simulator. The first nodalization is the traditional one with two nodes for steam separator. In this nodalization, the steam separation is modeled in the outer node, i.e., upper downcomer. Separated steam enters the Steen dome node and the liquid goes to the feedwater node. The second nodalization is similar to the first one with the steam separation modeled in the inner node. There is one additional junction connecting steam dome node and the inner node. The liquid fallback junction connects the inner node and feedwater node. The third nodalization is a combination of the former two with an integrated node for steam separator. Boundary conditions in this study are provided by a simplified feedwater and main steam driver. For comparison purpose, three tests including full power steady state initialisation, recirculation pumps runback and reactor scram are conducted. Major parameters such as reactor pressure, reactor level, void fractions, neutronic power and junction flows are recorded for analysis. Test results clearly show that the first nodalization is stable for steady state initialisation. However it has too responsive level performance in core flow reduction transients. The second nodalization is the closest representation of real plant structure, but not the performance. Test results show that an instability occurs in the separator region for both steady state initialisation and transients. This instability is caused by an unbalanced momentum in the dual loop configuration. The magnitude of the oscillation reduces as the power decreases. No superiority to the other nodalizations is shown in the test results. The third nodalization shows both stability and responsiveness in the tests. (author)

  15. Topological surface states in nodal superconductors

    International Nuclear Information System (INIS)

    Schnyder, Andreas P; Brydon, Philip M R

    2015-01-01

    Topological superconductors have become a subject of intense research due to their potential use for technical applications in device fabrication and quantum information. Besides fully gapped superconductors, unconventional superconductors with point or line nodes in their order parameter can also exhibit nontrivial topological characteristics. This article reviews recent progress in the theoretical understanding of nodal topological superconductors, with a focus on Weyl and noncentrosymmetric superconductors and their protected surface states. Using selected examples, we review the bulk topological properties of these systems, study different types of topological surface states, and examine their unusual properties. Furthermore, we survey some candidate materials for topological superconductivity and discuss different experimental signatures of topological surface states. (topical review)

  16. Nodal aberration theory applied to freeform surfaces

    Science.gov (United States)

    Fuerschbach, Kyle; Rolland, Jannick P.; Thompson, Kevin P.

    2014-12-01

    When new three-dimensional packages are developed for imaging optical systems, the rotational symmetry of the optical system is often broken, changing its imaging behavior and making the optical performance worse. A method to restore the performance is to use freeform optical surfaces that compensate directly the aberrations introduced from tilting and decentering the optical surfaces. In order to effectively optimize the shape of a freeform surface to restore optical functionality, it is helpful to understand the aberration effect the surface may induce. Using nodal aberration theory the aberration fields induced by a freeform surface in an optical system are explored. These theoretical predications are experimentally validated with the design and implementation of an aberration generating telescope.

  17. Neuroendocrine Merkel cell nodal carcinoma of unknown primary site: management and outcomes of a rare entity.

    Science.gov (United States)

    Kotteas, E A; Pavlidis, N

    2015-04-01

    Merkel cell nodal carcinoma of unknown primary (MCCUP) is a rare neuroendocrine tumour with distinct clinical and biological behaviour. We conducted a review of retrospective data extracted from 90 patients focusing on the management and outcome of this disease. We also compared life expectancy of these patients with the outcome of patients with known Merkel primaries and with neuroendocrine cancers of unidentifiable primary. There is a limited body of data for this type of malignancy, however, patients with Merkel cell nodal carcinoma of unknown primary site, seem to have better survival when treated aggressively than patients with cutaneous Merkel tumours of the same stage and equal survival with patients with low-grade neuroendocrine tumour of unknown origin. The lack of prospective trials, and the inadequate data, hamper the management of these tumours. Establishment of treatment guidelines is urgently needed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Elective nodal irradiation (ENI) vs. involved field radiotherapy (IFRT) for locally advanced non-small cell lung cancer (NSCLC): A comparative analysis of toxicities and clinical outcomes

    International Nuclear Information System (INIS)

    Fernandes, Annemarie T.; Shen, Jason; Finlay, Jarod; Mitra, Nandita; Evans, Tracey; Stevenson, James; Langer, Corey; Lin, Lilie; Hahn, Stephen; Glatstein, Eli; Rengan, Ramesh

    2010-01-01

    Background: Elective nodal irradiation (ENI) and involved field radiotherapy (IFRT) are definitive radiotherapeutic approaches used to treat patients with locally advanced non-small cell lung cancer (NSCLC). ENI delivers prophylactic radiation to clinically uninvolved lymph nodes, while IFRT only targets identifiable gross nodal disease. Because clinically uninvolved nodal stations may harbor microscopic disease, IFRT raises concerns for increased nodal failures. This retrospective cohort analysis evaluates failure rates and treatment-related toxicities in patients treated at a single institution with ENI and IFRT. Methods: We assessed all patients with stage III locally advanced or stage IV oligometastatic NSCLC treated with definitive radiotherapy from 2003 to 2008. Each physician consistently treated with either ENI or IFRT, based on their treatment philosophy. Results: Of the 108 consecutive patients assessed (60 ENI vs. 48 IFRT), 10 patients had stage IV disease and 95 patients received chemotherapy. The median follow-up time for survivors was 18.9 months. On multivariable logistic regression analysis, patients treated with IFRT demonstrated a significantly lower risk of high grade esophagitis (Odds ratio: 0.31, p = 0.036). The differences in 2-year local control (39.2% vs. 59.6%), elective nodal control (84.3% vs. 84.3%), distant control (47.7% vs. 52.7%) and overall survival (40.1% vs. 43.7%) rates were not statistically significant between ENI vs. IFRT. Conclusions: Nodal failure rates in clinically uninvolved nodal stations were not increased with IFRT when compared to ENI. IFRT also resulted in significantly decreased esophageal toxicity, suggesting that IFRT may allow for integration of concurrent systemic chemotherapy in a greater proportion of patients.

  19. Elective nodal irradiation (ENI) vs. involved field radiotherapy (IFRT) for locally advanced non-small cell lung cancer (NSCLC): A comparative analysis of toxicities and clinical outcomes.

    Science.gov (United States)

    Fernandes, Annemarie T; Shen, Jason; Finlay, Jarod; Mitra, Nandita; Evans, Tracey; Stevenson, James; Langer, Corey; Lin, Lilie; Hahn, Stephen; Glatstein, Eli; Rengan, Ramesh

    2010-05-01

    Elective nodal irradiation (ENI) and involved field radiotherapy (IFRT) are definitive radiotherapeutic approaches used to treat patients with locally advanced non-small cell lung cancer (NSCLC). ENI delivers prophylactic radiation to clinically uninvolved lymph nodes, while IFRT only targets identifiable gross nodal disease. Because clinically uninvolved nodal stations may harbor microscopic disease, IFRT raises concerns for increased nodal failures. This retrospective cohort analysis evaluates failure rates and treatment-related toxicities in patients treated at a single institution with ENI and IFRT. We assessed all patients with stage III locally advanced or stage IV oligometastatic NSCLC treated with definitive radiotherapy from 2003 to 2008. Each physician consistently treated with either ENI or IFRT, based on their treatment philosophy. Of the 108 consecutive patients assessed (60 ENI vs. 48 IFRT), 10 patients had stage IV disease and 95 patients received chemotherapy. The median follow-up time for survivors was 18.9 months. On multivariable logistic regression analysis, patients treated with IFRT demonstrated a significantly lower risk of high grade esophagitis (Odds ratio: 0.31, p = 0.036). The differences in 2-year local control (39.2% vs. 59.6%), elective nodal control (84.3% vs. 84.3%), distant control (47.7% vs. 52.7%) and overall survival (40.1% vs. 43.7%) rates were not statistically significant between ENI vs. IFRT. Nodal failure rates in clinically uninvolved nodal stations were not increased with IFRT when compared to ENI. IFRT also resulted in significantly decreased esophageal toxicity, suggesting that IFRT may allow for integration of concurrent systemic chemotherapy in a greater proportion of patients. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Nodal Control and Surgical Salvage after Primary Radiotherapy in 1,782 Patients with Laryngeal and Pharyngeal Carcinoma

    International Nuclear Information System (INIS)

    Vendelbo Johansen, Lars; Grau, Cai; Overgaard, Jens

    2004-01-01

    The purpose of this study was to evaluate the ultimate neck control after primary radiotherapy and surgical salvage in laryngeal and pharyngeal cancer patients. Some 1,782 consecutive patients with squamous cell carcinoma were treated by radiotherapy. At presentation 26% of the patients had metastatic lymph nodes. A total of 298 primary or secondary nodal recurrences were seen, 159 were treated, and 53 (∼18%) were controlled. Isolated N-recurrence was fatal in 2.7% (36/1,324) of the N0 patients. Univariate actuarial analysis of nodal control demonstrated that the region of origin, T-classification, T-size, N-classification, tumor stage, differentiation, hemoglobin, and radiation time were significant prognostic factors. In a Cox analysis the independent significant parameters were gender, region of origin, N-classification, and differentiation. The conclusions were that in patients with nodal recurrence a little over half were treated and of these a third of the nodal recurrences were controlled. Significant prognostic factors in multivariate analysis were gender, region of origin, N-classification, and tumor differentiation

  1. Tongue metastasis mimicking an abscess.

    Science.gov (United States)

    Mavili, Ertuğrul; Oztürk, Mustafa; Yücel, Tuba; Yüce, Imdat; Cağli, Sedat

    2010-03-01

    Primary tumors metastasizing to the oral cavity are extremely rare. Lung is one of the most common primary sources of metastases to the tongue. Although the incidence of lung cancer is increasing, tongue metastasis as the initial presentation of the tumor remains uncommon. Due to the rarity of tongue metastasis, little is known about its imaging findings. Herein we report the magnetic resonance imaging and clinical findings of a lingual metastasis, mimicking an abscess, from a primary lung cancer.

  2. Three-dimensional conformal radiation may deliver considerable dose of incidental nodal irradiation in patients with early stage node-negative non-small cell lung cancer when the tumor is large and centrally located

    International Nuclear Information System (INIS)

    Zhao Lujun; Chen Ming; Haken, Randall ten; Chetty, Indrin; Chapet, Olivier; Hayman, James A.; Kong Fengming

    2007-01-01

    Background and purpose: To determine the dose to regional nodal stations in patients with T 1-3 N 0 M 0 non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT) without intentional elective nodal irradiation (ENI). Materials and methods: Twenty-three patients with medically inoperable T 1-3 N 0 M 0 NSCLC were treated with 3DCRT without ENI. Hilar and mediastinal nodal regions were contoured on planning CT. The prescription dose was normalized to 70 Gy. Equivalent uniform dose (EUD) and other dosimetric parameters (e.g., V 40 ) were calculated for each nodal station. Results: The median EUD for the whole group ranged from 0.4 to 4.4 Gy for all elective nodal regions. Gross tumor volume (GTV) and the relationship between GTV and hilum were significantly correlated with irradiation dose to ipsilateral hilar nodal regions (P 3 (diameter ∼ 4 cm) and or having any overlap with hilum, the median EUDs were 9.6, 22.6, and 62.9 Gy for ipsilateral lower paratracheal, subcarinal, and ipsilateral hilar regions, respectively. The corresponding median V 40 were 32.5%, 39.3%, and 97.6%, respectively. Conclusions: Although incidental nodal irradiation dose is low in the whole group, the dose to high-risk nodal regions is considerable in patients with T 1-3 N 0 NSCLC when the primary is large and/or centrally located

  3. Development of Individualized Anti-Metastasis Strategies by Engineering Nanomedicines

    Science.gov (United States)

    He, Qianjun; Guo, Shengrong; Qian, Zhiyong; Chen, Xiaoyuan

    2015-01-01

    Metastasis is deadly and also tough to treat as it is much more complicated than the primary tumour. Anti-metastasis approaches available so far are far from being optimal. A variety of nanomedicine formulas provide a plethora of opportunities for developing new strategies and means for tackling metastasis. It should be noted that individualized anti-metastatic nanomedicines are different from common anti-cancer nanomedicines as they specifically target different populations of malignant cells. This review briefly introduces the features of the metastatic cascade, and proposes a series of nanomedicine-based anti-metastasis strategies aiming to block each metastatic step. Moreover, we also concisely introduce the advantages of several promising nanoparticle platforms and their potential for constructing state-of-the-art individualized anti-metastatic nanomedicines. PMID:26056688

  4. A nodal expansion method using conformal mapping for hexagonal geometry

    International Nuclear Information System (INIS)

    Chao, Y.A.; Shatilla, Y.A.

    1993-01-01

    Hexagonal nodal methods adopting the same transverse integration process used for square nodal methods face the subtle theoretical problem that this process leads to highly singular nonphysical terms in the diffusion equation. Lawrence, in developing the DIF3D-N code, tried to approximate the singular terms with relatively simple polynomials. In the HEX-NOD code, Wagner ignored the singularities to simplify the diffusion equation and introduced compensating terms in the nodal equations to restore the nodal balance relation. More recently developed hexagonal nodal codes, such as HEXPE-DITE and the hexagonal version of PANTHER, used methods similar to Wagner's. It will be shown that for light water reactor applications, these two different approximations significantly degraded the accuracy of the respective method as compared to the established square nodal methods. Alternatively, the method of conformal mapping was suggested to map a hexagon to a rectangle, with the unique feature of leaving the diffusion operator invariant, thereby fundamentally resolving the problems associated with transverse integration. This method is now implemented in the Westinghouse hexagonal nodal code ANC-H. In this paper we report on the results of comparing the three methods for a variety of problems via benchmarking against the fine-mesh finite difference code

  5. Benchmarking with high-order nodal diffusion methods

    International Nuclear Information System (INIS)

    Tomasevic, D.; Larsen, E.W.

    1993-01-01

    Significant progress in the solution of multidimensional neutron diffusion problems was made in the late 1970s with the introduction of nodal methods. Modern nodal reactor analysis codes provide significant improvements in both accuracy and computing speed over earlier codes based on fine-mesh finite difference methods. In the past, the performance of advanced nodal methods was determined by comparisons with fine-mesh finite difference codes. More recently, the excellent spatial convergence of nodal methods has permitted their use in establishing reference solutions for some important bench-mark problems. The recent development of the self-consistent high-order nodal diffusion method and its subsequent variational formulation has permitted the calculation of reference solutions with one node per assembly mesh size. In this paper, we compare results for four selected benchmark problems to those obtained by high-order response matrix methods and by two well-known state-of-the-art nodal methods (the open-quotes analyticalclose quotes and open-quotes nodal expansionclose quotes methods)

  6. Prognostic significance of several histological features in intermediate and high-risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Narayan, K.; Bernshaw, D.; Quinn, M.; Allen, D.; Rejeki, V.; Herschtal, A.; Jobling, T.

    2009-01-01

    Full text: The purpose of the present study was to explore the prognostic significance of several histological features with respect to lymph node metastasis, failure-free survival (FeS), and overall survival (Os) in intermediate and high-risk endometrial cancer patients treated with curative intent. One hundred and eighty patients with endometrial cancer were treated with hysterectomy with or without lymphadenectomy and received external beam radiotherapy (EBRT). The mean follow-up period was 4.25 years (range 0.44-10.45 years). In multifactor analysis, fractional myometrial invasion (MI) (P = 0.047), histology (P < 0.001) and lymph-vascular space invasion (LVSI) (P = 0.025) were significant predictors for FFS when nodal status was not included. When lymph node status was known, histology (P - 0.007) and LVSI (P = 0.014) remained significant factors for FFS. For OS, histology (P < 0.001) and fractional MI (P = 0.004) were the significant factors. Lymph node status could be predicted by tumour grading (P = 0.016) and absolute MI (P 0.002). Histology type and the presence of LVSI were the most important prognostic factors in high-risk endometrial cancer patients treated by surgery and postoperative radiotherapy. Absolute MI and tumour grading were useful predictors of nodal spread.

  7. A Hennart nodal method for the diffusion equation

    International Nuclear Information System (INIS)

    Lesaint, P.; Noceir, S.; Verwaerde, D.

    1995-01-01

    A modification of the Hennart nodal method for neutron diffusion problems is presented. The final system of equations obtained by this method is not positive definite. However, a flux elimination technique leads to a simple positive definite system, which can be solved by the traditional iterative methods. Calculations of a two-dimensional International Atomic Energy Agency benchmark problem are performed and compared with results of the original Hennart nodal method and some finite element methods. The high computational efficiency of this modified nodal method is clearly demonstrated

  8. Modifying nodal pricing method considering market participants optimality and reliability

    Directory of Open Access Journals (Sweden)

    A. R. Soofiabadi

    2015-06-01

    Full Text Available This paper develops a method for nodal pricing and market clearing mechanism considering reliability of the system. The effects of components reliability on electricity price, market participants’ profit and system social welfare is considered. This paper considers reliability both for evaluation of market participant’s optimality as well as for fair pricing and market clearing mechanism. To achieve fair pricing, nodal price has been obtained through a two stage optimization problem and to achieve fair market clearing mechanism, comprehensive criteria has been introduced for optimality evaluation of market participant. Social welfare of the system and system efficiency are increased under proposed modified nodal pricing method.

  9. Vulvar Metastasis from Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Vulvar metastasis of urothelial carcinoma of the bladder is a very rare entity; few cases are reported in the English literature. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of a patient with vulvar metastasis of urothelial carcinoma of the bladder followed by a brief review of the reported cases in the literature.

  10. Iris metastasis of gastric adenocarcinoma.

    Science.gov (United States)

    Celebi, Ali Riza Cenk; Kilavuzoglu, Ayse Ebru; Altiparmak, U Emrah; Cosar, C Banu; Ozkiris, Abdullah

    2016-03-08

    Iris metastasis in patients with gastric cancer is extremely rare. Herein, it is aimed to report on a patient with gastric adenocarcinoma and iris metastasis. A 65-year-old patient with the history of gastric cancer was admitted for eye pain and eye redness on his left eye. There was ciliary injection, severe +4 cells with hypopyon in the anterior chamber and a solitary, friable, yellow-white, fleshy-creamy vascularized 2 mm × 4 mm mass on the upper nasal part of the iris within the left eye. The presented patient's mass lesion in the iris fulfilled the criteria of the metastatic iris lesion's appearance. The ocular metastasis occurred during chemotherapy. Iris metastasis can masquerade as iridocyclitis with pseudohypopyon or glaucoma. In patients with a history of gastric cancer that present with an iris mass, uveitis, and high intraocular pressure, ocular metastasis of gastric cancer should be a consideration.

  11. Curative resection by splenectomy for solitary splenic metastasis from early gastric cancer: a case report and literature review.

    Science.gov (United States)

    Yoshizawa, Junichi; Kubo, Naoki; Ishizone, Satoshi; Karasawa, Fumitoshi; Nakayama, Ataru

    2017-06-20

    Solitary metastasis of a malignancy to the spleen is rare, particularly for gastric cancer. Only a few case reports have documented isolated splenic metastasis from early gastric cancer. We describe a case of splenic metastasis from early gastric cancer. A 60-year-old man underwent a distal gastrectomy for early gastric cancer. It infiltrated the submucosa with pathological nodal involvement (pT1bN2M0, stage IIB). One year after the gastrectomy, an abdominal computed tomography scan showed a low-density lesion, 17 mm in diameter, at the upper pole of the spleen. Positron emission tomography/computed tomography showed focal accumulation of fluorine-18 fluorodeoxyglucose in the spleen without extrasplenic tumor dissemination or metastasis. We diagnosed splenic metastasis of gastric cancer, and performed a splenectomy. Histological examination confirmed moderately differentiated tubular adenocarcinoma and poorly differentiated adenocarcinoma (solid type) that was consistent with the features of the primary gastric cancer. The splenic tumor was pathologically and immunohistochemically diagnosed as a metastasis from the gastric carcinoma. More than 18 months after the splenectomy, the patient has had no evidence of recurrent gastric cancer. When solitary metastasis to the spleen is suspected during the postoperative follow-up of a patient with gastric cancer, a splenectomy is a potentially effective treatment.

  12. CT simulation in nodal positive breast cancer

    International Nuclear Information System (INIS)

    Horst, E.; Schuck, A.; Moustakis, C.; Schaefer, U.; Micke, O.; Kronholz, H.L.; Willich, N.

    2001-01-01

    Background: A variety of solutions are used to match tangential fields and opposed lymph node fields in irradiation of nodal positive breast cancer. The choice is depending on the technical equipment which is available and the clinical situation. The CT simulation of a non-monoisocentric technique was evaluated in terms of accuracy and reproducibility. Patients, Material and Methods: The field match parameters were adjusted virtually at CT simulation and were compared with parameters derived mathematically. The coordinate transfer from the CT simulator to the conventional simulator was analyzed in 25 consecutive patients. Results: The angles adjusted virtually for a geometrically exact coplanar field match corresponded with the angles calculated for each set-up. The mean isocenter displacement was 5.7 mm and the total uncertainty of the coordinate transfer was 6.7 mm (1 SD). Limitations in the patient set-up became obvious because of the steep arm abduction necessary to fit the 70 cm CT gantry aperture. Required modifications of the arm position and coordinate transfer errors led to a significant shift of the marked matchline of >1.0 cm in eight of 25 patients (32%). Conclusion: The virtual CT simulation allows a precise and graphic definition of the field match parameters. However, modifications of the virtual set-up basically due to technical limitations were required in a total of 32% of cases, so that a hybrid technique was adapted at present that combines virtual adjustment of the ideal field alignment parameters with conventional simulation. (orig.) [de

  13. Present Status of GNF New Nodal Simulator

    International Nuclear Information System (INIS)

    Iwamoto, T.; Tamitani, M.; Moore, B.

    2001-01-01

    This paper presents core simulator consolidation work done at Global Nuclear Fuel (GNF). The unified simulator needs to supercede the capabilities of past simulator packages from the original GNF partners: GE, Hitachi, and Toshiba. At the same time, an effort is being made to produce a simulation package that will be a state-of-the-art analysis tool when released, in terms of the physics solution methodology and functionality. The core simulator will be capable and qualified for (a) high-energy cycles in the U.S. markets, (b) mixed-oxide (MOX) introduction in Japan, and (c) high-power density plants in Europe, etc. The unification of the lattice physics code is also in progress based on a transport model with collision probability methods. The AETNA core simulator is built upon the PANAC11 software base. The goal is to essentially replace the 1.5-energy-group model with a higher-order multigroup nonlinear nodal solution capable of the required modeling fidelity, while keeping highly automated library generation as well as functionality. All required interfaces to PANAC11 will be preserved, which minimizes the impact on users and process automation. Preliminary results show statistical accuracy improvement over the 1.5-group model

  14. BEACON: An application of nodal methods for operational support

    International Nuclear Information System (INIS)

    Boyd, W.A.; Nguyen, T.Q.

    1992-01-01

    A practical application of nodal methods is on-line plant operational support. However, to enable plant personnel to take full advantage of a nodal model to support plant operations, (a) a core nodal model must always be up to date with the current core history and conditions, (b) the nodal methods must be fast enough to allow numerous core calculations to be performed in minutes to support engineering decisions, and (c) the system must be easily accessible to engineering personnel at the reactor, their offices, or any other location considered appropriate. A core operational support package developed by Westinghouse called BEACON (best estimate analysis of core operations - nuclear) has been installed at several plants. Results from these plants and numerous in-core flux maps analyzed have demonstrated the accuracy of the model and the effectiveness of the methodology

  15. Aircraft Nodal Data Acquisition System (ANDAS), Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Development of an Aircraft Nodal Data Acquisition System (ANDAS) based upon the short haul Zigbee networking standard is proposed. It employs a very thin (135 um)...

  16. Hybrid nodal loop metal: Unconventional magnetoresponse and material realization

    Science.gov (United States)

    Zhang, Xiaoming; Yu, Zhi-Ming; Lu, Yunhao; Sheng, Xian-Lei; Yang, Hui Ying; Yang, Shengyuan A.

    2018-03-01

    A nodal loop is formed by a band crossing along a one-dimensional closed manifold, with each point on the loop a linear nodal point in the transverse dimensions, and can be classified as type I or type II depending on the band dispersion. Here, we propose a class of nodal loops composed of both type-I and type-II points, which are hence termed as hybrid nodal loops. Based on first-principles calculations, we predict the realization of such loops in the existing electride material Ca2As . For a hybrid loop, the Fermi surface consists of coexisting electron and hole pockets that touch at isolated points for an extended range of Fermi energies, without the need for fine-tuning. This leads to unconventional magnetic responses, including the zero-field magnetic breakdown and the momentum-space Klein tunneling observable in the magnetic quantum oscillations, as well as the peculiar anisotropy in the cyclotron resonance.

  17. A nodal method based on matrix-response method

    International Nuclear Information System (INIS)

    Rocamora Junior, F.D.; Menezes, A.

    1982-01-01

    A nodal method based in the matrix-response method, is presented, and its application to spatial gradient problems, such as those that exist in fast reactors, near the core - blanket interface, is investigated. (E.G.) [pt

  18. Nodal prices determination with wind integration for radial ...

    African Journals Online (AJOL)

    With competitive electricity market operation, open access to the transmission and distribution network is essential ... The results have been obtained for IEEE 33 ...... The value of intermittent wind DG under nodal prices and amp – mile tariffs.

  19. Nodal aberration theory for wild-filed asymmetric optical systems

    Science.gov (United States)

    Chen, Yang; Cheng, Xuemin; Hao, Qun

    2016-10-01

    Nodal Aberration Theory (NAT) was used to calculate the zero field position in Full Field Display (FFD) for the given aberration term. Aiming at wide-filed non-rotational symmetric decentered optical systems, we have presented the nodal geography behavior of the family of third-order and fifth-order aberrations. Meanwhile, we have calculated the wavefront aberration expressions when one optical element in the system is tilted, which was not at the entrance pupil. By using a three-piece-cellphone lens example in optical design software CodeV, the nodal geography is testified under several situations; and the wavefront aberrations are calculated when the optical element is tilted. The properties of the nodal aberrations are analyzed by using Fringe Zernike coefficients, which are directly related with the wavefront aberration terms and usually obtained by real ray trace and wavefront surface fitting.

  20. Regional control of melanoma neck node metastasis after selective neck dissection with or without adjuvant radiotherapy

    NARCIS (Netherlands)

    Hamming-Vrieze, Olga; Balm, Alfons J. M.; Heemsbergen, Wilma D.; Hooft van Huysduynen, Thijs; Rasch, Coen R. N.

    2009-01-01

    OBJECTIVE: To examine the effect of adjuvant radiotherapy on regional control of melanoma neck node metastasis. DESIGN: A single-institution retrospective study. SETTING: Tertiary care cancer center. PATIENTS: The study included 64 patients with melanoma neck node metastasis who were treated with

  1. The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck.

    Science.gov (United States)

    Jiang, Wen; Mohamed, Abdallah S R; Fuller, Clifton David; Kim, Betty Y S; Tang, Chad; Gunn, G Brandon; Hanna, Ehab Y; Frank, Steven J; Su, Shirley Y; Diaz, Eduardo; Kupferman, Michael E; Beadle, Beth M; Morrison, William H; Skinner, Heath; Lai, Stephen Y; El-Naggar, Adel K; DeMonte, Franco; Rosenthal, David I; Garden, Adam S; Phan, Jack

    2016-01-01

    Although adjuvant radiation to the tumor bed has been reported to improve the clinic outcomes of esthesioneuroblastoma (ENB) patients, the role of elective neck irradiation (ENI) in clinically node-negative (N0) patients remains controversial. Here, we evaluated the effects of ENI on neck nodal relapse risk in ENB patients treated with radiation therapy as a component of multimodality treatment. Seventy-one N0 ENB patients irradiated at the University of Texas MD Anderson Cancer Center between 1970 and 2013 were identified. ENI was performed on 22 of these patients (31%). Survival analysis was performed with focus on comparative outcomes of those patients who did and did not receive ENI. The median follow-up time for our cohort is 80.8 months (range, 6-350 months). Among N0 patients, 13 (18.3%) developed neck nodal relapses, with a median time to progression of 62.5 months. None of these 13 patients received prophylactic neck irradiation. ENI was associated with significantly improved regional nodal control at 5 years (regional control rate of 100% for ENI vs 82%, P ENI developed isolated neck recurrences. All had further treatment for their neck disease, including neck dissection (n = 10), radiation (n = 10), or chemotherapy (n = 5). Six of these 11 patients (54.5%) demonstrated no evidence of further recurrence with a median follow-up of 55.5 months. ENI significantly reduces the risk of cervical nodal recurrence in ENB patients with clinically N0 neck, but this did not translate to a survival benefit. Multimodality treatment for isolated neck recurrence provides a reasonable salvage rate. The greatest benefit for ENI appeared to be among younger patients who presented with Kadish C disease. Further studies are needed to confirm these findings. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  2. The role of elective-nodal irradiation for esthesioneuroblastoma patients with clinically negative neck

    Science.gov (United States)

    Jiang, Wen; Mohamed, Abdallah Sherif; Fuller, Clifton David; Kim, Betty Y.S.; Tang, Chad; Gunn, G. Brandon; Hanna, Ehab Y.; Frank, Steven J.; Su, Shirley Y.; Diaz, Eduardo; Kupferman, Michael E.; Beadle, Beth M.; Morrison, William H.; Skinner, Heath; Lai, Stephen Y.; El-Naggar, Adel K.; DeMonte, Franco; Rosenthal, David I.; Garden, Adam S.; Phan, Jack

    2017-01-01

    Purpose Although adjuvant radiation to the tumor bed has been reported to improve the clinic outcomes of esthesioneuroblastoma (ENB) patients, the role of elective neck irradiation (ENI) in clinically node negative (N0) patients remains controversial. Here, we evaluated the effects of ENI on neck nodal relapse risk in ENB patients treated with radiotherapy as a component of multi-modality treatment. Methods and Materials Seventy-one N0 ENB patients irradiated at XXXXXXXXX between 1970 and 2013 were identified. ENI was performed on 22 of these patients (31%). Survival analysis was performed with focus on comparative outcomes of those patients who did and did not receive ENI. Results The median follow up time for our cohort is 80.8 months (range 6 – 350 month). Among N0 patients, 13 (18.3%) developed neck nodal relapses, with a median time to progression of 62.5 months. None of these 13 patients received prophylactic neck irradiation. ENI was associated with significantly improved regional nodal control at 5-year (regional control rate of 100% for ENI vs 82%, p ENI developed isolated neck recurrences. All had further treatment for their neck disease, including neck dissection (n=10), radiation (n=10), or chemotherapy (n=5). Six of these 11 patients (54.5%) demonstrated no evidence of further recurrence with a median follow up of 55.5 month. Conclusion ENI significantly reduces the risk of cervical nodal recurrence in ENB patients with clinically N0 neck but this did not translate to a survival benefit. Multimodality treatment for isolated neck recurrence provides a reasonable salvage rate. The greatest benefit for ENI appeared to be among younger patients who presented with Kadish C disease. Further studies are needed to confirm these findings. PMID:26979544

  3. Squamous cell carcinomas metastatic to cervical lymph nodes from an unknown head-and-neck mucosal site treated with radiation therapy alone or in combination with neck dissection

    International Nuclear Information System (INIS)

    Erkal, Haldun S.; Mendenhall, William M.; Amdur, Robert J.; Villaret, Douglas B.; Stringer, Scott P.

    2001-01-01

    Purpose: The present study presents the experience at the University of Florida with treatment of patients with squamous cell carcinomas (SCC) metastatic to cervical lymph nodes from an unknown head-and-neck mucosal (H and NM) site with radiotherapy (RT) alone or in combination with neck dissection (ND). Methods and Materials: The study included 126 patients treated with curative intent from 1964 to 1997. All patients had follow-up for at least 2 years. No patients were lost to follow-up. Results: Twelve patients (10%) developed SCC in H and NM sites at 0.5 to 10.9 years (median, 1.8 years). The rate of developing carcinomas in H and NM sites at 5 years was 13%. Histologic differentiation significantly affected the rate of developing carcinomas in H and NM sites in multivariate analysis. Sixteen patients (13%) had persistent nodal disease and 12 patients (10%) developed recurrent nodal disease at 0.5 to 10.9 years (median, 1.1 years). The nodal control rate at 5 years was 78%. Nodal size, N stage, and planned ND significantly affected the rate of nodal control in multivariate analysis. Nineteen patients (15%) developed distant metastasis at 0.2-5.1 years (median, 0.9 years). The distant metastases rate at 5 years was 14%. Extracapsular extension and RT dose significantly affected the risk of distant metastases in multivariate analysis. The overall absolute survival rate at 5 years was 47%. Extracapsular extension, N stage, RT dose for H and NM sites, and planned ND significantly affected absolute survival in multivariate analysis. The rate of cause-specific survival at 5 years was 67%. Extracapsular extension, nodal size, N stage, overall treatment time, and planned ND significantly affected cause-specific survival in multivariate analysis. Eight patients (6%) had severe postoperative complications and 6 patients (5%) had severe late complications. Conclusion: The present study supports the effectiveness of RT in lowering the rate of developing carcinomas in the H

  4. Extension of the analytic nodal method to four energy groups

    International Nuclear Information System (INIS)

    Parsons, D.K.; Nigg, D.W.

    1985-01-01

    The Analytic Nodal Method is one of several recently-developed coarse mesh numerical methods for efficiently and accurately solving the multidimensional static and transient neutron diffusion equations. This summary describes a mathematically rigorous extension of the Analytic Nodal Method to the frequently more physically realistic four-group case. A few general theoretical considerations are discussed, followed by some calculated results for a typical steady-state two-dimensional PWR quarter core application. 8 refs

  5. Bilinear nodal transport method in weighted diamond difference form

    International Nuclear Information System (INIS)

    Azmy, Y.Y.

    1987-01-01

    Nodal methods have been developed and implemented for the numerical solution of the discrete ordinates neutron transport equation. Numerical testing of these methods and comparison of their results to those obtained by conventional methods have established the high accuracy of nodal methods. Furthermore, it has been suggested that the linear-linear approximation is the most computationally efficient, practical nodal approximation. Indeed, this claim has been substantiated by comparing the accuracy in the solution, and the CPU time required to achieve convergence to that solution by several nodal approximations, as well as the diamond difference scheme. Two types of linear-linear nodal methods have been developed in the literature: analytic linear-linear (NLL) methods, in which the transverse-leakage terms are derived analytically, and approximate linear-linear (PLL) methods, in which these terms are approximated. In spite of their higher accuracy, NLL methods result in very complicated discrete-variable equations that exhibit a high degree of coupling, thus requiring special solution algorithms. On the other hand, the sacrificed accuracy in PLL methods is compensated for by the simple discrete-variable equations and diamond-difference-like solution algorithm. In this paper the authors outline the development of an NLL nodal method, the bilinear method, which can be written in a weighted diamond difference form with one spatial weight per dimension that is analytically derived rather than preassigned in an ad hoc fashion

  6. Ampullary carcinoma with cutaneous metastasis

    Directory of Open Access Journals (Sweden)

    I-Ting Liu

    2016-06-01

    Full Text Available Carcinoma of the ampulla of Vater is a rare gastrointestinal tumor. Additionally, cutaneous metastasis from such an internal malignancy is also uncommon. We reported the case of a 55-year-old man afflicted with ampullary carcinoma with cutaneous metastasis. The patient did not undergo the standard Whipple procedure but received chemotherapy due to apparent left neck lymph node metastasis noted by initial PET/CT imaging. The skin metastasis presented as a left neck infiltrating purpuric lesion, which was confirmed by skin biopsy approximately one year after the patient's disease was first diagnosed. Thereafter, the patient received further chemotherapy pursuant to his course of medical management. Skin metastasis usually represents a poor patient prognosis. In these cases, treatment of cutaneous metastasis typically includes systemic chemotherapy and local management such as radiation therapy or tumor excision. And when choosing a chemotherapy regimen for the ampullary cancer, the histological subtypes (intestinal or pancreatobiliary should be comprehensively considered. In our review of the literature, the intestinal type seems to have less distant lymph node metastasis, advanced local invasion, as well as recurrence than pancreatobiliary type of ampullary cancer.

  7. Extra-nodal lymphoma. A survey of Japan lymphoma radiation therapy group

    International Nuclear Information System (INIS)

    Oguchi, Masahiko; Ikeda, Hiroshi; Nakamura, Shigeo

    2002-01-01

    The purpose of this study was to examine, retrospectively, national-wide clinical data of patients with localized extranodal non-Hodgkin's lymphoma (NHL) who were treated by radiation therapy with or without chemotherapy. The survey was carried out at 25 radiation oncology institutions in Japan in 1998. In 1999, according to the Revised European American Lymphoma (REAL) classification, central pathological review conducted at Aichi cancer center was carried out for the data from 7 radiation oncology institutions. The 5-year progression free survival rates (PFS) were calculated to identify prognostic factors. Survey: Data from 1, 141 patients with stage I and II NHL were recruited from 1988 through 1992. Of them, 787 patients, who were treated using definitive radiotherapy with or without chemotherapy for intermediate and high-grade lymphomas in Working Formulation, constituted the core of this study. Primary tumors arose mainly from extra-nodal organs (71%) in the head and neck (Waldeyer's ring: 41%, thyroid gland: 7%, nasal cavities: 5%, oral cavities: 4%, sinus: 3%, orbital structures: 3%, skin: 2% and etc.). The median age of 60 years for patients with extra-nodal NHL was higher than that of 56 years for patients with nodal NHL (p<0.01). Female were dominant in incidence of extra-nodal NHL arising from the thyroid gland, skin and gastrointestinal tract. The percentage of stage I to the extra-nodal NHL from orbit, sino-nasal presentation was higher than that of other NHLs. The percentage of stage II to the extra-nodal NHL from Waldeyer's ring and thyroid gland was higher than that of other NHLs. Central pathological review was carried out for pathological data from 79 patients (Waldeyer's ring: 45, thyroid gland: 19, sinonasal cavities: 15). Of these, diffuse large B cell lymphoma (DLBCL) composed 63% of all patients, mucosa associated lyumphoid tissue lymphoma (MALT-L): 16%, Natural Killer/T cell lymphoma (NK/T-L): 11%, and mantle cell lymphoma: 5% in REAL

  8. Uniqueness Theorem for the Inverse Aftereffect Problem and Representation the Nodal Points Form

    Directory of Open Access Journals (Sweden)

    A. Neamaty

    2015-03-01

    Full Text Available In this paper, we consider a boundary value problem with aftereffect on a finite interval. Then, the asymptotic behavior of the solutions, eigenvalues, the nodal points and the associated nodal length are studied. We also calculate the numerical values of the nodal points and the nodal length. Finally, we prove the uniqueness theorem for the inverse aftereffect problem by applying any dense subset of the nodal points.

  9. Uniqueness Theorem for the Inverse Aftereffect Problem and Representation the Nodal Points Form

    OpenAIRE

    A. Neamaty; Sh. Akbarpoor; A. Dabbaghian

    2015-01-01

    In this paper, we consider a boundary value problem with aftereffect on a finite interval. Then, the asymptotic behavior of the solutions, eigenvalues, the nodal points and the associated nodal length are studied. We also calculate the numerical values of the nodal points and the nodal length. Finally, we prove the uniqueness theorem for the inverse aftereffect problem by applying any dense subset of the nodal points.

  10. Phase I Trial of Pelvic Nodal Dose Escalation With Hypofractionated IMRT for High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Adkison, Jarrod B.; McHaffie, Derek R.; Bentzen, Soren M.; Patel, Rakesh R.; Khuntia, Deepak [Department of Human Oncology, University of Wisconsin Carbone Cancer Center, School of Medicine and Public Health, Madison, WI (United States); Petereit, Daniel G. [Department of Radiation Oncology, John T. Vucurevich Regional Cancer Care Institute, Rapid City Regional Hospital, Rapid City, SD (United States); Hong, Theodore S.; Tome, Wolfgang [Department of Human Oncology, University of Wisconsin Carbone Cancer Center, School of Medicine and Public Health, Madison, WI (United States); Ritter, Mark A., E-mail: ritter@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin Carbone Cancer Center, School of Medicine and Public Health, Madison, WI (United States)

    2012-01-01

    Purpose: Toxicity concerns have limited pelvic nodal prescriptions to doses that may be suboptimal for controlling microscopic disease. In a prospective trial, we tested whether image-guided intensity-modulated radiation therapy (IMRT) can safely deliver escalated nodal doses while treating the prostate with hypofractionated radiotherapy in 5 Vulgar-Fraction-One-Half weeks. Methods and Materials: Pelvic nodal and prostatic image-guided IMRT was delivered to 53 National Comprehensive Cancer Network (NCCN) high-risk patients to a nodal dose of 56 Gy in 2-Gy fractions with concomitant treatment of the prostate to 70 Gy in 28 fractions of 2.5 Gy, and 50 of 53 patients received androgen deprivation for a median duration of 12 months. Results: The median follow-up time was 25.4 months (range, 4.2-57.2). No early Grade 3 Radiation Therapy Oncology Group or Common Terminology Criteria for Adverse Events v.3.0 genitourinary (GU) or gastrointestinal (GI) toxicities were seen. The cumulative actuarial incidence of Grade 2 early GU toxicity (primarily alpha blocker initiation) was 38%. The rate was 32% for Grade 2 early GI toxicity. None of the dose-volume descriptors correlated with GU toxicity, and only the volume of bowel receiving {>=}30 Gy correlated with early GI toxicity (p = 0.029). Maximum late Grades 1, 2, and 3 GU toxicities were seen in 30%, 25%, and 2% of patients, respectively. Maximum late Grades 1 and 2 GI toxicities were seen in 30% and 8% (rectal bleeding requiring cautery) of patients, respectively. The estimated 3-year biochemical control (nadir + 2) was 81.2 {+-} 6.6%. No patient manifested pelvic nodal failure, whereas 2 experienced paraaortic nodal failure outside the field. The six other clinical failures were distant only. Conclusions: Pelvic IMRT nodal dose escalation to 56 Gy was delivered concurrently with 70 Gy of hypofractionated prostate radiotherapy in a convenient, resource-efficient, and well-tolerated 28-fraction schedule. Pelvic nodal dose

  11. Stereotactic radiosurgery for brain metastasis: Pitie-Salpetriere Hospital experience

    International Nuclear Information System (INIS)

    Feuvret, L.; Germain, I.; Cornu, P.; Boisserie, G.; Dormont, D.; Hardiman, C.; Tep, B.; Faillot, T.; Duffau, H.; Simon, J.M.; Dendale, R.; Delattre, J.Y.; Poisson, M.; Marsault, C.; Philippon, J.; Fohanno, D.; Baillet, F.; Mazeron, J.J.

    1998-01-01

    Retrospective analysis of the influence of clinical and technical factors on local control and survival after radiosurgery for brain metastasis. From january 1994 to December 1996, 42 patients presenting with 71 metastases underwent radiosurgery for brain metastasis. The median age was 56 years and the median Karnofsky index 80. Primary sites included: lung (20 patients), kidney (seven), breast (five), colon (two), melanoma (three), osteosarcoma (one) and it was unknown for three patients. Seventeen patients had extracranial metastasis. Twenty-four patients were treated at recurrence which occurred after whole brain irradiation (12 patients), surgical excision (four) or after both treatments (eight). Thirty-six sessions of radiosurgery have been realized for one metastasis and 13 for two, three or four lesions. The median metastasis diameter was 21 mm and the median volume 1.7 cm 3 . The median peripheral dose to the lesion was 14 Gy, and the median dose at the isocenter 20 Gy. Sixty-five metastasis were evaluable for response analysis. The overall local control rate was 82% and the 1-year actuarial rate was 72%. In univariate analysis, theoretical radioresistance (P = 0.001), diameter less than 3 cm (P = 0.039) and initial treatment with radiosurgery (P 0.041) were significantly associated with increased local control. Only the first two factors remained significant in multivariate analysis. No prognostic factor of overall survival was identified. The median survival was 12 months. Six patients had a symptomatic oedema (RTOG grade 2), only one of which requiring a surgical excision. In conclusion, 14 Gy delivered at the periphery of metastasis seems to be a sufficient dose to control most brain metastases, with a minimal toxicity. Better results were obtained for lesions initially treated with radiosurgery, theoretically radioresistant and with a diameter less than 3 cm. (authors)

  12. Multimodal imaging of breast cancer metastasis targeting and antimetastatic nanotherapy

    NARCIS (Netherlands)

    Rizzo, Larissa; Rijcken, Cristianne|info:eu-repo/dai/nl/304833770; Pola, Robert; Storm, G|info:eu-repo/dai/nl/073356328; Ehling, Josef; Von Stillfried, Saskia; Kiessling, Fabian; Lammers, Twan|info:eu-repo/dai/nl/304824577

    INTRODUCTION: As opposed to the routine use of nanomedicines for drug targeting to solid tumors, the highest medical need refers to targeting and treating metastasis. Little is known regarding the accumulation of polymers, liposomes and micelles in metastases, and no systematic analyses have been

  13. Clinical significance of lymph node metastasis in gastric cancer

    Science.gov (United States)

    Deng, Jing-Yu; Liang, Han

    2014-01-01

    Gastric cancer, one of the most common malignancies in the world, frequently reveals lymph node, peritoneum, and liver metastases. Most of gastric cancer patients present with lymph node metastasis when they were initially diagnosed or underwent surgical resection, which results in poor prognosis. Both the depth of tumor invasion and lymph node involvement are considered as the most important prognostic predictors of gastric cancer. Although extended lymphadenectomy was not considered a survival benefit procedure and was reported to be associated with high mortality and morbidity in two randomized controlled European trials, it showed significant superiority in terms of lower locoregional recurrence and disease related deaths compared to limited lymphadenectomy in a 15-year follow-up study. Almost all clinical investigators have reached a consensus that the predictive efficiency of the number of metastatic lymph nodes is far better than the extent of lymph node metastasis for the prognosis of gastric cancer worldwide, but other nodal metastatic classifications of gastric cancer have been proposed as alternatives to the number of metastatic lymph nodes for improving the predictive efficiency for patient prognosis. It is still controversial over whether the ratio between metastatic and examined lymph nodes is superior to the number of metastatic lymph nodes in prognostic evaluation of gastric cancer. Besides, the negative lymph node count has been increasingly recognized to be an important factor significantly associated with prognosis of gastric cancer. PMID:24744586

  14. Metástasis cervical contralateral en el carcinoma epidermoide de la cavidad oral: Estudio clínico analítico retrospectivo en 315 pacientes primariamente tratados con cirugía Contralateral neck metastasis in squamous cell carcinoma of the oral cavity: An analytical retrospective clinical study of 315 patients primarily treated with surgery

    Directory of Open Access Journals (Sweden)

    R. González-García

    2008-06-01

    carcinoma epidermoide de lengua. El tiempo de supervivencia medio libre de enfermedad fue 147± 6 meses. Veintinueve (9,1% pacientes desarrollaron recurrencia cervical ipsilateral, mientras que 18 (5,69% mostraron recurrencia cervical contralateral. Para los pacientes con carcinoma epidermoide de lengua, y considerando los porcentajes en relación a los 203 pacientes con esta entidad, estas cifras fueron de 20 (9,8% y 9 (4,4%, respectivamente. El tiempo medio de aparición de las metástasis cervicales desde la cirugía fue de 12,52 meses (rango: 3-49, algo menor para el subgrupo de pacientes con carcinoma epidermoide de lengua (11,4 meses, rango: 3-27. Dieciocho de los 29 pacientes con recurrencia cervical ipsilateral murieron finalmente de la enfermedad. Siete de 18 pacientes con metástasis contralateral murieron igualmente de la enfermedad. En el subgrupo de pacientes con carcinoma epidermoide de lengua, estas cifras fueron: catorce de 20 pacientes con metástasis cervical ipsilateral y ocho de 9 pacientes con metástasis cervical contralateral. Varios factores clínicopatológicos mostraron asociación estadísticamente significativa (pObjectives. There are numerous studies in the literature on the prognostic factors involved in the appearance of ipsilateral neck metastasis in squamous cell carcinoma of the oral cavity. However, there are no extensive clinical studies on the association of clinicopathological factors and the appearance of contralateral neck metastasis after the surgical resection of the primary tumor. The object of this study is to analyze the factors implied in the appearance of contralateral neck metastasis in patients with squamous cell carcinoma of the oral cavity treated primarily with surgery. Patients and methods. A series of 315 consecutive patients with squamous cell carcinoma of the oral cavity, who had not been treated previously, were analyzed. A complementary study of a subgroup of 203 patients with squamous cell carcinoma of the lateral

  15. Cutaneous metastasis in anorectal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Krishnendra Varma

    2015-01-01

    Full Text Available Cutaneous metastasis in anorectal adenocarcinoma is a rare entity. Here, we report the case of a 40-year-old female who presented with yellowish-brown, irregular, solid, elevated rashes over the pubis with a recent history off palliative colostomy for anorectal adenocarcinoma. Clinically, we suspected metastasis that was proved on biopsy. We report this case due to the rare presenting site (i.e., perineum of a metastatic adenocarcinoma.

  16. Accidente cerebrovascular isquémico asociado con ablación por radiofrecuencia de reentrada nodal Ischemic stroke associated with radio frequency ablation for nodal reentry

    Directory of Open Access Journals (Sweden)

    Juan C Díaz Martínez

    2010-04-01

    Full Text Available La taquicardia por reentrada nodal es la causa más común de taquicardia supraventricular paroxística; en aquellos pacientes en quienes el manejo farmacológico no es efectivo o deseado la ablación por radiofrecuencia es un excelente método terapéutico dada su alta tasa de curación. Aunque en términos generales dichos procedimientos son rápidos y seguros, se han descrito varias complicaciones entre las que sobresale el accidente cerebrovascular isquémico. Se presenta el caso de una paciente de 41 años con episodios de taquicardia por reentrada nodal a repetición, que fue llevada a ablación por radiofrecuencia. En el post-operatorio inmediato se evidenció déficit neurológico focal con isquemia en el territorio de la arteria cerebral media derecha, tras lo cual se realizó angiografía con intento de angioplastia y abxicimab y posteriormente infusión local de activador de plasminógeno tisular (rtPA con adecuado resultado clínico y angiográfico.Atrioventricular nodal reentry tachycardia is the most common type of paroxismal supraventricular tachycardia. In those patients in whom drug therapy is not effective or not desired, radio frequency ablation is an excellent therapeutic method. Although overall these procedures are fast and safe, several complications among which ischemic stroke stands out, have been reported. We present the case of a 41 year old female patient with repetitive episodes of tachycardia due to nodal reentry who was treated with radiofrequency ablation. Immediately after the procedure she presented focal neurologic deficit consistent with ischemic stroke in the right medial cerebral artery territory. Angiography with angioplastia and abxicimab was performed and then tissue plasminogen activator (rtPA was locally infused, with appropriate clinical and angiographic outcome.

  17. Retrospective analysis of outcome differences in preoperative concurrent chemoradiation with or without elective nodal irradiation for esophageal squamous cell carcinoma.

    Science.gov (United States)

    Hsu, Feng-Ming; Lee, Jang-Ming; Huang, Pei-Ming; Lin, Chia-Chi; Hsu, Chih-Hung; Tsai, Yu-Chieh; Lee, Yung-Chie; Chia-Hsien Cheng, Jason

    2011-11-15

    To evaluate the efficacy and patterns of failure of elective nodal irradiation (ENI) in patients with esophageal squamous cell carcinoma (SCC) undergoing preoperative concurrent chemoradiation (CCRT) followed by radical surgery. We retrospectively studied 118 patients with AJCC Stage II to III esophageal SCC undergoing preoperative CCRT (median, 36 Gy), followed by radical esophagectomy. Of them, 73 patients (62%) had ENI and 45 patients (38%) had no ENI. Patients with ENI received radiotherapy to either supraclavicular (n = 54) or celiac (n = 19) lymphatics. Fifty-six patients (57%) received chemotherapy with paclitaxel plus cisplatin. The 3-year progression-free survival, overall survival, and patterns of failure were analyzed. Distant nodal recurrence was classified into M1a and M1b regions. A separate analysis using matched cases was conducted. The median follow-up was 38 months. There were no differences in pathological complete response rate (p = 0.12), perioperative mortality rate (p = 0.48), or delayed Grade 3 or greater cardiopulmonary toxicities (p = 0.44), between the groups. More patients in the non-ENI group had M1a failure than in the ENI group, with 3-year rates of 11% and 3%, respectively (p = 0.05). However, the 3-year isolated distant nodal (M1a + M1b) failure rates were not different (ENI, 10%; non-ENI, 14%; p = 0.29). In multivariate analysis, pathological nodal status was the only independent prognostic factor associated with overall survival (hazard ratio = 1.78, p = 0.045). The 3-year overall survival and progression-free survival were 45% and 45%, respectively, in the ENI group, and 52% and 43%, respectively, in the non-ENI group (p = 0.31 and 0.89, respectively). Matched cases analysis did not show a statistical difference in outcomes between the groups. ENI reduced the M1a failure rate but was not associated with improved outcomes in patients undergoing preoperative CCRT for esophageal SCC. Pathological nodal metastasis predicted poor

  18. Retrospective Analysis of Outcome Differences in Preoperative Concurrent Chemoradiation With or Without Elective Nodal Irradiation for Esophageal Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Feng-Ming [Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan (China); Lee, Jang-Ming; Huang, Pei-Ming [Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Lin, Chia-Chi; Hsu, Chih-Hung; Tsai, Yu-Chieh [Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Lee, Yung-Chie [Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Chia-Hsien Cheng, Jason, E-mail: jasoncheng@ntu.edu.tw [Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (China); Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan (China)

    2011-11-15

    SCC. Pathological nodal metastasis predicted poor outcome.

  19. A rare case of ileal metastasis from cervical cancer.

    Science.gov (United States)

    Iliescu, L; David, L; Orban, C; Herlea, V; Toma, L

    2014-01-01

    We present the case of a 70-year-old woman, with a history of radiation-treated and surgically- resected cervical cancer, who was admitted to our clinic for intermittent sub occlusive symptoms. CT scan revealed a liver nodule and intestinal obstruction. The patient underwent surgery for excision of suspected liver metastasis and resolution of intestinal obstruction.Intraoperatively an ileal tumour was found to be the cause of the obstruction. Anatomo-pathological findings were consistent with an ileal metastasis from the cervical cancer.The liver nodule was only an area of focal steatosis. Celsius.

  20. 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.

  1. Nodal methods for problems in fluid mechanics and neutron transport

    International Nuclear Information System (INIS)

    Azmy, Y.Y.

    1985-01-01

    A new high-accuracy, coarse-mesh, nodal integral approach is developed for the efficient numerical solution of linear partial differential equations. It is shown that various special cases of this general nodal integral approach correspond to several high efficiency nodal methods developed recently for the numerical solution of neutron diffusion and neutron transport problems. The new approach is extended to the nonlinear Navier-Stokes equations of fluid mechanics; its extension to these equations leads to a new computational method, the nodal integral method which is implemented for the numerical solution of these equations. Application to several test problems demonstrates the superior computational efficiency of this new method over previously developed methods. The solutions obtained for several driven cavity problems are compared with the available experimental data and are shown to be in very good agreement with experiment. Additional comparisons also show that the coarse-mesh, nodal integral method results agree very well with the results of definitive ultra-fine-mesh, finite-difference calculations for the driven cavity problem up to fairly high Reynolds numbers

  2. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    Science.gov (United States)

    Ellsworth, Rachel E.; Field, Lori A.; Love, Brad; Kane, Jennifer L.; Hooke, Jeffrey A.; Shriver, Craig D.

    2011-01-01

    Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative (n = 41) and positive (n = 35) lymph node status matched for possible confounding factors were subjected to laser microdissection and gene expression data generated. Although ANOVA analysis (P 1.5) revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis. PMID:22295210

  3. Thick tumor capsule is a valuable risk factor for distant metastasis in follicular thyroid carcinoma.

    Science.gov (United States)

    Shimbashi, Wataru; Sugitani, Iwao; Kawabata, Kazuyoshi; Mitani, Hiroki; Toda, Kazuhisa; Yamada, Keiko; Sato, Yukiko

    2018-02-01

    While the biological behavior of follicular thyroid carcinoma (FTC) has been studied in great detail using clinical experience, few studies have investigated pre- or intraoperative factors related to the risk of distant metastasis (DM) among patients with FTC. The aim of this study was to analyze the characteristics of FTC with DM. This study retrospectively investigated 102 patients with FTC who underwent surgery between 1988 and 2013. We compared clinicopathological characteristics between FTC with and without DM. Univariate analysis revealed nodal metastasis (p=0.045), serum thyroglobulin (Tg) at initial operation (≥1000ng/ml; pthick tumor capsule (≥1mm; pthick tumor capsule (≥1mm), serum Tg at initial operation (≥1000ng/ml), and macroscopically widely invasive appearance as risk factors independently associated with development of DM. Patients with these risk factors should undergo total thyroidectomy and radioactive iodine ablation. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    International Nuclear Information System (INIS)

    Ellsworth, R.E.; Field, L.A.; Kane, J.L.; Love, B.; Hooke, J.A.; Shriver, C.D.

    2011-01-01

    Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative (n=41) and positive (n=35) lymph node status matched for possible confounding factors were subjected to laser micro dissection and gene expression data generated. Although ANOVA analysis (P 1.5) revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis

  5. Differential Gene Expression in Primary Breast Tumors Associated with Lymph Node Metastasis

    Directory of Open Access Journals (Sweden)

    Rachel E. Ellsworth

    2011-01-01

    Full Text Available Lymph node status remains one of the most useful prognostic indicators in breast cancer; however, current methods to assess nodal status disrupt the lymphatic system and may lead to secondary complications. Identification of molecular signatures discriminating lymph node-positive from lymph node-negative primary tumors would allow for stratification of patients requiring surgical assesment of lymph nodes. Primary breast tumors from women with negative (=41 and positive (=35 lymph node status matched for possible confounding factors were subjected to laser microdissection and gene expression data generated. Although ANOVA analysis (1.5 revealed 13 differentially expressed genes, hierarchical clustering classified 90% of node-negative but only 66% of node-positive tumors correctly. The inability to derive molecular profiles of metastasis in primary tumors may reflect tumor heterogeneity, paucity of cells within the primary tumor with metastatic potential, influence of the microenvironment, or inherited host susceptibility to metastasis.

  6. Carcinoma of Gall bladder with distant metastasis to breast parenchyma. Report of a case and review of literature

    International Nuclear Information System (INIS)

    Kumaran, D.; Anamalai, M.; Velu, U.; Julka, P.K.; Nambirajan, A.

    2016-01-01

    Background: Gall bladder carcinoma is one of the most common cancers in India. Gall bladder cancer with metastasis to the breast is very rare. Herein we intend to report a case of carcinoma gall bladder with breast metastasis and a short review of the literature. Methods: This report describes an interesting and unusual case of gall bladder carcinoma presenting with breast metastasis. Case report: A 38-year lady presented with complaints of right abdominal pain. Bilateral breast examination showed 2 2 cm palpable lump in the upper outer quadrant of the left breast. Contrast-enhanced CT of the abdomen and pelvis showed circumferential thickening of gall bladder with the loss of fat plane with the adjacent liver parenchyma. Biopsy from the breast lump was reported as metastatic adenocarcinoma compatible with primary in the gall bladder. Whole body PET-CT showed gall bladder mass with abdominal and pelvic nodes with metastasis to liver, left breast, C7 vertebral body and left supra-clavicular node. She was diagnosed to have disseminated carcinoma gall bladder with liver, breast and supraclavicular nodal metastasis. She received palliative chemotherapy with gemcitabine and carboplatin and radiotherapy to C7 vertebra. After receiving 3 cycles of chemotherapy, chemotherapy was changed to the second line with single agent capecitabine. In spite of two lines of chemotherapy, she succumbed to disease progression and expired. Conclusion: There are limited examples of gall bladder adenocarcinoma with simultaneous metastasis to breast in the English literature. Our case showed an unusual dissemination of gall bladder cancer

  7. Analytic function expansion nodal method for nuclear reactor core design

    International Nuclear Information System (INIS)

    Noh, Hae Man

    1995-02-01

    In most advanced nodal methods the transverse integration is commonly used to reduce the multi-dimensional diffusion equation into equivalent one- dimensional diffusion equations when derving the nodal coupling equations. But the use of the transverse integration results in some limitations. The first limitation is that the transverse leakage term which appears in the transverse integration procedure must be appropriately approximated. The second limitation is that the one-dimensional flux shapes in each spatial direction resulted from the nodal calculation are not accurate enough to be directly used in reconstructing the pinwise flux distributions. Finally the transverse leakage defined for a non-rectangular node such as a hexagonal node or a triangular node is too complicated to be easily handled and may contain non-physical singular terms of step-function and delta-function types. In this thesis, the Analytic Function Expansion Nodal (AFEN) method and its two variations : the Polynomial Expansion Nodal (PEN) method and the hybrid of the AFEN and PEN methods, have been developed to overcome the limitations of the transverse integration procedure. All of the methods solve the multidimensional diffusion equation without the transverse integration. The AFEN method which we believe is the major contribution of this study to the reactor core analysis expands the homogeneous flux distributions within a node in non-separable analytic basis functions satisfying the neutron diffusion equations at any point of the node and expresses the coefficients of the flux expansion in terms of the nodal unknowns which comprise a node-average flux, node-interface fluxes, and corner-point fluxes. Then, the nodal coupling equations composed of the neutron balance equations, the interface current continuity equations, and the corner-point leakage balance equations are solved iteratively to determine all the nodal unknowns. Since the AFEN method does not use the transverse integration in

  8. Relapsing pattern of brain metastasis after brain irradiation in small cell lung cancer

    International Nuclear Information System (INIS)

    Murakami, Masao; Kuroda, Yasumasa; Okamoto, Yoshiaki; Kono, Koichi; Yoden, Eisaku; Mori, Takeki

    1997-01-01

    Many reports concerning radiation therapy for brain metastasis have been published, and which of the various methods urged by these reports provide optional control is still controversial. According to developing diagnosis of metastasis in CNS, therapeutic problems should be referred. We reviewed 67 patients with small cell lung cancer and brain metastasis who underwent brain irradiation (Ave. 47 Gy/5W), and all 15 patients with brain relapse after the irradiation. Relapsing patterns in this clinical setting were divided into local regrowth in the same lesions and re-metastasis (reseeding) in other regions, by reviewing follow up CT and MRI studies. Total survival among 15 patients with brain relapse and 52 without relapse was longer in the former cases than the later: 1-, and 2-year survival (47/19%, 13/8%) and MST (10.8/5.7 months), from the initial brain irradiation. The concerned significant factors limited in younger age, low value of LDH and improvement of NF. Of the 15 patients with brain relapse, 4 developed local regrowth and 11 did re-metastasis. The period of remission since brain irradiation were 172±94.4 and 393±281 days, respectively. Lower number of brain metastasis and lower value of LDH were shown in re-metastasis patients. At the time of brain relapse, 11 patients had recurrence of carcinomatous meningitis. 4 patients were treated with whole brain re-irradiation. All patients died of cancer, including 12 of relapsing CNS diseases and 3 of primary lesion and hepatic metastasis. Leukoencephalopathy developed in 2 patients. Survival since the brain relapse was 2 to 238 days without significant difference in cases of local regrowth and re-metastasis. According to our data on relapsing pattern of brain metastasis after conventional fractionated brain irradiation with an objective dose of 50 Gy, 75% of brain relapse were re-metastasis, we appreciate this irradiation for initial brain metastasis if limited to the brain. (author)

  9. Popliteal lymphadenectomy for treating metastatic melanoma: case report

    Directory of Open Access Journals (Sweden)

    Sergio Renato Pais Costa

    Full Text Available CONTEXT: Regional lymph node involvement in patients with malignant melanomas has been associated with poor prognosis. In-transit metastases also lead to poor long-term survival. Whereas for nodal disease only regional lymphadenectomy offers adequate locoregional control, for in-transit metastasis both local excision and isolated limb perfusion with chemotherapy plus tumor necrosis factor-alpha can be used for disease control. In cases of tumors located in the distal region of the legs, the lymphatic dissemination most commonly observed is to the inguinal chain. Consequently, therapeutic inguinal lymphadenectomy or even selective lymphadenectomy (sentinel lymph node biopsy have been recommended. On the other hand, involvement of the popliteal chain is very rare. When this occurs, popliteal lymphadenectomy should be indicated. Local excision may be the logical approach for a few small in-transit metastases because of the low morbidity in this procedure, when compared with isolated limb perfusion. CASE REPORT: A case of melanoma of the heel with popliteal chain involvement and in-transit metastases is presented. This was treated by means of regional lymphadenectomy plus in-transit metastases excision, with a good postoperative course.

  10. On the Nodal Lines of Eisenstein Series on Schottky Surfaces

    Science.gov (United States)

    Jakobson, Dmitry; Naud, Frédéric

    2017-04-01

    On convex co-compact hyperbolic surfaces {X=Γ backslash H2}, we investigate the behavior of nodal curves of real valued Eisenstein series {F_λ(z,ξ)}, where {λ} is the spectral parameter, {ξ} the direction at infinity. Eisenstein series are (non-{L^2}) eigenfunctions of the Laplacian {Δ_X} satisfying {Δ_X F_λ=(1/4+λ^2)F_λ}. As {λ} goes to infinity (the high energy limit), we show that, for generic {ξ}, the number of intersections of nodal lines with any compact segment of geodesic grows like {λ}, up to multiplicative constants. Applications to the number of nodal domains inside the convex core of the surface are then derived.

  11. A computational study of nodal-based tetrahedral element behavior.

    Energy Technology Data Exchange (ETDEWEB)

    Gullerud, Arne S.

    2010-09-01

    This report explores the behavior of nodal-based tetrahedral elements on six sample problems, and compares their solution to that of a corresponding hexahedral mesh. The problems demonstrate that while certain aspects of the solution field for the nodal-based tetrahedrons provide good quality results, the pressure field tends to be of poor quality. Results appear to be strongly affected by the connectivity of the tetrahedral elements. Simulations that rely on the pressure field, such as those which use material models that are dependent on the pressure (e.g. equation-of-state models), can generate erroneous results. Remeshing can also be strongly affected by these issues. The nodal-based test elements as they currently stand need to be used with caution to ensure that their numerical deficiencies do not adversely affect critical values of interest.

  12. A theoretical study on a convergence problem of nodal methods

    Energy Technology Data Exchange (ETDEWEB)

    Shaohong, Z.; Ziyong, L. [Shanghai Jiao Tong Univ., 1954 Hua Shan Road, Shanghai, 200030 (China); Chao, Y. A. [Westinghouse Electric Company, P. O. Box 355, Pittsburgh, PA 15230-0355 (United States)

    2006-07-01

    The effectiveness of modern nodal methods is largely due to its use of the information from the analytical flux solution inside a homogeneous node. As a result, the nodal coupling coefficients depend explicitly or implicitly on the evolving Eigen-value of a problem during its solution iteration process. This poses an inherently non-linear matrix Eigen-value iteration problem. This paper points out analytically that, whenever the half wave length of an evolving node interior analytic solution becomes smaller than the size of that node, this non-linear iteration problem can become inherently unstable and theoretically can always be non-convergent or converge to higher order harmonics. This phenomenon is confirmed, demonstrated and analyzed via the simplest 1-D problem solved by the simplest analytic nodal method, the Analytic Coarse Mesh Finite Difference (ACMFD, [1]) method. (authors)

  13. Analysis of metastasis of melanoma-bearing hamsters in thermal neutron capture therapy

    International Nuclear Information System (INIS)

    Ueda, Masataka; Mishima, Yutaka; Ichihashi, Masamitsu

    1985-01-01

    Melanoma-bearing hamsters were divided into three groups: the MG I was treated with both 10 B 1 -para-boronophenylalanine.HCl ( 10 B 1 -BPA) and neutron capture therapy (NCT); the MG II was treated with NCT alone; and the control group (MG III). The most satisfactory effect on regression was seen in the MG I. When the opposite site to the transplanted tumor site was exposed to thermal neutrons, no enhanced effect on metastasis was seen. Tumor cells of MG I and MG II were transplanted subcutaneously 24 hr after NCT into normal hamsters (MG It and MG IIt), and their growth and metastasis abilities were examined. MG It cells possessed neither growth nor metastasis ability; while MG IIt cells showed normal growth and metastasis abilities. Lethal effects on tumor cells seemed to occur in the MG I at 24 hr after NCT, suggesting no effects of NCT on the metastasis ability of tumor cells. Metastasis was seen in 2 of 8 animals in the MG III; however, inhibitory effects on tumor cells were the same as those in the other groups MG I and MG II. When the cells were exposed to 100 rad and 300 rad of gamma rays to assess effects of gamma rays during NCT, neither tumor growth nor lung metastasis was affected. When the tumor was excised with 5 mm margin, relapse occurred in a high incidence. There was no difference in lung metastasis between NCT and gamma irradiation. (Namekawa, K.)

  14. Super-nodal methods for space-time kinetics

    Science.gov (United States)

    Mertyurek, Ugur

    The purpose of this research has been to develop an advanced Super-Nodal method to reduce the run time of 3-D core neutronics models, such as in the NESTLE reactor core simulator and FORMOSA nuclear fuel management optimization codes. Computational performance of the neutronics model is increased by reducing the number of spatial nodes used in the core modeling. However, as the number of spatial nodes decreases, the error in the solution increases. The Super-Nodal method reduces the error associated with the use of coarse nodes in the analyses by providing a new set of cross sections and ADFs (Assembly Discontinuity Factors) for the new nodalization. These so called homogenization parameters are obtained by employing consistent collapsing technique. During this research a new type of singularity, namely "fundamental mode singularity", is addressed in the ANM (Analytical Nodal Method) solution. The "Coordinate Shifting" approach is developed as a method to address this singularity. Also, the "Buckling Shifting" approach is developed as an alternative and more accurate method to address the zero buckling singularity, which is a more common and well known singularity problem in the ANM solution. In the course of addressing the treatment of these singularities, an effort was made to provide better and more robust results from the Super-Nodal method by developing several new methods for determining the transverse leakage and collapsed diffusion coefficient, which generally are the two main approximations in the ANM methodology. Unfortunately, the proposed new transverse leakage and diffusion coefficient approximations failed to provide a consistent improvement to the current methodology. However, improvement in the Super-Nodal solution is achieved by updating the homogenization parameters at several time points during a transient. The update is achieved by employing a refinement technique similar to pin-power reconstruction. A simple error analysis based on the relative

  15. A comparison of Nodal methods in neutron diffusion calculations

    Energy Technology Data Exchange (ETDEWEB)

    Tavron, Barak [Israel Electric Company, Haifa (Israel) Nuclear Engineering Dept. Research and Development Div.

    1996-12-01

    The nuclear engineering department at IEC uses in the reactor analysis three neutron diffusion codes based on nodal methods. The codes, GNOMERl, ADMARC2 and NOXER3 solve the neutron diffusion equation to obtain flux and power distributions in the core. The resulting flux distributions are used for the furl cycle analysis and for fuel reload optimization. This work presents a comparison of the various nodal methods employed in the above codes. Nodal methods (also called Coarse-mesh methods) have been designed to solve problems that contain relatively coarse areas of homogeneous composition. In the nodal method parts of the equation that present the state in the homogeneous area are solved analytically while, according to various assumptions and continuity requirements, a general solution is sought out. Thus efficiency of the method for this kind of problems, is very high compared with the finite element and finite difference methods. On the other hand, using this method one can get only approximate information about the node vicinity (or coarse-mesh area, usually a feel assembly of a 20 cm size). These characteristics of the nodal method make it suitable for feel cycle analysis and reload optimization. This analysis requires many subsequent calculations of the flux and power distributions for the feel assemblies while there is no need for detailed distribution within the assembly. For obtaining detailed distribution within the assembly methods of power reconstruction may be applied. However homogenization of feel assembly properties, required for the nodal method, may cause difficulties when applied to fuel assemblies with many absorber rods, due to exciting strong neutron properties heterogeneity within the assembly. (author).

  16. Nodal spectrum method for solving neutron diffusion equation

    International Nuclear Information System (INIS)

    Sanchez, D.; Garcia, C. R.; Barros, R. C. de; Milian, D.E.

    1999-01-01

    Presented here is a new numerical nodal method for solving static multidimensional neutron diffusion equation in rectangular geometry. Our method is based on a spectral analysis of the nodal diffusion equations. These equations are obtained by integrating the diffusion equation in X, Y directions and then considering flat approximations for the current. These flat approximations are the only approximations that are considered in this method, as a result the numerical solutions are completely free from truncation errors. We show numerical results to illustrate the methods accuracy for coarse mesh calculations

  17. Oddness of least energy nodal solutions on radial domains

    Directory of Open Access Journals (Sweden)

    Christopher Grumiau

    2010-07-01

    Full Text Available In this article, we consider the Lane-Emden problem $$displaylines{ Delta u(x + |{u(x}mathclose|^{p-2}u(x=0, quad hbox{for } xinOmega,cr u(x=0, quad hbox{for } xinpartialOmega, }$$ where $2 < p < 2^{*}$ and $Omega$ is a ball or an annulus in $mathbb{R}^{N}$, $Ngeq 2$. We show that, for p close to 2, least energy nodal solutions are odd with respect to an hyperplane -- which is their nodal surface. The proof ingredients are a constrained implicit function theorem and the fact that the second eigenvalue is simple up to rotations.

  18. Development and validation of a nodal code for core calculation

    International Nuclear Information System (INIS)

    Nowakowski, Pedro Mariano

    2004-01-01

    The code RHENO solves the multigroup three-dimensional diffusion equation using a nodal method of polynomial expansion.A comparative study has been made between this code and present internationals nodal diffusion codes, resulting that the RHENO is up to date.The RHENO has been integrated to a calculation line and has been extend to make burnup calculations.Two methods for pin power reconstruction were developed: modulation and imbedded. The modulation method has been implemented in a program, while the implementation of the imbedded method will be concluded shortly.The validation carried out (that includes experimental data of a MPR) show very good results and calculation efficiency

  19. Nodal algorithm derived from a new variational principle

    International Nuclear Information System (INIS)

    Watson, Fernando V.

    1995-01-01

    As a by-product of the research being carried on by the author on methods of recovering pin power distribution of PWR cores, a nodal algorithm based on a modified variational principle for the two group diffusion equations has been obtained. The main feature of the new algorithm is the low dimensionality achieved by the reduction of the original diffusion equations to a system of algebraic Eigen equations involving the average sources only, instead of sources and interface group currents used in conventional nodal methods. The advantage of this procedure is discussed and results generated by the new algorithm and by a finite difference code are compared. (author). 2 refs, 7 tabs

  20. Nodal approximations in space and time for neutron kinetics

    International Nuclear Information System (INIS)

    Grossman, L.M.; Hennart, J.P.

    2005-01-01

    A general formalism is described of the nodal type in time and space for the neutron kinetics equations. In space, several nodal methods are given of the Raviart-Thomas type (RT0 and RT1), of the Brezzi-Douglas-Marini type (BDM0 and BDM1) and of the Brezzi-Douglas-Fortin-Marini type (BDFM 1). In time, polynomial and analytical approximations are derived. In the analytical case, they are based on the inclusion of an exponential term in the basis function. They can be continuous or discontinuous in time, leading in particular to the well-known Crank-Nicolson, Backward Euler and θ schemes

  1. Discontinuous nodal schemes applied to the bidimensional neutron transport equation

    International Nuclear Information System (INIS)

    Delfin L, A.; Valle G, E. Del; Hennart B, J.P.

    1996-01-01

    In this paper several strong discontinuous nodal schemes are described, starting from the one that has only two interpolation parameters per cell to the one having ten. Their application to the spatial discretization of the neutron transport equation in X-Y geometry is also described, giving, for each one of the nodal schemes, the approximation for the angular neutron flux that includes the set of interpolation parameters and the corresponding polynomial space. Numerical results were obtained for several test problems presenting here the problem with the highest degree of difficulty and their comparison with published results 1,2 . (Author)

  2. Microenvironment Determinants of Brain Metastasis

    Directory of Open Access Journals (Sweden)

    Zhang Chenyu

    2011-02-01

    Full Text Available Abstract Metastasis accounts for 90% of cancer-related mortality. Brain metastases generally present during the late stages in the natural history of cancer progression. Recent advances in cancer treatment and management have resulted in better control of systemic disease metastatic to organs other than the brain and improved patient survival. However, patients who experience recurrent disease manifest an increasing number of brain metastases, which are usually refractory to therapies. To meet the new challenges of controlling brain metastasis, the research community has been tackling the problem with novel experimental models and research tools, which have led to an improved understanding of brain metastasis. The time-tested "seed-and-soil" hypothesis of metastasis indicates that successful outgrowth of deadly metastatic tumors depends on permissible interactions between the metastatic cancer cells and the site-specific microenvironment in the host organs. Consistently, recent studies indicate that the brain, the major component of the central nervous system, has unique physiological features that can determine the outcome of metastatic tumor growth. The current review summarizes recent discoveries on these tumor-brain interactions, and the potential clinical implications these novel findings could have for the better treatment of patients with brain metastasis.

  3. Reactive Astrocytes in Brain Metastasis

    Directory of Open Access Journals (Sweden)

    David Wasilewski

    2017-12-01

    Full Text Available Brain metastasis, the secondary growth of malignant cells within the central nervous system (CNS, exceeds the incidence of primary brain tumors (i.e., gliomas by tenfold and are seemingly on the rise owing to the emergence of novel targeted therapies that are more effective in controlling extracranial disease relatively to intracranial lesions. Despite the fact that metastasis to the brain poses a unmet clinical problem, with afflicted patients carrying significant morbidity and a fatal prognosis, our knowledge as to how metastatic cells manage to adapt to the tissue environment of the CNS remains limited. Answering this question could pave the way for novel and more specific therapeutic modalities in brain metastasis by targeting the specific makeup of the brain metastatic niche. In regard to this, astrocytes have emerged as the major host cell type that cancer cells encounter and interact with during brain metastasis formation. Similarly to other CNS disorders, astrocytes become reactive and respond to the presence of cancer cells by changing their phenotype and significantly influencing the outcome of disseminated cancer cells within the CNS. Here, we summarize the current knowledge on the contribution of reactive astrocytes in brain metastasis by focusing on the signaling pathways and types of interactions that play a crucial part in the communication with cancer cells and how these could be translated into innovative therapies.

  4. Urethral metastasis from non-seminomatous germ cell tumor: a case report

    Directory of Open Access Journals (Sweden)

    Joffe Johnathan

    2011-01-01

    Full Text Available Abstract Introduction We present a case of nonseminomatous germ cell tumor of the testes with acute urinary retention secondary to urethral metastasis. This presentation, and similar cases of urethral metastasis from this tumor, have not been reported previously. Case presentation A 35-year-old Caucasian man presented to hospital with a history of acute urinary retention. On examination he was found to have right testicular enlargement with raised β-human chorionic gonadotrophin, serum α-fetoprotein and lactate dehydrogenase levels. He underwent radical left inguinal orchidectomy and histology confirmed a nonseminomatous germ cell tumor of the testes. Cystoscopy carried out due to urinary retention showed penile metastasis and the biopsy confirmed metastatic malignant undifferentiated teratoma. Staging computed tomography scan and magnetic resonance imaging of the pelvis showed pulmonary, pelvic nodal, ischial and penile metastasis. The diagnosis of the International Germ Cell Cancer Collaborative Group of poor prognosis metastatic nonseminomatous germ cell tumor was made, following which he received four cycles of bleomycin, etoposide and cisplatin chemotherapy with curative intent. He had a complete marker and an excellent radiological response. He is currently under follow up. Conclusion The unusual presentation of lymphovascular spread in this case of nonseminomatous germ cell tumor highlights the need to include routine pelvic imaging in the assessment and follow up of testicular cancer.

  5. Outcomes of surgically treated human papillomavirus-related oropharyngeal squamous cell carcinoma with N3 disease.

    Science.gov (United States)

    Zenga, Joseph; Haughey, Bruce H; Jackson, Ryan S; Adkins, Douglas R; Aranake-Chrisinger, John; Bhatt, Neel; Gay, Hiram A; Kallogjeri, Dorina; Martin, Eliot J; Moore, Eric J; Paniello, Randal C; Rich, Jason T; Thorstad, Wade L; Nussenbaum, Brian

    2017-09-01

    To evaluate outcomes for patients with pathological N3 (pN3) neck disease from human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and determine variables predictive of survival. Retrospective case series with chart review. This study was conducted between 1998 and 2013 and included patients with HPV-related OPSCC treated with surgery with or without adjuvant therapy and who had pN3 nodal disease. The primary outcome was disease-specific survival (DSS). Secondary outcomes included overall survival (OS), disease-free survival (DFS), adverse events, and gastrostomy tube rates. Thirty-nine patients were included, of whom 36 (90%) underwent adjuvant therapy. Median follow-up was 39 months (range, 2-147 months). Mean age was 56 years, and 87% were male. Seventeen patients (44%) underwent selective neck dissection, whereas six (15%) underwent radical (n = 2) or extended radical (n = 4) neck dissection. Ninety-two percent had extracapsular extension. Five-year Kaplan-Meier estimated DSS, OS, and DFS were 89% (95% confidence interval [CI]: 79%-99%), 87% (95% CI: 75%-99%), and 84% (95% CI: 72%-96%), respectively. The disease recurrence rate was 10% (5% regional, 5% distant metastasis). Patients with less than 5 pathologically positive lymph nodes (P = .041) had improved DFS. Patients with HPV-related OPSCC and pN3 nodal disease treated with surgery and adjuvant therapy have very favorable long-term survival and regional control. Patients with five or more pathologically positive lymph nodes may be at higher risk for recurrence. 4. Laryngoscope, 127:2033-2037, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  6. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Jara, Sebastian M; Carson, Kathryn A; Pai, Sara I; Agrawal, Nishant; Richmon, Jeremy D; Prescott, Jason D; Dackiw, Alan; Zeiger, Martha A; Bishop, Justin A; Tufano, Ralph P

    2013-12-01

    Several studies have reported that concurrent chronic lymphocytic thyroiditis (CLT) with papillary thyroid carcinoma (PTC) is associated with improved prognosis of the PTC, including decreased lymph node metastasis. We sought to assess the incidence of central nodal metastasis (CNM) in patients with PTC and concurrent CLT. We studied 495 consecutive patients who underwent thyroidectomy with nodal excision for PTC. Pathology reports identified the presence of CLT and the extent of CNM. There were 226 patients (46%) with CLT and 220 (44%) with CNM. Patients with CLT were more often female (88% vs. 71%; P CLT was associated with a 39% decreased odds of CNM after adjusting for age, gender, tumor size, PTC histopathologic subtype, and presence of lymphovascular invasion (odds ratio, 0.61; 95% confidence interval, 0.38-0.99; P = .046). Predicted probability modeling showed that all females with CLT and no suspicious nodal findings on ultrasonography had a 9-11% risk of CNM with pT1a tumors. Female patients of all ages with CLT and small PTCs have the least incidence of CNM. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Adenocarcinoma arising at a colostomy site with inguinal lymph node metastasis: report of a case.

    Science.gov (United States)

    Iwamoto, Masayoshi; Kawada, Kenji; Hida, Koya; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-02-01

    Inguinal lymph node metastasis from adenocarcinoma arising at a colostomy site is extremely rare, and the significance of surgical resection for metastatic inguinal lymph nodes has not been established. An 82-year-old woman who had undergone abdominoperineal resection 27 years earlier was admitted to our hospital complaining of bleeding from a colostomy. Physical examination revealed that a tumor at the colostomy site directly invaded into the peristomal skin, and that a left inguinal lymph node was firm and swollen. Positron emission tomography/computed tomography scan demonstrated accumulation of (18)F-fluorodeoxy glucose into both the colostomy tumor and the left swollen inguinal lymph node, while there was no evidence of metastasis to liver or lungs. She underwent open left hemicolectomy with wide local resection of the colostomy, and dissection of left inguinal lymph nodes. Histological diagnosis was a moderately differentiated adenocarcinoma that directly invaded into the surrounding skin and metastasized to the left inguinal lymph node. The patient has been followed up for >5 years without any sign of recurrence. In general, inguinal lymph node metastasis from colorectal cancers is regarded as a systemic disease with a poor prognosis, and so systemic chemotherapy and radiotherapy, but not surgical lymph node dissection, are recommended. Considering the lymphatic drainage route in the present case, inguinal lymph node metastasis does not represent a systemic disease but rather a sentinel nodal metastasis from adenocarcinoma at a colostomy site. Surgical dissection of metastatic inguinal lymph nodes should be considered to enable a favorable prognosis in the absence of distant metastasis to other organs. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Intracardiac metastasis originated from chondrosarcoma.

    Science.gov (United States)

    Maurea, Nicola; Ragone, Gianluca; Coppola, Carmela; Caronna, Antonietta; Tocchetti, Carlo G; Agozzino, Lucio; Apice, Gaetano; Iaffaioli, Rosario V

    2017-05-01

    Primary cardiac tumors are extremely rare. By comparison, metastatic involvement of the heart is over 20 times more common and has been reported in autopsy series in up to one in five patients dying of cancer. Cardiac metastasis of chondrosarcoma is absolutely not frequent. In the recent literature, a cardiac metastasis from chondrosarcoma has never been described. We report the case of an 18-year-old man with a diagnosis of cardiac metastasis that originated from a left scapular chondrosarcoma. Chondrosarcoma is a skeletal tumor with various grades of malignancy, rapidly evolving, and with a strong tendency to metastasize, with low responsiveness to chemotherapy. The onset of characteristic systemic symptoms in the late stage of the disease led to the diagnosis of a mass localized in the right atrium. Management and differential diagnosis of infective heart lesions were also very complex in a rapidly evolving life-threatening condition.

  9. Extension of the linear nodal method to large concrete building calculations

    International Nuclear Information System (INIS)

    Childs, R.L.; Rhoades, W.A.

    1985-01-01

    The implementation of the linear nodal method in the TORT code is described, and the results of a mesh refinement study to test the effectiveness of the linear nodal and weighted diamond difference methods available in TORT are presented

  10. Advances in Spectral Nodal Methods applied to SN Nuclear Reactor Global calculations in Cartesian Geometry

    International Nuclear Information System (INIS)

    Barros, R.C.; Filho, H.A.; Oliveira, F.B.S.; Silva, F.C. da

    2004-01-01

    Presented here are the advances in spectral nodal methods for discrete ordinates (SN) eigenvalue problems in Cartesian geometry. These coarse-mesh methods are based on three ingredients: (i) the use of the standard discretized spatial balance SN equations; (ii) the use of the non-standard spectral diamond (SD) auxiliary equations in the multiplying regions of the domain, e.g. fuel assemblies; and (iii) the use of the non-standard spectral Green's function (SGF) auxiliary equations in the non-multiplying regions of the domain, e.g., the reflector. In slab-geometry the hybrid SD-SGF method generates numerical results that are completely free of spatial truncation errors. In X,Y-geometry, we obtain a system of two 'slab-geometry' SN equations for the node-edge average angular fluxes by transverse-integrating the X,Y-geometry SN equations separately in the y- and then in the x-directions within an arbitrary node of the spatial grid set up on the domain. In this paper, we approximate the transverse leakage terms by constants. These are the only approximations considered in the SD-SGF-constant nodal method, as the source terms, that include scattering and eventually fission events, are treated exactly. Moreover, we describe in this paper the progress of the approximate SN albedo boundary conditions for substituting the non-multiplying regions around the nuclear reactor core. We show numerical results to typical model problems to illustrate the accuracy of spectral nodal methods for coarse-mesh SN criticality calculations. (Author)

  11. The Nodal Location of Metastases in Melanoma Sentinel Lymph Nodes

    DEFF Research Database (Denmark)

    Riber-Hansen, Rikke; Nyengaard, Jens; Hamilton-Dutoit, Stephen

    2009-01-01

    BACKGROUND: The design of melanoma sentinel lymph node (SLN) histologic protocols is based on the premise that most metastases are found in the central parts of the nodes, but the evidence for this belief has never been thoroughly tested. METHODS: The nodal location of melanoma metastases in 149...

  12. Real-time control of power systems using nodal prices

    NARCIS (Netherlands)

    Jokic, A.; Lazar, M.; Bosch, van den P.P.J.

    2009-01-01

    This article presents a novel control scheme for achieving optimal power balancing and congestion management in electrical power systems via nodal prices. We develop a dynamic controller that guarantees economically optimal steady-state operation while respecting all line flow constraints in

  13. Topological transport in Dirac nodal-line semimetals

    Science.gov (United States)

    Rui, W. B.; Zhao, Y. X.; Schnyder, Andreas P.

    2018-04-01

    Topological nodal-line semimetals are characterized by one-dimensional Dirac nodal rings that are protected by the combined symmetry of inversion P and time-reversal T . The stability of these Dirac rings is guaranteed by a quantized ±π Berry phase and their low-energy physics is described by a one-parameter family of (2+1)-dimensional quantum field theories exhibiting the parity anomaly. Here we study the Berry-phase supported topological transport of P T -invariant nodal-line semimetals. We find that small inversion breaking allows for an electric-field-induced anomalous transverse current, whose universal component originates from the parity anomaly. Due to this Hall-like current, carriers at opposite sides of the Dirac nodal ring flow to opposite surfaces when an electric field is applied. To detect the topological currents, we propose a dumbbell device, which uses surface states to filter charges based on their momenta. Suggestions for experiments and device applications are discussed.

  14. Note on the nodal line of the p-Laplacian

    Directory of Open Access Journals (Sweden)

    Abdel R. El Amrouss

    2006-09-01

    Full Text Available In this paper, we prove that the length of the nodal line of the eigenfunctions associated to the second eigenvalue of the problem $$ -Delta_p u = lambda ho (x |u|^{p-2}u quad hbox{in } Omega $$ with the Dirichlet conditions is not bounded uniformly with respect to the weight.

  15. A nodal method based on the response-matrix method

    International Nuclear Information System (INIS)

    Cunha Menezes Filho, A. da; Rocamora Junior, F.D.

    1983-02-01

    A nodal approach based on the Response-Matrix method is presented with the purpose of investigating the possibility of mixing two different allocations in the same problem. It is found that the use of allocation of albedo combined with allocation of direct reflection produces good results for homogeneous fast reactor configurations. (Author) [pt

  16. CRY 1AB trangenic cowpea obtained by nodal electroporation ...

    African Journals Online (AJOL)

    Electroporation-mediated genetic transformation was used to introduce Cry 1 Ab insecticidal gene into cowpea. Nodal buds were electroporated in planta with a plasmid carrying the Cry 1Ab and antibiotic resistance npt II genes driven by a 35S CaMV promoter. T1 seeds derived from electroporated branches were selected ...

  17. 47 CFR 101.503 - Digital Electronic Message Service Nodal Stations.

    Science.gov (United States)

    2010-10-01

    ... Service § 101.503 Digital Electronic Message Service Nodal Stations. 10.6 GHz DEMS Nodal Stations may be... 47 Telecommunication 5 2010-10-01 2010-10-01 false Digital Electronic Message Service Nodal Stations. 101.503 Section 101.503 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

  18. Cutaneous metastasis of bilateral renal cell carcinoma.

    Science.gov (United States)

    Abbasi, Fariba; Alizadeh, Mansur; Noroozinia, Farahnaz; Moradi, Amin

    2013-01-01

    Renal cell carcinoma (RCC) is a malignant lethal tumour with high potential of metastasis. However, metastasis from RCC to the skin is much less common. It is virtually a sign of poor prognosis. We represent a 42 years old man with bilateral RCC of clear cell type followed by metastasis to the scalp one month later. In this case the relatively young age of the patient, bilaterality of RCC and occurance of skin metastasis in the absence of recurrent kidney tumour are interesting.

  19. Survival benefit of adding docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy to concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma with nodal Stage N2-3.

    Science.gov (United States)

    Kawahira, Masahiro; Yokota, Tomoya; Hamauchi, Satoshi; Onozawa, Yusuke; Ogawa, Hirofumi; Onoe, Tsuyoshi; Kamijo, Tomoyuki; Iida, Yoshiyuki; Nishimura, Tetsuo; Onitsuka, Tetsuro; Yasui, Hirofumi

    2017-08-01

    Concurrent chemoradiotherapy followed by adjuvant chemotherapy (CCRT-AC) has been established as the standard of care in locally advanced nasopharyngeal carcinoma (LA-NPC). The survival benefit of induction chemotherapy (ICT) for LA-NPC remains controversial. We analyzed the efficacy and feasibility of docetaxel, cisplatin and 5-fluorouracil (TPF) ICT followed by CCRT for LA-NPC with nodal Stage N2-3. We performed a retrospective analysis of 28 LA-NPC patients with nodal Stage N2-3 receiving induction TPF followed by CCRT (TPF group; n = 12) or CCRT-AC (CCRT group; n = 16) between October 2006 and May 2016. The median follow-up periods were 36.4 (range 6.7-55.2) and 40.1 months (range 4.3-99.0) for the TPF and CCRT groups, respectively. One- and three-year overall survival for the TPF group vs. the CCRT group were 100% and 100% vs. 94% and 75%, respectively (P = 0.21). The cumulative one- and three-year incidences of locoregional recurrence or progression for the TPF group vs. the CCRT group were 10% and 21% vs. 16% and 32% (P = 0.49), and those of distant metastasis were 0% and 0% vs. 26% and 26%, respectively (P = 0.08). The common Grade 3-4 acute toxicities were neutropenia, anorexia, febrile neutropenia, and stomatitis in the TPF group. The Grade 3-4 late toxicities did not differ significantly between the two groups. This study suggests that induction TPF followed by CCRT might reduce distant metastasis, so this combination may be feasible for the treatment of LA-NPC with nodal Stage N2-3. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Metastasis genetics, epigenetics, and the tumor microenvironment

    Science.gov (United States)

    KISS1 is a member of a family of genes known as metastasis suppressors, defined by their ability to block metastasis without blocking primary tumor development and growth. KISS1 re-expression in multiple metastatic cell lines of diverse cellular origin suppresses metastasis; yet, still allows comple...

  1. Understanding patterns of invasion: a novel approach to assessment of podoplanin expression in the prediction of lymph node metastasis in oral squamous cell carcinoma.

    Science.gov (United States)

    Sharma, Ankita; Boaz, Karen; Natarajan, Srikant

    2018-03-01

    Cellular motility is considered to be central to the process of metastasis, and podoplanin expression can be explored as a prospective link, owing to its ability to modulate the actin cytoskeleton. We aimed to evaluate the tumoral expression of D2-40 (monoclonal antibody against podoplanin) in pathologically neck-node-negative/positive cases (pN0/N+) to characterise the pattern of invasion, potentially explaining the role of various patterns of invasion in causing tumour metastasis. Paraffin-embedded tissue blocks of 60 oral squamous cell carcinoma cases of known nodal status were selected for immunohistochemical staining of tumour (invasive front) by D2-40 along with routine staining by haematoxylin and eosin. Various staining patterns were assessed and evaluated for D2-40 expression, and correlated with nodal status. Tumoral D2-40 expression correspondingly increased with nodal metastasis (P = 0.261). Furthermore, D2-40 staining was more efficient in detecting individual tumour cells, and also characterised the motility factor irrespective of the pattern of invasion (P = 0.001). The pattern of D2-40 staining did not show a significant association with tumour grade, indicating that motility is an overlooked, albeit important, component of the pattern of invasion in routine histological grading. D2-40 expression successfully identifies the motility profile of tumour, irrespective of the pattern of invasion. The presence of larger motile islands in the tumour cohort supports the concept of 'collective cell migration'. Podoplanin also aids evasion of immune responses by inducing platelet aggregation over tumour cells, thereby favouring distant metastasis. A multivariate model using immunohistochemical staining with D2-40 provides greater sensitivity for the prediction of lymph node metastasis. © 2017 John Wiley & Sons Ltd.

  2. Association between US features of primary tumor and axillary lymph node metastasis in patients with clinical T1-T2N0 breast cancer.

    Science.gov (United States)

    Bae, Min Sun; Shin, Sung Ui; Song, Sung Eun; Ryu, Han Suk; Han, Wonshik; Moon, Woo Kyung

    2018-04-01

    Background Most patients with early-stage breast cancer have clinically negative lymph nodes (LNs). However, 15-20% of patients have axillary nodal metastasis based on the sentinel LN biopsy. Purpose To assess whether ultrasound (US) features of a primary tumor are associated with axillary LN metastasis in patients with clinical T1-T2N0 breast cancer. Material and Methods This retrospective study included 138 consecutive patients (median age = 51 years; age range = 27-78 years) who underwent breast surgery with axillary LN evaluation for clinically node-negative T1-T2 breast cancer. Three radiologists blinded to the axillary surgery results independently reviewed the US images. Tumor distance from the skin and distance from the nipple were determined based on the US report. Association between US features of a breast tumor and axillary LN metastasis was assessed using a multivariate logistic regression model after controlling for clinicopathologic variables. Results Of the 138 patients, 28 (20.3%) had nodal metastasis. At univariate analysis, tumor distance from the skin ( P = 0.019), tumor size on US ( P = 0.023), calcifications ( P = 0.036), architectural distortion ( P = 0.001), and lymphovascular invasion ( P = 0.049) were associated with axillary LN metastasis. At multivariate analysis, shorter skin-to-tumor distance (odds ratio [OR] = 4.15; 95% confidence interval [CI] = 1.01-16.19; P = 0.040) and masses with associated architectural distortion (OR = 3.80; 95% CI = 1.57-9.19; P = 0.003) were independent predictors of axillary LN metastasis. Conclusion US features of breast cancer can be promising factors associated with axillary LN metastasis in patients with clinically node-negative early-stage breast cancer.

  3. Gut metastasis from breast carcinoma.

    Science.gov (United States)

    Al-Qahtani, Mohammed S

    2007-10-01

    Breast cancer is the second most common malignancy in women. Common sites of metastases include the liver, lung, bone, and the brain. Metastases to the gastrointestinal tract are rare with patients presenting with small-bowel perforation, intestinal obstruction, and gastrointestinal bleeding. Here we report a case of a Saudi female presenting with invasive lobular carcinoma and ileo-cecal junction metastasis.

  4. Gut metastasis from breast carcinoma

    International Nuclear Information System (INIS)

    Al-Qahtani, Mohammad S.

    2007-01-01

    Breast cancer is the second most common malignancy in women. Common sites of metastases include the liver, lung, bone and the brain. Metastases to the gastrointestinal tract are with patients presenting with small-bowel perforation, intestinal obstruction and gastrointestinal bleeding. Here we report a case of Saudi female presenting with invasive lobular carcinoma and i leo-junction metastasis. (author)

  5. Pulmonary Metastasis from Pseudomyxoma Peritonei

    Directory of Open Access Journals (Sweden)

    Toshiyuki Kitai

    2012-01-01

    Full Text Available Pseudomyxoma peritonei (PMP is a rare clinical condition, where copious mucinous ascites accumulate in the peritoneal cavity due to dissemination of mucin-producing tumor. Because of this disseminating, yet nonmetastasizing, behavior, PMP attracts much interest from surgical oncologists in that aggressive locoregional therapy can give the opportunity of long survival and even cure. Although extra-abdominal metastasis is exceptionally rare, the lung is the most likely site in such a case. In this paper, the clinical findings and treatment of eleven cases with pulmonary metastasis from PMP were reviewed, including ten cases in the literature and one case which we experienced. The clinical features of PMP cases with pulmonary metastasis were similar to cases without pulmonary metastasis. The histological type was low-grade mucinous neoplasm in most cases. Pulmonary lesions were resected in seven cases in which abdominal lesions were controlled by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy or another therapeutic modality. Disease-free state was maintained in five cases at the end of the follow-up period. However, it should be noted that rapid progression after resection was seen in two cases, suggesting that biological features may have changed by surgical intervention.

  6. In vitro clonal propagation of Achyranthes aspera L. and Achyranthes bidentata Blume using nodal explants.

    Science.gov (United States)

    Gnanaraj, Wesely Edward; Antonisamy, Johnson Marimuthu; R B, Mohanamathi; Subramanian, Kavitha Marappampalyam

    2012-01-01

    To develop the reproducible in vitro propagation protocols for the medicinally important plants viz., Achyranthes aspera (A. aspera) L. and Achyranthes bidentata (A. bidentata) Blume using nodal segments as explants. Young shoots of A. aspera and A. bidentata were harvested and washed with running tap water and treated with 0.1% bavistin and rinsed twice with distilled water. Then the explants were surface sterilized with 0.1% (w/v) HgCl2 solutions for 1 min. After rinsing with sterile distilled water for 3-4 times, nodal segments were cut into smaller segments (1 cm) and used as the explants. The explants were placed horizontally as well as vertically on solid basal Murashige and Skoog (MS) medium supplemented with 3% sucrose, 0.6% (w/v) agar (Hi-Media, Mumbai) and different concentration and combination of 6-benzyl amino purine (BAP), kinetin (Kin), naphthalene acetic acid (NAA) and indole acetic acid (IAA) for direct regeneration. Adventitious proliferation was obtained from A. aspera and A. bidentata nodal segments inoculated on MS basal medium with 3% sucrose and augmented with BAP and Kin with varied frequency. MS medium augmented with 3.0 mg/L of BAP showed the highest percentage (93.60±0.71) of shootlets formation for A. aspera and (94.70±0.53) percentages for A. bidentata. Maximum number of shoots/explants (10.60±0.36) for A. aspera and (9.50±0.56) for A. bidentata was observed in MS medium fortified with 5.0 mg/L of BAP. For A. aspera, maximum mean length (5.50±0.34) of shootlets was obtained in MS medium augmented with 3.0 mg/L of Kin and for A. bidentata (5.40±0.61) was observed in the very same concentration. The highest percentage, maximum number of rootlets/shootlet and mean length of rootlets were observed in 1/2 MS medium supplemented with 1.0 mg/L of IBA. Seventy percentages of plants were successfully established in polycups. Sixty eight percentages of plants were well established in the green house condition. Sixty five percentages of

  7. A study of skeletal metastasis of carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Tanouchi, Miki; Sui, Osamu; Kashihara, Kenichi

    1990-01-01

    Between January 1980 and December 1988, 373 patients with carcinoma of the uterine cervix were treated at the Department of Radiology, Tokushima University Hospital. Of the 373 patients, 229 were treated by radiotherapy alone, and 144 were treated by post-operative radiotherapy. The incidence of skeletal metastasis was 6.4%, 24 patients out of 373. Ten of these patients were treated with radiotherapy alone, and 14 with radical surgery and radiotherapy. Nineteen patients belonged in the early clinical stage (stage Ia through stage IIb). Lesions of skeletal metastases were usually detected within 2 years after the initial treatment, and the most common site of skeletal metastasis was the pelvic bone, followed by the lumbar spine. Most patients with skeletal metastases were treated by radiotherapy, chemotherapy, and combined radio- and chemotherapy. Severe pain due to skeletal metastasis was relieved by radiotherapy and combined therapy, but no method of treatment could extend the prognosis. (author)

  8. Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T1-3N0 non-small-cell lung cancer: Is low incidence of regional failure due to incidental nodal irradiation?

    International Nuclear Information System (INIS)

    Chen Ming; Hayman, James A.; Haken, Randall K. ten; Tatro, Daniel; Fernando, Shaneli; Kong, F.-M.

    2006-01-01

    Purpose: To report the results of high-dose conformal irradiation and examine incidental nodal irradiation and nodal failure in patients with inoperable early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: This analysis included patients with inoperable CT-staged T1-3N0M0 NSCLC treated on our prospective dose-escalation trial. Patients were treated with radiation alone (total dose, 63-102.9 Gy in 2.1-Gy daily fractions) with a three-dimensional conformal technique without intentional nodal irradiation. Bilateral highest mediastinal and upper/lower paratracheal, prevascular and retrotracheal, sub- and para-aortic, subcarinal, paraesophageal, and ipsilateral hilar regions were delineated individually. Nodal failure and doses of incidental irradiation were studied. Results: The potential median follow-up was 104 months. For patients who completed protocol treatment, median survival was 31 months. The actuarial overall survival rate was 86%, 61%, 43%, and 21% and the cause-specific survival rate was 89%, 70%, 53%, and 35% at 1, 2, 3, and 5 years, respectively. Weight loss (p = 0.008) and radiation dose in Gy (p = 0.013) were significantly associated with overall survival. In only 22% and 13% of patients examined did ipsilateral hilar and paratracheal (and subaortic for left-sided tumor) nodal regions receive a dose of ≥40 Gy, respectively. Less than 10% of all other nodal regions received a dose of ≥40 Gy. No patients failed initially at nodal sites. Conclusions: Radiation dose is positively associated with overall survival in patients with medically inoperable T1-3N0 NSCLC, though long-term results remain poor. The nodal failure rate is low and does not seem to be due to high-dose incidental irradiation

  9. CT manifestation of peritoneal metastasis

    International Nuclear Information System (INIS)

    Cha, Soon Joo; Kang, Eun Young; Suh, Won Hyuck

    1989-01-01

    Peritoneal metastasis is frequent mode of dissemination of intraabdominal malignancies. Radiologic diagnosis of peritoneal metastasis has relied on indirect evidence on a barium UGI series and small bowel examination. With the advent of CT scanning, CT is capable of direct imaging of peritoneum. The sensitivity of CT in detecting peritoneal metastasis and CT manifestation of peritoneal metastatic lesions had reported occasionally, but rarely in Korea. So, authors illustrated the CT manifestation of peritoneal metastatic lesions in 32 cases of macroscopically proven cases in laparoscopy or laparotomy in Korea University Hae Wha Hospital during recent 4 years. The results are as follows. 1. Of total 32 cases, 18 cases were male and 14 cases were female. Age incidence was the most common in 6th decade. 2. The most common type of malignancy that cause peritoneal metastasis was the stomach cancer and next common type of malignancies were pancreas cancer in men and ovarian cancer in women. 3. Of total 32 cases of peritoneal metastasis which was confirmed by laparoscopy or laparotomy macroscopically, 23 cases (72%) were detected peritoneal thickening and/or omental pathology by CT, and the remaining 9 cases (28%) were not detected by CT. 4. Ascites was present in 19 cases (59%). 5. Parietal peritoneal thickening was present in 16 cases (50%) by CT and sheetlike pattern was the most common findings. The patterns of peritoneal thickening was relatively nonspecific and was not correlated with primary tumor type. 6. Tumor involvement of greater omentum by CT was present in 19 cases (59%). There were 7 cases of smudged appearance pattern, 6 cases of nodular pattern, 6 cases of omental cake pattern and no cystic mass pattern. The patterns of omental pathology was relatively nonspecific and was nor correlated with primary tumor type

  10. Blocking Breast Cancer Metastasis by Targeting RNA-Binding Protein HuR

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0730 TITLE: Blocking Breast Cancer Metastasis by Targeting RNA-Binding Protein HuR PRINCIPAL INVESTIGATOR: Danny Welch...NUMBER Blocking Breast Cancer Metastasis by Targeting RNA-Binding Protein HuR 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...increased aggressiveness in breast cancer , the primary objective of this proposal is to assess whether HuR (or analogs) prevent and/or treat metastasis and/or

  11. Rationale of chemotherapy for Nodal Disease

    International Nuclear Information System (INIS)

    Zwelling, L.A.; Silberman, L.; Estey, E.

    1987-01-01

    Defining biochemical differences between malignant and normal cells or between drug-sensitive and drug-resistant cells may lead to the discovery of pharmacologically exploitable pathways by which to treat human cancer. Systems in which active antineoplastic agents display different cytotoxic effects allow biochemical study of the basis for these differences. The interaction between topoisomerase II and active, anti-neoplastic DNA intercalating agents may be the way these active drugs kill cells. Details of the biochemical mechanisms and their effects on cellular events await precise description, but the principles learned in studies of this unique drug-protein-DNA interaction may be applicable to the treatment of locally advanced and diffusely disseminated human malignancies

  12. Implications of improved diagnostic imaging of small nodal metastases in head and neck cancer: Radiotherapy target volume transformation and dose de-escalation.

    Science.gov (United States)

    van den Bosch, Sven; Vogel, Wouter V; Raaijmakers, Cornelis P; Dijkema, Tim; Terhaard, Chris H J; Al-Mamgani, Abrahim; Kaanders, Johannes H A M

    2018-05-03

    Diagnostic imaging continues to evolve, and now has unprecedented accuracy for detecting small nodal metastasis. This influences the tumor load in elective target volumes and subsequently has consequences for the radiotherapy dose required to control disease in these volumes. Small metastases that used to remain subclinical and were included in elective volumes, will nowadays be detected and included in high-dose volumes. Consequentially, high-dose volumes will more often contain low-volume disease. These target volume transformations lead to changes in the tumor burden in elective and "gross" tumor volumes with implications for the radiotherapy dose prescribed to these volumes. For head and neck tumors, nodal staging has evolved from mere palpation to combinations of high-resolution imaging modalities. A traditional nodal gross tumor volume in the neck typically had a minimum diameter of 10-15 mm, while nowadays much smaller tumor deposits are detected in lymph nodes. However, the current dose levels for elective nodal irradiation were empirically determined in the 1950s, and have not changed since. In this report the radiobiological consequences of target volume transformation caused by modern imaging of the neck are evaluated, and theoretically derived reductions of dose in radiotherapy for head and neck cancer are proposed. The concept of target volume transformation and subsequent strategies for dose adaptation applies to many other tumor types as well. Awareness of this concept may result in new strategies for target definition and selection of dose levels with the aim to provide optimal tumor control with less toxicity. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Correlation of elvated tumor markers and hepatic and nodal metastases on CT in postgastrectomy patients for gastric cancer

    International Nuclear Information System (INIS)

    Lee, Hwa Jin; Park, Won Kyu; Seong, Ki Ho; Cho, Hyun Chul; Chang, Jae Chun; Park, Bok Hwan; Song, Sun Kyo

    1997-01-01

    The evaluation of tumor recurrence or metastasis in postgastrectomy cancer patients usually depends on a serum tumor marker test or radiologic study, but in both cases, accuracy is difficult to determine. The purpose of this study was to evaluate the relationship between abdominal CT and serum tumor markers. In 337cases involving 226 patients who had undergone curative surgery for gastric cancer, we compared serum tumor markers and CT for the evaluation of metastasis. Amoong these 337 cases, CEA level was measured in 317, CA 19-9 level in 166,and both of these in 146. The cutoff level for serum carcinoembryonic antigen (CEA) and CA19-9 were 10ng/ml and 33U/ml, respectively. CEA level was elevated in 59 of 317 cases(18.6%) and that of CA 19-9 in 58 of 166(34.9%). Slightly higher overall senstivity and specificity was observed for CEA than for CA19-9 (72.9% vs 67.2%, 83.3% vs 70.4%, respectively). Among the total of 337 cases, liver or lymph node metastases were detected in 91 cases (27.0%) on CT. Negative predictive value was significantly higher in CEA than in CA19-9 (93.1% vs 80%, respectively)(p<0.01), but positive predictive value was lower (50% vs 54.9%, respectively). On CT scan, there was a significant relationship between serum tumor marker level and hepatic and nodal metastasis ; specificity and positivity of serum tumor markers were both higher than senstivity and negativity. Follow-up CT less useful when tumor markers levels are not elevated, but when these are elevated in postgastrectomy cancer patients, meticulous radiologic evaluation is necessary for the early detection of residual or recurrent tumors

  14. Pain relief by Cyberknife radiosurgery for spinal metastasis.

    Science.gov (United States)

    Lee, Sunyoung; Chun, Mison

    2012-01-01

    To report pain relief effect in patients with spinal metastases treated with Cyberknife® and to analyze the factors associated with pain relapse after initial pain relief. We retrospectively analyzed patients with spinal metastasis treated with stereotactic body radiosurgery between April 2007 and June 2009. A total of 57 patients with 73 lesions were available for analysis with a median follow-up of 6.8 months (range, 1-30). Pain was assessed by a verbal/visual analogue scale at each visit: from 0 to 10. Pain relief was defined as a decrease of at least three levels of the pain score without an increase in analgesic use. Complete relief was defined as no analgesics or a score 0 or 1. Pain relief was achieved in 88% of the lesions, with complete relief in 51% within 7 days from the start of radiosurgery. The median duration of pain relief was 3.2 months (range, 1-30). Pain reappeared in 16 patients (27%). Spinal cord compression (P = 0.001) and performance status (P = 0.01) were predictive of pain relapse by multivariate Cox analysis. All 6 patients treated with solitary spinal metastasis experienced pain relief; 5 of them were alive without evidence of disease at a median of 16 months (range, 7-30). As previous studies have shown, our study confirms that pain relief with spinal radiosurgery is around 90%. In particular, long-term pain relief and disease control was observed in patients with solitary spinal metastasis.

  15. New procedure for criticality search using coarse mesh nodal methods

    International Nuclear Information System (INIS)

    Pereira, Wanderson F.; Silva, Fernando C. da; Martinez, Aquilino S.

    2011-01-01

    The coarse mesh nodal methods have as their primary goal to calculate the neutron flux inside the reactor core. Many computer systems use a specific form of calculation, which is called nodal method. In classical computing systems that use the criticality search is made after the complete convergence of the iterative process of calculating the neutron flux. In this paper, we proposed a new method for the calculation of criticality, condition which will be over very iterative process of calculating the neutron flux. Thus, the processing time for calculating the neutron flux was reduced by half compared with the procedure developed by the Nuclear Engineering Program of COPPE/UFRJ (PEN/COPPE/UFRJ). (author)

  16. New procedure for criticality search using coarse mesh nodal methods

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Wanderson F.; Silva, Fernando C. da; Martinez, Aquilino S., E-mail: wneto@con.ufrj.b, E-mail: fernando@con.ufrj.b, E-mail: Aquilino@lmp.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear

    2011-07-01

    The coarse mesh nodal methods have as their primary goal to calculate the neutron flux inside the reactor core. Many computer systems use a specific form of calculation, which is called nodal method. In classical computing systems that use the criticality search is made after the complete convergence of the iterative process of calculating the neutron flux. In this paper, we proposed a new method for the calculation of criticality, condition which will be over very iterative process of calculating the neutron flux. Thus, the processing time for calculating the neutron flux was reduced by half compared with the procedure developed by the Nuclear Engineering Program of COPPE/UFRJ (PEN/COPPE/UFRJ). (author)

  17. Radiological signs of extra nodal abdominal involvements in lymphoma

    International Nuclear Information System (INIS)

    Carro, A.I.; Alegre, N.; Cervera, J.L.; Montero, A.I.

    1998-01-01

    To assess abdominal CT images in lymphoma patients for the study of extra nodal abdominal involvement. Ninety-two patients diagnosed as having lymphoma were studied retrospectively. All the patients underwent abdominopelvic CT with oral and intravenous contrast (except in one patient who was allergic). In every case, the diagnosis was confirmed by biopsy or radiological follow-up after treatment had been completed. Fifty-two patients (56.5%) presented infiltration of extra nodal organs. The organs most frequently involved were liver and spleen, followed by the gastrointestinal tract, the musculoskeletal system and the genitourinary tract. The findings in this study coincide with those reported elsewhere with the exception of the splenic involvement the incidence of which was lower in the present series. (Author) 17 refs

  18. On the nodal structure of atomic and molecular Wigner functions

    International Nuclear Information System (INIS)

    Dahl, J.P.; Schmider, H.

    1996-01-01

    In previous work on the phase-space representation of quantum mechanics, we have presented detailed pictures of the electronic one-particle reduced Wigner function for atoms and small molecules. In this communication, we focus upon the nodal structure of the function. On the basis of the simplest systems, we present an expression which relates the oscillatory decay of the Wigner function solely to the dot product of the position and momentum vector, if both arguments are large. We then demonstrate the regular behavior of nodal patterns for the larger systems. For the molecular systems, an argument analogous to the open-quotes bond-oscillatory principleclose quotes for momentum densities links the nuclear framework to an additional oscillatory term in momenta parallel to bonds. It is shown that these are visible in the Wigner function in terms of characteristic nodes

  19. An alternative solver for the nodal expansion method equations - 106

    International Nuclear Information System (INIS)

    Carvalho da Silva, F.; Carlos Marques Alvim, A.; Senra Martinez, A.

    2010-01-01

    An automated procedure for nuclear reactor core design is accomplished by using a quick and accurate 3D nodal code, aiming at solving the diffusion equation, which describes the spatial neutron distribution in the reactor. This paper deals with an alternative solver for nodal expansion method (NEM), with only two inner iterations (mesh sweeps) per outer iteration, thus having the potential to reduce the time required to calculate the power distribution in nuclear reactors, but with accuracy similar to the ones found in conventional NEM. The proposed solver was implemented into a computational system which, besides solving the diffusion equation, also solves the burnup equations governing the gradual changes in material compositions of the core due to fuel depletion. Results confirm the effectiveness of the method for practical purposes. (authors)

  20. Topological and trivial magnetic oscillations in nodal loop semimetals

    Science.gov (United States)

    Oroszlány, László; Dóra, Balázs; Cserti, József; Cortijo, Alberto

    2018-05-01

    Nodal loop semimetals are close descendants of Weyl semimetals and possess a topologically dressed band structure. We argue by combining the conventional theory of magnetic oscillation with topological arguments that nodal loop semimetals host coexisting topological and trivial magnetic oscillations. These originate from mapping the topological properties of the extremal Fermi surface cross sections onto the physics of two dimensional semi-Dirac systems, stemming from merging two massless Dirac cones. By tuning the chemical potential and the direction of magnetic field, a sharp transition is identified from purely trivial oscillations, arising from the Landau levels of a normal two dimensional (2D) electron gas, to a phase where oscillations of topological and trivial origin coexist, originating from 2D massless Dirac and semi-Dirac points, respectively. These could in principle be directly identified in current experiments.

  1. RELAP 4/MOD 6 boiling water nodalization study

    International Nuclear Information System (INIS)

    Sonneck, G.; Pfau, H.

    1985-09-01

    The risk of nuclear steam supply systems is dominated by the core melt accidents. The first step to a realistic assessment of these sequences is the successful prediction of a loss of coolant event in a test loop. One of the codes for that is RELAP 4/MOD 6 and one of the important options in this code is the nodalization. The base of this work is the test LOCA No. 1 FIX II in Studsvik (Sweden) which also served as the OECD International Standard Problem 15. This report discusses the influence of different nodalizations, of different distributions of pressure, water and structural heat as well as of different bubble rise options, break flow coefficients, and heat transfer time steps. The most important result is that a simple RELAP 4/MOD6 model with less than 10 volumes is able to predict an experiment as LOCA No. 1 in FIX II successfully using only a fraction of the usual computing time. (Author)

  2. A nodal model for the simulation of a PWR core

    International Nuclear Information System (INIS)

    Souza Pinto, R. de.

    1981-06-01

    A computer program FORTRAN language was developed to simulate the neutronic and thermal-hydraulic transient behaviour of a PWR reactor core. The reator power is calculated using a point kinectics model with six groups of delayed neutron precursors. The fission product decay heat was considered assuming three effective decay heat groups. A nodal model was employed for the treatment of heat transfer in the fuel rod, with integration of the heat equation by the lumped parameter technique. Axial conduction was neglected. A single-channel nodal model was developed for the thermo-hydrodynamic simulation using mass and energy conservation equations for the control volumes. The effect of the axial pressure variation was neglected. The computer program was tested, with good results, through the simulation of the transient behaviour of postulated accidents in a typical PWR. (Author) [pt

  3. Hybrid microscopic depletion model in nodal code DYN3D

    International Nuclear Information System (INIS)

    Bilodid, Y.; Kotlyar, D.; Shwageraus, E.; Fridman, E.; Kliem, S.

    2016-01-01

    Highlights: • A new hybrid method of accounting for spectral history effects is proposed. • Local concentrations of over 1000 nuclides are calculated using micro depletion. • The new method is implemented in nodal code DYN3D and verified. - Abstract: The paper presents a general hybrid method that combines the micro-depletion technique with correction of micro- and macro-diffusion parameters to account for the spectral history effects. The fuel in a core is subjected to time- and space-dependent operational conditions (e.g. coolant density), which cannot be predicted in advance. However, lattice codes assume some average conditions to generate cross sections (XS) for nodal diffusion codes such as DYN3D. Deviation of local operational history from average conditions leads to accumulation of errors in XS, which is referred as spectral history effects. Various methods to account for the spectral history effects, such as spectral index, burnup-averaged operational parameters and micro-depletion, were implemented in some nodal codes. Recently, an alternative method, which characterizes fuel depletion state by burnup and 239 Pu concentration (denoted as Pu-correction) was proposed, implemented in nodal code DYN3D and verified for a wide range of history effects. The method is computationally efficient, however, it has applicability limitations. The current study seeks to improve the accuracy and applicability range of Pu-correction method. The proposed hybrid method combines the micro-depletion method with a XS characterization technique similar to the Pu-correction method. The method was implemented in DYN3D and verified on multiple test cases. The results obtained with DYN3D were compared to those obtained with Monte Carlo code Serpent, which was also used to generate the XS. The observed differences are within the statistical uncertainties.

  4. SPANDOM - source projection analytic nodal discrete ordinates method

    International Nuclear Information System (INIS)

    Kim, Tae Hyeong; Cho, Nam Zin

    1994-01-01

    We describe a new discrete ordinates nodal method for the two-dimensional transport equation. We solve the discrete ordinates equation analytically after the source term is projected and represented in polynomials. The method is applied to two fast reactor benchmark problems and compared with the TWOHEX code. The results indicate that the present method accurately predicts not only multiplication factor but also flux distribution

  5. HEXAN - a hexagonal nodal code for solving the diffusion equation

    International Nuclear Information System (INIS)

    Makai, M.

    1982-07-01

    This report describes the theory of and provides a user's manual for the HEXAN program, which is a nodal program for the solution of the few-group diffusion equation in hexagonal geometry. Based upon symmetry considerations, the theory provides an analytical solution in a homogeneous node. WWER and HTGR test problem solutions are presented. The equivalence of the finite-difference scheme and the response matrix method is proven. The properties of a symmetric node's response matrix are investigated. (author)

  6. Pericytes limit tumor cell metastasis

    DEFF Research Database (Denmark)

    Xian, Xiaojie; Håkansson, Joakim; Ståhlberg, Anders

    2006-01-01

    Previously we observed that neural cell adhesion molecule (NCAM) deficiency in beta tumor cells facilitates metastasis into distant organs and local lymph nodes. Here, we show that NCAM-deficient beta cell tumors grew leaky blood vessels with perturbed pericyte-endothelial cell-cell interactions...... the microvessel wall. To directly address whether pericyte dysfunction increases the metastatic potential of solid tumors, we studied beta cell tumorigenesis in primary pericyte-deficient Pdgfb(ret/ret) mice. This resulted in beta tumor cell metastases in distant organs and local lymph nodes, demonstrating a role...... and deficient perivascular deposition of ECM components. Conversely, tumor cell expression of NCAM in a fibrosarcoma model (T241) improved pericyte recruitment and increased perivascular deposition of ECM molecules. Together, these findings suggest that NCAM may limit tumor cell metastasis by stabilizing...

  7. Applications of a systematic homogenization theory for nodal diffusion methods

    International Nuclear Information System (INIS)

    Zhang, Hong-bin; Dorning, J.J.

    1992-01-01

    The authors recently have developed a self-consistent and systematic lattice cell and fuel bundle homogenization theory based on a multiple spatial scales asymptotic expansion of the transport equation in the ratio of the mean free path to the reactor characteristics dimension for use with nodal diffusion methods. The mathematical development leads naturally to self-consistent analytical expressions for homogenized diffusion coefficients and cross sections and flux discontinuity factors to be used in nodal diffusion calculations. The expressions for the homogenized nuclear parameters that follow from the systematic homogenization theory (SHT) are different from those for the traditional flux and volume-weighted (FVW) parameters. The calculations summarized here show that the systematic homogenization theory developed recently for nodal diffusion methods yields accurate values for k eff and assembly powers even when compared with the results of a fine mesh transport calculation. Thus, it provides a practical alternative to equivalence theory and GET (Ref. 3) and to simplified equivalence theory, which requires auxiliary fine-mesh calculations for assemblies embedded in a typical environment to determine the discontinuity factors and the equivalent diffusion coefficient for a homogenized assembly

  8. Flow-based market coupling. Stepping stone towards nodal pricing?

    International Nuclear Information System (INIS)

    Van der Welle, A.J.

    2012-07-01

    For achieving one internal energy market for electricity by 2014, market coupling is deployed to integrate national markets into regional markets and ultimately one European electricity market. The extent to which markets can be coupled depends on the available transmission capacities between countries. Since interconnections are congested from time to time, congestion management methods are deployed to divide the scarce available transmission capacities over market participants. For further optimization of the use of available transmission capacities while maintaining current security of supply levels, flow-based market coupling (FBMC) will be implemented in the CWE region by 2013. Although this is an important step forward, important hurdles for efficient congestion management remain. Hence, flow based market coupling is compared to nodal pricing, which is often considered as the most optimal solution from theoretical perspective. In the context of decarbonised power systems it is concluded that advantages of nodal pricing are likely to exceed its disadvantages, warranting further development of FBMC in the direction of nodal pricing.

  9. Patterns of practice of regional nodal irradiation in breast cancer: results of the European Organization for Research and Treatment of Cancer (EORTC) NOdal Radiotherapy (NORA) survey

    NARCIS (Netherlands)

    Belkacemi, Y.; Kaidar-Person, O.; Poortmans, P.; Ozsahin, M.; Valli, M.-C.; Russell, N.; Kunkler, I.; Hermans, J.; Kuten, A.; van Tienhoven, G.; Westenberg, H.

    2015-01-01

    Predicting outcome of breast cancer (BC) patients based on sentinel lymph node (SLN) status without axillary lymph node dissection (ALND) is an area of uncertainty. It influences the decision-making for regional nodal irradiation (RNI). The aim of the NORA (NOdal RAdiotherapy) survey was to examine

  10. Clinical outcome for patients of solitary bone only metastasis.

    Science.gov (United States)

    Hosaka, Seiichi; Katagiri, Hirohisa; Honda, Yosuke; Wasa, Junji; Murata, Hideki; Takahashi, Mitsuru

    2016-03-01

    Solitary bone only metastasis (SBOM) is a rare condition in which metastasis is limited to a single skeletal lesion originating from a previously treated or controllable primary lesion. The study objective was to evaluate the clinical features and survival regarding this rare condition and to clarify its treatment strategy. A total of 1453 patients with bone metastasis registered in our hospital database were enrolled. To assess the primary and/or metastatic lesion we used plain X-ray images, CT, MRI and FDG-PET scans as well as bone scans. Among the patients, only 27 (1.8%) had SBOM. The primary cancers responsible for SBOM were lung in seven patients, breast in five, kidney in four, prostate in two, uterus in two and other types in seven. Treatment of SBOM involved resection in four patients, radiotherapy only in 17, radiotherapy in combination with zoledronate in six and chemotherapy with zoledronate in one. Local recurrence did not develop in the four cases treated with resection. However, in-field recurrence was found in 4 of 22 (18%) patients who underwent radiotherapy. All three patients who received >40 Gy did not develop in-field recurrence. The overall and event free survival rates at 5 years were 63% and 41%, respectively. Solitary bone only metastasis should be treated with wide resection or long-course radiotherapy at doses 40-50 Gy to achieve long lasting local tumor control. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  11. Comparison of four staging systems of lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Zhang, Ming; Zhu, Guanyu; Ma, Yan; Xue, Yingwei

    2009-11-01

    The classification of lymph node metastasis in patients with gastric cancer is still controversial. Our aim was to evaluate the relative merits of four staging systems of lymph node metastasis. In our study, the nodal status was classified according to the 5th edition of the tumor node metastasis (TNM) system, the Japanese Classification of Gastric Carcinoma (JCGC), the ratio of metastatic lymph nodes, and the size of the largest metastatic lymph node. Each staging system was scored as good (+2), fair (+1), or poor (0) with respect to the theoretical value (extent of the anatomical lymphatic tumor spread), convenience (simplicity), surgical applicability (extent of lymph node dissection), and prognostic value (ability to predict survival rate). In the multivariate analysis including the four staging systems and other potential prognostic factors, stepwise Cox regression revealed that the ratio of metastatic lymph nodes was the most independent prognostic factor. The TNM, ratio, and size systems were convenient because they had no consideration for the location of the tumor and lymph node. Although the JCGC system had advantages in theoretical value and surgical application, it was most optional due to the complexity of the system. Although all different staging systems are comparable, the metastatic lymph node ratio system is convenient, reproducible, and has the highest ability to predict survival.

  12. Investigation of the roles of exosomes in colorectal cancer liver metastasis.

    Science.gov (United States)

    Wang, Xia; Ding, Xiaoling; Nan, Lijuan; Wang, Yiting; Wang, Jing; Yan, Zhiqiang; Zhang, Wei; Sun, Jihong; Zhu, Wei; Ni, Bing; Dong, Suzhen; Yu, Lei

    2015-05-01

    The leading cause of death among cancer patients is tumor metastasis. Tumor-derived exosomes are emerging as mediators of metastasis. In the present study, we demonstrated that exosomes play a pivotal role in the metastatic progression of colorectal cancer. First, a nude mouse model of colorectal cancer liver metastasis was established and characterized. Then, we demonstrated that exosomes from a highly liver metastatic colorectal cancer cell line (HT-29) could significantly increase the metastatic tumor burden and distribution in the mouse liver of Caco-2 colorectal cancer cells, which ordinarily exhibit poor liver metastatic potential. We further investigated the mechanisms by which HT-29-derived-exosomes influence the liver metastasis of colorectal cancer and found that mice treated with HT-29-derived exosomes had a relatively higher level of CXCR4 in the metastatic microenvironment, indicating that exosomes may promote colorectal cancer metastasis by recruiting CXCR4-expressing stromal cells to develop a permissive metastatic microenvironment. Finally, the migration of Caco-2 cells was significantly increased following treatment with HT-29-derived exosomes in vitro, further supporting a role for exosomes in modulating colorectal tumor-derived liver metastasis. The data from the present study may facilitate further translational medicine research into the prevention and treatment of colorectal cancer liver metastasis.

  13. Brain metastasis from male breast cancer treated 12 years ago ...

    African Journals Online (AJOL)

    A month ago, the patient had headache and vomiting complicated by the sudden onset of left hemiplegia. The brain MRI showed a huge right temporal process with a shift of the ... The development of brain metastases has been associated with young age, ... and immunohistochemistry different profiles regardless of gender.

  14. [A case of transverse colon cancer without a recurrence lesion after five years from resection of hepatic metastasis].

    Science.gov (United States)

    Ami, Katsunori; Nakamura, Masahiro; Takasaki, Jun; Watayou, Yoshihisa; Amagasa, Hidetoshi; Ganno, Hideaki; Kurokawa, Toshiaki; Fukuda, Akira; Nagahama, Takeshi; Ando, Masayuki; Tei, Shikofumi; Okada, Youichi; Arai, Kuniyoshi

    2011-11-01

    The treatment of hepatic metastasis of colon cancer was in progress by new biochemical agents. Generally, a resection was the first alternative treatment against hepatic metastasis of colon cancer, but new antitumor agents were more effective than conventional antitumor agents. Disappearance of metastasis for colon cancer treated with only antitumor agents was commenced to report. We were experienced a case of transverse colon cancer without a recurrence lesion after five years from the resection of hepatic metastasis. A case was a 77-year-old man. He was operated against transverse colon cancer in February 2003. Pathological stage was ss, n0, Stage II. In April 2004, serum CEA was increased. CT examination was not detected a hepatic metastasis but ultrasound examination and MRI detected the metastasis at S7 lesion in the liver. In July 2004, he was admitted to S-1 and PSK until October 2004. In December 2004, the lesion of hepatic metastasis was reduced and serum CEA was decreased. But in September 2005, the metastatic lesion was re-grown. A resection for hepatic metastasis was executed in November 2005. After the resection for hepatic metastasis, he was admitted to UFT/ UZEL from January 2006 to October 2006. Present time( June 2011), the lesion of recurrence was not detected by several examinations (CT, MRI, Ultrasound etc).

  15. Development and external validation of nomograms to predict the risk of skeletal metastasis at the time of diagnosis and skeletal metastasis-free survival in nasopharyngeal carcinoma.

    Science.gov (United States)

    Yang, Lin; Xia, Liangping; Wang, Yan; He, Shasha; Chen, Haiyang; Liang, Shaobo; Peng, Peijian; Hong, Shaodong; Chen, Yong

    2017-09-06

    The skeletal system is the most common site of distant metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal metastasis at initial diagnosis (SMAD) and skeletal metastasis-free survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 2496 patients without skeletal metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P system (P skeletal metastasis, which may improve counseling and facilitate individualized management of patients with NPC.

  16. Oral gingival metastasis: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Nalini Aswath

    2017-01-01

    Full Text Available Oral cavity is a rare target for metastasis with an incidence of 1% among all oral cancers. In 24% of such cases, oral metastasis is the first indication of an undiagnosed primary. Metastatic oral malignancies have been reported in the mandible, tongue, and gingiva. Although gingival metastasis has been reported from lung, prostate, rectal carcinoma in men and carcinoma of breast, adrenal glands, and genitalia in females, gingival metastasis from carcinoma of the penis has not been reported. Herein, a case of metastatic gingival carcinoma that developed after extraction of teeth from primary carcinoma of the penis is presented. An extensive literature search revealed no such similar case reports.

  17. CT diagnosis of peritoneal metastasis tumor

    International Nuclear Information System (INIS)

    Deng Xueying; Chen Xiaoqi; Qi Le; Huang Feng

    2005-01-01

    Objective: To study the CT findings and diagnosis of peritoneal metastasis. Methods: The CT findings of 17 cases with surgical- pathologically proved peritoneal metastasis were analyzed retrospectively. Results The CT findings of peritoneal metastasis included: (1)ascites (12 cases ); (2)the aternation of parietal peritoneum including broad band thickening (7 cases), nodular sign (2 cases), and massive thickening (1 cases); (3) the involved omentum and mesenterium: 'smut' appearances (7 cases), nodular sign (2 cases), 'omental cake' (5 cases); (4) the invlovement of mesenteric vessels; (5) single-or multi-cystic lesions within peritoneum (1 case) . Conclusion: CT scan is the first choice for metastasis of peritoneum. (authors)

  18. Apropos of a case of cutaneous metastasis from laryngeal cancer with review of literature

    Directory of Open Access Journals (Sweden)

    Romeeta Trehan

    2015-01-01

    Full Text Available Cutaneous metastasis from laryngeal carcinoma is a rare occurrence. A 55-year-old male patient with supraglottic cancer was treated with concurrent chemoradiation. Eighteen months later, he presented with ulceroproliferative growth on dorsum of the right hand. Biopsy revealed metastatic squamous cell carcinoma. Further investigations revealed underlying bone destruction with lung metastasis. In view of poor general condition and widespread dissemination of disease, palliative radiotherapy was delivered to the hand of the patient. He achieved satisfactory palliation in form of pain relief, control of bleeding, and discharge. The present report serves to emphasize the importance of properly diagnosing metastatic spread to unusual sites. Such metastasis is rare and is associated with a poor prognosis. Treatment is usually aimed at providing pain relief in these patients with limited life expectancy. Hence, we present a case of extensive cutaneous metastasis from laryngeal carcinoma with review of the literature.

  19. Radiotherapy studies and extra-nodal non-Hodgkin lymphomas, progress and challenges

    DEFF Research Database (Denmark)

    Specht, L

    2012-01-01

    Extra-nodal lymphomas may arise in any organ, and different histological subtypes occur in distinct patterns. Prognosis and treatment depend not only on the histological subtype and disease extent, but also on the particular involved extra-nodal organ. The clinical course and response to treatment...... for the more common extra-nodal organs, e.g. stomach, Waldeyer's ring, skin and brain, are fairly well known and show significant variation. A few randomised trials have been carried out testing the role of radiotherapy in these lymphomas. However, for most extra-nodal lymphomas, randomised trials have...... not been carried out, and treatment decisions are made on small patient series and extrapolations from nodal lymphomas. Hopefully, wide international collaboration will make controlled clinical trials possible in the less common extra-nodal lymphomas. Modern highly conformal radiotherapy allows better...

  20. Solution and study of nodal neutron transport equation applying the LTSN-DiagExp method

    International Nuclear Information System (INIS)

    Hauser, Eliete Biasotto; Pazos, Ruben Panta; Vilhena, Marco Tullio de; Barros, Ricardo Carvalho de

    2003-01-01

    In this paper we report advances about the three-dimensional nodal discrete-ordinates approximations of neutron transport equation for Cartesian geometry. We use the combined collocation method of the angular variables and nodal approach for the spatial variables. By nodal approach we mean the iterated transverse integration of the S N equations. This procedure leads to the set of one-dimensional averages angular fluxes in each spatial variable. The resulting system of equations is solved with the LTS N method, first applying the Laplace transform to the set of the nodal S N equations and then obtained the solution by symbolic computation. We include the LTS N method by diagonalization to solve the nodal neutron transport equation and then we outline the convergence of these nodal-LTS N approximations with the help of a norm associated to the quadrature formula used to approximate the integral term of the neutron transport equation. (author)

  1. Five-point form of the nodal diffusion method and comparison with finite-difference

    International Nuclear Information System (INIS)

    Azmy, Y.Y.

    1988-01-01

    Nodal Methods have been derived, implemented and numerically tested for several problems in physics and engineering. In the field of nuclear engineering, many nodal formalisms have been used for the neutron diffusion equation, all yielding results which were far more computationally efficient than conventional Finite Difference (FD) and Finite Element (FE) methods. However, not much effort has been devoted to theoretically comparing nodal and FD methods in order to explain the very high accuracy of the former. In this summary we outline the derivation of a simple five-point form for the lowest order nodal method and compare it to the traditional five-point, edge-centered FD scheme. The effect of the observed differences on the accuracy of the respective methods is established by considering a simple test problem. It must be emphasized that the nodal five-point scheme derived here is mathematically equivalent to previously derived lowest order nodal methods. 7 refs., 1 tab

  2. A Nodal-independent and tissue-intrinsic mechanism controls heart-looping chirality

    Science.gov (United States)

    Noël, Emily S.; Verhoeven, Manon; Lagendijk, Anne Karine; Tessadori, Federico; Smith, Kelly; Choorapoikayil, Suma; den Hertog, Jeroen; Bakkers, Jeroen

    2013-11-01

    Breaking left-right symmetry in bilateria is a major event during embryo development that is required for asymmetric organ position, directional organ looping and lateralized organ function in the adult. Asymmetric expression of Nodal-related genes is hypothesized to be the driving force behind regulation of organ laterality. Here we identify a Nodal-independent mechanism that drives asymmetric heart looping in zebrafish embryos. In a unique mutant defective for the Nodal-related southpaw gene, preferential dextral looping in the heart is maintained, whereas gut and brain asymmetries are randomized. As genetic and pharmacological inhibition of Nodal signalling does not abolish heart asymmetry, a yet undiscovered mechanism controls heart chirality. This mechanism is tissue intrinsic, as explanted hearts maintain ex vivo retain chiral looping behaviour and require actin polymerization and myosin II activity. We find that Nodal signalling regulates actin gene expression, supporting a model in which Nodal signalling amplifies this tissue-intrinsic mechanism of heart looping.

  3. Elsevier Trophoblast Research Award lecture: The multifaceted role of Nodal signaling during mammalian reproduction.

    Science.gov (United States)

    Park, C B; Dufort, D

    2011-03-01

    Nodal, a secreted signaling protein in the transforming growth factor-beta (TGF-β) superfamily, has established roles in vertebrate development. However, components of the Nodal signaling pathway are also expressed at the maternal-fetal interface and have been implicated in many processes of mammalian reproduction. Emerging evidence indicates that Nodal and its extracellular inhibitor Lefty are expressed in the uterus and complex interactions between the two proteins mediate menstruation, decidualization and embryo implantation. Furthermore, several studies have shown that Nodal from both fetal and maternal sources may regulate trophoblast cell fate and facilitate placentation as both embryonic and uterine-specific Nodal knockout mouse strains exhibit disrupted placenta morphology. Here we review the established and prospective roles of Nodal signaling in facilitating successful pregnancy, including recent evidence supporting a potential link to parturition and preterm birth. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. PEGylated liposome IHL-305 markedly improved the survival of ovarian cancer peritoneal metastasis in mouse

    International Nuclear Information System (INIS)

    Konishi, Hiroaki; Takagi, Akimitsu; Kurita, Akinobu; Kaneda, Norimasa; Matsuzaki, Takeshi

    2012-01-01

    Advanced ovarian cancer is characterized by peritoneal metastasis and the accumulation of ascites. Peritoneal metastasis of ovarian cancer is a major cause of the negative treatment outcome, as these metastases are resistant to most chemotherapy regimens. The aim of this study was to clarify aggressive pathology of peritoneal metastasis and examine the therapeutic efficacy of a liposomal agent in the model. A human cancer cell line ES-2 of ovarian clear cell carcinoma, known as a chemotherapy-resistant cancer, was cultured in nonadherent plate to form spheroid and single cell suspension was transplanted into mouse peritoneal cavity. The epidermal growth factor receptor (EGFR) pathways in the cellular aggregates were analyzed both spheroid and ascites. The pharmacokinetics and therapeutic efficacy of CPT-11 (45 mg/kg) and IHL-305 (45 mg/kg), an irinotecan-encapsulated liposome, were examined by intravenous administration. Established peritoneal metastasis model showed an accumulation of ascites. The activation of EGFR and Akt was demonstrated in cellular aggregates both in the spheroid and ascites. In ascites samples, the area under the curve of SN-38, the activated form of CPT-11, was 3.8 times higher from IHL-305-treated mice than from CPT-11-treated mice. IHL-305 prolonged the survival time and decreased the accumulation of ascites and tumor metastasis. The median survival time were 22, 37 and 54 days in the control, CPT-11-treated, and IHL-305-treated mice, respectively. EGFR/Akt pathway contributes to the aggressive progression in ES-2 peritoneal metastasis model and effective delivery into ascites of IHL-305 was thought to useful treatment for ovarian cancer with peritoneal metastasis

  5. Treatment of metastasis localizations by intratumoral injection of radionuclide microsphere

    International Nuclear Information System (INIS)

    Tuo Peiyu; Pang Yan; Zhu Dianqing; Chang Keli; Zhu Yanjia

    2001-01-01

    Objective: To evaluate the therapeutic effects of radionuclide-labeled microsphere by intratumoral injection into 18 patients with superficial metastasis tumor for treatment. Methods: 18 patients with superficial metastasis were treated with radionuclide-labeled microsphere ( 90 Y-GTMS and 32 P-GTMS) by multi-point intratumoral injection. Each injection dose was 11.1-18.5 MBq/g (tumor). Results: 1 patient was relieved completely, 9 were relieved partly, 5 were improved and 3 kept stable. The total rate of relief and virtual value were 55.6% and 83.3% respectively. Conclusion: Topical treatment by using radionuclide may help diminish the tumor, control its progress and ease the symptoms. Thus it can be used as a supplement of routine treatment of tumors and it should do some work in therapy of malignant tumors in late stages

  6. Adjuvant chemotherapy versus chemoradiotherapy for small cell lung cancer with lymph node metastasis: a retrospective observational study with use of a national database in Japan

    OpenAIRE

    Urushiyama, Hirokazu; Jo, Taisuke; Yasunaga, Hideo; Yamauchi, Yasuhiro; Matsui, Hiroki; Hasegawa, Wakae; Takeshima, Hideyuki; Hiraishi, Yoshihisa; Mitani, Akihisa; Fushimi, Kiyohide; Nagase, Takahide

    2017-01-01

    Background The optimal postoperative treatment strategy for small cell lung cancer (SCLC) remains unclear, especially in patients with lymph node metastasis. We aimed to compare the outcomes of patients with SCLC and lymph node metastasis treated with postoperative adjuvant chemotherapy or chemoradiotherapy. Methods We retrospectively collected data on patients with postoperative SCLC diagnosed with N1 and N2 lymph node metastasis from the Diagnosis Procedure Combination database in Japan, be...

  7. Pulmonary metastasis in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.; Rajashekharrao, B.; Shah, D.H.

    1999-01-01

    Although thyroid cancer (TC) in its differentiated form is generally associated with a good prognosis and a near normal life expectancy, a subset of patients especially with distant metastatic disease may run an aggressive course leading to poor survival and early death. The clinical presentation and the manner in which the disease progresses differs with the site and type of the metastatic disease. The behaviour and course of skeletal metastasis has been described elsewhere. The biological behaviour and treatment of pulmonary metastatic disease is focussed on

  8. Pancreatic Metastasis from Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Julian Jacob

    2010-01-01

    Full Text Available The pancreas is an unusual location for metastases from other primary cancers. Rarely, pancreatic metastases from kidney or colorectal cancers have been reported. However, a variety of other cancers may also spread to the pancreas. We report an exceptional case of pancreatic metastasis from prostate cancer. Differences in management between primary and secondary pancreatic tumors make recognition of metastases to the pancreas an objective of first importance. Knowledge of unusual locations for metastatic spread will reduce diagnostic delay and lead to a timely delivery of an appropriate treatment.

  9. Dissecting and Targeting Latent Metastasis

    Science.gov (United States)

    2014-09-01

    Option in Brain Metastasis Manuel Valiente,1 Anna C. Obenauf,1 Xin Jin,1 Qing Chen,1 Xiang H.-F. Zhang,1,8 Derek J. Lee,1 Jamie E. Chaft,2 Mark G. Kris,2...of poor response to tamoxifen therapy in recurrent breast cancer. J. Natl. Cancer Inst. 87, 751–756. Francia, G., Cruz -Munoz, W., Man, S., Xu, P... Manuel Valiente1, Xin Jin1†, Ekrem Emrah Er1, Ruzeen Patwa1, Ke Xu3 and Joan Massagué1 1 Cancer Biology and Genetics Program, 2 Department of

  10. Endocannabinoids as Guardians of Metastasis

    Directory of Open Access Journals (Sweden)

    Irmgard Tegeder

    2016-02-01

    Full Text Available Endocannabinoids including anandamide and 2-arachidonoylglycerol are involved in cancer pathophysiology in several ways, including tumor growth and progression, peritumoral inflammation, nausea and cancer pain. Recently we showed that the endocannabinoid profiles are deranged during cancer to an extent that this manifests in alterations of plasma endocannabinoids in cancer patients, which was mimicked by similar changes in rodent models of local and metastatic cancer. The present topical review summarizes the complexity of endocannabinoid signaling in the context of tumor growth and metastasis.

  11. The clinical value of 99mTc-MIBI imaging for axillary lymph node metastasis of breast cancer

    International Nuclear Information System (INIS)

    Song Bangkun; Yang Jisheng; Shen Dawei; Zuo Lei; Jiang Ling; Zhou Ya

    2001-01-01

    Objective: To observe the clinical value of 99m Tc-MIBI imaging for axillary lymph node metastasis of breast cancer. Methods: 56 patients with breast cancer proven by pathology were imaged with 99m Tc-MIBI. Images were taken at 5, 30, 60 minutes. The axillary area of affected side was included in imaging field. Results: The primary foci in 55 cases were positive and one case was negative in uptake. Of the 56 cases, 35 had histologically proven axillary lymph node metastases. MIBI uptake was seen in 30 cases and negative in 5 cases. The sensitivity was 85.7% (30/35 cases). In 21 cases who had no metastasis, 3 cases showed false positive uptake and 18 cases were true negative, making the specificity 85.7%. In the case who had negative imaging for primary focus, which was non-palpable, had an enlarged axillary lymphatic node. Positive MIBI uptake of the node area was seen in this case. Conclusion: 99m Tc-MIBI imaging is valuable for the diagnosis of axillary nodal metastasis of breast cancer. Even though there is no palpable primary focus, if there is an enlarged axillary lymphatic node and positive MIBI uptake, metastasis should be considered

  12. Metastasis

    Science.gov (United States)

    ... and Care Surgical Treatment Laparoscopic Surgery Vaccine Radiation Therapy Chemotherapy Clinical Trials Pain Management Nutrition and Exercise Holistic Care Pathology Intraductal Papillary Mucinous Neoplasms Islet Cell ...

  13. Nodal wear model: corrosion in carbon blast furnace hearths

    International Nuclear Information System (INIS)

    Verdeja, L. F.; Gonzalez, R.; Alfonso, A.; Barbes, M. F.

    2003-01-01

    Criteria developed for the Nodal Wear Model (NWM) were applied to estimate the shape of the corrosion profiles that a blast furnace hearth may acquire during its campaign. Taking into account design of the hearth, the boundary conditions, the characteristics of the refractory materials used and the operation conditions of the blast furnace, simulation of wear profiles with central well, mushroom and elephant foot shape were accomplished. The foundations of the NWM are constructed considering that the corrosion of the refractory is a function of the temperature present at each point (node) of the liquid metal-refractory interface and the corresponding physical and chemical characteristics of the corrosive fluid. (Author) 31 refs

  14. Mechanism of polyuria and natriuresis in atrioventricular nodal tachycardia.

    Science.gov (United States)

    Canepa-Anson, R; Williams, M; Marshall, J; Mitsuoka, T; Lightman, S; Sutton, R

    1984-01-01

    A woman with tachycardia associated with polyuria was investigated. Electrophysiological analysis showed that the tachycardia was an atrioventricular nodal re-entrant tachycardia. Programmed stimulation was then used to provoke and sustain the tachycardia for 40 minutes. Polyuria, with an appreciable increase in free water clearance, was observed. This was associated with reduction in plasma and urinary arginine vasopressin concentrations. Appreciable natriuresis also developed. These results support the hypothesis that the polyuria with increased free water clearance and the natriuresis occurring during sustained tachycardia in man are due to inhibition of secretion of vasopressin and the release of natriuretic factor. PMID:6434116

  15. Approximate Schur complement preconditioning of the lowest order nodal discretizations

    Energy Technology Data Exchange (ETDEWEB)

    Moulton, J.D.; Ascher, U.M. [Univ. of British Columbia, Vancouver, British Columbia (Canada); Morel, J.E. [Los Alamos National Lab., NM (United States)

    1996-12-31

    Particular classes of nodal methods and mixed hybrid finite element methods lead to equivalent, robust and accurate discretizations of 2nd order elliptic PDEs. However, widespread popularity of these discretizations has been hindered by the awkward linear systems which result. The present work exploits this awkwardness, which provides a natural partitioning of the linear system, by defining two optimal preconditioners based on approximate Schur complements. Central to the optimal performance of these preconditioners is their sparsity structure which is compatible with Dendy`s black box multigrid code.

  16. Evaluation of the use of nodal methods for MTR neutronic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Reitsma, F.; Mueller, E.Z.

    1997-08-01

    Although modern nodal methods are used extensively in the nuclear power industry, their use for research reactor analysis has been very limited. The suitability of nodal methods for material testing reactor analysis is investigated with the emphasis on the modelling of the core region (fuel assemblies). The nodal approach`s performance is compared with that of the traditional finite-difference fine mesh approach. The advantages of using nodal methods coupled with integrated cross section generation systems are highlighted, especially with respect to data preparation, simplicity of use and the possibility of performing a great variety of reactor calculations subject to strict time limitations such as are required for the RERTR program.

  17. Nodal line optimization and its application to violin top plate design

    Science.gov (United States)

    Yu, Yonggyun; Jang, In Gwun; Kim, In Kyum; Kwak, Byung Man

    2010-10-01

    In the literature, most problems of structural vibration have been formulated to adjust a specific natural frequency: for example, to maximize the first natural frequency. In musical instruments like a violin; however, mode shapes are equally important because they are related to sound quality in the way that natural frequencies are related to the octave. The shapes of nodal lines, which represent the natural mode shapes, are generally known to have a unique feature for good violins. Among the few studies on mode shape optimization, one typical study addresses the optimization of nodal point location for reducing vibration in a one-dimensional beam structure. However, nodal line optimization, which is required in violin plate design, has not yet been considered. In this paper, the central idea of controlling the shape of the nodal lines is proposed and then applied to violin top plate design. Finite element model for a violin top plate was constructed using shell elements. Then, optimization was performed to minimize the square sum of the displacement of selected nodes located along the target nodal lines by varying the thicknesses of the top plate. We conducted nodal line optimization for the second and the fifth modes together at the same time, and the results showed that the nodal lines obtained match well with the target nodal lines. The information on plate thickness distribution from nodal line optimization would be valuable for tailored trimming of a violin top plate for the given performances.

  18. Time-dependent patterning of the mesoderm and endoderm by Nodal signals in zebrafish

    Directory of Open Access Journals (Sweden)

    Dougan Scott T

    2007-03-01

    Full Text Available Abstract Background The vertebrate body plan is generated during gastrulation with the formation of the three germ layers. Members of the Nodal-related subclass of the TGF-β superfamily induce and pattern the mesoderm and endoderm in all vertebrates. In zebrafish, two nodal-related genes, called squint and cyclops, are required in a dosage-dependent manner for the formation of all derivatives of the mesoderm and endoderm. These genes are expressed dynamically during the blastula stages and may have different roles at different times. This question has been difficult to address because conditions that alter the timing of nodal-related gene expression also change Nodal levels. We utilized a pharmacological approach to conditionally inactivate the ALK 4, 5 and 7 receptors during the blastula stages without disturbing earlier signaling activity. This permitted us to directly examine when Nodal signals specify cell types independently of dosage effects. Results We show that two drugs, SB-431542 and SB-505124, completely block the response to Nodal signals when added to embryos after the mid-blastula transition. By blocking Nodal receptor activity at later stages, we demonstrate that Nodal signaling is required from the mid-to-late blastula period to specify sequentially, the somites, notochord, blood, Kupffer's vesicle, hatching gland, heart, and endoderm. Blocking Nodal signaling at late times prevents specification of cell types derived from the embryo margin, but not those from more animal regions. This suggests a linkage between cell fate and length of exposure to Nodal signals. Confirming this, cells exposed to a uniform Nodal dose adopt progressively more marginal fates with increasing lengths of exposure. Finally, cell fate specification is delayed in squint mutants and accelerated when Nodal levels are elevated. Conclusion We conclude that (1 Nodal signals are most active during the mid-to-late blastula stages, when nodal-related gene

  19. Adjuvant radiotherapy after salvage lymph node dissection because of nodal relapse of prostate cancer versus salvage lymph node dissection only

    International Nuclear Information System (INIS)

    Rischke, Hans Christian; Schultze-Seemann, Wolfgang; Kroenig, Malte; Schlager, Daniel; Jilg, Cordula Annette; Wieser, Gesche; Drendel, Vanessa; Stegmaier, Petra; Henne, Karl; Volegova-Neher, Natalia; Grosu, Anca-Ligia; Krauss, Tobias; Kirste, Simon

    2015-01-01

    Nodal pelvic/retroperitoneal recurrent prostate cancer (PCa) after primary therapy can be treated with salvage lymph node dissection (salvage-LND) in order to delay disease progression and offer cure for a subset of patients. Whether adjuvant radiotherapy (ART) in affected regions improves the outcome by elimination of residual tumour burden remains unclear. A total of 93 patients with exclusively nodal PCa relapse underwent choline-positron-emission tomography-computed-tomography-directed pelvic/retroperitoneal salvage-LND; 46 patients had surgery only and 47 patients received ART in regions with proven lymph node metastases. In case of subsequent prostate specific antigen (PSA) progression, different imaging modalities were performed to confirm next relapse within or outside the treated region (TR). Mean follow-up was 3.2 years. Lymphatic tumour burden was balanced between the two groups. Additional ART resulted in delayed relapse within TR (5-year relapse-free rate 70.7 %) versus surgery only (5-year relapse-free rate 26.3 %, p < 0.0001). In both treatment arms, time to next relapse outside the TR was almost equal (median 27 months versus 29.6 months, p = 0.359). With respect to the detection of the first new lesion, regardless if present within or outside the TR, 5 years after the treatment 34.3 % of patients in the group with additional ART were free of relapse, versus 15.4 % in the surgery only group (p = 0.0122). ART had no influence on the extent of PSA reduction at latest follow-up compared to treatment with surgery only. ART after salvage-LND provides stable local control in TR and results in overall significant improved next-relapse-free survival, compared to patients who received surgery only in case of nodal PCa-relapse. (orig.) [de

  20. 89Sr and 153Sm-EDTMP therapy of disseminated skeletal metastasis

    International Nuclear Information System (INIS)

    Zhang Junning; Hong Chengjiao; Zhu Shoupeng

    2001-01-01

    A retrospective analysis was performed on 72 patients with disseminated skeletal metastasis to evaluate the effect of strontium-89 or samarium-153 EDTMP therapy. There existed 87.88% of clinical response, 12.12% of no response in the group treated with strontium-89 as compared with 90.24% of clinical response, 9.76% no response in one treated with samarium-153 EDTMP; and there were no correlation between the treatment results and the amounts of isotopes administrated. The results suggest that strontium-89 or samarium-153 EDTMP therapy is a method of first choice in the palliative treatment for disseminated skeletal metastasis

  1. {sup 89}Sr and {sup 153}Sm-EDTMP therapy of disseminated skeletal metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Junning, Zhang; Chengjiao, Hong; Shoupeng, Zhu [Suzhou Univ., Suzhou (China)

    2001-07-01

    A retrospective analysis was performed on 72 patients with disseminated skeletal metastasis to evaluate the effect of strontium-89 or samarium-153 EDTMP therapy. There existed 87.88% of clinical response, 12.12% of no response in the group treated with strontium-89 as compared with 90.24% of clinical response, 9.76% no response in one treated with samarium-153 EDTMP; and there were no correlation between the treatment results and the amounts of isotopes administrated. The results suggest that strontium-89 or samarium-153 EDTMP therapy is a method of first choice in the palliative treatment for disseminated skeletal metastasis.

  2. The Role of Redox-Regulating Enzymes in Inoperable Breast Cancers Treated with Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Nelli Roininen

    2017-01-01

    Full Text Available Although validated predictive factors for breast cancer chemoresistance are scarce, there is emerging evidence that the induction of certain redox-regulating enzymes may contribute to a poor chemotherapy effect. We investigated the possible association between chemoresistance and cellular redox state regulation in patients undergoing neoadjuvant chemotherapy (NACT for breast cancer. In total, 53 women with primarily inoperable or inflammatory breast cancer who were treated with NACT were included in the study. Pre-NACT core needle biopsies and postoperative tumor samples were immunohistochemically stained for nuclear factor erythroid 2-related factor 2 (Nrf2, Kelch-like ECH-associated protein 1 (Keap1, thioredoxin (Trx, and peroxiredoxin I (Prx I. The expression of all studied markers increased during NACT. Higher pre-NACT nuclear Prx I expression predicted smaller size of a resected tumor (p=0.00052; r=−0.550, and higher pre-NACT cytoplasmic Prx I expression predicted a lower amount of evacuated nodal metastasis (p=0.0024; r=−0.472. Pre-NACT nuclear Trx expression and pre-NACT nuclear Keap1 expression had only a minor prognostic significance as separate factors, but when they were combined, low expression for both antibodies before NACT predicted dismal disease-free survival (log-rank p=0.0030. Our results suggest that redox-regulating enzymes may serve as potential prognostic factors in primarily inoperable breast cancer patients.

  3. Primary lung sarcoma treated with stereotactic ablative radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Yeo SG

    2017-07-01

    Full Text Available Seung-Gu Yeo Department of Radiation Oncology, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea Abstract: Primary lung sarcoma (PLS is an extremely rare, very aggressive malignancy. Surgical removal is considered the treatment of choice, and patients who have been given conventional radiotherapy have had inferior outcomes. This study is the first describing a case of PLS treated with stereotactic ablative radiotherapy (SABR, which precisely targets a small tumor with a markedly higher biologically effective dose than conventional radiotherapy. The patient was an 82-year-old man who was diagnosed with primary lung leiomyosarcoma based on radiology, pathology, and immunohistochemical examinations. The PLS was located in the right lower lobe and measured 2.5 cm. No regional nodal or distant organ metastasis was observed. He was inoperable medically. The SABR was performed using volumetric modulated arc therapy and a dose of 56 Gy in four fractions. Follow-up computed tomography 2 months after SABR revealed a complete tumor response. The toxicity was limited to mild respiratory symptoms. The patient is alive and has had no evidence of disease for 2 years. This study suggests that SABR can be a safe and effective treatment option for PLS. Keywords: primary lung sarcoma, leiomyosarcoma, stereotactic ablative radiotherapy, stereotactic body radiotherapy, radiation therapy, sarcoma 

  4. Is there a requirement for axillary lymph node dissection following identification of micro-metastasis or isolated tumour cells at sentinel node biopsy for breast cancer?

    LENUS (Irish Health Repository)

    Joyce, D P

    2012-02-29

    INTRODUCTION: Recent decades have seen a significant shift towards conservative management of the axilla. Increasingly, immunohistochemical analysis of sentinel nodes leads to the detection of small tumour deposits, the significance of which remains uncertain. The aims of this study are to examine patients whose sentinel lymph nodes are positive for macro-metastasis, micro-metastasis or isolated tumour cells (ITCs) and to determine the rate of further nodal disease after axillary lymph node dissection (ALND). METHODS: A retrospective analysis of all patients undergoing a sentinel lymph node biopsy (SLNB) between January 2007 and December 2010 in a tertiary referral breast unit was performed. Patients who underwent an axillary lymph node dissection for macro-metastasis, micro-metastasis or ITCs were identified. Demographics, histological data and the rate of further axillary disease were examined. RESULTS: In total, 664 breast cancer patients attended the symptomatic breast unit during the study period, 360 of whom underwent a SLNB. Seventy patients had a SLNB positive for macro-metastasis. All of these patients underwent ALND. A positive SLNB with either micro-metastasis or ITCs was identified in 58 patients. Only 41 of the 58 patients went on to have an ALND, due primarily to variations in surgeons\\' preferences. Nineteen patients with micro-metastasis underwent an ALND. Four patients had further axillary disease (21%). Twenty-two patients had ITCs identified, of whom only one had further disease (4.5%). No statistically significant difference was found between the two groups in terms of tumour size, grade, lymphovascular invasion or oestrogen receptor status. CONCLUSION: ALND should be considered in patients with micro-metastasis at SLNB. It should rarely be employed in the setting of SLNB positive for ITCs.

  5. Exact boundary controllability of nodal profile for quasilinear hyperbolic systems

    CERN Document Server

    Li, Tatsien; Gu, Qilong

    2016-01-01

    This book provides a comprehensive overview of the exact boundary controllability of nodal profile, a new kind of exact boundary controllability stimulated by some practical applications. This kind of controllability is useful in practice as it does not require any precisely given final state to be attained at a suitable time t=T by means of boundary controls, instead it requires the state to exactly fit any given demand (profile) on one or more nodes after a suitable time t=T by means of boundary controls. In this book we present a general discussion of this kind of controllability for general 1-D first order quasilinear hyperbolic systems and for general 1-D quasilinear wave equations on an interval as well as on a tree-like network using a modular-structure construtive method, suggested in LI Tatsien's monograph "Controllability and Observability for Quasilinear Hyperbolic Systems"(2010), and we establish a complete theory on the local exact boundary controllability of nodal profile for 1-D quasilinear hyp...

  6. Hereditary bone dysplasia with pathological fractures and nodal osteoarthropathy

    International Nuclear Information System (INIS)

    Arendse, Regan; Brink, Paul; Beighton, Peter

    2009-01-01

    A father and daughter both had multiple pathological fractures and nodal osteoarthropathy. The father, aged 50 years, had at least 20 healed fractures of the axial and appendicular skeleton, sustained by minor trauma over his 50-year lifespan, many of which had been surgically fixed prior to his first presentation to us. Fractures of the clavicles, thoracic cage and long bones of the arms and legs, had healed with malalignment and deformity. Healed fractures were complicated by ankylosis of the cervical vertebrae and both elbows. He also had osteoarthritis of the hands, with exuberant osteophytosis, and profound perceptive deafness. His general health was good, his intellect and facies were normal, and his sclerae were white. The daughter, aged 27 years, had sustained at least seven fractures of the axial and appendicular skeleton following trivial injuries, in distribution similar to those of the father. She had also experienced painful swelling of the fingers, which preceded progressive development of nodal osteoarthropathy. Her hearing was normal. In both individuals, biochemical and immunological investigations yielded normal results. It was not possible for molecular studies to be undertaken. Pedigree data were consistent with autosomal dominant transmission, and this disorder appeared to be a previously undocumented heritable skeletal dysplasia. (orig.)

  7. Hereditary bone dysplasia with pathological fractures and nodal osteoarthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Arendse, Regan [University of Stellenbosch, Department of Medicine, Tygerberg Hospital, Stellenbosch (South Africa); University of Cape Town, Division of Rheumatology, Groote Schuur Hospital, Cape Town (South Africa); Brink, Paul [University of Stellenbosch, Department of Medicine, Tygerberg Hospital, Stellenbosch (South Africa); Beighton, Peter [University of Cape Town, Division of Human Genetics, Faculty of Health Sciences, Cape Town (South Africa)

    2009-12-15

    A father and daughter both had multiple pathological fractures and nodal osteoarthropathy. The father, aged 50 years, had at least 20 healed fractures of the axial and appendicular skeleton, sustained by minor trauma over his 50-year lifespan, many of which had been surgically fixed prior to his first presentation to us. Fractures of the clavicles, thoracic cage and long bones of the arms and legs, had healed with malalignment and deformity. Healed fractures were complicated by ankylosis of the cervical vertebrae and both elbows. He also had osteoarthritis of the hands, with exuberant osteophytosis, and profound perceptive deafness. His general health was good, his intellect and facies were normal, and his sclerae were white. The daughter, aged 27 years, had sustained at least seven fractures of the axial and appendicular skeleton following trivial injuries, in distribution similar to those of the father. She had also experienced painful swelling of the fingers, which preceded progressive development of nodal osteoarthropathy. Her hearing was normal. In both individuals, biochemical and immunological investigations yielded normal results. It was not possible for molecular studies to be undertaken. Pedigree data were consistent with autosomal dominant transmission, and this disorder appeared to be a previously undocumented heritable skeletal dysplasia. (orig.)

  8. Dirac Magnon Nodal Loops in Quasi-2D Quantum Magnets.

    Science.gov (United States)

    Owerre, S A

    2017-07-31

    In this report, we propose a new concept of one-dimensional (1D) closed lines of Dirac magnon nodes in two-dimensional (2D) momentum space of quasi-2D quantum magnetic systems. They are termed "2D Dirac magnon nodal-line loops". We utilize the bilayer honeycomb ferromagnets with intralayer coupling J and interlayer coupling J L , which is realizable in the honeycomb chromium compounds CrX 3 (X ≡ Br, Cl, and I). However, our results can also exist in other layered quasi-2D quantum magnetic systems. Here, we show that the magnon bands of the bilayer honeycomb ferromagnets overlap for J L  ≠ 0 and form 1D closed lines of Dirac magnon nodes in 2D momentum space. The 2D Dirac magnon nodal-line loops are topologically protected by inversion and time-reversal symmetry. Furthermore, we show that they are robust against weak Dzyaloshinskii-Moriya interaction Δ DM  magnon edge modes.

  9. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    International Nuclear Information System (INIS)

    Lee, Chul Min; Lee, Seung Hun; Bae, Ji Yoon

    2015-01-01

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis

  10. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)

    2015-12-15

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  11. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    International Nuclear Information System (INIS)

    Hyun, Su Jeong; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung

    2016-01-01

    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  12. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)

    2016-11-15

    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  13. Novel chemokine-like activities of histones in tumor metastasis.

    Science.gov (United States)

    Chen, Ruochan; Xie, Yangchun; Zhong, Xiao; Fu, Yongmin; Huang, Yan; Zhen, Yixiang; Pan, Pinhua; Wang, Haichao; Bartlett, David L; Billiar, Timothy R; Lotze, Michael T; Zeh, Herbert J; Fan, Xue-Gong; Tang, Daolin; Kang, Rui

    2016-09-20

    Histones are intracellular nucleosomal components and extracellular damage-associated molecular pattern molecules that modulate chromatin remodeling, as well as the immune response. However, their extracellular roles in cell migration and invasion remain undefined. Here, we demonstrate that histones are novel regulators of tumor metastasis with chemokine-like activities. Indeed, exogenous histones promote both hepatocellular carcinoma (HCC) cell migration and invasion through toll-like receptor (TLR)4, but not TLR2 or the receptor for advanced glycosylation end product. TLR4-mediated activation of nuclear factor-κB (NF-κB) by extracellular signal-regulated kinase (ERK) is required for histone-induced chemokine (e.g., C-C motif ligand 9/10) production. Pharmacological and genetic inhibition of TLR4-ERK-NF-κB signaling impairs histone-induced chemokine production and HCC cell migration. Additionally, TLR4 depletion (by using TLR4-/- mice and TLR4-shRNA) or inhibition of histone release/activity (by administration of heparin and H3 neutralizing antibody) attenuates lung metastasis of HCC cells injected via the tail vein of mice. Thus, histones promote tumor metastasis of HCC cells through the TLR4-NF-κB pathway and represent novel targets for treating patients with HCC.

  14. Suppression of breast cancer metastasis through the inactivation of ADP-ribosylation factor 1.

    Science.gov (United States)

    Xie, Xiayang; Tang, Shou-Ching; Cai, Yafei; Pi, Wenhu; Deng, Libin; Wu, Guangyu; Chavanieu, Alain; Teng, Yong

    2016-09-06

    Metastasis is the major cause of cancer-related death in breast cancer patients, which is controlled by specific sets of genes. Targeting these genes may provide a means to delay cancer progression and allow local treatment to be more effective. We report for the first time that ADP-ribosylation factor 1 (ARF1) is the most amplified gene in ARF gene family in breast cancer, and high-level amplification of ARF1 is associated with increased mRNA expression and poor outcomes of patients with breast cancer. Knockdown of ARF1 leads to significant suppression of migration and invasion in breast cancer cells. Using the orthotopic xenograft model in NSG mice, we demonstrate that loss of ARF1 expression in breast cancer cells inhibits pulmonary metastasis. The zebrafish-metastasis model confirms that the ARF1 gene depletion suppresses breast cancer cells to metastatic disseminate throughout fish body, indicating that ARF1 is a very compelling target to limit metastasis. ARF1 function largely dependents on its activation and LM11, a cell-active inhibitor that specifically inhibits ARF1 activation through targeting the ARF1-GDP/ARNO complex at the Golgi, significantly impairs metastatic capability of breast cancer cell in zebrafish. These findings underline the importance of ARF1 in promoting metastasis and suggest that LM11 that inhibits ARF1 activation may represent a potential therapeutic approach to prevent or treat breast cancer metastasis.

  15. [Evaluation and classification of drug therapy for breast cancer with bone-only metastasis].

    Science.gov (United States)

    Meng, X Y; Song, S T

    2017-03-23

    Skeleton is one of the most common metastatic organs for breast cancer, which has a better prognosis than visceral metastases. Bone-only metastasis was defined"non-measurable" in the RECIST (Response Evaluation Criteria in Solid Tumors) criteria, and was excluded by clinical trials. However, patients with bone-only metastasis are also in need of effective treatment to prolong survival. Endocrine therapy is the most important treatment for bone metastatic patients. Tumor response of bone metastases can be determined objectively by bone-window CT. Effective treatment should be continued if the symptoms are relieved or osteogenesis is observed. Osteoblastic change in bone-window CT is a sign of improvement after treatment. Endocrine therapy is proper for ER-positive patients. The patients with initial osteoblastic metastasis should not be treated with salvage chemotherapy or anti-HER2 treatment, only if osteolytic metastasis or visceral metastasis is observed. Bishosphonates are just auxiliary drugs in bone metastasis, which should not be abused.

  16. Immunomodulation of murine B16 melanoma metastasis: thymosin, thymectomy and irradiation

    International Nuclear Information System (INIS)

    Naylor, P.H.; Bhakoo, H.S.; Rosen, F.; Paolini, N.S.; Goldstein, A.L.

    1983-01-01

    Thymosin, a product of the endocrine system, was used to further define the effects of immunomodulation of metastasis. Adult thymectomized C57BL/6 mice, 4 wk post-irradiation (400 R) had a decrease in the number of pulmonary metastases (compared to controls) following tail vein injection of 5 X 10 4 B16 melanoma cells. Thymosin fraction 5 (fr. 5) administration (200 μg/mouse, 3 times weekly beginning 2 days post-thymectomy) returned the number of metastases to the nonthymectomized values. Thymosin treatment of sham-operated, sham-operated irradiated, or thymectomized nonirradiated mice did not significantly elevate the number of metastases compared to the respective controls. Variant tumors which have an increase in metastasis following thymectomy and irradiation were also used. Thymosin administration reversed the effects of thymectomy in such variants, resulting in a decrease in metastasis. Metastases in thymosin-treated control mice were not significantly altered. A role for the thymus in metastasis via an endocrine product (thymosin) is suggested by these studies. Since thymosin did not increase metastasis in intact mice with tumors, further clinical trials with thymosin in cancer patients are not counterindicated by the results. These experiments confirm that thymosin fr. 5 is an important probe of the immunoendocrine events involved in tumor growth and metastasis. (Auth.)

  17. Drug Development for Metastasis Prevention.

    Science.gov (United States)

    Fontebasso, Yari; Dubinett, Steven M

    2015-01-01

    Metastatic disease is responsible for 90% of death from solid tumors. However, only a minority of metastasis-specific targets has been exploited therapeutically, and effective prevention and suppression of metastatic disease is still an elusive goal. In this review, we will first summarize the current state of knowledge about the molecular features of the disease, with particular focus on steps and targets potentially amenable to therapeutic intervention. We will then discuss the reasons underlying the paucity of metastatic drugs in the current oncological arsenal and potential ways to overcome this therapeutic gap. We reason that the discovery of novel promising targets, an increased understanding of the molecular features of the disease, the effect of disruptive technologies, and a shift in the current preclinical and clinical settings have the potential to create more successful drug development endeavors.

  18. Stereotactic radiotherapy for brain metastasis

    International Nuclear Information System (INIS)

    Noel, G.; Daisne, J.F.; Thillays, F.

    2012-01-01

    Stereotactic radiosurgery is now well implanted in the radiotherapy treatment tools of brain metastasis. The dose can be delivered in one or multiple sessions. Results seem equivalent. CT scan and MRI imaging are required to delineate and calculate dosimetry. Doses are variable according to the size of the metastases, localization, pathology or equipment. Stabilization or reduction of tumour size is the rules after stereotactic treatment. Impact in terms of overall survival is more difficult to apprehend because of the general context of the disease. Many questions remain unresolved, such as the usefulness of whole brain irradiation, adaptation of the treatment schedule to tumour pathophysiology, role of stereotactic treatment after surgery of metastases, etc. (authors)

  19. Treatment of lymphatic nodes metastasis in advanced cancer with interventional chemotherapy combined radiotherapy

    International Nuclear Information System (INIS)

    Xia Shian; Guo Weijian; Wu Guohua; Lin Qing; Jiang Mawei; Yao Yuan

    2000-01-01

    Objective: To evaluate the clinical effects of treatment with interventional chemotherapy combined radiotherapy for lymphatic nodes metastasis in advanced cancer. Methods: Treated with interventional chemotherapy for 27 cases of lymphatic rode metastasis once a month with average 2-3 times totally. Simultaneously treated with linear accelerator radiotherapy with average dose of 40-50 Gy/20-25 times/4-5 weeks. Results: To evaluate the clinical effects after finished the whole treatment program two months later. CR + PR reached 77.8% (24/27). All patients showed tolerance to accept the treatment. Conclusion: Treatment for lymphatic node metastasis in advanced cancer with interventional chemotherapy combined radiation therapy seems to be a valuable way

  20. Assessment of Effect on LBLOCA PCT for Change in Upper Head Nodalization

    International Nuclear Information System (INIS)

    Kang, Dong Gu; Huh, Byung Gil; Yoo, Seung Hun; Bang, Youngseok; Seul, Kwangwon; Cho, Daehyung

    2014-01-01

    In this study, the best estimate plus uncertainty (BEPU) analysis of LBLOCA for original and modified nodalizations was performed, and the effect on LBLOCA PCT for change in upper head nodalization was assessed. In this study, the best estimate plus uncertainty (BEPU) analysis of LBLOCA for original and modified nodalizations was performed, and the effect on LBLOCA PCT for change in upper head nodalization was assessed. It is confirmed that modification of upper head nodalization influences PCT behavior, especially in the reflood phase. In conclusions, the modification of nodalization to reflect design characteristic of upper head temperature should be done to predict PCT behavior accurately in LBLOCA analysis. In the best estimate (BE) method with the uncertainty evaluation, the system nodalization is determined by the comparative studies of the experimental data. Up to now, it was assumed that the temperature of the upper dome in OPR-1000 was close to that of the cold leg. However, it was found that the temperature of the upper head/dome might be a little lower than or similar to that of the hot leg through the evaluation of the detailed design data. Since the higher upper head temperature affects blowdown quenching and peak cladding temperature in the reflood phase, the nodalization for upper head should be modified

  1. LOLA SYSTEM: A code block for nodal PWR simulation. Part. I - Simula-3 Code

    Energy Technology Data Exchange (ETDEWEB)

    Aragones, J M; Ahnert, C; Gomez Santamaria, J; Rodriguez Olabarria, I

    1985-07-01

    Description of the theory and users manual of the SIMULA-3 code, which is part of the core calculation system by nodal theory in one group, called LOLA SYSTEM. SIMULA-3 is the main module of the system, it uses a modified nodal theory, with interface leakages equivalent to the diffusion theory. (Author) 4 refs.

  2. Rules for Phase Shifts of Quantum Oscillations in Topological Nodal-Line Semimetals

    Science.gov (United States)

    Li, Cequn; Wang, C. M.; Wan, Bo; Wan, Xiangang; Lu, Hai-Zhou; Xie, X. C.

    2018-04-01

    Nodal-line semimetals are topological semimetals in which band touchings form nodal lines or rings. Around a loop that encloses a nodal line, an electron can accumulate a nontrivial π Berry phase, so the phase shift in the Shubnikov-de Haas (SdH) oscillation may give a transport signature for the nodal-line semimetals. However, different experiments have reported contradictory phase shifts, in particular, in the WHM nodal-line semimetals (W =Zr /Hf , H =Si /Ge , M =S /Se /Te ). For a generic model of nodal-line semimetals, we present a systematic calculation for the SdH oscillation of resistivity under a magnetic field normal to the nodal-line plane. From the analytical result of the resistivity, we extract general rules to determine the phase shifts for arbitrary cases and apply them to ZrSiS and Cu3 PdN systems. Depending on the magnetic field directions, carrier types, and cross sections of the Fermi surface, the phase shift shows rich results, quite different from those for normal electrons and Weyl fermions. Our results may help explore transport signatures of topological nodal-line semimetals and can be generalized to other topological phases of matter.

  3. Nodal integral method for the neutron diffusion equation in cylindrical geometry

    International Nuclear Information System (INIS)

    Azmy, Y.Y.

    1987-01-01

    The nodal methodology is based on retaining a higher a higher degree of analyticity in the process of deriving the discrete-variable equations compared to conventional numerical methods. As a result, extensive numerical testing of nodal methods developed for a wide variety of partial differential equations and comparison of the results to conventional methods have established the superior accuracy of nodal methods on coarse meshes. Moreover, these tests have shown that nodal methods are more computationally efficient than finite difference and finite-element methods in the sense that they require shorter CPU times to achieve comparable accuracy in the solutions. However, nodal formalisms and the final discrete-variable equations they produce are, in general, more complicated than their conventional counterparts. This, together with anticipated difficulties in applying the transverse-averaging procedure in curvilinear coordinates, has limited the applications of nodal methods, so far, to Cartesian geometry, and with additional approximations to hexagonal geometry. In this paper the authors report recent progress in deriving and numerically implementing a nodal integral method (NIM) for solving the neutron diffusion equation in cylindrical r-z geometry. Also, presented are comparisons of numerical solutions to two test problems with those obtained by the Exterminator-2 code, which indicate the superior accuracy of the nodal integral method solutions on much coarser meshes

  4. LOLA SYSTEM: A code block for nodal PWR simulation. Part. I - Simula-3 Code

    International Nuclear Information System (INIS)

    Aragones, J. M.; Ahnert, C.; Gomez Santamaria, J.; Rodriguez Olabarria, I.

    1985-01-01

    Description of the theory and users manual of the SIMULA-3 code, which is part of the core calculation system by nodal theory in one group, called LOLA SYSTEM. SIMULA-3 is the main module of the system, it uses a modified nodal theory, with interface leakages equivalent to the diffusion theory. (Author) 4 refs

  5. A practical implementation of the higher-order transverse-integrated nodal diffusion method

    International Nuclear Information System (INIS)

    Prinsloo, Rian H.; Tomašević, Djordje I.; Moraal, Harm

    2014-01-01

    Highlights: • A practical higher-order nodal method is developed for diffusion calculations. • The method resolves the issue of the transverse leakage approximation. • The method achieves much superior accuracy as compared to standard nodal methods. • The calculational cost is only about 50% greater than standard nodal methods. • The method is packaged in a module for connection to existing nodal codes. - Abstract: Transverse-integrated nodal diffusion methods currently represent the standard in full core neutronic simulation. The primary shortcoming of this approach is the utilization of the quadratic transverse leakage approximation. This approach, although proven to work well for typical LWR problems, is not consistent with the formulation of nodal methods and can cause accuracy and convergence problems. In this work, an improved, consistent quadratic leakage approximation is formulated, which derives from the class of higher-order nodal methods developed some years ago. Further, a number of iteration schemes are developed around this consistent quadratic leakage approximation which yields accurate node average results in much improved calculational times. The most promising of these iteration schemes results from utilizing the consistent leakage approximation as a correction method to the standard quadratic leakage approximation. Numerical results are demonstrated on a set of benchmark problems and further applied to a realistic reactor problem, particularly the SAFARI-1 reactor, operating at Necsa, South Africa. The final optimal solution strategy is packaged into a standalone module which may simply be coupled to existing nodal diffusion codes

  6. Concurrent whole brain radiotherapy and bortezomib for brain metastasis

    International Nuclear Information System (INIS)

    Lao, Christopher D; Hamstra, Daniel; Lawrence, Theodore; Hayman, James; Redman, Bruce G; Friedman, Judah; Tsien, Christina I; Normolle, Daniel P; Chapman, Christopher; Cao, Yue; Lee, Oliver; Schipper, Matt; Van Poznak, Catherine

    2013-01-01

    Survival of patients with brain metastasis particularly from historically more radio-resistant malignancies remains dismal. A phase I study of concurrent bortezomib and whole brain radiotherapy was conducted to determine the tolerance and safety of this approach in patients with previously untreated brain metastasis. A phase I dose escalation study evaluated the safety of bortezomib (0.9, 1.1, 1.3, 1.5, and 1.7 mg/m 2 ) given on days 1, 4, 8 and 11 of whole brain radiotherapy. Patients with confirmed brain metastasis were recruited for participation. The primary endpoint was the dose-limiting toxicity, defined as any ≥ grade 3 non-hematologic toxicity or grade ≥ 4 hematologic toxicity from the start of treatment to one month post irradiation. Time-to-Event Continual Reassessment Method (TITE-CRM) was used to determine dose escalation. A companion study of brain diffusion tensor imaging MRI was conducted on a subset of patients to assess changes in the brain that might predict delayed cognitive effects. Twenty-four patients were recruited and completed the planned therapy. Patients with melanoma accounted for 83% of all participants. The bortezomib dose was escalated as planned to the highest dose of 1.7 mg/m 2 /dose. No grade 4/5 toxicities related to treatment were observed. Two patients had grade 3 dose-limiting toxicities (hyponatremia and encephalopathy). A partial or minor response was observed in 38% of patients. Bortezomib showed greater demyelination in hippocampus-associated white matter structures on MRI one month after radiotherapy compared to patients not treated with bortezomib (increase in radial diffusivity +16.8% versus 4.8%; p = 0.0023). Concurrent bortezomib and whole brain irradiation for brain metastasis is well tolerated at one month follow-up, but MRI changes that have been shown to predict delayed cognitive function can be detected within one month of treatment

  7. Construction of radiation - induced metastasis model in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Kuk; Jang, Su Jin; Kang, Sung Wook; Kim, Jae Sung; Hwang, Sang Gu; Kang, Joo Hyun [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2011-05-15

    In treatment of cancer, distant metastases are important limiting factor because an estimated 50% of all cancer patients will develop metastases, and the metastases are major causing of cancer treatment failure. Recently a few reports indicated {gamma}-radiation induced an increase of invasiveness of several cancer cells. In this study, we had tried to show the possibility that radiation could also induce metastasis in vivo system. To prove our hypothesis, we constructed primary tumor by using C6-TL transfectant cell line expressing HSV1-tk and firefly luciferase (fLuc), and then {gamma}-radiation was treated to xenografts locally. Treatment of {gamma}-radiation to primary C6-TL xenografts of mice reduced size of xenografts and elongated survival of mice than those of mock control mice. But we also show that {gamma}-radiation treatment was followed by the growth of dormant metastases in various organs including lung and intestine after 2-4 weeks of {gamma}-radiation treatment. When bioluminescence imaging indicated growth of tumor in organs in mice, we sacrificed the mice and repeat acquired bioluminescence imaging after repeatedly. These images presented tumor growth locations exactly in organs. Because metastatic tumor candidates have morphology of foci, biopsies were performed for histological analysis or PCR analysis to confirm metastases. In most foci, histological analysis indicated several features of typical cancer tissue and PCR analysis showed present of fLuc gene in metastases. Detection of fLuc gene in metastases indicated these foci were originated from primary C6-TL xenografts, and the results suggest that {gamma}-radiation could promote metastasis in vivo as well as in vitro system. Although we need to understand changes of intracellular signaling or physiological phenomena of the radiation-induced metastasis yet, these results also imply that {gamma}-radiation treatment only to cancer patients need to pay attention carefully, and development of new

  8. Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients

    Science.gov (United States)

    2010-01-01

    recurrence group was 59.53 years. Most common oral sites included the lateral border of tongue and floor of mouth. Recurrence was associated with clinical N-stage disease. The surgical margins in this group was evaluated and found that 17 had non-cohesive invasion, 30 had dysplasia at margin, 21 had vascular invasion, 9 had nerve invasion and 3 had bony invasion. Severe dysplasia was present in 37 patients. Tumour clearance was achieved in only 8 patients. The mean depth of tumour invasion in the recurrence group was 7.6 mm. An interesting finding was that 5/11 patients who died of distant metastasis had their primary disease in the tongue. Nodal disease comparison showed that 8/10 patients who died of locoregional metastasis and 8/11 patients who died from distant metastasis had clinical nodal involvement. Comparing this to pathological nodal disease (pTNM) showed that 10/10 patients and 10/11 patients who died from locoregional and distant metastasis, respectively, had nodal disease. All patients who died from locoregional and distant metastasis were shown to have recurrence after the primary tumour resection. Squamous cell carcinoma of the oral cavity has a poor overall prognosis with a high tendency to recur at the primary site and extend to involve the cervical lymph nodes. Several clinicopathological parameters can be employed to assess outcome, recurrence and overall survival. PMID:20406474

  9. The CT diagnose of pleural metastasis tumour

    International Nuclear Information System (INIS)

    Chen Liqun; Han Kaibin; Pan Heng; Huang Xiaoru; Zhou Bingcao; Huang Yuehua

    2007-01-01

    Objective: To discuss the CT characteristic of pleural metastasis tumour,enhance the diagnostic level of pleural metastasis tumour. Methods: Review 30 cases which have been performed CT scan in our hospital during March 2002 to June 2003, which have been approved to pleural metastasis tumour by pathology and clinic. Make use of GE Hispeed.zx/i spiral CT,10mm thickness,10mm increment, l.5 pitch, some of them use 10mm or high resolution mode. All cases have been performed normal scan, 25 cases with contrast scan. Results: The CT representation of pleural metastasis tumour are encapsulated pleural effusion with irregular pleural thickening(56.6%), nodular pleural thickening(46.6%), pleural masses (13.3%), pneumothorax (3.3%), etc. Encapsulated pleural effusion and nodular pleural thickening are 76.6%, use contrast mode to scan pleural pathological changes enhance upon middle level, CT value increment > 20HU, there are 66.6% cases with other chest metastasis symptom, 73.3% primary lesion are pulmonary cancer, and 20% no primary lesion are found. Conclusion: Combine primary lesion history and other chest metastasis symptom, Spiral CT examination can differentiate most of pleural metastasis tumour, but it is difficult to differentiate the cases between with a little pleural effusion or light band pleural thickening and reactive alteration. (authors)

  10. Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer

    International Nuclear Information System (INIS)

    Ogasawara, Yutaka; Doihara, Hiroyoshi; Shiraiwa, Misaki; Ishihara, Setsuko

    2008-01-01

    We evaluated the effectiveness of multidetector-row computed tomography (MD-CT) for detecting axillary lymph nodal status (ALNS) in patients with breast cancer. We reviewed 42 patients with breast cancer. A metastatic lymph node on MD-CT was defined as oval or round, with more than 5 mm on the short axis. We evaluated ALNS preoperatively by both palpation and MD-CT findings and performed sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND). For establishing the ALNS, MD-CT showed a sensitivity of 76.9%, a specificity of 96.6%, and an accuracy of 90.5%. On the basis of the MD-CT findings, misdiagnosis was made in 4 of the 42 patients, only one of which was false positive. On the other hand, one patient with a histologically negative sentinel lymph node (SLN) result had metastasis only in a non-SLN. Preoperative MD-CT showed a positive node in this patient. Multidetector-row computed tomography assists in identifying women who require ALND without SLNB, with sufficient positive predictive value. False-negative detection by SLNB could be avoided with careful interpretation of the axillary lymph nodes shown by MD-CT. (author)

  11. Proton beam radiotherapy as part of comprehensive regional nodal irradiation for locally advanced breast cancer.

    Science.gov (United States)

    Verma, Vivek; Iftekaruddin, Zaid; Badar, Nida; Hartsell, William; Han-Chih Chang, John; Gondi, Vinai; Pankuch, Mark; Gao, Ming; Schmidt, Stacey; Kaplan, Darren; McGee, Lisa

    2017-05-01

    This study evaluates acute toxicity outcomes in breast cancer patients treated with adjuvant proton beam therapy (PBT). From 2011 to 2016, 91 patients (93 cancers) were treated with adjuvant PBT targeting the intact breast/chest wall and comprehensive regional nodes including the axilla, supraclavicular fossa, and internal mammary lymph nodes. Toxicity was recorded weekly during treatment, one month following treatment, and then every 6months according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Charts were retrospectively reviewed to verify toxicities, patient parameters, disease and treatment characteristics, and disease-related outcomes. Median follow-up was 15.5months. Median PBT dose was 50.4 Gray relative biological effectiveness (GyRBE), with subsequent boost as clinically indicated (N=61, median 10 GyRBE). Chemotherapy, when administered, was given adjuvantly (N=42) or neoadjuvantly (N=46). Grades 1, 2, and 3 dermatitis occurred in 23%, 72%, and 5%, respectively. Eight percent required treatment breaks owing to dermatitis. Median time to resolution of dermatitis was 32days. Grades 1, 2, and 3 esophagitis developed in 31%, 33%, and 0%, respectively. PBT displays acceptable toxicity in the setting of comprehensive regional nodal irradiation. Copyright © 2017. Published by Elsevier B.V.

  12. Opposing nodal and BMP signals regulate left-right asymmetry in the sea urchin larva.

    Directory of Open Access Journals (Sweden)

    Yi-Jyun Luo

    Full Text Available Nodal and BMP signals are important for establishing left-right (LR asymmetry in vertebrates. In sea urchins, Nodal signaling prevents the formation of the rudiment on the right side. However, the opposing pathway to Nodal signaling during LR axis establishment is not clear. Here, we revealed that BMP signaling is activated in the left coelomic pouch, specifically in the veg2 lineage, but not in the small micromeres. By perturbing BMP activities, we demonstrated that BMP signaling is required for activating the expression of the left-sided genes and the formation of the left-sided structures. On the other hand, Nodal signals on the right side inhibit BMP signaling and control LR asymmetric separation and apoptosis of the small micromeres. Our findings show that BMP signaling is the positive signal for left-sided development in sea urchins, suggesting that the opposing roles of Nodal and BMP signals in establishing LR asymmetry are conserved in deuterostomes.

  13. A spectral nodal method for discrete ordinates problems in x,y geometry

    International Nuclear Information System (INIS)

    Barros, R.C. de; Larsen, E.W.

    1991-06-01

    A new nodal method is proposed for the solution of S N problems in x- y-geometry. This method uses the Spectral Green's Function (SGF) scheme for solving the one-dimensional transverse-integrated nodal transport equations with no spatial truncation error. Thus, the only approximations in the x, y-geometry nodal method occur in the transverse leakage terms, as in diffusion theory. We approximate these leakage terms using a flat or constant approximation, and we refer to the resulting method as the SGF-Constant Nodal (SGF-CN) method. We show in numerical calculations that the SGF-CN method is much more accurate than other well-known transport nodal methods for coarse-mesh deep-penetration S N problems, even though the transverse leakage terms are approximated rather simply. (author)

  14. Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

    Directory of Open Access Journals (Sweden)

    Bhalaghuru Chokkalingam Mani, MD

    2014-01-01

    Full Text Available More than half a century has passed since the concept of dual atrioventricular (AV nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.

  15. Intensity-modulated proton therapy for elective nodal irradiation and involved-field radiation in the definitive treatment of locally advanced non-small-cell lung cancer: a dosimetric study.

    Science.gov (United States)

    Kesarwala, Aparna H; Ko, Christine J; Ning, Holly; Xanthopoulos, Eric; Haglund, Karl E; O'Meara, William P; Simone, Charles B; Rengan, Ramesh

    2015-05-01

    Photon involved-field (IF) radiation therapy (IFRT), the standard for locally advanced (LA) non-small cell lung cancer (NSCLC), results in favorable outcomes without increased isolated nodal failures, perhaps from scattered dose to elective nodal stations. Because of the high conformality of intensity-modulated proton therapy (IMPT), proton IFRT could increase nodal failures. We investigated the feasibility of IMPT for elective nodal irradiation (ENI) in LA-NSCLC. IMPT IFRT plans were generated to the same total dose of 66.6-72 Gy received by 20 LA-NSCLC patients treated with photon IFRT. IMPT ENI plans were generated to 46 cobalt Gray equivalent (CGE) to elective nodal planning treatment volumes (PTV) plus 24 CGE to IF-PTVs. Proton IFRT and ENI improved the IF-PTV percentage of volume receiving 95% of the prescribed dose (D95) by 4% (P ENI. The mean esophagus dose decreased 16% with IFRT and 12% with ENI; heart V25 decreased 63% with both (all P ENI. Potential decreased toxicity indicates that IMPT could allow ENI while maintaining a favorable therapeutic ratio compared with photon IFRT. Published by Elsevier Inc.

  16. Intensity-Modulated Proton Therapy for Elective Nodal Irradiation and Involved-Field Radiation in the Definitive Treatment of Locally Advanced Non-Small Cell Lung Cancer: A Dosimetric Study

    Science.gov (United States)

    Kesarwala, Aparna H.; Ko, Christine J.; Ning, Holly; Xanthopoulos, Eric; Haglund, Karl E.; O’Meara, William P.; Simone, Charles B.; Rengan, Ramesh

    2015-01-01

    Background Photon involved-field radiation therapy (IFRT), the standard for locally advanced non-small cell lung cancer (LA-NSCLC), results in favorable outcomes without increased isolated nodal failures, perhaps from scattered dose to elective nodal stations. Given the high conformality of intensity-modulated proton therapy (IMPT), proton IFRT could increase nodal failures. We investigated the feasibility of IMPT for elective nodal irradiation (ENI) in LA-NSCLC. Materials and Methods IMPT IFRT plans were generated to the same total dose of 66.6–72 Gy received by 20 LA-NSCLC patients treated with photon IFRT. IMPT ENI plans were generated to 46 CGE to elective nodal (EN) planning treatment volumes (PTV) plus 24 CGE to involved field (IF)-PTVs. Results Proton IFRT and ENI both improved D95 involved field (IF)-PTV coverage by 4% (pENI. Mean esophagus dose decreased 16% with IFRT and 12% with ENI; heart V25 decreased 63% with both (all pENI. Potential decreased toxicity indicates IMPT could allow ENI while maintaining a favorable therapeutic ratio compared to photon IFRT. PMID:25604729

  17. Incidence of isolated nodal failure in non-small cell lung cancer patients included in a prospective study of the value of PET–CT

    International Nuclear Information System (INIS)

    Kolodziejczyk, Milena; Bujko, Krzysztof; Michalski, Wojciech; Kepka, Lucyna

    2012-01-01

    Purpose: Elective nodal irradiation (ENI) is not recommended in PET–CT-based radiotherapy for NSCLC despite a low level of evidence to support such guidelines. The aim of this investigation is to find out whether omitting ENI is safe. Materials and methods: Sixty-seven patients treated within a frame of a previously published prospective trial of the value of PET–CT were included in the analysis. Seventeen (25%) patients received ENI due to higher initial nodal involvement and in the remaining 50 patients (75%) with N0-N1 or single N2 disease ENI was omitted. Isolated nodal failure (INF) was recorded if relapse occurred in the initially uninvolved regional lymph node without previous or simultaneous local recurrence regardless of the status of distant metastases. Results: With a median follow-up of 32 months, the estimated 3-year overall survival was 42%, local progression-free interval was 55%, and distant metastases-free interval was 62%. Three patients developed INF; all had ENI omitted from treatment, giving a final result of three INFs in 50 (6%) patients treated without ENI. In this group of patients, the 3-year cause-specific cumulative incidence of INF was 6.4% (95% confidence interval: 0–17%). Conclusions: The omission of ENI appears to be not as safe as suggested by current recommendations.

  18. Incidence of isolated nodal failure in non-small cell lung cancer patients included in a prospective study of the value of PET-CT.

    Science.gov (United States)

    Kolodziejczyk, Milena; Bujko, Krzysztof; Michalski, Wojciech; Kepka, Lucyna

    2012-07-01

    Elective nodal irradiation (ENI) is not recommended in PET-CT-based radiotherapy for NSCLC despite a low level of evidence to support such guidelines. The aim of this investigation is to find out whether omitting ENI is safe. Sixty-seven patients treated within a frame of a previously published prospective trial of the value of PET-CT were included in the analysis. Seventeen (25%) patients received ENI due to higher initial nodal involvement and in the remaining 50 patients (75%) with N0-N1 or single N2 disease ENI was omitted. Isolated nodal failure (INF) was recorded if relapse occurred in the initially uninvolved regional lymph node without previous or simultaneous local recurrence regardless of the status of distant metastases. With a median follow-up of 32 months, the estimated 3-year overall survival was 42%, local progression-free interval was 55%, and distant metastases-free interval was 62%. Three patients developed INF; all had ENI omitted from treatment, giving a final result of three INFs in 50 (6%) patients treated without ENI. In this group of patients, the 3-year cause-specific cumulative incidence of INF was 6.4% (95% confidence interval: 0-17%). The omission of ENI appears to be not as safe as suggested by current recommendations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. An integral nodal variational method for multigroup criticality calculations

    International Nuclear Information System (INIS)

    Lewis, E.E.; Tsoulfanidis, N.

    2003-01-01

    An integral formulation of the variational nodal method is presented and applied to a series of benchmark critically problems. The method combines an integral transport treatment of the even-parity flux within the spatial node with an odd-parity spherical harmonics expansion of the Lagrange multipliers at the node interfaces. The response matrices that result from this formulation are compatible with those in the VARIANT code at Argonne National Laboratory. Either homogeneous or heterogeneous nodes may be employed. In general, for calculations requiring higher-order angular approximations, the integral method yields solutions with comparable accuracy while requiring substantially less CPU time and memory than the standard spherical harmonics expansion using the same spatial approximations. (author)

  20. An Adaptive Approach to Variational Nodal Diffusion Problems

    International Nuclear Information System (INIS)

    Zhang Hui; Lewis, E.E.

    2001-01-01

    An adaptive grid method is presented for the solution of neutron diffusion problems in two dimensions. The primal hybrid finite elements employed in the variational nodal method are used to reduce the diffusion equation to a coupled set of elemental response matrices. An a posteriori error estimator is developed to indicate the magnitude of local errors stemming from the low-order elemental interface approximations. An iterative procedure is implemented in which p refinement is applied locally by increasing the polynomial order of the interface approximations. The automated algorithm utilizes the a posteriori estimator to achieve local error reductions until an acceptable level of accuracy is reached throughout the problem domain. Application to a series of X-Y benchmark problems indicates the reduction of computational effort achievable by replacing uniform with adaptive refinement of the spatial approximations

  1. A nonlinear analytic function expansion nodal method for transient calculations

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Han Gyn; Park, Sang Yoon; Cho, Byung Oh; Zee, Sung Quun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1998-12-31

    The nonlinear analytic function expansion nodal (AFEN) method is applied to the solution of the time-dependent neutron diffusion equation. Since the AFEN method requires both the particular solution and the homogeneous solution to the transient fixed source problem, the derivation of the solution method is focused on finding the particular solution efficiently. To avoid complicated particular solutions, the source distribution is approximated by quadratic polynomials and the transient source is constructed such that the error due to the quadratic approximation is minimized, In addition, this paper presents a new two-node solution scheme that is derived by imposing the constraint of current continuity at the interface corner points. The method is verified through a series of application to the NEACRP PWR rod ejection benchmark problems. 6 refs., 2 figs., 1 tab. (Author)

  2. On-line application of the PANTHER advanced nodal code

    International Nuclear Information System (INIS)

    Hutt, P.K.; Knight, M.P.

    1992-01-01

    Over the last few years, Nuclear Electric has developed an integrated core performance code package for both light water reactors (LWRs) and advanced gas-cooled reactors (AGRs) that can perform a comprehensive range of calculations for fuel cycle design, safety analysis, and on-line operational support for such plants. The package consists of the following codes: WIMS for lattice physics, PANTHER whole reactor nodal flux and AGR thermal hydraulics, VIPRE for LWR thermal hydraulics, and ENIGMA for fuel performance. These codes are integrated within a UNIX-based interactive system called the Reactor Physics Workbench (RPW), which provides an interactive graphic user interface and quality assurance records/data management. The RPW can also control calculational sequences and data flows. The package has been designed to run both off-line and on-line accessing plant data through the RPW

  3. Fourier-Accelerated Nodal Solvers (FANS) for homogenization problems

    Science.gov (United States)

    Leuschner, Matthias; Fritzen, Felix

    2017-11-01

    Fourier-based homogenization schemes are useful to analyze heterogeneous microstructures represented by 2D or 3D image data. These iterative schemes involve discrete periodic convolutions with global ansatz functions (mostly fundamental solutions). The convolutions are efficiently computed using the fast Fourier transform. FANS operates on nodal variables on regular grids and converges to finite element solutions. Compared to established Fourier-based methods, the number of convolutions is reduced by FANS. Additionally, fast iterations are possible by assembling the stiffness matrix. Due to the related memory requirement, the method is best suited for medium-sized problems. A comparative study involving established Fourier-based homogenization schemes is conducted for a thermal benchmark problem with a closed-form solution. Detailed technical and algorithmic descriptions are given for all methods considered in the comparison. Furthermore, many numerical examples focusing on convergence properties for both thermal and mechanical problems, including also plasticity, are presented.

  4. Nodal domains on isospectral quantum graphs: the resolution of isospectrality?

    International Nuclear Information System (INIS)

    Band, Ram; Shapira, Talia; Smilansky, Uzy

    2006-01-01

    We present and discuss isospectral quantum graphs which are not isometric. These graphs are the analogues of the isospectral domains in R 2 which were introduced recently in Gordon et al (1992 Bull. Am. Math. Soc. 27 134-8), Chapman (1995 Am. Math. Mon. 102 124), Buser et al (1994 Int. Math. Res. Not. 9 391-400), Okada and Shudo (2001 J. Phys. A: Math. Gen. 34 5911-22), Jakobson et al (2006 J. Comput. Appl. Math. 194 141-55) and Levitin et al (2006 J. Phys. A: Math. Gen. 39 2073-82)) all based on Sunada's construction of isospectral domains (Sunada T 1985 Ann. Math. 121 196-86). After presenting some of the properties of these graphs, we discuss a few examples which support the conjecture that by counting the nodal domains of the corresponding eigenfunctions one can resolve the isospectral ambiguity

  5. CAISO flicks switch on nodal scheme and lights stay on

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-06-15

    In 2000-01, two years after introducing a competitive wholesale power auction in California - with a separate day-ahead zonal market operated by the California Power Exchange and a zonal market for ancillary services and balancing energy operated by the California Independent System Operator (CAISO) - the California market collapsed from exorbitant prices, flagrant gaming, and abuse of market power. Nine years later, CAISO introduced a nodal pricing auction for the wholesale market in April, replacing the zonal scheme, which was among many causes of the original market's demise. With nearly 3,000 nodes on the network, high prices in one region do not affect prices everywhere on the system. After investing some $200 million to upgrade the software, countless delays, and 18 months of market simulation and testing, the new auction was introduced and nothing unusual happened.

  6. Ultrasound beam characteristics of a symmetric nodal origami based array

    Science.gov (United States)

    Bilgunde, Prathamesh N.; Bond, Leonard J.

    2018-04-01

    Origami-the ancient art of paper folding-is being explored in acoustics for effective focusing of sound. In this short communication, we present a numerical investigation of beam characteristics for an origami based ultrasound array. A spatial re-configuration of array elements is performed based upon the symmetric nodal origami. The effect of fold angle on the ultrasound beam is evaluated using frequency domain and transient finite element analysis. It was found that increase in the fold angle reduces near field length by 58% and also doubles the beam intensity as compared to the linear array. Transient analysis also indicated 80% reduction in the -6dB beam width, which can improve the lateral resolution of phased array. Such a spatially re-configurable array could potentially be used in the future to reduce the cost of electronics in the phased array instrumentation.

  7. Space-angle approximations in the variational nodal method

    International Nuclear Information System (INIS)

    Lewis, E. E.; Palmiotti, G.; Taiwo, T.

    1999-01-01

    The variational nodal method is formulated such that the angular and spatial approximations maybe examined separately. Spherical harmonic, simplified spherical harmonic, and discrete ordinate approximations are coupled to the primal hybrid finite element treatment of the spatial variables. Within this framework, two classes of spatial trial functions are presented: (1) orthogonal polynomials for the treatment of homogeneous nodes and (2) bilinear finite subelement trial functions for the treatment of fuel assembly sized nodes in which fuel-pin cell cross sections are represented explicitly. Polynomial and subelement trial functions are applied to benchmark water-reactor problems containing MOX fuel using spherical harmonic and simplified spherical harmonic approximations. The resulting accuracy and computing costs are compared

  8. A nonlinear analytic function expansion nodal method for transient calculations

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Han Gyn; Park, Sang Yoon; Cho, Byung Oh; Zee, Sung Quun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1999-12-31

    The nonlinear analytic function expansion nodal (AFEN) method is applied to the solution of the time-dependent neutron diffusion equation. Since the AFEN method requires both the particular solution and the homogeneous solution to the transient fixed source problem, the derivation of the solution method is focused on finding the particular solution efficiently. To avoid complicated particular solutions, the source distribution is approximated by quadratic polynomials and the transient source is constructed such that the error due to the quadratic approximation is minimized, In addition, this paper presents a new two-node solution scheme that is derived by imposing the constraint of current continuity at the interface corner points. The method is verified through a series of application to the NEACRP PWR rod ejection benchmark problems. 6 refs., 2 figs., 1 tab. (Author)

  9. ANDREA: Advanced nodal diffusion code for reactor analysis

    International Nuclear Information System (INIS)

    Belac, J.; Josek, R.; Klecka, L.; Stary, V.; Vocka, R.

    2005-01-01

    A new macro code is being developed at NRI which will allow coupling of the advanced thermal-hydraulics model with neutronics calculations as well as efficient use in core loading pattern optimization process. This paper describes the current stage of the macro code development. The core simulator is based on the nodal expansion method, Helios lattice code is used for few group libraries preparation. Standard features such as pin wise power reconstruction and feedback iterations on critical control rod position, boron concentration and reactor power are implemented. A special attention is paid to the system and code modularity in order to enable flexible and easy implementation of new features in future. Precision of the methods used in the macro code has been verified on available benchmarks. Testing against Temelin PWR operational data is under way (Authors)

  10. Comparison of PANTHER nodal solutions in hexagonal-z geometry

    International Nuclear Information System (INIS)

    Knight, M.; Hutt, P.; Lewis, I.

    1995-01-01

    The reactor physics code PANTHER has been extended to hexagonal geometries. Steady-state, depletion, and transient calculations with feedback can all be performed. Two hexagonal nodal flux solutions have been developed. In the first method, transverse integration is performed exactly as in the rectangular case. The resulting transverse integrated equation has singular terms, which are simply ignored. The second approach applies a conformal mapping that transforms the hexagon onto a rectangle. Pin power reconstruction has also been developed with both methods. For a benchmark VVER-1000 reactor depletion problem, both methods give accurate results for standard depletion calculations. In the more extreme situation with all rods inserted, the simpler method breaks down. However, the accuracy of the conformal solution was found to be excellent in all cases studied

  11. Static benchmarking of the NESTLE advanced nodal code

    International Nuclear Information System (INIS)

    Mosteller, R.D.

    1997-01-01

    Results from the NESTLE advanced nodal code are presented for multidimensional numerical benchmarks representing four different types of reactors, and predictions from NESTLE are compared with measured data from pressurized water reactors (PWRs). The numerical benchmarks include cases representative of PWRs, boiling water reactors (BWRs), CANDU heavy water reactors (HWRs), and high-temperature gas-cooled reactors (HTGRs). The measured PWR data include critical soluble boron concentrations and isothermal temperature coefficients of reactivity. The results demonstrate that NESTLE correctly solves the multigroup diffusion equations for both Cartesian and hexagonal geometries, that it reliably calculates k eff and reactivity coefficients for PWRs, and that--subsequent to the incorporation of additional thermal-hydraulic models--it will be able to perform accurate calculations for the corresponding parameters in BWRs, HWRs, and HTGRs as well

  12. Contemporary Management of Recurrent Nodal Disease in Differentiated Thyroid Carcinoma

    Science.gov (United States)

    Na’ara, Shorook; Amit, Moran; Fridman, Eran; Gil, Ziv

    2016-01-01

    Differentiated thyroid carcinoma (DTC) comprises over 90% of thyroid tumors and includes papillary and follicular carcinomas. Patients with DTC have an excellent prognosis, with a 10-year survival rate of over 90%. However, the risk of recurrent tumor ranges between 5% and 30% within 10 years of the initial diagnosis. Cervical lymph node disease accounts for the majority of recurrences and in most cases is detected during follow-up by ultrasound or elevated levels of serum thyroglobulin. Recurrent disease is accompanied by increased morbidity. The mainstay of treatment of nodal recurrence is surgical management. We provide an overview of the literature addressing surgical management of recurrent or persistent lymph node disease in patients with DTC. PMID:26886954

  13. Error Estimation and Accuracy Improvements in Nodal Transport Methods

    International Nuclear Information System (INIS)

    Zamonsky, O.M.

    2000-01-01

    The accuracy of the solutions produced by the Discrete Ordinates neutron transport nodal methods is analyzed.The obtained new numerical methodologies increase the accuracy of the analyzed scheems and give a POSTERIORI error estimators. The accuracy improvement is obtained with new equations that make the numerical procedure free of truncation errors and proposing spatial reconstructions of the angular fluxes that are more accurate than those used until present. An a POSTERIORI error estimator is rigurously obtained for one dimensional systems that, in certain type of problems, allows to quantify the accuracy of the solutions. From comparisons with the one dimensional results, an a POSTERIORI error estimator is also obtained for multidimensional systems. LOCAL indicators, which quantify the spatial distribution of the errors, are obtained by the decomposition of the menctioned estimators. This makes the proposed methodology suitable to perform adaptive calculations. Some numerical examples are presented to validate the theoretical developements and to illustrate the ranges where the proposed approximations are valid

  14. Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Masaaki Karino

    Full Text Available BACKGROUND: We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma. METHODS: A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio, and nuclear area coefficient of variation (NACV. Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis. RESULTS: Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site. CONCLUSION: Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

  15. Radiation promotes cancer cell metastasis via EMT induction in mouse model

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jongkuk; Kang, Sungwook; Hwang, Sanggu; Um, Hongduck [Department of Radiation Cancer, New York (United States); Jang, Su Jin; Kang, Joohyun [Molecular Imaging Research Center, Charlestown (United States); Park, Sunhoo [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Wunjae [Chungbuk National Univ., Cheongju (Korea, Republic of)

    2013-05-15

    Whether γ-IR-induced invasion and metastasis are stimulated in our in vitro C6L cell line and in vivo systems, and further identify the associated changes in signal pathways or mice physiology. We constructed an animal model system with a view to clarifying the intracellular molecular events underlying the promotion of metastasis after γ-IR treatment for primary cancer and developing effective anti-metastatic reagents. Our results demonstrate that γ-IR treatment of cancer cell lines and mice xenografts triggers invasion and metastasis. In particular, γ-IR-treated cancer cells or mouse xenografts and metastatic lesions in mice bearing γ-IR-treated xenografts also display typical EMT marker expression patterns, such as increased venetum or MMP-2 expression, decreased E-chondron, and enhanced activity of MMP-2. Our results collectively suggest that γ-IR-induced invasion or metastasis results from induction of EMT, and inhibition of EMT may thus be a means to enhance the effectiveness of radiation therapy. Our results also suggested EMT might be one of the major therapeutic targets to block metastasis.

  16. Radiation promotes cancer cell metastasis via EMT induction in mouse model

    International Nuclear Information System (INIS)

    Park, Jongkuk; Kang, Sungwook; Hwang, Sanggu; Um, Hongduck; Jang, Su Jin; Kang, Joohyun; Park, Sunhoo; Kim, Wunjae

    2013-01-01

    Whether γ-IR-induced invasion and metastasis are stimulated in our in vitro C6L cell line and in vivo systems, and further identify the associated changes in signal pathways or mice physiology. We constructed an animal model system with a view to clarifying the intracellular molecular events underlying the promotion of metastasis after γ-IR treatment for primary cancer and developing effective anti-metastatic reagents. Our results demonstrate that γ-IR treatment of cancer cell lines and mice xenografts triggers invasion and metastasis. In particular, γ-IR-treated cancer cells or mouse xenografts and metastatic lesions in mice bearing γ-IR-treated xenografts also display typical EMT marker expression patterns, such as increased venetum or MMP-2 expression, decreased E-chondron, and enhanced activity of MMP-2. Our results collectively suggest that γ-IR-induced invasion or metastasis results from induction of EMT, and inhibition of EMT may thus be a means to enhance the effectiveness of radiation therapy. Our results also suggested EMT might be one of the major therapeutic targets to block metastasis

  17. Nodal wear model: corrosion in carbon blast furnace hearths

    Directory of Open Access Journals (Sweden)

    Verdeja, L. F.

    2003-06-01

    Full Text Available Criterions developed for the Nodal Wear Model (NWM were applied to estimate the shape of the corrosion profiles that a blast furnace hearth may acquire during its campaign. Taking into account design of the hearth, the boundary conditions, the characteristics of the refractory materials used and the operation conditions of the blast furnace, simulation of wear profiles with central well, mushroom and elephant foot shape were accomplished. The foundations of the NWM are constructed considering that the corrosion of the refractory is a function of the temperature present at each point (node of the liquid metal-refractory interface and the corresponding physical and chemical characteristics of the corrosive fluid.

    Se aplican los criterios del Modelo de Desgaste Nodal (MDN para la estimación de los perfiles de corrosión que podría ir adquiriendo el crisol de un homo alto durante su campaña. Atendiendo al propio diseño del crisol, a las condiciones límites de contorno, a las características del material refractario utilizado y a las condiciones de operación del horno, se consiguen simular perfiles de desgaste con "pozo central", con "forma de seta" ó de "pie de elefante". Los fundamentos del MDN se apoyan en la idea de considerar que la corrosión del refractario es función de la temperatura que el sistema pueda presentar en cada punto (nodo de la intercara refractario-fundido y de las correspondientes características físico-químicas del fluido corrosivo.

  18. Long-term outcome of concurrent chemoradiotherapy with elective nodal irradiation for inoperable esophageal cancer.

    Science.gov (United States)

    Jing, Zhao; Chen, Tian; Zhang, Xuebang; Wu, Shixiu

    2017-09-01

    Elective nodal irradiation (ENI) might improve overall survival in patients with inoperable esophageal cancer. We conducted a retrospective analysis to assess the long-term survival and toxicity of esophageal cancer patients treated with ENI versus conventional-field irradiation (CFI). All data in the present study were based on our institutional experience from 2000 to 2005 of patients with inoperable esophageal cancer treated with ENI or CFI plus two concurrent cycles of paclitaxel/cisplatin. Based on the inclusion and exclusion criteria, 89 patients were included in the analysis. Of these patients, 51 were treated with ENI, whereas 38 were treated with CFI. For the per-protocol population, the patients in the ENI group significantly improved in terms of their 10-year disease-specific overall survival (43.1% vs 10.5%, P = 0.019), 10-year disease-free survival (36.7% vs 10.2%, P = 0.040) and 10-year local recurrence-free survival (47.2% vs 17.2%, P = 0.018) compared with the CFI group. Aside from radiation esophagitis, the incidence of grade 3 or greater acute toxicities did not differ between the two groups. Multivariate analysis showed that radiation field, tumor length and clinical stage were independent prognostic factors associated with OS. Concurrent chemoradiotherapy with ENI improves both disease-specific overall survival and loco-regional control in patients with inoperable esophageal cancer receiving per-protocol treatment. The regimen has a manageable tolerability profile. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  19. Results of a Phase 2 Study Examining the Effects of Omitting Elective Neck Irradiation to Nodal Levels IV and V{sub b} in Patients With N{sub 0-1} Nasopharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Jian-zhou [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Han, Fei; Lu, Li-Xia; Huang, Shao-Min; Lin, Cheng-Guang; Deng, Xiao-Wu; Cui, Nian-Ji [State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, Guangdong (China); Zhao, Chong, E-mail: gzzhaochong@hotmail.com [State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, Guangdong (China)

    2013-03-15

    Purpose: To evaluate the patterns of nodal failure and toxicity in clinically negative necks of N{sub 0-1} nasopharyngeal carcinoma (NPC) patients who were treated with intensity modulated radiation therapy (IMRT) but did not receive elective neck irradiation (ENI) to level IV and V{sub b} nodes. Methods and Materials: We conducted a phase 2 prospective study in N{sub 0-1} NPC patients treated with IMRT. ENI included the retropharyngeal nodes and levels II to V{sub a} but omitted levels IV and V{sub b} in clinically negative necks. Patterns of nodal failure, regional control (RC), and late toxicity were evaluated. Results: Between 2001 and 2008, a total of 212 patients (128 N{sub 0} and 84 N{sub 1}) were enrolled in the study. Seven patients (4 in-field and 3 out-of-field) developed nodal failure. One patient (0.5%) developed nodal failure at level V{sub b}, but no patients developed nodal failure at level IV. The 5-year RC rates of the entire group, N{sub 0} patients and N{sub 1} patients were 95.6%, 98.2%, and 91.3%, respectively. Fifteen patients (7.1%) developed distant metastases. The 5-year distant failure-free survival (DFFS) and overall survival (OS) rates were 91.4% and 89.8%, respectively. The rates of grade 2 or greater skin dystrophy, subcutaneous fibrosis and xerostomia were 6.2%, 16.6%, and 17.9%, respectively. Conclusions: The rate of out-of-field nodal failure when omitting ENI to levels IV and V{sub b} in clinically negative necks of patients with N{sub 0-1} NPC was extremely low; therefore, a further phase 3 study is warranted.

  20. De Novo Nodal Diffuse Large B-Cell Lymphoma: Identification of Biologic Prognostic Factors

    International Nuclear Information System (INIS)

    Abd El-Hameed, A.

    2005-01-01

    Diffuse large B-cell Lymphoma (DLBCL) represents the most frequent type of non-Hodgkin lymphoma (NHL). Although combination chemotherapy has improved the outcome, long-term cure is now possible for approximately 50% of all patients. making the search for parameters identifying patients at high risk particularly needed. The presence of bcl-2 gene rearrangement in de novo DLBCL suggests a possible follicle center cell origin and perhaps a distinct clinical behavior. This study investigated the frequency and prognostic significance of t( 14; 18) translocation and bcl-2 protein overexpression in a cohort of patients with de novo nodal DLBCL who where uniformly evaluated and treated. Material and Methods: A total of 40 patients with de novo nodal DLBCL treated at National Cancer Institute (NCI), Cairo University were investigated. Formal infixed, paraffin-embedded sections were analyzed for: I) bcl-2 gene rearrangement including major break point region (mbr) and minor cluster region (mcr) by polymerase chain reaction (PCR). and 2) bcl-2 protein expression by immunohistochemistry using Dako 124 clone. Results were correlated with the clinical features and subsequent clinical course. Bcl-2 gene rearrangement was detected in 8 cases (20%). 2 cases at mbr, and 6 cases at mcr. Bcl-2 protein (> I 0%) was expressed in 24 cases (60%), irrespective of the presence of t( 14; 18) translocation. The t( 14; 18), and bcl-2 protein overexpression were more frequently associated with failure to achieve a complete response to therapy (ρ=0.008. and 0.04. respectively). DLBCL patients with t(14;18), and bcl-2 protein expression had a significantly reduced 5-year disease free survival (ρ=0.04, and 0.01, respectively). The t( 14; 18) translocation, and bcl-2 protein expression define a group of DLBCL patients with a poor prognosis, and could be used to tailor treatment, and to identify candidates for therapeutic approaches. Geographic differences in t(14;18) may be related to the

  1. Solitary metastasis of ampullary carcinoma to the spleen: a case report.

    Science.gov (United States)

    Phan, Tri M

    2018-04-01

    Here, we report a first case of ampullary cancer with solitary metastasis of the spleen, which was successfully treated with pancreatoduodenectomy and splenectomy and was discharged 7 days after the operation with outpatient chemotherapy. In such cases, physicians should consider splenectomy as an effective treatment option.

  2. Profile of prognostic factors in 1022 Indian women with early-stage breast cancer treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Dinshaw, Ketayun A.; Budrukkar, Ashwini N.; Chinoy, Roshan F.; Sarin, Rajiv; Badwe, Rajendra M.S.; Hawaldar, Rohini; Shrivastava, Shyam Kishore

    2005-01-01

    Purpose: The outcome of breast cancer treatment can vary in different geographic and ethnic groups. A multivariate analysis was performed for various prognostic factors in 1022 Indian women with pathologic Stage I-II breast cancer treated between 1980 and 2000 with standard breast-conserving therapy with or without systemic adjuvant therapy. Methods and Materials: At a mean follow-up of 53 months, the outcomes studied were local failure, locoregional failure, and distant failure, overall survival (OS), and disease-free survival (DFS). Results: The median pathologic tumor size was 3 cm (range, 1-5 cm), and axillary lymph node metastasis was present in 39% of women. The actuarial 5- and 10-year OS and DFS rate was 87% and 77% and 76% and 68%, respectively. Lymphovascular emboli or invasion (LVI) was the strongest independent adverse factor for all failure and survival (local failure, hazard ratio 2.85; 95% confidence interval, 1.68-4.83; OS; hazard ratio, 2.01, 95% confidence interval, 1.35-2.99). Lymph node metastasis was also an independent adverse factor for local failure, locoregional failure, distant failure, DFS, and OS (hazard ratio, 1.55, 95% confidence interval, 1.04-2.30). Age ≤40 years increased the incidence of local recurrence, and patients with inner quadrant tumors had inferior DFS. The incidence of LVI was significantly greater in women with lymph node metastases than in node-negative women (p < 0.001) and in women with Grade 3 tumors than in those with Grade 1 or 2 tumors (p = 0.001). Conclusion: In Indian women, LVI was the strongest independent prognostic factor for OS, DFS, and local recurrence, irrespective of nodal status and systemic adjuvant treatment. Although LVI may not be a contraindication for BCT, as has been proposed by certain groups, it is necessary to define its role in prospective studies in determining local and systemic treatment

  3. Contemporary management of patients with penile cancer and lymph node metastasis.

    Science.gov (United States)

    Leone, Andrew; Diorio, Gregory J; Pettaway, Curtis; Master, Viraj; Spiess, Philippe E

    2017-06-01

    Penile cancer is a rare disease that causes considerable physical and psychological patient morbidity, especially at advanced stages. Patients with low-stage nodal metastasis can achieve durable survival with surgery alone, but those with extensive locoregional metastasis have overall low survival. Contemporary management strategies for lymph node involvement in penile cancer aim to minimize the morbidity associated with traditional radical inguinal lymphadenectomy through appropriate risk stratification while optimizing oncological outcomes. Modified (or superficial) inguinal lymph node dissection and dynamic sentinel lymph node biopsy are diagnostic modalities that have been recommended in patients with high-risk primary penile tumours and nonpalpable inguinal lymph nodes. In addition, advances in minimally invasive and robot-assisted lymphadenectomy techniques are being investigated in patients with penile cancer and might further decrease lymphadenectomy-related adverse effects. The management of patients with advanced disease has evolved to include multimodal treatment with systemic chemotherapy before surgical intervention and can include adjuvant chemotherapy after pelvic lymphadenectomy. The role of radiotherapy in the neoadjuvant or adjuvant setting remains largely unclear, owing to a lack of high-level evidence of possible benefits. New targeted therapies have shown efficacy in squamous cell carcinomas of other sites and might also prove effective in patients with penile cancer.

  4. Molecular biology of breast cancer metastasis: Genetic regulation of human breast carcinoma metastasis

    International Nuclear Information System (INIS)

    Welch, Danny R; Steeg, Patricia S; Rinker-Schaeffer, Carrie W

    2000-01-01

    The present is an overview of recent data that describes the genetic underpinnings of the suppression of cancer metastasis. Despite the explosion of new information about the genetics of cancer, only six human genes have thus far been shown to suppress metastasis functionally. Not all have been shown to be functional in breast carcinoma. Several additional genes inhibit various steps of the metastatic cascade, but do not necessarily block metastasis when tested using in vivo assays. The implications of this are discussed. Two recently discovered metastasis suppressor genes block proliferation of tumor cells at a secondary site, offering a new target for therapeutic intervention

  5. Leptomeningeal metastasis mimicking Chronic Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2017-12-01

    Full Text Available The presentation of Leptomeningeal Metastasis varies widely. It can also present a condition very similar to Chronic Subdural Hematoma. One should have a low threshold for suspicion while diagnosing such conditions to avoid catastrophic events.

  6. Leptomeningeal metastasis mimicking Chronic Subdural Hematoma

    OpenAIRE

    Jain Saurabh

    2017-01-01

    The presentation of Leptomeningeal Metastasis varies widely. It can also present a condition very similar to Chronic Subdural Hematoma. One should have a low threshold for suspicion while diagnosing such conditions to avoid catastrophic events.

  7. Colorectal cancer presenting as bone metastasis

    Directory of Open Access Journals (Sweden)

    M C Suresh Babu

    2017-01-01

    Conclusions: In this study, the patients of colorectal cancer presenting with bone metastasis were of male sex and younger age. The factors that were associated with reduced survival were extraosseous and liver involvement.

  8. Isolated malignant melanoma metastasis to the pancreas

    DEFF Research Database (Denmark)

    Larsen, Anne K; Krag, Christen; Geertsen, Poul

    2013-01-01

    SUMMARY: Malignant melanomas rarely develop isolated pancreatic metastases. We describe a unique patient who is still alive 22 years following an isolated pancreatic melanoma metastasis, and we review the sparse literature in the field....

  9. Osthole inhibits bone metastasis of breast cancer

    OpenAIRE

    Wu, Chunyu; Sun, Zhenping; Guo, Baofeng; Ye, Yiyi; Han, Xianghui; Qin, Yuenong; Liu, Sheng

    2017-01-01

    Bone is one of the most common sites for breast cancer metastasis, which greatly contributes to patient morbidity and mortality. Osthole, a major extract from Cnidium monnieri (L.), exhibits many biological and pharmacological activities, however, its potential as a therapeutic agent in the treatment of breast cancer bone metastases remain poorly understood. In this study, we set out to investigate whether osthole could inhibit breast cancer metastasis to bone in mice and clarified the potent...

  10. Brain metastasis from melanoma: the prognostic value of varying sites of extracranial disease.

    Science.gov (United States)

    Bates, James E; Youn, Paul; Usuki, Kenneth Y; Walter, Kevin A; Huggins, Christine F; Okunieff, Paul; Milano, Michael T

    2015-11-01

    Patients with brain metastasis from melanoma have poor outcomes. Radiation is used both for prognostic and symptomatic value. We aimed to further clarify the role of stereotactic radiosurgery (SRS) and whole brain radiotherapy (WBRT) as well as the prognostic implication of various sites of extracranial disease. The records of 73 consecutive patients treated at the University of Rochester Medical Center for brain-metastatic melanoma from January 2004 to October 2013 were reviewed. The median overall survival (OS) was 3.0 months. Patients treated with WBRT alone had decreased OS compared to those treated with SRS alone (HR = 0.38, p = 0.001) or WBRT and SRS (HR = 0.51, p = 0.039). The mean number of brain metastasis differed (p = 0.002) in patients in patients who received WBRT (4.0) compared to those who did not (2.0). Among patients with extracranial disease (n = 63), bone metastasis (HR = 1.86, p = 0.047, n = 15) was a negative prognostic factor; liver (HR = 1.59, p = 0.113, n = 17), lung (HR = 1.51, p = 0.23, n = 51) and adrenal metastasis (HR = 1.70, p = 0.15, n = 10) were not. In patients with concurrent brain and lung metastasis, those with disease limited to those two sites (OS = 8.7 mo, n = 13) had improved OS (HR = 0.44, p = 0.014) compared to those with additional disease (OS = 1.8 mo, n = 50). Based on this hypothesis-generating retrospective analysis, SRS may offer survival benefit compared to WBRT alone in patients with brain metastatic melanoma. Bone metastasis appears to confer a particularly poor prognosis. Those with disease confined to the lung and brain may represent a population with improved prognosis.

  11. FGFR-1 amplification in metastatic lymph-nodal and haematogenous lobular breast carcinoma

    Directory of Open Access Journals (Sweden)

    Brunello Eleonora

    2012-12-01

    Full Text Available Abstract Background Lobular breast carcinoma usually shows poor responsiveness to chemotherapies and often lacks targeted therapies. Since FGFR1 expression has been shown to play pivotal roles in primary breast cancer tumorigenesis, we sought to analyze the status of FGFR1 gene in a metastatic setting of lobular breast carcinoma, since promising FGFR1 inhibitors has been recently developed. Methods Fifteen tissue metastases from lobular breast carcinomas with matched primary infiltrative lobular breast carcinoma were recruited. Eleven cases showed loco-regional lymph-nodal and four haematogenous metastases. FGFR-1 gene (8p12 amplification was evaluated by chromogenic in situ hybridization (CISH analysis. Her-2/neu and topoisomerase-IIα gene status was assessed. E-cadherin and Hercept Test were also performed. We distinguished amplification (>6 or cluster of signals versus gains (3–6 signals of the locus specific FGFR-1 gene. Results Three (20% primary lobular breast carcinomas showed >6 or cluster of FGFR1 signals (amplification, six cases (40% had a mean of three (range 3–6 chromogenic signals (gains whereas in 6 (40% was not observed any abnormality. Three of 15 metastasis (20% were amplified, 2/15 (13,4% did not. The ten remaining cases (66,6% showed three chromogenic signals. The three cases with FGFR-1 amplification matched with those primary breast carcinomas showing FGFR-1 amplification. The six cases showing FGFR-1 gains in the primary tumour again showed FGFR-1 gains in the metastases. Four cases showed gains of FGFR-1 gene signals in the metastases and not in the primary tumours. Her-2/neu gene amplification was not observed in all cases but one (6% case. Topoisomerase-IIα was not amplified in all cases. Conclusions 1 a subset of metastatic lobular breast carcinoma harbors FGFR-1 gene amplification or gains of chromogenic signals; 2 a minor heterogeneity has been observed after matching primary and metastatic carcinomas; 3 in the

  12. A simple nodal force distribution method in refined finite element meshes

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jai Hak [Chungbuk National University, Chungju (Korea, Republic of); Shin, Kyu In [Gentec Co., Daejeon (Korea, Republic of); Lee, Dong Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Cho, Seungyon [National Fusion Research Institute, Daejeon (Korea, Republic of)

    2017-05-15

    In finite element analyses, mesh refinement is frequently performed to obtain accurate stress or strain values or to accurately define the geometry. After mesh refinement, equivalent nodal forces should be calculated at the nodes in the refined mesh. If field variables and material properties are available at the integration points in each element, then the accurate equivalent nodal forces can be calculated using an adequate numerical integration. However, in certain circumstances, equivalent nodal forces cannot be calculated because field variable data are not available. In this study, a very simple nodal force distribution method was proposed. Nodal forces of the original finite element mesh are distributed to the nodes of refined meshes to satisfy the equilibrium conditions. The effect of element size should also be considered in determining the magnitude of the distributing nodal forces. A program was developed based on the proposed method, and several example problems were solved to verify the accuracy and effectiveness of the proposed method. From the results, accurate stress field can be recognized to be obtained from refined meshes using the proposed nodal force distribution method. In example problems, the difference between the obtained maximum stress and target stress value was less than 6 % in models with 8-node hexahedral elements and less than 1 % in models with 20-node hexahedral elements or 10-node tetrahedral elements.

  13. A polygonal nodal SP3 method for whole core Pin-by-Pin neutronics calculation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yunzhao; Wu, Hongchun; Cao, Liangzhi, E-mail: xjtulyz@gmail.com, E-mail: hongchun@mail.xjtu.edu.cn, E-mail: caolz@mail.xjtu.edu.cn [School of Nuclear Science and Technology, Xi' an Jiaotong University, Shaanxi (China)

    2011-07-01

    In this polygonal nodal-SP3 method, neutron transport equation is transformed by employing an isotropic SP3 method into two coupled equations that are both in the same mathematic form with the diffusion equation, and then a polygonal nodal method is proposed to solve the two coupled equations. In the polygonal nodal method, adjacent nodes are coupled through partial currents, and a nodal response matrix between incoming and outgoing currents is obtained by expanding detailed nodal flux distribution into a sum of exponential functions. This method avoids the transverse integral technique, which is widely used in regular nodal method and can not be used in triangular geometry because of the mathematical singularity. It is demonstrated by the numerical results of the test problems that the k{sub eff} and power distribution agree well with other codes, the triangular nodal-SP3 method appears faster, and that whole core pin-by-pin transport calculation with fine meshes is feasible after parallelization and acceleration. (author)

  14. Nodal price volatility reduction and reliability enhancement of restructured power systems considering demand-price elasticity

    International Nuclear Information System (INIS)

    Goel, L.; Wu, Qiuwei; Wang, Peng

    2008-01-01

    With the development of restructured power systems, the conventional 'same for all customers' electricity price is getting replaced by nodal prices. Electricity prices will fluctuate with time and nodes. In restructured power systems, electricity demands will interact mutually with prices. Customers may shift some of their electricity consumption from time slots of high electricity prices to those of low electricity prices if there is a commensurate price incentive. The demand side load shift will influence nodal prices in return. This interaction between demand and price can be depicted using demand-price elasticity. This paper proposes an evaluation technique incorporating the impact of the demand-price elasticity on nodal prices, system reliability and nodal reliabilities of restructured power systems. In this technique, demand and price correlations are represented using the demand-price elasticity matrix which consists of self/cross-elasticity coefficients. Nodal prices are determined using optimal power flow (OPF). The OPF and customer damage functions (CDFs) are combined in the proposed reliability evaluation technique to assess the reliability enhancement of restructured power systems considering demand-price elasticity. The IEEE reliability test system (RTS) is simulated to illustrate the developed techniques. The simulation results show that demand-price elasticity reduces the nodal price volatility and improves both the system reliability and nodal reliabilities of restructured power systems. Demand-price elasticity can therefore be utilized as a possible efficient tool to reduce price volatility and to enhance the reliability of restructured power systems. (author)

  15. Type-I and type-II topological nodal superconductors with s -wave interaction

    Science.gov (United States)

    Huang, Beibing; Yang, Xiaosen; Xu, Ning; Gong, Ming

    2018-01-01

    Topological nodal superconductors with protected gapless points in momentum space are generally realized based on unconventional pairings. In this work we propose a minimal model to realize these topological nodal phases with only s -wave interaction. In our model the linear and quadratic spin-orbit couplings along the two orthogonal directions introduce anisotropic effective unconventional pairings in momentum space. This model may support different nodal superconducting phases characterized by either an integer winding number in BDI class or a Z2 index in D class at the particle-hole invariant axes. In the vicinity of the nodal points the effective Hamiltonian can be described by either type-I or type-II Dirac equations, and the Lifshitz transition from type-I nodal phases to type-II nodal phases can be driven by external in-plane magnetic fields. We show that these nodal phases are robust against weak impurities, which only slightly renormalizes the momentum-independent parameters in the impurity-averaged Hamiltonian, thus these phases are possible to be realized in experiments with real semi-Dirac materials. The smoking-gun evidences to verify these phases based on scanning tunneling spectroscopy method are also briefly discussed.

  16. Magnetic Resonance Imaging of Liver Metastasis.

    Science.gov (United States)

    Karaosmanoglu, Ali Devrim; Onur, Mehmet Ruhi; Ozmen, Mustafa Nasuh; Akata, Deniz; Karcaaltincaba, Musturay

    2016-12-01

    Liver magnetic resonance imaging (MRI) is becoming the gold standard in liver metastasis detection and treatment response assessment. The most sensitive magnetic resonance sequences are diffusion-weighted images and hepatobiliary phase images after Gd-EOB-DTPA. Peripheral ring enhancement, diffusion restriction, and hypointensity on hepatobiliary phase images are hallmarks of liver metastases. In patients with normal ultrasonography, computed tomography (CT), and positron emission tomography (PET)-CT findings and high clinical suspicion of metastasis, MRI should be performed for diagnosis of unseen metastasis. In melanoma, colon cancer, and neuroendocrine tumor metastases, MRI allows confident diagnosis of treatment-related changes in liver and enables differential diagnosis from primary liver tumors. Focal nodular hyperplasia-like nodules in patients who received platinum-based chemotherapy, hypersteatosis, and focal fat can mimic metastasis. In cancer patients with fatty liver, MRI should be preferred to CT. Although the first-line imaging for metastases is CT, MRI can be used as a problem-solving method. MRI may be used as the first-line method in patients who would undergo curative surgery or metastatectomy. Current limitation of MRI is low sensitivity for metastasis smaller than 3mm. MRI fingerprinting, glucoCEST MRI, and PET-MRI may allow simpler and more sensitive diagnosis of liver metastasis. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Nodal-dependent mesendoderm specification requires the combinatorial activities of FoxH1 and Eomesodermin.

    Directory of Open Access Journals (Sweden)

    Christopher E Slagle

    2011-05-01

    Full Text Available Vertebrate mesendoderm specification requires the Nodal signaling pathway and its transcriptional effector FoxH1. However, loss of FoxH1 in several species does not reliably cause the full range of loss-of-Nodal phenotypes, indicating that Nodal signals through additional transcription factors during early development. We investigated the FoxH1-dependent and -independent roles of Nodal signaling during mesendoderm patterning using a novel recessive zebrafish FoxH1 mutation called midway, which produces a C-terminally truncated FoxH1 protein lacking the Smad-interaction domain but retaining DNA-binding capability. Using a combination of gel shift assays, Nodal overexpression experiments, and genetic epistasis analyses, we demonstrate that midway more accurately represents a complete loss of FoxH1-dependent Nodal signaling than the existing zebrafish FoxH1 mutant schmalspur. Maternal-zygotic midway mutants lack notochords, in agreement with FoxH1 loss in other organisms, but retain near wild-type expression of markers of endoderm and various nonaxial mesoderm fates, including paraxial and intermediate mesoderm and blood precursors. We found that the activity of the T-box transcription factor Eomesodermin accounts for specification of these tissues in midway embryos. Inhibition of Eomesodermin in midway mutants severely reduces the specification of these tissues and effectively phenocopies the defects seen upon complete loss of Nodal signaling. Our results indicate that the specific combinations of transcription factors available for signal transduction play critical and separable roles in determining Nodal pathway output during mesendoderm patterning. Our findings also offer novel insights into the co-evolution of the Nodal signaling pathway, the notochord specification program, and the chordate branch of the deuterostome family of animals.

  18. Long-term survival in bronchogenic carcinoma with a solitary metastasis.

    Science.gov (United States)

    Shachor, J; Luria, H; Cordova, M; Bernheim, J; Griffel, B; Bruderman, I

    1986-03-01

    Partial resection of a huge anaplastic large cell carcinoma of the upper lobe of the right lung was performed in a 47-year-old patient in order to relieve symptoms of pulmonary hypertrophic osteoarthropathy. Several months later a solitary metastasis was noted in the muscles of the right forearm. The metastasis was resected and the forearm irradiated. The patient was further treated with injections of autologous tumour cell vaccine and BCG. Today, 7 years later, the patient is alive, without any signs of neoplastic disease.

  19. Merkel cell carcinoma with axillary metastasis; a case report of a rare disease

    Directory of Open Access Journals (Sweden)

    Serdar Culcu

    2018-04-01

    Full Text Available Merkel cell carcinoma is a rare primer neuroendocrine carcinoma of the skin. It is an extremely aggressive tumor. This rare carcinoma is seen with high local and regional recurrence ratios and distant metastasis. We report that a 64 years old female patient who had undergo an excision in another center because of a mass on 4 cm proximal of her right elbow had been diagnosed with Merkel cell carcinoma with positive surgical margins. She was treated with wide re-excision and axillary dissection at our clinic. Keywords: Merkel cell carcinoma, Skin, Axillary metastasis

  20. Immunohistochemical analysis of stromal fibrocytes and myofibroblasts to envision the invasion and lymph node metastasis in oral squamous cell carcinoma.

    Science.gov (United States)

    Rao, Sowmya J; Rao, Jyothi Bellur Madhava; Rao, Pp Jagadish

    2017-01-01

    Tumor cells work in close coordination with stromal elements from its stage of emergence to metastasis. The study was designed to assess the presence and distribution pattern of stromal fibrocytes and myofibroblasts in oral squamous cell carcinoma (OSCC). Possibility of using these stromal cells as a marker for invasion and lymphnode metastasis was evaluated. A total of 40 cases of OSCC consisting twenty cases of each lymph node positive (pN+) and lymph node negative (pN0) samples and ten normal oral mucosa (NOM) tissues were subjected to double immunostaining using CD34 and alpha-smooth muscle actin (α-SMA) antibodies. Stained sections were evaluated semiquantitatively. CD34 fibrocytes were seen in 70% of NOM and none of OSCC samples. α-SMA myofibroblasts were seen in 80% of OSCC and none of NOM samples. A statistically significant difference was found in fibrocyte values ( P < 0.001) and myofibroblast values ( P < 0.001) between NOM and OSCC study samples. No statistical significance in myofibroblast values between pN0 and pN+ study groups; however, their distribution pattern appreciably varied. This study suggested that fibrocytes could be used as one of the markers for early invasion. Abrupt loss of fibrocytes at the transition zone toward carcinoma and statistical significance in their values supported this inference. Heterogeneity in the distribution pattern of myofibroblasts in tumor stroma indicates that this variability may predict the tumor behavior toward nodal metastasis rather than their mere presence or absence.

  1. Obstructive Small Bowel Metastasis from Uterine Leiomyosarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Mutahir A. Tunio

    2014-01-01

    Full Text Available Background. Uterine leiomyosarcoma is a rare and aggressive gynecologic malignancy with an overall poor prognosis. Lungs, bones, and brain are common sites of metastases of uterine leiomyosarcoma. Metastases of uterine leiomyosarcoma to the small bowel are extremely rare, and only four case reports have been published to date. Case presentation. A 55-year-old Saudi woman diagnosed with a case of uterine leiomyosarcoma treated with total abdominal hysterectomy (TAH and bilateral salpingooophorectomy (BSO presented in emergency room after sixteen months with acute abdomen. Subsequent work-up showed a jejunal mass for which resection and end-to-end anastomosis were performed. Biopsy confirmed the diagnosis of small bowel metastasis from uterine leiomyosarcoma. Further staging work-up showed wide spread metastasis in lungs and brain. After palliative cranial irradiation, systemic chemotherapy based on single agent doxorubicin was started. Conclusion. Metastatic leiomyosarcoma of small bowel from uterine leiomyosarcoma is a rare entity and is sign of advanced disease. It should be differentiated from primary leiomyosarcoma of small bowel as both are treated with different systemic chemotherapeutic agents.

  2. Face centered cubic SnSe as a Z2 trivial Dirac nodal line material

    OpenAIRE

    Tateishi, Ikuma; Matsuura, Hiroyasu

    2018-01-01

    The presence of Dirac nodal line in the time-reversal and inversion symmetric system is dictated by Z2 index when spin-orbit interaction is absent. With the first principles calculation, we show that the Dirac nodal line can emerge in Z2 trivial material by calculating the band structure of SnSe of face centered cubic lattice as an example and it becomes a topological crystalline insulator when spin-orbit interaction is taken into account. We clarify the origin of the Dirac nodal line by obta...

  3. NUMERICAL SOLUTION OF SINGULAR INVERSE NODAL PROBLEM BY USING CHEBYSHEV POLYNOMIALS

    OpenAIRE

    NEAMATY, ABDOLALI; YILMAZ, EMRAH; AKBARPOOR, SHAHRBANOO; DABBAGHIAN, ABDOLHADI

    2017-01-01

    In this study, we consider Sturm-Liouville problem in two cases: the first case having no singularity and the second case having a singularity at zero. Then, we calculate the eigenvalues and the nodal points and present the uniqueness theorem for the solution of the inverse problem by using a dense subset of the nodal points in two given cases. Also, we use Chebyshev polynomials of the first kind for calculating the approximate solution of the inverse nodal problem in these cases. Finally, we...

  4. Using nodal expansion method in calculation of reactor core with square fuel assemblies

    International Nuclear Information System (INIS)

    Abdollahzadeh, M. Y.; Boroushaki, M.

    2009-01-01

    A polynomial nodal method is developed to solve few-group neutron diffusion equations in cartesian geometry. In this article, the effective multiplication factor, group flux and power distribution based on the nodal polynomial expansion procedure is presented. In addition, by comparison of the results the superiority of nodal expansion method on finite-difference and finite-element are fully demonstrated. The comparison of the results obtained by these method with those of the well known benchmark problems have shown that they are in very good agreement.

  5. [Method for optimal sensor placement in water distribution systems with nodal demand uncertainties].

    Science.gov (United States)

    Liu, Shu-Ming; Wu, Xue; Ouyang, Le-Yan

    2013-08-01

    The notion of identification fitness was proposed for optimizing sensor placement in water distribution systems. Nondominated Sorting Genetic Algorithm II was used to find the Pareto front between minimum overlap of possible detection times of two events and the best probability of detection, taking nodal demand uncertainties into account. This methodology was applied to an example network. The solutions show that the probability of detection and the number of possible locations are not remarkably affected by nodal demand uncertainties, but the sources identification accuracy declines with nodal demand uncertainties.

  6. The application of modern nodal methods to PWR reactor physics analysis

    International Nuclear Information System (INIS)

    Knight, M.P.

    1988-06-01

    The objective of this research is to develop efficient computational procedures for PWR reactor calculations, based on modern nodal methods. The analytic nodal method, which is characterised by the use of exact exponential expansions in transverse-integrated equations, is implemented within an existing finite-difference code. This shows considerable accuracy and efficiency on standard benchmark problems, very much in line with existing experience with nodal methods., Assembly powers can be calculated to within 2.0% with just one mesh per assembly. (author)

  7. A variational nodal diffusion method of high accuracy; Varijaciona nodalna difuziona metoda visoke tachnosti

    Energy Technology Data Exchange (ETDEWEB)

    Tomasevic, Dj; Altiparmarkov, D [Institut za Nuklearne Nauke Boris Kidric, Belgrade (Yugoslavia)

    1988-07-01

    A variational nodal diffusion method with accurate treatment of transverse leakage shape is developed and presented in this paper. Using Legendre expansion in transverse coordinates higher order quasi-one-dimensional nodal equations are formulated. Numerical solution has been carried out using analytical solutions in alternating directions assuming Legendre expansion of the RHS term. The method has been tested against 2D and 3D IAEA benchmark problem, as well as 2D CANDU benchmark problem. The results are highly accurate. The first order approximation yields to the same order of accuracy as the standard nodal methods with quadratic leakage approximation, while the second order reaches reference solution. (author)

  8. Regional nodal relapse in surgically staged Merkel cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoeller, Ulrike; Mueller, Thomas; Schubert, Tina; Budach, Volker; Ghadjar, Pirus [Charite Universitaetsmedizin Berlin, Department of Radiation Oncology, Berlin (Germany); Brenner, Winfried [Charite Universitaetsmedizin Berlin, Department of Nuclear Medicine, Berlin (Germany); Kiecker, Felix [Charite Universitaetsmedizin Berlin, Department of Dermatology, Berlin (Germany); Schicke, Bernd [Tumor Center Berlin, Berlin (Germany); Haase, Oliver [Charite Universitaetsmedizin Berlin, Department of Surgery, Berlin (Germany)

    2014-10-08

    The nodal relapse pattern of surgically staged Merkel cell carcinoma (MCC) with/without elective nodal radiotherapy (RT) was studied in a single institution. A total of 51 patients with MCC, 33 % UICC stage I, 14 % II, 53 % III (4 lymph node metastases of unknown primary) were eligible. All patients had surgical staging: 23 patients sentinel node biopsy (SNB), 22 patients SNB followed by lymphadenectomy (LAD) and 6 patients LAD. In all, 94 % of the primary tumors (PT) were completely resected; 57 % of patients received RT, 51 % of known PT sites, 33 % (8/24 patients) regional RT to snN0 nodes and 68 % (17/27 patients) to pN+ nodes, mean reference dose 51.5 and 50 Gy, respectively. Mean follow-up was 6 years (range 2-14 years). A total of 22 % (11/51) patients developed regional relapses (RR); the 5-year RR rate was 27 %. In snN0 sites (stage I/II), relapse occurred in 5 of 14 nonirradiated vs. none of 8 irradiated sites (p = 0.054), resulting in a 5-year RR rate of 33 % versus 0 % (p = 0.16). The crude RR rate was lower in stage I (12 %, 2/17 patients) than for stage II (43 %, 3/7 patients). In stage III (pN+), RR appeared to be less frequent in irradiated sites (18 %, 3/14 patients) compared with nonirradiated sites (33 %, 3/10 patients, p = 0.45) with 5-year RR rates of 23 % vs. 34 %, respectively. Our data suggest that adjuvant nodal RT plays a major role even if the sentinel nodes were negative. Adjuvant RT of the lymph nodes in patients with stage IIa tumors and RT after LAD in stage III tumors is proposed and should be evaluated prospectively. (orig.) [German] Untersucht wurde das regionaere Rezidivmuster des Merkelzell-Karzinoms (MCC) nach chirurgischem Staging und stadienadaptierter Therapie. Eingeschlossen wurden 51 Patienten mit lokalisiertem MCC: 33 % hatten UICC-Stadium-I-, 14 % -II-, 53 % -III-Tumoren (davon 4 Lymphknotenmetastasen eines unbekannten Primaertumors). Alle Patienten erhielten ein chirurgisches Staging: 23 Waechterlymphknotenbiopsien (SNB

  9. Relationship of tumor grade to other pathologic features and to treatment outcome for patients with early-stage breast cancer treated with breast-conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Nixon, Asa J; Gage, Irene; Connolly, James L; Schnitt, Stuart; Silver, Barbara; Hetelekidis, Stella; Recht, Abram; Harris, Jay R

    1995-07-01

    Purpose: To study the relationship of tumor grade to the distribution of pathologic features and to the risk of local and distant recurrence following breast-conserving therapy in patients with pure infiltrating ductal carcinoma, and to explore the differences between this type and tubular carcinoma. Materials and Methods: Between 1968 and 1986, 1624 patients were treated for clinical Stage I or II invasive breast cancer with a complete gross excision and {>=}60 Gy to the tumor bed. The original slides were reviewed in 1337 cases (82%). Of these, 1081 were pure infiltrating ductal carcinoma and 28 were tubular carcinoma and these constitute the study population. Fifty-five patients (5%) have been lost to followup after 7-181 months. Median followup for 742 survivors is 134 months (7-278 mos.). We evaluated the following features: histologic grade (modified Bloom-Richardson system), the presence of nodal metastases (in 891 pts. (80%) undergoing axillary dissection [pLN+]), an extensive intraductal component (EIC), lymphatic vessel invasion (LVI), mononuclear cellular response (MCR), and necrosis. We analyzed the incidence of clinical and pathologic characteristics as a function of histology and histologic grade (Table 1). We also examined the 10-year crude rates of first failure for evaluable patients (Table 2) and calculated actuarial curves for regional nodal failure or distant metastasis (RNF/DM) at any time during followup (Figure 1). Results: Conclusions: 1) The proportion of tumors with LVI, EIC, or lymph node involvement did not vary significantly by histologic grade. Low grade tumors tended to be smaller and exhibit less MCR and necrosis; 2) Grade did not predict for local recurrence. Distant recurrence rates were significantly higher in patients with grade II or III as compared with grade I tumors, although recurrence rates continued to rise for grade I tumors through 10 years of followup; 3) Although patient numbers are small, tubular breast carcinomas

  10. Arachidonic Acid Metabolite as a Novel Therapeutic Target in Breast Cancer Metastasis

    Directory of Open Access Journals (Sweden)

    Thaiz F. Borin

    2017-12-01

    Full Text Available Metastatic breast cancer (BC (also referred to as stage IV spreads beyond the breast to the bones, lungs, liver, or brain and is a major contributor to the deaths of cancer patients. Interestingly, metastasis is a result of stroma-coordinated hallmarks such as invasion and migration of the tumor cells from the primary niche, regrowth of the invading tumor cells in the distant organs, proliferation, vascularization, and immune suppression. Targeted therapies, when used as monotherapies or combination therapies, have shown limited success in decreasing the established metastatic growth and improving survival. Thus, novel therapeutic targets are warranted to improve the metastasis outcomes. We have been actively investigating the cytochrome P450 4 (CYP4 family of enzymes that can biosynthesize 20-hydroxyeicosatetraenoic acid (20-HETE, an important signaling eicosanoid involved in the regulation of vascular tone and angiogenesis. We have shown that 20-HETE can activate several intracellular protein kinases, pro-inflammatory mediators, and chemokines in cancer. This review article is focused on understanding the role of the arachidonic acid metabolic pathway in BC metastasis with an emphasis on 20-HETE as a novel therapeutic target to decrease BC metastasis. We have discussed all the significant investigational mechanisms and put forward studies showing how 20-HETE can promote angiogenesis and metastasis, and how its inhibition could affect the metastatic niches. Potential adjuvant therapies targeting the tumor microenvironment showing anti-tumor properties against BC and its lung metastasis are discussed at the end. This review will highlight the importance of exploring tumor-inherent and stromal-inherent metabolic pathways in the development of novel therapeutics for treating BC metastasis.

  11. Aminomethylphosphonic acid inhibits growth and metastasis of human prostate cancer in an orthotopic xenograft mouse model.

    Science.gov (United States)

    Parajuli, Keshab Raj; Zhang, Qiuyang; Liu, Sen; You, Zongbing

    2016-03-01

    Aminomethylphosphonic acid (AMPA) has been shown to inhibit prostate cancer cell growth in vitro. The purpose of the present study was to determine if AMPA could inhibit growth and metastasis of prostate cancer in vivo. Human prostate cancer PC-3-LacZ-luciferase cells were implanted into the ventral lateral lobes of the prostate in 39 athymic Nu/Nu nude male mice. Seven days later, mice were randomized into the control group (n = 14, treated intraperitoneally with phosphate buffered saline), low dose group (n = 10, treated intraperitoneally with AMPA at 400 mg/kg body weight/day), and high dose group (n = 15, treated intraperitoneally with AMPA at 800 mg/kg body weight/day). Tumor growth and metastasis were examined every 4-7 days by bioluminescence imaging of live mice. We found that AMPA treatment significantly inhibited growth and metastasis of orthotopic xenograft prostate tumors and prolonged the survival time of the mice. AMPA treatment decreased expression of BIRC2 and activated caspase 3, leading to increased apoptosis in the prostate tumors. AMPA treatment decreased expression of cyclin D1. AMPA treatment also reduced angiogenesis in the prostate tumors. Taken together, these results demonstrate that AMPA can inhibit prostate cancer growth and metastasis, suggesting that AMPA may be developed into a therapeutic agent for the treatment of prostate cancer.

  12. Unstructured characteristic method embedded with variational nodal method using domain decomposition techniques

    Energy Technology Data Exchange (ETDEWEB)

    Girardi, E.; Ruggieri, J.M. [CEA Cadarache (DER/SPRC/LEPH), 13 - Saint-Paul-lez-Durance (France). Dept. d' Etudes des Reacteurs; Santandrea, S. [CEA Saclay, Dept. Modelisation de Systemes et Structures DM2S/SERMA/LENR, 91 - Gif sur Yvette (France)

    2005-07-01

    This paper describes a recently-developed extension of our 'Multi-methods,multi-domains' (MM-MD) method for the solution of the multigroup transport equation. Based on a domain decomposition technique, our approach allows us to treat the one-group equation by cooperatively employing several numerical methods together. In this work, we describe the coupling between the Method of Characteristics (integro-differential equation, unstructured meshes) with the Variational Nodal Method (even parity equation, cartesian meshes). Then, the coupling method is applied to the benchmark model of the Phebus experimental facility (Cea Cadarache). Our domain decomposition method give us the capability to employ a very fine mesh in describing a particular fuel bundle with an appropriate numerical method (MOC), while using a much large mesh size in the rest of the core, in conjunction with a coarse-mesh method (VNM). This application shows the benefits of our MM-MD approach, in terms of accuracy and computing time: the domain decomposition method allows us to reduce the Cpu time, while preserving a good accuracy of the neutronic indicators: reactivity, core-to-bundle power coupling coefficient and flux error. (authors)

  13. Unstructured characteristic method embedded with variational nodal method using domain decomposition techniques

    International Nuclear Information System (INIS)

    Girardi, E.; Ruggieri, J.M.

    2005-01-01

    This paper describes a recently-developed extension of our 'Multi-methods,multi-domains' (MM-MD) method for the solution of the multigroup transport equation. Based on a domain decomposition technique, our approach allows us to treat the one-group equation by cooperatively employing several numerical methods together. In this work, we describe the coupling between the Method of Characteristics (integro-differential equation, unstructured meshes) with the Variational Nodal Method (even parity equation, cartesian meshes). Then, the coupling method is applied to the benchmark model of the Phebus experimental facility (Cea Cadarache). Our domain decomposition method give us the capability to employ a very fine mesh in describing a particular fuel bundle with an appropriate numerical method (MOC), while using a much large mesh size in the rest of the core, in conjunction with a coarse-mesh method (VNM). This application shows the benefits of our MM-MD approach, in terms of accuracy and computing time: the domain decomposition method allows us to reduce the Cpu time, while preserving a good accuracy of the neutronic indicators: reactivity, core-to-bundle power coupling coefficient and flux error. (authors)

  14. CT-guided percutaneous acetic acid injection therapy for liver metastasis

    International Nuclear Information System (INIS)

    Yu Tongfu; Wang Dehang; Zhuang Zhenwu; Li Linxun; Shi Haibin

    2002-01-01

    Objective: To evaluate the efficacy of CT-guided percutaneous acetic acid injection (PAI) for liver metastasis. Methods: Thirty-five cases (40 lesions) with liver metastasis were treated with PAI. 4-10 ml of 30% acetic acid with 1 ml contrast media was injected into every lesion. PAI was performed twice a week, and repeated for 2 to 3 weeks. Results: The tumors shrunk in 23 lesions, and remained unchanged in 12 lesions. The efficiency was 87.5%. All cases were followed up for 3 months to 3 years. One year survival rates was 62.9% (22 cases), 2 years 40.0% (14 cases), and 3 years 22.9% (8 cases). Conclusion: PAI was an effective therapy for liver metastasis

  15. Gastrointestinal metastasis from primary lung cancer. Case series and systematic literature review.

    Science.gov (United States)

    Balla, Andrea; D Subiela, José; Bollo, Jesús; Martínez, Carmen; Rodriguez Luppi, Carlos; Hernández, Pilar; Pascual-González, Yuliana; Quaresima, Silvia; M Targarona, Eduard

    2018-04-01

    Aim of the present study is to report clinical characteristics and outcomes of patients treated in authors' hospital for GI metastasis from primary lung cancer, and to report and analyse the same data concerning patients retrieved from a systematic literature review. We performed a retrospective analysis of prospectively collected data, and a systematic review using the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Ninety-one patients were included, 5 patients from the authors' hospital and 86 through PubMed database using the keywords "intestinal metastasis" AND "lung cancer". The median time between primary lung cancer diagnosis and GI metastasis diagnosis was 2 months and the median overall survival was 4 months. This group of patients present a poor prognosis and the gold standard treatment is not defined. None of the reported treatments had a significant impact on survival. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Effective Treatment of Solitary Pituitary Metastasis with Panhypopituitarism in HER2-Positive Breast Cancer by Lapatinib.

    Science.gov (United States)

    Park, Youngmok; Kim, Hyemin; Kim, Eui-Hyun; Suh, Chang-Ok; Lee, Soohyeon

    2016-01-01

    Brain metastasis affects one third of patients with HER2-positive breast cancer after treatment with trastuzumab. Surgical resection and radiation therapy are often unsuccessful at accomplishing complete control of metastasis. Lapatinib is presumed to cross the blood-brain barrier, and exhibits clinical activities for treatment of HER2-positive breast cancer. A 43-year-old woman was treated for early breast carcinoma with total mastectomy, axillary lymph-node dissection, and adjuvant chemotherapy with cyclophosphamide plus doxorubicin. After the end of adjuvant trastuzumab therapy, she was diagnosed with panhypopituitarism due to pituitary metastasis. Surgical removal and whole brain radiation therapy were performed, but a portion of viable tumor remained. Only taking lapatinib, the size of the metastatic lesion began to shrink. Trastuzumab may have controlled the micro-metastasis of breast cancer, but it was unable to control its progression to the central nervous system. Lapatinib is a possible option for HER2-positive metastatic breast cancer patients with brain metastasis.

  17. Tiamulin inhibits breast cancer growth and pulmonary metastasis by decreasing the activity of CD73.

    Science.gov (United States)

    Yang, Xu; Pei, Shimin; Wang, Huanan; Jin, Yipeng; Yu, Fang; Zhou, Bin; Zhang, Hong; Zhang, Di; Lin, Degui

    2017-04-11

    Metastasis is the leading cause of death in breast cancer patients. CD73, also known as ecto-5'-nucleotidase, plays a critical role in cancer development including metastasis. The existing researches indicate that overexpression of CD73 promotes growth and metastasis of breast cancer. Therefore, CD73 inhibitor can offer a promising treatment for breast cancer. Here, we determined whether tiamulin, which was found to inhibit CD73, was able to suppress breast cancer development and explored the related mechanisms. We firstly measured the effect of tiamulin hydrogen fumarate (THF) on CD73 using high performance liquid chromatography (HPLC). Then, we investigated cell proliferation, migration and invasion in MDA-MB-231 human breast cancer cell line and 4 T1 mouse breast cancer cell line treated with THF by migration assay, invasion assay and activity assay. Besides, we examined the effect of THF on syngeneic mammary tumors of mice by immunohistochemistry. Our data demonstrated that THF inhibited CD73 by decreasing the activity instead of the expression of CD73. In vitro, THF inhibited the proliferation, migration and invasion of MDA-MB-231 and 4 T1 cells by suppressing CD73 activity. In vivo, animal experiments showed that THF treatment resulted in significant reduction in syngeneic tumor growth, microvascular density and lung metastasis rate. Our results indicate that THF inhibits growth and metastasis of breast cancer by blocking the activity of CD73, which may offer a promising treatment for breast cancer therapy.

  18. The Effect of Electroacupuncture on Osteosarcoma Tumor Growth and Metastasis: Analysis of Different Treatment Regimens

    Directory of Open Access Journals (Sweden)

    Branden A. Smeester

    2013-01-01

    Full Text Available Osteosarcoma is the most common malignant bone tumor found in children and adolescents and is associated with many complications including cancer pain and metastasis. While cancer patients often seek complementary and alternative medicine (CAM approaches to treat cancer pain and fatigue or the side effects of chemotherapy and treatment, there is little known about the effect of acupuncture treatment on tumor growth and metastasis. Here we evaluate the effects of six different electroacupuncture (EA regimens on osteosarcoma tumor growth and metastasis in both male and female mice. The most significant positive effects were observed when EA was applied to the ST-36 acupoint twice weekly (EA-2X/3 beginning at postimplantation day 3 (PID 3. Twice weekly treatment produced robust reductions in tumor growth. Conversely, when EA was applied twice weekly (EA-2X/7, starting at PID 7, there was a significant increase in tumor growth. We further demonstrate that EA-2X/3 treatment elicits significant reductions in tumor lymphatics, vasculature, and innervation. Lastly, EA-2X/3 treatment produced a marked reduction in pulmonary metastasis, thus providing evidence for EA’s potential antimetastatic capabilities. Collectively, EA-2X/3 treatment was found to reduce both bone tumor growth and lung metastasis, which may be mediated in part through reductions in tumor-associated vasculature, lymphatics, and innervation.

  19. Molecular pathogenesis of splenic and nodal marginal zone lymphoma.

    Science.gov (United States)

    Spina, Valeria; Rossi, Davide

    Genomic studies have improved our understanding of the biological basis of splenic (SMZL) and nodal (NMZL) marginal zone lymphoma by providing a comprehensive and unbiased view of the genes/pathways that are deregulated in these diseases. Consistent with the physiological involvement of NOTCH, NF-κB, B-cell receptor and toll-like receptor signaling in mature B-cells differentiation into the marginal zone B-cells, many oncogenic mutations of genes involved in these pathways have been identified in SMZL and NMZL. Beside genetic lesions, also epigenetic and post-transcriptional modifications contribute to the deregulation of marginal zone B-cell differentiation pathways in SMZL and NMZL. This review describes the progress in understanding the molecular mechanism underlying SMZL and NMZL, including molecular and post-transcriptional modifications, and discusses how information gained from these efforts has provided new insights on potential targets of diagnostic, prognostic and therapeutic relevance in SMZL and NMZL. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Micropropagation of Calophyllum brasiliense (Cambess.) from nodal segments.

    Science.gov (United States)

    Silveira, S S; Cordeiro-Silva, R; Degenhardt-Goldbach, J; Quoirin, M

    2016-05-03

    Micropropagation of Calophyllum brasiliense Cambess. (Clusiaceae) is a way to overcome difficulties in achieving large-scale plant production, given the recalcitrant nature of the seeds, irregular fructification and absence of natural vegetative propagation of the species. Cultures were established using nodal segments 2 cm in length, obtained from 1-2 year old seedlings, maintained in a greenhouse. Mercury chloride and Plant Preservative Mixture™ were used in the surface sterilizing stage, better results being achieved with Plant Preservative Mixture™ incorporation in culture medium, at any concentration. Polyvinylpyrrolidone, activated charcoal, cysteine, ascorbic acid or citric acid were added to the culture medium to avoid oxidation. After 30 days of culture, polyvinylpirrolidone and ascorbic acid gave better results, eliminating oxidation in most explants. For shoot multiplication, benzylaminopurine was used in concentrations of 4.4 and 8.8 µM in Woody Plant Medium, resulting in an average of 4.43 and 4.68 shoots per explant, respectively, after 90 days. Indole-3-butyric acid and α-naphthalene acetic acid were used to induce root formation, reaching a maximum rooting rate of 24% with 20µM α-naphthalene acetic acid. For acclimatization. the rooted plants were transferred to Plantmax® substrate and cultured in a greenhouse, reaching 79% of survival after 30 days and 60% after one year.

  1. Relevance of regional nodal management in multimodality esophageal cancer treatment

    International Nuclear Information System (INIS)

    Wong, J.; Perez-Tamayo, C.; Takasugi, B.; Orringer, M.B.; Flint, A.; Lichter, A.S.

    1986-01-01

    A prospective study has been undertaken at the University of Michigan Hospital, where patients with distal esophageal carcinoma receive concurrent radiation therapy (3,750 cGy delivered in 15 fractions) and systemic chemotherapy (cisplatin, Velban, 5-FU), followed by blunt esophagectomy with exploration and lymph node sampling. Strict pathologic screening and handling of nodal tissue and esophagectomy specimens were analyzed. Eighteen patients with distal esophageal lesions ranging from 5 to 12 cm (average, 7 cm) detected on the initial barium swallow study have been seen to date. In three of these patients celiac axis involvement has been demonstrated on CT. All primary lesions were confirmed by biopsy. Five were found to be squamous cell carcinoma and thirteen were adenocarcinomas. One of 15 of the presently evaluable patients (5%) had microscopic involvement of a celiac node at surgery. Celiac, lesser curvature, and superior gastric nodes where all encompassed in the radiation therapy portals to the aforementioned dose. CT scan planning was done in all patients. This added volume was well tolerated by the patients without morbidity

  2. Topological Nodal Cooper Pairing in Doped Weyl Metals

    Science.gov (United States)

    Li, Yi; Haldane, F. D. M.

    2018-02-01

    We generalize the concept of Berry connection of the single-electron band structure to that of a two-particle Cooper pairing state between two Fermi surfaces with opposite Chern numbers. Because of underlying Fermi surface topology, the pairing Berry phase acquires nontrivial monopole structure. Consequently, pairing gap functions have topologically protected nodal structure as vortices in the momentum space with the total vorticity solely determined by the pair monopole charge qp. The nodes of gap function behave as the Weyl-Majorana points of the Bogoliubov-de Gennes pairing Hamiltonian. Their relation with the connection patterns of the surface modes from the Weyl band structure and the Majorana surface modes inside the pairing gap is also discussed. Under the approximation of spherical Fermi surfaces, the pairing symmetry are represented by monopole harmonic functions. The lowest possible pairing channel carries angular momentum number j =|qp|, and the corresponding gap functions are holomorphic or antiholomorphic functions on Fermi surfaces. After projected on the Fermi surfaces with nontrivial topology, all the partial-wave channels of pairing interactions acquire the monopole charge qp independent of concrete pairing mechanism.

  3. Application of the SPH method in nodal diffusion analyses of SFR cores

    Energy Technology Data Exchange (ETDEWEB)

    Nikitin, Evgeny; Fridman, Emil [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Div. Reactor Safety; Mikityuk, K. [Paul Scherrer Institut, Villigen (Switzerland)

    2016-07-01

    The current study investigated the potential of the SPH method, applied to correct the few-group XS produced by Serpent, to further improve the accuracy of the nodal diffusion solutions. The procedure for the generation of SPH-corrected few-group XS is presented in the paper. The performance of the SPH method was tested on a large oxide SFR core from the OECD/NEA SFR benchmark. The reference SFR core was modeled with the DYN3D and PARCS nodal diffusion codes using the SPH-corrected few-group XS generated by Serpent. The nodal diffusion results obtained with and without SPH correction were compared to the reference full-core Serpent MC solution. It was demonstrated that the application of the SPH method improves the accuracy of the nodal diffusion solutions, particularly for the rodded core state.

  4. A Hybrid Interpolation Method for Geometric Nonlinear Spatial Beam Elements with Explicit Nodal Force

    Directory of Open Access Journals (Sweden)

    Huiqing Fang

    2016-01-01

    Full Text Available Based on geometrically exact beam theory, a hybrid interpolation is proposed for geometric nonlinear spatial Euler-Bernoulli beam elements. First, the Hermitian interpolation of the beam centerline was used for calculating nodal curvatures for two ends. Then, internal curvatures of the beam were interpolated with a second interpolation. At this point, C1 continuity was satisfied and nodal strain measures could be consistently derived from nodal displacement and rotation parameters. The explicit expression of nodal force without integration, as a function of global parameters, was founded by using the hybrid interpolation. Furthermore, the proposed beam element can be degenerated into linear beam element under the condition of small deformation. Objectivity of strain measures and patch tests are also discussed. Finally, four numerical examples are discussed to prove the validity and effectivity of the proposed beam element.

  5. ANOVA-HDMR structure of the higher order nodal diffusion solution

    International Nuclear Information System (INIS)

    Bokov, P. M.; Prinsloo, R. H.; Tomasevic, D. I.

    2013-01-01

    Nodal diffusion methods still represent a standard in global reactor calculations, but employ some ad-hoc approximations (such as the quadratic leakage approximation) which limit their accuracy in cases where reference quality solutions are sought. In this work we solve the nodal diffusion equations utilizing the so-called higher-order nodal methods to generate reference quality solutions and to decompose the obtained solutions via a technique known as High Dimensional Model Representation (HDMR). This representation and associated decomposition of the solution provides a new formulation of the transverse leakage term. The HDMR structure is investigated via the technique of Analysis of Variance (ANOVA), which indicates why the existing class of transversely-integrated nodal methods prove to be so successful. Furthermore, the analysis leads to a potential solution method for generating reference quality solutions at a much reduced calculational cost, by applying the ANOVA technique to the full higher order solution. (authors)

  6. Concomitant occurrence of sinus histiocytosis with massive lymphadenopathy and nodal marginal zone lymphoma.

    Science.gov (United States)

    Pang, Changlee S; Grier, David D; Beaty, Michael W

    2011-03-01

    Sinus histiocytosis with massive lymphadenopathy (SHML), also known as Rosai-Dorfman disease, is a rare self-limiting disorder of histiocytes with unknown etiology. Sinus histiocytosis with massive lymphadenopathy is most common in children and young adults and is characterized by painless lymphadenopathy. Histologically there is a proliferation of sinus histiocytes with lymphophagocytosis or emperipolesis. On rare occasions, SHML has been associated with lymphoma, usually involving different anatomic sites and developing at different times. We report a case of concomitant SHML and nodal marginal zone lymphoma involving the same lymph node without involvement of other nodal or extranodal sites. The presence of concomitant SHML within the lymph node involved by nodal marginal zone lymphoma may represent the responsiveness of SHML histiocytes to B-cell-derived cytokines in lymphoproliferative disorders. To our knowledge, this is the first description of concomitant occurrence of SHML and nodal marginal zone lymphoma.

  7. MicroRNA expression in nodal and extranodal Diffuse Large B-cell Lymphoma

    DEFF Research Database (Denmark)

    Mandrup, Charlotte; Petersen, Anders; Højfeldt, Anne Dirks

    MicroRNA expression in nodal and extranodal Diffuse Large B-cell Lymphoma   C. Mandrup1, A. Petersen1, A. D. Hoejfeldt1, H. F. Thomsen1, J. Madsen1, J. Dahlgaard1, P. Johansen2, A. Bukh1, K. Dybkaer1 and H. E Johnsen1. 1Department of Hematology, 2Pathological Institute, Aalborg Hospital, Aarhus...... University Hospital, Aalborg, Denmark Introduction: The aim of this project was to analyse microRNA (miRNA) expression in nodal and extranodal diffuse large B-cell lymphoma (DLBCL). Manifestation at diagnosis may be nodal and/or extranodal. At present, there are no known determinants for none...... of the manifestations, and no way to predict the potential progression from nodal to extranodal disease. miRNA are small regulatory RNA molecules with core function to repress/cleave sequence complementary mRNA targets. Abnormalities in miRNA genetics and expression are known to affect initiation and development...

  8. Quality of Life after Post-Prostatectomy Intensity Modulated Radiation Therapy: Pelvic Nodal Irradiation Is Not Associated with Worse Bladder, Bowel, or Sexual Outcomes.

    Directory of Open Access Journals (Sweden)

    James M Melotek

    Full Text Available Limited data exist regarding toxicity and quality of life (QOL after post-prostatectomy intensity modulated radiation therapy (IMRT and whether pelvic nodal RT influences these outcomes.118 men were treated with curative-intent RT after radical prostatectomy. 69 men (58% received pelvic nodal RT. QOL data and physician-assigned toxicity were prospectively collected. Changes in QOL from baseline were assessed with Wilcoxon signed-rank tests and risk factors associated with each domain were identified with generalized estimating equation (GEE models. Late freedom from (FF toxicity was estimated by the Kaplan-Meier method and comparisons were tested using the log-rank test.Urinary irritation/obstruction, bowel, and sexual domain scores declined at 2 months (all P ≤ 0.01 but were no different than baseline at subsequent visits through 4 years of follow-up. At 4 years, FF grade 2+ GI toxicity was 90% and FF grade 2+ GU toxicity was 89%. On GEE analysis, pelvic nodal RT was associated with decreased bowel function (P = 0.09 and sexual function (P = 0.01. On multivariate analysis, however, there was no significant association with either decreased bowel (P = 0.31 or sexual (P = 0.84 function. There was also no association with either FF grade 2+ GI toxicity (P = 0.24 or grade 2+ GU toxicity (P = 0.51.Receipt of pelvic nodal RT was not associated with inferior QOL or toxicity compared to prostate bed alone RT. For the entire cohort, RT was associated with only temporary declines in patient-reported urinary, bowel, or sexual QOL.

  9. Intra nodal reconstruction of the numerical solution generated by the spectro nodal constant for Sn problems of eigenvalues in two-dimensional rectangular geometry

    International Nuclear Information System (INIS)

    Menezes, Welton Alves de

    2009-01-01

    In this dissertation the spectral nodal method SD-SGF-CN, cf. spectral diamond - spectral Green's function - constant nodal, is used to determine the angular fluxes averaged along the edges of the homogenized nodes in heterogeneous domains. Using these results, we developed an algorithm for the reconstruction of the node-edge average angular fluxes within the nodes of the spatial grid set up on the domain, since more localized numerical solutions are not generated by coarse-mesh numerical methods. Numerical results are presented to illustrate the accuracy of the algorithm we offer. (author)

  10. Tumour exosome integrins determine organotropic metastasis.

    Science.gov (United States)

    Hoshino, Ayuko; Costa-Silva, Bruno; Shen, Tang-Long; Rodrigues, Goncalo; Hashimoto, Ayako; Tesic Mark, Milica; Molina, Henrik; Kohsaka, Shinji; Di Giannatale, Angela; Ceder, Sophia; Singh, Swarnima; Williams, Caitlin; Soplop, Nadine; Uryu, Kunihiro; Pharmer, Lindsay; King, Tari; Bojmar, Linda; Davies, Alexander E; Ararso, Yonathan; Zhang, Tuo; Zhang, Haiying; Hernandez, Jonathan; Weiss, Joshua M; Dumont-Cole, Vanessa D; Kramer, Kimberly; Wexler, Leonard H; Narendran, Aru; Schwartz, Gary K; Healey, John H; Sandstrom, Per; Labori, Knut Jørgen; Kure, Elin H; Grandgenett, Paul M; Hollingsworth, Michael A; de Sousa, Maria; Kaur, Sukhwinder; Jain, Maneesh; Mallya, Kavita; Batra, Surinder K; Jarnagin, William R; Brady, Mary S; Fodstad, Oystein; Muller, Volkmar; Pantel, Klaus; Minn, Andy J; Bissell, Mina J; Garcia, Benjamin A; Kang, Yibin; Rajasekhar, Vinagolu K; Ghajar, Cyrus M; Matei, Irina; Peinado, Hector; Bromberg, Jacqueline; Lyden, David

    2015-11-19

    Ever since Stephen Paget's 1889 hypothesis, metastatic organotropism has remained one of cancer's greatest mysteries. Here we demonstrate that exosomes from mouse and human lung-, liver- and brain-tropic tumour cells fuse preferentially with resident cells at their predicted destination, namely lung fibroblasts and epithelial cells, liver Kupffer cells and brain endothelial cells. We show that tumour-derived exosomes uptaken by organ-specific cells prepare the pre-metastatic niche. Treatment with exosomes from lung-tropic models redirected the metastasis of bone-tropic tumour cells. Exosome proteomics revealed distinct integrin expression patterns, in which the exosomal integrins α6β4 and α6β1 were associated with lung metastasis, while exosomal integrin αvβ5 was linked to liver metastasis. Targeting the integrins α6β4 and αvβ5 decreased exosome uptake, as well as lung and liver metastasis, respectively. We demonstrate that exosome integrin uptake by resident cells activates Src phosphorylation and pro-inflammatory S100 gene expression. Finally, our clinical data indicate that exosomal integrins could be used to predict organ-specific metastasis.

  11. Understanding the biology of urothelial cancer metastasis

    Directory of Open Access Journals (Sweden)

    Takashi Kobayashi

    2016-10-01

    Full Text Available Management of unresectable urothelial cancer (UC has been a clinical challenge for decades. While drug resistance is a key issue, precise understanding of biology of UC metastasis is another challenge for the improvement of treatment outcome of UC patients. Introduction of the cell biology concepts including epithelial-mesenchymal transition (EMT and cancer stemness seems to explain UC metastasis. Molecular genetics based on gene expression profiling, next generation sequencing, and explosion of non-coding RNA world has opened the door to intrinsic molecular subtyping of UC. Next steps include, based on the recently accumulated understanding, the establishment of novel disease models representing UC metastasis in various experimental platforms, particularly in vivo animal systems. Indeed, novel knowledge molecular genetics has not been fully linked to the modeling of UC metastasis. Further understanding of bladder carcinogenesis is needed particularly with regard to cell of origin related to tumor characteristics including driver gene alterations, pathological differentiations, and metastatic ability. Then we will be able to establish better disease models, which will consequently lead us to further understanding of biology and eventually the development of novel therapeutic strategies for UC metastasis.

  12. A study of the literature on nodal methods in reactor physics calculations

    International Nuclear Information System (INIS)

    Van de Wetering, T.F.H.

    1993-01-01

    During the last few decades several calculation methods have been developed for the three-dimensional analysis of a reactor core. A literature survey was carried out to gain insights in the starting points and method of operation of the advanced nodal methods. These methods are applied in reactor core analyses of large nuclear power reactors, because of their high computing speed. The so-called Nodal-Expansion method is described in detail

  13. Cilia are required for asymmetric nodal induction in the sea urchin embryo.

    Science.gov (United States)

    Tisler, Matthias; Wetzel, Franziska; Mantino, Sabrina; Kremnyov, Stanislav; Thumberger, Thomas; Schweickert, Axel; Blum, Martin; Vick, Philipp

    2016-08-23

    Left-right (LR) organ asymmetries are a common feature of metazoan animals. In many cases, laterality is established by a conserved asymmetric Nodal signaling cascade during embryogenesis. In most vertebrates, asymmetric nodal induction results from a cilia-driven leftward fluid flow at the left-right organizer (LRO), a ciliated epithelium present during gastrula/neurula stages. Conservation of LRO and flow beyond the vertebrates has not been reported yet. Here we study sea urchin embryos, which use nodal to establish larval LR asymmetry as well. Cilia were found in the archenteron of embryos undergoing gastrulation. Expression of foxj1 and dnah9 suggested that archenteron cilia were motile. Cilia were polarized to the posterior pole of cells, a prerequisite of directed flow. High-speed videography revealed rotating cilia in the archenteron slightly before asymmetric nodal induction. Removal of cilia through brief high salt treatments resulted in aberrant patterns of nodal expression. Our data demonstrate that cilia - like in vertebrates - are required for asymmetric nodal induction in sea urchin embryos. Based on these results we argue that the anterior archenteron represents a bona fide LRO and propose that cilia-based symmetry breakage is a synapomorphy of the deuterostomes.

  14. Solution and Study of the Two-Dimensional Nodal Neutron Transport Equation

    International Nuclear Information System (INIS)

    Panta Pazos, Ruben; Biasotto Hauser, Eliete; Tullio de Vilhena, Marco

    2002-01-01

    In the last decade Vilhena and coworkers reported an analytical solution to the two-dimensional nodal discrete-ordinates approximations of the neutron transport equation in a convex domain. The key feature of these works was the application of the combined collocation method of the angular variable and nodal approach in the spatial variables. By nodal approach we mean the transverse integration of the SN equations. This procedure leads to a set of one-dimensional S N equations for the average angular fluxes in the variables x and y. These equations were solved by the old version of the LTS N method, which consists in the application of the Laplace transform to the set of nodal S N equations and solution of the resulting linear system by symbolic computation. It is important to recall that this procedure allow us to increase N the order of S N up to 16. To overcome this drawback we step forward performing a spectral painstaking analysis of the nodal S N equations for N up to 16 and we begin the convergence of the S N nodal equations defining an error for the angular flux and estimating the error in terms of the truncation error of the quadrature approximations of the integral term. Furthermore, we compare numerical results of this approach with those of other techniques used to solve the two-dimensional discrete approximations of the neutron transport equation. (authors)

  15. Advances in the solution of three-dimensional nodal neutron transport equation

    International Nuclear Information System (INIS)

    Pazos, Ruben Panta; Hauser, Eliete Biasotto; Vilhena, Marco Tullio de

    2003-01-01

    In this paper we study the three-dimensional nodal discrete-ordinates approximations of neutron transport equation in a convex domain with piecewise smooth boundaries. We use the combined collocation method of the angular variables and nodal approach for the spatial variables. By nodal approach we mean the iterated transverse integration of the S N equations. This procedure leads to the set of one-dimensional averages angular fluxes in each spatial variable. The resulting system of equations is solved with the LTS N method, first applying the Laplace transform to the set of the nodal S N equations and then obtaining the solution by symbolic computation. We include the LTS N method by diagonalization to solve the nodal neutron transport equation and then we outline the convergence of these nodal-LTS N approximations with the help of a norm associated to the quadrature formula used to approximate the integral term of the neutron transport equation. We give numerical results obtained with an algebraic computer system (for N up to 8) and with a code for higher values of N. We compare our results for the geometry of a box with a source in a vertex and a leakage zone in the opposite with others techniques used in this problem. (author)

  16. The implementation of a simplified spherical harmonics semi-analytic nodal method in PANTHER

    International Nuclear Information System (INIS)

    Hall, S.K.; Eaton, M.D.; Knight, M.P.

    2013-01-01

    Highlights: ► An SP N nodal method is proposed. ► Consistent CMFD derived and tested. ► Mark vacuum boundary conditions applied. ► Benchmarked against other diffusions and transport codes. - Abstract: In this paper an SP N nodal method is proposed which can utilise existing multi-group neutron diffusion solvers to obtain the solution. The semi-analytic nodal method is used in conjunction with a coarse mesh finite difference (CMFD) scheme to solve the resulting set of equations. This is compared against various nuclear benchmarks to show that the method is capable of computing an accurate solution for practical cases. A few different CMFD formulations are implemented and their performance compared. It is found that the effective diffusion coefficent (EDC) can provide additional stability and require less power iterations on a coarse mesh. A re-arrangement of the EDC is proposed that allows the iteration matrix to be computed at the beginning of a calculation. Successive nodal updates only modify the source term unlike existing CMFD methods which update the iteration matrix. A set of Mark vacuum boundary conditions are also derived which can be applied to the SP N nodal method extending its validity. This is possible due to a similarity transformation of the angular coupling matrix, which is used when applying the nodal method. It is found that the Marshak vacuum condition can also be derived, but would require the significant modification of existing neutron diffusion codes to implement it

  17. Multiarea Transmission Cost Allocation in Large Power Systems Using the Nodal Pricing Control Approach

    Directory of Open Access Journals (Sweden)

    M. Ghayeni

    2010-12-01

    Full Text Available This paper proposes an algorithm for transmission cost allocation (TCA in a large power system based on nodal pricing approach using the multi-area scheme. The nodal pricing approach is introduced to allocate the transmission costs by the control of nodal prices in a single area network. As the number of equations is dependent on the number of buses and generators, this method will be very time consuming for large power systems. To solve this problem, the present paper proposes a new algorithm based on multi-area approach for regulating the nodal prices, so that the simulation time is greatly reduced and therefore the TCA problem with nodal pricing approach will be applicable for large power systems. In addition, in this method the transmission costs are allocated to users more equitable. Since the higher transmission costs in an area having a higher reliability are paid only by users of that area in contrast with the single area method, in which these costs are allocated to all users regardless of their locations. The proposed method is implemented on the IEEE 118 bus test system which comprises three areas. Results show that with application of multi-area approach, the simulation time is greatly reduced and the transmission costs are also allocated to users with less variation in new nodal prices with respect to the single area approach.

  18. A quasi-static polynomial nodal method for nuclear reactor analysis

    International Nuclear Information System (INIS)

    Gehin, J.C.

    1992-09-01

    Modern nodal methods are currently available which can accurately and efficiently solve the static and transient neutron diffusion equations. Most of the methods, however, are limited to two energy groups for practical application. The objective of this research is the development of a static and transient, multidimensional nodal method which allows more than two energy groups and uses a non-linear iterative method for efficient solution of the nodal equations. For both the static and transient methods, finite-difference equations which are corrected by the use of discontinuity factors are derived. The discontinuity factors are computed from a polynomial nodal method using a non-linear iteration technique. The polynomial nodal method is based upon a quartic approximation and utilizes a quadratic transverse-leakage approximation. The solution of the time-dependent equations is performed by the use of a quasi-static method in which the node-averaged fluxes are factored into shape and amplitude functions. The application of the quasi-static polynomial method to several benchmark problems demonstrates that the accuracy is consistent with that of other nodal methods. The use of the quasi-static method is shown to substantially reduce the computation time over the traditional fully-implicit time-integration method. Problems involving thermal-hydraulic feedback are accurately, and efficiently, solved by performing several reactivity/thermal-hydraulic updates per shape calculation

  19. A quasi-static polynomial nodal method for nuclear reactor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gehin, Jess C. [Massachusetts Inst. of Tech., Cambridge, MA (United States)

    1992-09-01

    Modern nodal methods are currently available which can accurately and efficiently solve the static and transient neutron diffusion equations. Most of the methods, however, are limited to two energy groups for practical application. The objective of this research is the development of a static and transient, multidimensional nodal method which allows more than two energy groups and uses a non-linear iterative method for efficient solution of the nodal equations. For both the static and transient methods, finite-difference equations which are corrected by the use of discontinuity factors are derived. The discontinuity factors are computed from a polynomial nodal method using a non-linear iteration technique. The polynomial nodal method is based upon a quartic approximation and utilizes a quadratic transverse-leakage approximation. The solution of the time-dependent equations is performed by the use of a quasi-static method in which the node-averaged fluxes are factored into shape and amplitude functions. The application of the quasi-static polynomial method to several benchmark problems demonstrates that the accuracy is consistent with that of other nodal methods. The use of the quasi-static method is shown to substantially reduce the computation time over the traditional fully-implicit time-integration method. Problems involving thermal-hydraulic feedback are accurately, and efficiently, solved by performing several reactivity/thermal-hydraulic updates per shape calculation.

  20. Topological crystalline superconductivity and second-order topological superconductivity in nodal-loop materials

    Science.gov (United States)

    Shapourian, Hassan; Wang, Yuxuan; Ryu, Shinsei

    2018-03-01

    We study the intrinsic fully gapped odd-parity superconducting order in doped nodal-loop materials with a torus-shaped Fermi surface. We show that the mirror symmetry, which protects the nodal loop in the normal state, also protects the superconducting state as a topological crystalline superconductor. As a result, the surfaces preserving the mirror symmetry host gapless Majorana cones. Moreover, for a Weyl-loop system (twofold degenerate at the nodal loop), the surfaces that break the mirror symmetry (those parallel to the bulk nodal loop) contribute a Chern (winding) number to the quasi-two-dimensional system in a slab geometry, which leads to a quantized thermal Hall effect and a single Majorana zero mode bound at a vortex line penetrating the system. This Chern number can be viewed as a higher-order topological invariant, which supports hinge modes in a cubic sample when mirror symmetry is broken. For a Dirac-loop system (fourfold degenerate at the nodal loop), the fully gapped odd-parity state can be either time-reversal symmetry-breaking or symmetric, similar to the A and B phases of 3He. In a slab geometry, the A phase has a Chern number two, while the B phase carries a nontrivial Z2 invariant. We discuss the experimental relevance of our results to nodal-loop materials such as CaAgAs.

  1. Optical conductivity of three and two dimensional topological nodal-line semimetals

    Science.gov (United States)

    Barati, Shahin; Abedinpour, Saeed H.

    2017-10-01

    The peculiar shape of the Fermi surface of topological nodal-line semimetals at low carrier concentrations results in their unusual optical and transport properties. We analytically investigate the linear optical responses of three- and two-dimensional nodal-line semimetals using the Kubo formula. The optical conductivity of a three-dimensional nodal-line semimetal is anisotropic. Along the axial direction (i.e., the direction perpendicular to the nodal-ring plane), the Drude weight has a linear dependence on the chemical potential at both low and high carrier dopings. For the radial direction (i.e., the direction parallel to the nodal-ring plane), this dependence changes from linear into quadratic in the transition from low into high carrier concentration. The interband contribution into optical conductivity is also anisotropic. In particular, at large frequencies, it saturates to a constant value for the axial direction and linearly increases with frequency along the radial direction. In two-dimensional nodal-line semimetals, no interband optical transition could be induced and the only contribution to the optical conductivity arises from the intraband excitations. The corresponding Drude weight is independent of the carrier density at low carrier concentrations and linearly increases with chemical potential at high carrier doping.

  2. Impact of pelvic nodal irradiation with intensity-modulated radiotherapy on treatment of prostate cancer

    International Nuclear Information System (INIS)

    Price, Robert A.; Hannoun-Levi, Jean-Michel; Horwitz, Eric; Buyyounouski, Mark; Ruth, Karen J.; Ma, C.-M.; Pollack, Alan

    2006-01-01

    Purpose: The aim of this study was to evaluate the feasibility of treating the pelvic lymphatic regions during prostate intensity-modulated radiotherapy (IMRT) with respect to our routine acceptance criteria. Methods and Materials: A series of 10 previously treated prostate patients were randomly selected and the pelvic lymphatic regions delineated on the fused magnetic resonance/computed tomography data sets. A targeting progression was formed from the prostate and proximal seminal vesicles only to the inclusion of all pelvic lymphatic regions and presacral region resulting in 5 planning scenarios of increasing geometric difficulty. IMRT plans were generated for each stage for two accelerator manufacturers. Dose volume histogram data were analyzed with respect to dose to the planning target volumes, rectum, bladder, bowel, and normal tissue. Analysis was performed for the number of segments required, monitor units, 'hot spots,' and treatment time. Results: Both rectal endpoints were met for all targets. Bladder endpoints were not met and the bowel endpoint was met in 40% of cases with the inclusion of the extended and presacral lymphatics. A significant difference was found in the number of segments and monitor units with targeting progression and between accelerators, with the smaller beamlets yielding poorer results. Treatment times between the 2 linacs did not exhibit a clinically significant difference when compared. Conclusions: Many issues should be considered with pelvic lymphatic irradiation during IMRT delivery for prostate cancer including dose per fraction, normal structure dose/volume limits, planning target volumes generation, localization, treatment time, and increased radiation leakage. We would suggest that, at a minimum, the endpoints used in this work be evaluated before beginning IMRT pelvic nodal irradiation

  3. Ruptured hepatoblastoma treated with primary surgical resection

    African Journals Online (AJOL)

    The remaining part of the left lobe of the liver, including segment IV ... lung, and brain metastasis, and was treated with comfort measures only ... tumor was noted on the right side of the liter. ... invasive and can control the bleeding to allow for a complete workup and ... Our two cases presented here add to the growing body.

  4. Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease

    International Nuclear Information System (INIS)

    Devineni, V.R.; Simpson, J.R.; Sessions, D.; Spector, J.G.; Hayden, R.; Fredrickson, J.; Fineberg, B.

    1991-01-01

    Seventy-nine patients with supraglottic carcinoma treated between 1966 and 1985 are reviewed. All patients were treated with surgery and postoperative radiation therapy. Thirty-five percent of the patients had positive margins at the site of resection of the primary tumor. Of the 25 patients who had positive nodal disease, 13 patients (52%) had either extracapsular extension or soft-tissue or adjacent organ invasion, referred to in composite as grave signs. The median follow-up of the patients was 4.9 years and all patients were followed for a minimum of 3 years. The disease-free survival for all patients was 76% at 2 years and 71% at 3 years. The locoregional control rate for all patients was 70%. This study demonstrates that there is no difference in local recurrence or disease-free survival, or time to recurrence relative to the status of the surgical margins, which may be a benefit of the postoperative radiation therapy. This study also demonstrates that there is an increase in the number of patients with grave signs with increasing nodal stage. The rate of neck recurrence in patients with grave signs was substantially higher (54%) than in patients without grave signs (8%), even though these patients also had positive lymph nodes. Interestingly, there was also a higher rate of local recurrence among patients who had grave signs. Patients receiving doses higher than 6000 cGy to the primary site had fewer local failures, although within each group of patients with positive or negative surgical margins the differences in survival were minimal

  5. sup 8 sup 9 Sr and sup 1 sup 5 sup 3 Sm-EDTMP therapy of disseminated skeletal metastasis

    CERN Document Server

    Zhang Jun Ning; Zhu Shou Peng

    2001-01-01

    A retrospective analysis was performed on 72 patients with disseminated skeletal metastasis to evaluate the effect of strontium-89 or samarium-153 EDTMP therapy. There existed 87.88% of clinical response, 12.12% of no response in the group treated with strontium-89 as compared with 90.24% of clinical response, 9.76% no response in one treated with samarium-153 EDTMP; and there were no correlation between the treatment results and the amounts of isotopes administrated. The results suggest that strontium-89 or samarium-153 EDTMP therapy is a method of first choice in the palliative treatment for disseminated skeletal metastasis

  6. TGF-β promotes glioma cell growth via activating Nodal expression through Smad and ERK1/2 pathways

    International Nuclear Information System (INIS)

    Sun, Jing; Liu, Su-zhi; Lin, Yan; Cao, Xiao-pan; Liu, Jia-ming

    2014-01-01

    Highlights: •TGF-β promoted Nodal expression in glioma cells. •TGF-β promoted Nodal expression via activating Smad and ERK1/2 pathways. •TGF-β promotes glioma cell growth via activating Nodal expression. -- Abstract: While there were certain studies focusing on the mechanism of TGF-β promoting the growth of glioma cells, the present work revealed another novel mechanism that TGF-β may promote glioma cell growth via enhancing Nodal expression. Our results showed that Nodal expression was significantly upregulated in glioma cells when TGF-β was added, whereas the TGF-β-induced Nodal expression was evidently inhibited by transfection Smad2 or Smad3 siRNAs, and the suppression was especially significant when the Smad3 was downregulated. Another, the attenuation of TGF-β-induced Nodal expression was observed with blockade of the ERK1/2 pathway also. Further detection of the proliferation, apoptosis, and invasion of glioma cells indicated that Nodal overexpression promoted the proliferation and invasion of tumor cells and inhibited their apoptosis, resembling the effect of TGF-β addition. Downregulation of Nodal expression via transfection Nodal-specific siRNA in the presence of TGF-β weakened the promoting effect of the latter on glioma cells growth, and transfecting Nodal siRNA alone in the absence of exogenous TGF-β more profoundly inhibited the growth of glioma cells. These results demonstrated that while both TGF-β and Nodal promoted glioma cells growth, the former might exert such effect by enhancing Nodal expression, which may form a new target for glioma therapy

  7. The orphan receptor ALK7 and the Activin receptor ALK4 mediate signaling by Nodal proteins during vertebrate development

    Science.gov (United States)

    Reissmann, Eva; Jörnvall, Henrik; Blokzijl, Andries; Andersson, Olov; Chang, Chenbei; Minchiotti, Gabriella; Persico, M. Graziella; Ibáñez, Carlos F.; Brivanlou, Ali H.

    2001-01-01

    Nodal proteins have crucial roles in mesendoderm formation and left–right patterning during vertebrate development. The molecular mechanisms of signal transduction by Nodal and related ligands, however, are not fully understood. In this paper, we present biochemical and functional evidence that the orphan type I serine/threonine kinase receptor ALK7 acts as a receptor for mouse Nodal and Xenopus Nodal-related 1 (Xnr1). Receptor reconstitution experiments indicate that ALK7 collaborates with ActRIIB to confer responsiveness to Xnr1 and Nodal. Both receptors can independently bind Xnr1. In addition, Cripto, an extracellular protein genetically implicated in Nodal signaling, can independently interact with both Xnr1 and ALK7, and its expression greatly enhances the ability of ALK7 and ActRIIB to respond to Nodal ligands. The Activin receptor ALK4 is also able to mediate Nodal signaling but only in the presence of Cripto, with which it can also interact directly. A constitutively activated form of ALK7 mimics the mesendoderm-inducing activity of Xnr1 in Xenopus embryos, whereas a dominant-negative ALK7 specifically blocks the activities of Nodal and Xnr1 but has little effect on other related ligands. In contrast, a dominant-negative ALK4 blocks all mesoderm-inducing ligands tested, including Nodal, Xnr1, Xnr2, Xnr4, and Activin. In agreement with a role in Nodal signaling, ALK7 mRNA is localized to the ectodermal and organizer regions of Xenopus gastrula embryos and is expressed during early stages of mouse embryonic development. Therefore, our results indicate that both ALK4 and ALK7 can mediate signal transduction by Nodal proteins, although ALK7 appears to be a receptor more specifically dedicated to Nodal signaling. PMID:11485994

  8. Pterostilbene acts through metastasis-associated protein 1 to inhibit tumor growth, progression and metastasis in prostate cancer.

    Directory of Open Access Journals (Sweden)

    Kun Li

    Full Text Available The development of natural product agents with targeted strategies holds promise for enhanced anticancer therapy with reduced drug-associated side effects. Resveratrol found in red wine, has anticancer activity in various tumor types. We reported earlier on a new molecular target of resveratrol, the metastasis-associated protein 1 (MTA1, which is a part of nucleosome remodeling and deacetylation (NuRD co-repressor complex that mediates gene silencing. We identified resveratrol as a regulator of MTA1/NuRD complex and re-activator of p53 acetylation in prostate cancer (PCa. In the current study, we addressed whether resveratrol analogues also possess the ability to inhibit MTA1 and to reverse p53 deacetylation. We demonstrated that pterostilbene (PTER, found in blueberries, had greater increase in MTA1-mediated p53 acetylation, confirming superior potency over resveratrol as dietary epigenetic agent. In orthotopic PCa xenografts, resveratrol and PTER significantly inhibited tumor growth, progression, local invasion and spontaneous metastasis. Furthermore, MTA1-knockdown sensitized cells to these agents resulting in additional reduction of tumor progression and metastasis. The reduction was dependent on MTA1 signaling showing increased p53 acetylation, higher apoptotic index and less angiogenesis in vivo in all xenografts treated with the compounds, and particularly with PTER. Altogether, our results indicate MTA1 as a major contributor in prostate tumor malignant progression, and support the use of strategies targeting MTA1. Our strong pre-clinical data indicate PTER as a potent, selective and pharmacologically safe natural product that may be tested in advanced PCa.

  9. [Surgical managment of colorectal liver metastasis].

    Science.gov (United States)

    Prot, Thomas; Halkic, Nermin; Demartines, Nicolas

    2007-06-27

    Surgery offer the only curative treatment for colorectal hepatic metastasis. Nowadays, five-year survival increases up to 58% in selected cases, due to the improvement and combination of chemotherapy, surgery and ablative treatment like embolisation, radio-frequency or cryoablation. Surgery should be integrated in a multi disciplinary approach and initial work-up must take in account patient general conditions, tumor location, and possible extra hepatic extension. Thus, a surgical resection may be performed immediately or after preparation with chemotherapy or selective portal embolization. Management of liver metastasis should be carried out in oncological hepato-biliary centre.

  10. The role of exosomes in cancer metastasis.

    Science.gov (United States)

    Steinbichler, Teresa Bernadette; Dudás, József; Riechelmann, Herbert; Skvortsova, Ira-Ida

    2017-06-01

    Exosomes are small membrane vesicles with a size ranging from 40 to 100nm. They can serve as functional mediators in cell interaction leading to cancer metastasis. Metastasis is a complex multistep process of cancer cell invasion, survival in blood vessels, attachment to and colonization of the host organ. Exosomes influence every step of this cascade and can be targeted by oncological treatment. This review highlights the role of exosomes in the various steps of the metastatic cascade and how exosome dependent pathways can be targeted as therapeutic approach or used for liquid biopsies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The Multiple Roles of Exosomes in Metastasis

    Science.gov (United States)

    WEIDLE, H. ULRICH; BIRZELE, FABIAN; KOLLMORGEN, GWEN; RÜGER, RÜDIGER

    2016-01-01

    Exosomes are important contributors to cell−cell communication and their role as diagnostic markers for cancer and the pathogenesis for cancer is under intensive investigation. Here, we focus on their role in metastasis-related processes. We discuss their impact regarding promotion of invasion and migration of tumor cells, conditioning of lymph nodes, generation of premetastatic niches and organotropism of metastasis. Furthermore, we highlight interactions of exosomes with bone marrow and stromal components such as fibroblasts, endothelial cells, myeloid- and other immune-related cells in the context of metastases. For all processes as described above, we outline molecular and cellular components for therapeutic intervention with metastatic processes. PMID:28031234

  12. Renal cell carcinoma presenting as mandibular metastasis

    Directory of Open Access Journals (Sweden)

    Hassan Ahmadnia

    2013-01-01

    Full Text Available Renal clear cell carcinoma (RCC has different manifestations, including uncommon metastasis and paraneoplastic syndromes. Here we report a rare case of RCC presenting as metastasis to the mandible. A 57-year-old patient with mandibular swelling was referred to the dentist. After necessary evaluations, an incisional biopsy of mandible showed metastatic RCC. The patient was referred to the urologist. The patient underwent right radical nephrectomy. Pathological examination showed clear renal cell carcinoma. Every abnormal bone lesion in the oral cavity should be evaluated carefully and the possibility of a malignant lesion should always be considered.

  13. Duodenal Metastasis of Malignant Pleural Mesothelioma

    Directory of Open Access Journals (Sweden)

    Huang-Chi Chen

    2008-12-01

    Full Text Available Metastatic malignant mesothelioma of the pleura is uncommon at the time of initial diagnosis. The gastrointestinal lumen is rarely found at autopsy in patients with widespread disease. Here, we describe an extremely rare case of isolated duodenal metastasis of sarcomatoid mesothelioma of the pleura in a 73-year-old man, without memory of any direct exposure to asbestos. The possibility of gastrointestinal tract metastasis should be considered in the presence of anemia or positive occult blood test in patients with malignant pleural mesothelioma.

  14. Radiofrequency ablation of hepatic metastasis: Results of treatment in forty patients

    Directory of Open Access Journals (Sweden)

    Rath G

    2008-01-01

    Full Text Available Aim: To evaluate the local control of hepatic metastasis with radiofrequency ablation treatment. Materials and Methods: We did a retrospective analysis in 40 patients treated with radiofrequency ablation for hepatic metastasis. The tumors ablated included up to two metastatic liver lesions, with primaries in breast, gastrointestinal tract, cervix, etc. Radiofrequency ablation was performed under general anesthesia in all cases, using ultrasound guidance. Radionics Cool-Tip RF System was used to deliver the treatment. Results: The median age of patients treated was 49 years. There were 13 female and 27 male patients. The median tumor size ablated was 1.5 cm (0.75-4.0 cm. A total of 52 radiofrequency ablation cycles were delivered. Successful ablation was achieved in all patients with hepatic metastasis less than 3 cm in size. Pain was the most common complication seen (75%. One patients developed skin burns. At 2-year follow-up 7.5% of patients had locally recurrent disease. Conclusions: Radiofrequency ablation is a minimally invasive treatment modality. It can be useful in a select group of patients with solitary liver metastasis of less than 3 cm size.

  15. Brain abscess mimicking brain metastasis in breast cancer

    International Nuclear Information System (INIS)

    Khullar, P.; Datta, N.R.; Wahi, I.K.; Kataria, S.

    2016-01-01

    61 year old female presented with chief complaints of headache for 30 days, fever for 10 days, altered behavior for 10 days and convulsion for 2 days. She was diagnosed and treated as a case of carcinoma of left breast 5 years ago. MRI brain showed a lobulated lesion in the left frontal lobe. She came to our hospital for whole brain radiation as a diagnosed case of carcinoma of breast with brain metastasis. Review of MRI brain scan, revealed metastasis or query infective pathology. MR spectroscopy of the lesion revealed choline: creatinine and choline: NAA (N-Acety- laspartate) ratios of 1.6 and 1.5 respectively with the presence of lactate within the lesion suggestive of infective pathology. She underwent left fronto temporal craniotomy and evacuation of abscess and subdural empyema. Gram stain showed gram positive cocci. After 1 month of evacuation and treatment she was fine. This case suggested a note of caution in every case of a rapidly evolving space-occupying lesion independent of the patient’s previous history

  16. Brain abscess mimicking brain metastasis in breast cancer.

    Science.gov (United States)

    Khullar, Pooja; Datta, Niloy R; Wahi, Inderjeet Kaur; Kataria, Sabeena

    2016-03-01

    61 year old female presented with chief complaints of headache for 30 days, fever for 10 days, altered behavior for 10 days and convulsion for 2 days. She was diagnosed and treated as a case of carcinoma of left breast 5 years ago. MRI brain showed a lobulated lesion in the left frontal lobe. She came to our hospital for whole brain radiation as a diagnosed case of carcinoma of breast with brain metastasis. Review of MRI brain scan, revealed metastasis or query infective pathology. MR spectroscopy of the lesion revealed choline: creatinine and choline: NAA (N-Acetylaspartate) ratios of ∼1.6 and 1.5 respectively with the presence of lactate within the lesion suggestive of infective pathology. She underwent left fronto temporal craniotomy and evacuation of abscess and subdural empyema. Gram stain showed gram positive cocci. After 1 month of evacuation and treatment she was fine. This case suggested a note of caution in every case of a rapidly evolving space-occupying lesion independent of the patient's previous history. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  17. Inhibition of Breast Cancer Metastasis by Heregulin-Beta 1

    National Research Council Canada - National Science Library

    Yu, Dihua

    1999-01-01

    The major goal of this Idea proposal is to determine whether and how HRG-Beta1 inhibits breast cancer metastasis and to identify the functional domains that are sufficient for inhibition of breast cancer metastasis...

  18. Spontaneous rupture of adrenal metastasis from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chae Hun; Kim, Hyun Jin; Park, Soo Youn; Hwang, Seong Su; Choi, Hyun Joo [St. Vincent Hospital, Suwon (Korea, Republic of)

    2007-03-15

    Rupture of adrenal tumor from various primary origins is a rather rare event. We report here on a ruptured adrenal metastasis from hepatocellular carcinoma, and this ruptured metastasis was observed at the time of the initial diagnosis.

  19. Invasive cancer cells and metastasis

    Science.gov (United States)

    Mierke, Claudia Tanja

    2013-12-01

    The physics of cancer is a relatively new emerging field of cancer research. In the last decade it has become a focus of biophysical research as well as becoming a novel focus for classical cancer research. This special section of Physical Biology focusing on invasive cancer cells and metastasis (physical oncology) will give greater insight into the different subfields where physical approaches are being applied to cancer research. This focus on the physical aspects of cancer is necessary because novel approaches in the field of genomics and proteomics have not altered the field of cancer research dramatically, due to the fact that few breakthroughs have been made. It is still not understood why some primary tumors metastasize and thus have a worse outcome compared to others that do not metastasize. As biophysicists, we and others suggest that the mechanical properties of the cancer cells, which possess the ability to transmigrate, are quite different compared to non-metastatic and non-invasive cancer cells. Furthermore, we hypothesize that these cancer cells undergo a selection process within the primary tumor that enables them to weaken their cell-cell adhesions and to alter their cell-matrix adhesions in order to be able to cross the outermost boundary of the primary tumor, as well as the surrounding basement membrane, and to invade the connective tissue. This prerequisite may also help the cancer cells to enter blood or lymph vessels, get transported with the vessel flow and form secondary tumors either within the vessel, directly on the endothelium, or in a different organ after crossing the endothelial lining a second time. This special section begins with a paper by Mark F Coughlin and Jeffrey J Fredberg on the changes in cytoskeletal dynamics and nonlinear rheology due to the metastatic capability of cancer cells from different cancer tissue types such as skin, bladder, prostate and kidney [1]. The hypothesis was that the metastatic outcome is impacted by

  20. Metastasis in renal cell carcinoma: Biology and implications for therapy

    Directory of Open Access Journals (Sweden)

    Jun Gong

    2016-10-01

    Full Text Available Although multiple advances have been made in systemic therapy for renal cell carcinoma (RCC, metastatic RCC remains incurable. In the current review, we focus on the underlying biology of RCC and plausible mechanisms of metastasis. We further outline evolving strategies to combat metastasis through adjuvant therapy. Finally, we discuss clinical patterns of metastasis in RCC and how distinct systemic therapy approaches may be considered based on the anatomic location of metastasis.

  1. Fusion positron emission/computed tomography underestimates the presence of hilar nodal metastases in patients with resected non-small cell lung cancer.

    Science.gov (United States)

    Carrillo, Sergio A; Daniel, Vincent C; Hall, Nathan; Hitchcock, Charles L; Ross, Patrick; Kassis, Edmund S

    2012-05-01

    The 5-year survival for patients with resected stage II (N1) non-small cell lung cancer ranges from 40% to 55%. No data exist addressing the benefit of neoadjuvant therapy for patients with stage II disease. This is largely in part due to the lack of a reliable, minimally invasive method to assess hilar nodes. This study is aimed at determining the ability of fusion positron emission/computed tomography (PET/CT) to identify hilar metastases in patients with resected non-small cell lung cancer. A retrospective review of surgically resected patients with fusion PET/CT within 30 days of resection was performed. The sensitivity, specificity, positive predictive value, and negative predictive value for PET/CT in detecting hilar nodal metastases was calculated for a range of maximum standardized uptake values (SUVmax). Hilar nodes from patients with falsely positive PET/CT scans were analyzed for the presence of histoplasmosis. Additionally, the impact of hilar node size greater than 1 centimeter on the calculated values was assessed. There were 119 patients evaluated. The number of lymph nodes resected ranged from 1 to 12 (X=2.98). There was decreased sensitivity and increased specificity with higher SUVmax cutoff values. At the standard SUVmax value of 2.5, the sensitivity and specificity were only 48.5% and 80.2%. The addition of size of hilar node by CT led to a modest improvement in sensitivity at all SUVmax cutoff values. Fusion PET/CT lacks sensitivity and specificity in identifying hilar nodal metastasis in patients with resected non-small cell lung cancer. Further prospective studies assessing the utility of PET/CT versus alternative sampling techniques are warranted. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Selective sentinel lymph node biopsy in papillary thyroid carcinoma in patients with no preoperative evidence of lymph node metastasis.

    Science.gov (United States)

    González, Óscar; Zafon, Carles; Caubet, Enric; García-Burillo, Amparo; Serres, Xavier; Fort, José Manuel; Mesa, Jordi; Castell, Joan; Roca, Isabel; Ramón Y Cajal, Santiago; Iglesias, Carmela

    2017-10-01

    Lymphadenectomy is recommended during surgery for papillary thyroid carcinoma when there is evidence of cervical lymph node metastasis (therapeutic) or in high-risk patients (prophylactic) such as those with T3 and T4 tumors of the TNM classification. Selective sentinel lymph node biopsy may improve preoperative diagnosis of nodal metastases. To analyze the results of selective sentinel lymph node biopsy in a group of patients with papillary thyroid carcinoma and no evidence of nodal involvement before surgery. A retrospective, single-center study in patients with papillary thyroid carcinoma and no clinical evidence of lymph node involvement who underwent surgery between 2011 and 2013. The sentinel node was identified by scintigraphy. When the sentinel node was positive, the affected compartment was removed, and when sentinel node was negative, central lymph node dissection was performed. Forty-three patients, 34 females, with a mean age of 52.3 (±17) years, were enrolled. Forty-six (27%) of the 170 SNs resected from 24 (55.8%) patients were positive for metastasis. In addition, 94 (15.6%) out of the 612 lymph nodes removed in the lymphadenectomies were positive for metastases. Twelve of the 30 (40%) low risk patients (cT1N0 and cT2N0) changed their stage to pN1, whereas 12 of 13 (92%) high risk patients (cT3N0 and cT4N0) changed to pN1 stage. Selective sentinel lymph node biopsy changes the stage of more than 50% of patients from cN0 to pN1. This confirms the need for lymph node resection in T3 and T4 tumors, but reveals the presence of lymph node metastases in 40% of T1-T2 tumors. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Group-decoupled multi-group pin power reconstruction utilizing nodal solution 1D flux profiles

    International Nuclear Information System (INIS)

    Yu, Lulin; Lu, Dong; Zhang, Shaohong; Wang, Dezhong

    2014-01-01

    Highlights: • A direct fitting multi-group pin power reconstruction method is developed. • The 1D nodal solution flux profiles are used as the condition. • The least square fit problem is analytically solved. • A slowing down source improvement method is applied. • The method shows good accuracy for even challenging problems. - Abstract: A group-decoupled direct fitting method is developed for multi-group pin power reconstruction, which avoids both the complication of obtaining 2D analytic multi-group flux solution and any group-coupled iteration. A unique feature of the method is that in addition to nodal volume and surface average fluxes and corner fluxes, transversely-integrated 1D nodal solution flux profiles are also used as the condition to determine the 2D intra-nodal flux distribution. For each energy group, a two-dimensional expansion with a nine-term polynomial and eight hyperbolic functions is used to perform a constrained least square fit to the 1D intra-nodal flux solution profiles. The constraints are on the conservation of nodal volume and surface average fluxes and corner fluxes. Instead of solving the constrained least square fit problem numerically, we solve it analytically by fully utilizing the symmetry property of the expansion functions. Each of the 17 unknown expansion coefficients is expressed in terms of nodal volume and surface average fluxes, corner fluxes and transversely-integrated flux values. To determine the unknown corner fluxes, a set of linear algebraic equations involving corner fluxes is established via using the current conservation condition on all corners. Moreover, an optional slowing down source improvement method is also developed to further enhance the accuracy of the reconstructed flux distribution if needed. Two test examples are shown with very good results. One is a four-group BWR mini-core problem with all control blades inserted and the other is the seven-group OECD NEA MOX benchmark, C5G7

  4. Churchill regulates cell movement and mesoderm specification by repressing Nodal signaling

    Directory of Open Access Journals (Sweden)

    Mentzer Laura

    2007-11-01

    Full Text Available Abstract Background Cell movements are essential to the determination of cell fates during development. The zinc-finger transcription factor, Churchill (ChCh has been proposed to regulate cell fate by regulating cell movements during gastrulation in the chick. However, the mechanism of action of ChCh is not understood. Results We demonstrate that ChCh acts to repress the response to Nodal-related signals in zebrafish. When ChCh function is abrogated the expression of mesodermal markers is enhanced while ectodermal markers are expressed at decreased levels. In cell transplant assays, we observed that ChCh-deficient cells are more motile than wild-type cells. When placed in wild-type hosts, ChCh-deficient cells often leave the epiblast, migrate to the germ ring and are later found in mesodermal structures. We demonstrate that both movement of ChCh-compromised cells to the germ ring and acquisition of mesodermal character depend on the ability of the donor cells to respond to Nodal signals. Blocking Nodal signaling in the donor cells at the levels of Oep, Alk receptors or Fast1 inhibited migration to the germ ring and mesodermal fate change in the donor cells. We also detect additional unusual movements of transplanted ChCh-deficient cells which suggests that movement and acquisition of mesodermal character can be uncoupled. Finally, we demonstrate that ChCh is required to limit the transcriptional response to Nodal. Conclusion These data establish a broad role for ChCh in regulating both cell movement and Nodal signaling during early zebrafish development. We show that chch is required to limit mesodermal gene expression, inhibit Nodal-dependant movement of presumptive ectodermal cells and repress the transcriptional response to Nodal signaling. These findings reveal a dynamic role for chch in regulating cell movement and fate during early development.

  5. Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma.

    Science.gov (United States)

    Seol, Ki Ho; Lee, Jeong Eun

    2016-03-01

    To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

  6. Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Ki Ho; Lee, Jeong Eun [Dept. of Radiation Oncology, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2016-03-15

    To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

  7. Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Seol, Ki Ho; Lee, Jeong Eun

    2016-01-01

    To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC

  8. Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

    LENUS (Irish Health Repository)

    Solon, Jacqueline G

    2012-02-01

    BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210\\/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient\\'s preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.

  9. The effect of nodalization and temperature of reactor upper region: Sensitivity analysis for APR-1400 LBLOCA

    International Nuclear Information System (INIS)

    Kang, Dong Gu

    2017-01-01

    Highlights: • The nodalization of APR-1400 was modified to reflect the characteristic of upper region temperature. • The effect of nodalization and temperature of reactor upper region on LBLOCA consequence was evaluated. • The modification of nodalization is an essential prerequisite in APR-1400 LBLOCA analysis. - Abstract: In best estimate (BE) calculation, the definition of system nodalization is important step influencing the prediction accuracy for specific thermal-hydraulic phenomena. The upper region of reactor is defined as the region of the upper guide structure (UGS) and upper dome. It has been assumed that the temperature of upper region is close to average temperature in most large break loss of coolant accident (LBLOCA) analysis cases. However, it was recently found that the temperature of upper region of APR-1400 reactor might be little lower than or similar to hot leg temperature through the review of detailed design data. In this study, the nodalization of APR-1400 was modified to reflect the characteristic of upper region temperature, and the effect of nodalization and temperature of reactor upper region on LBLOCA consequence was evaluated by sensitivity analysis including best estimate plus uncertainty (BEPU) calculation. In basecase calculation, in case of modified version, the peak cladding temperature (PCT) in blowdown phase became higher and the blowdown quenching (or cooling) was significantly deteriorated as compared to original case, and as a result, the cladding temperature in reflood phase became higher and the final quenching was also delayed. In addition, thermal-hydraulic parameters were compared and analyzed to investigate the effect of change of upper region on cladding temperature. In BEPU analysis, the 95 percentile PCT used in current regulatory practice was increased due to the modification of upper region nodalization, and it occurred in the reflood phase unlike original case.

  10. Development of an object oriented nodal code using the refined AFEN derived from the method of component decomposition

    International Nuclear Information System (INIS)

    Noh, J. M.; Yoo, J. W.; Joo, H. K.

    2004-01-01

    In this study, we invented a method of component decomposition to derive the systematic inter-nodal coupled equations of the refined AFEN method and developed an object oriented nodal code to solve the derived coupled equations. The method of component decomposition decomposes the intra-nodal flux expansion of a nodal method into even and odd components in three dimensions to reduce the large coupled linear system equation into several small single equations. This method requires no additional technique to accelerate the iteration process to solve the inter-nodal coupled equations, since the derived equations can automatically act as the coarse mesh re-balance equations. By utilizing the object oriented programming concepts such as abstraction, encapsulation, inheritance and polymorphism, dynamic memory allocation, and operator overloading, we developed an object oriented nodal code that can facilitate the input/output and the dynamic control of the memories, and can make the maintenance easy. (authors)

  11. Metachronous solitary splenic metastasis arising from early gastric cancer: a case report and literature review.

    Science.gov (United States)

    Namikawa, Tsutomu; Kawanishi, Yasuhiro; Fujisawa, Kazune; Munekage, Eri; Munekage, Masaya; Sugase, Takahito; Maeda, Hiromichi; Kitagawa, Hiroyuki; Kumon, Tatsuya; Hiroi, Makoto; Kobayashi, Michiya; Hanazaki, Kazuhiro

    2017-08-29

    The metastasis of malignant tumors to the spleen is rare, and only a small percentage of cases can be treated surgically, as splenic metastases generally occur in the context of multivisceral metastatic cancer at a terminal stage. We report a rare case of metachronous solitary splenic metastasis arising from early gastric cancer. A 75-year-old man was initially referred to our hospital for examination of gastric cancer, diagnosed at a medical check-up. Esophagogastroduodenoscopy showed a slightly elevated lesion with a central irregular depression in the upper-third of the stomach. Biopsy specimens of the lesion showed a moderately-differentiated adenocarcinoma, and abdominal computed tomography showed no evidence of distant metastases. Endoscopic submucosal dissection was performed, with histological confirmation of a moderately-differentiated adenocarcinoma invading the submucosal layer. The patient subsequently underwent laparoscopic total gastrectomy with regional lymph node dissection, resulting in no residual carcinoma and no lymph node metastasis. Computed tomography, 28 months later, showed a well-defined mass measuring 4.2 cm in diameter in the spleen, and the patient underwent a splenectomy, since there was no evidence of further metastatic lesions in any other organs. Histological examination confirmed the diagnosis of a poorly-differentiated adenocarcinoma originating from the previous gastric cancer. The patient was alive 2 months after surgical resection of the splenic metastasis without any recurrence. To the best of our knowledge, this is only the second case of a solitary splenic metastasis from early gastric cancer to be reported in the English literature. The present case suggests surgical resection may be the preferred treatment of choice for patients with a solitary splenic metastasis from gastric cancer.

  12. Mechanisms of Twist 1-Induced Invasion in Breast Cancer Metastasis

    Science.gov (United States)

    2011-01-01

    affect breast cancer metastasis with a subcutaneous mouse tumor implantation model of breast cancer metastasis. HMLE -Twist1 cells expressing shRNAs...13 4 Introduction Distant metastases are responsible for the vast majority of breast cancer deaths. This process...to migrate and invade is therefore essential to the metastatic process. The initial steps of breast cancer metastasis, local invasion and

  13. Computed tomography demonstration of a hypothalamic metastasis

    International Nuclear Information System (INIS)

    Chakeres, D.W.

    1983-01-01

    This case report describes a patient who presented with panhypopituitarism secondary to hypothalamic metastasis. A primary hypothalamic abnormality was suggested by computed tomographic (CT) demonstration of a small enhancing circular mass centered within the hypothalamus. Sellar radiographs and cerebral angiography were normal. (orig.)

  14. Computed tomography demonstration of a hypothalamic metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Chakeres, D.W.

    1983-05-01

    This case report describes a patient who presented with panhypopituitarism secondary to hypothalamic metastasis. A primary hypothalamic abnormality was suggested by computed tomographic (CT) demonstration of a small enhancing circular mass centered within the hypothalamus. Sellar radiographs and cerebral angiography were normal.

  15. A new protein Girdin in tumor metastasis

    Institute of Scientific and Technical Information of China (English)

    WANG Jing; FU Li; GU Feng; MA Yong-jie

    2010-01-01

    @@ The phosphatidylinositol 3-kinase/Akt serine/threonine kinase system regulates multiple cellular processes through the phosphorylation of a great number of downstream substrates and has been recognized as an important pathway for signal transduction, and in cancer invasion and metastasis.

  16. Detection of cancer before distant metastasis

    NARCIS (Netherlands)

    Coumans, F.A.W.; Siesling, Sabine; Terstappen, Leonardus Wendelinus Mathias Marie

    2013-01-01

    Background To establish a distant metastasis (DM) cells must disseminate from the primary tumor and overcome a series of obstacles, the metastatic cascade. In this study we develop a mathematical model for this cascade to estimate the tumor size and the circulating tumor cell (CTC) load before the

  17. Detection of cancer before distant metastasis

    NARCIS (Netherlands)

    Coumans, Frank A. W.; Siesling, Sabine; Terstappen, Leon W. M. M.

    2013-01-01

    Background: To establish a distant metastasis (DM) cells must disseminate from the primary tumor and overcome a series of obstacles, the metastatic cascade. In this study we develop a mathematical model for this cascade to estimate the tumor size and the circulating tumor cell (CTC) load before the

  18. The protein C pathway in cancer metastasis

    NARCIS (Netherlands)

    Spek, C. Arnold; Arruda, Valder R.

    2012-01-01

    Cancer is frequently associated with activation of blood coagulation, which in turn has been suggested to promote tumor growth and metastasis. Indeed, low molecular weight heparin treatment significantly prolongs the survival of a wide variety of patients with cancer. Based on this notion that

  19. Diagnosis of bone metastasis from thyroid carcinoma

    DEFF Research Database (Denmark)

    Bechsgaard, Thor; Lelkaitis, Giedrius; Jensen, Karl E

    2015-01-01

    (MRI), but histology revealed a metastasis from thyroid carcinoma, although the patient had no previous history of thyroid malignancy and resection of the thyroid gland was without malignancy. Ultrasound-guided biopsy was possible due to cortical destruction and the multidisciplinary approach with re...

  20. Presumed choroidal metastasis of Merkel cell carcinoma

    International Nuclear Information System (INIS)

    Small, K.W.; Rosenwasser, G.O.; Alexander, E. III; Rossitch, G.; Dutton, J.J.

    1990-01-01

    Merkel cell carcinoma is a rare skin tumor of neural crest origin and is part of the amine precursor uptake and decarboxylase system. It typically occurs on the face of elderly people. Distant metastasis is almost uniformly fatal. Choroidal metastasis, to our knowledge, has not been described. We report a patient with Merkel cell carcinoma who had a synchronous solid choroidal tumor and a biopsy-proven brain metastasis. Our 56-year-old patient presented with a rapidly growing, violaceous preauricular skin tumor. Computed tomography of the head disclosed incidental brain and choroidal tumors. Light and electron microscopy of biopsy specimens of both the skin and the brain lesions showed Merkel cell carcinoma. Ophthalmoscopy, fluorescein angiography, and A and B echography revealed a solid choroidal mass. The brain and skin tumors responded well to irradiation. A radioactive episcleral plaque was applied subsequently to the choroidal tumor. All tumors regressed, and the patient was doing well 28 months later. To our knowledge this is the first case of presumed choroidal metastasis of Merkel cell carcinoma

  1. Brain metastasis from hepatocellular carcinoma: the role of surgery as a prognostic factor

    International Nuclear Information System (INIS)

    Han, Moon-Soo; Moon, Kyung-Sub; Lee, Kyung-Hwa; Cho, Sung-Bum; Lim, Sa-Hoe; Jang, Woo-Youl; Jung, Tae-Young; Kim, In-Young; Jung, Shin

    2013-01-01

    The incidence of brain metastasis from hepatocellular carcinoma (HCC) is expected to increase as a result of prolonged survival due to the recent advances in HCC treatment. However, there is no definite treatment strategy for brain metastasis from HCC mainly due to its rarity and dismal prognosis. To provide helpful recommendations in treatment of brain metastasis from HCC, the authors aimed to identify prognostic factors that influence survival rates with a review of the recently published data. Thirty-three cases of brain metastasis, whose incidence was 0.65%, were selected from a total of 5015 HCC patients and reviewed retrospectively in terms of clinical and radiological features. Median overall survival time after diagnosis of brain metastasis was 10.4 weeks (95% confidence interval [CI], 5.1-15.7 weeks) with 1-, 6- and 12-month survival rates, of 79%, 24% and 6%, respectively. Median survival of the patients treated with surgical resection or surgical resection followed by whole-brain radiation therapy (WBRT) (25.3 weeks; range, 15.8-34.8 weeks) was longer than that of the patients treated with gamma knife surgery (GKS), WBRT, or GKS followed by WBRT (10.4 weeks; range, 7.5-13.3 weeks) as well as that of patients treated with only steroids (1 week; range, 0.0-3.3 weeks) (p < 0.001). Child-Pugh’s classification A group had a longer median survival time than Child-Pugh’s classification B or C group (14.4 weeks vs 8.4 weeks, p = 0.038). RPA class I & II group had also a longer median survival time than RPA class III group did (13.4 weeks vs 2.4 weeks, p = 0.001). Surgical resection (hazard ratio [HR] 0.23, 95% CI 0.08-0.66, p = 0.006) and good liver function at the time of brain metastasis (HR 0.25, 95% CI 0.09-0.69, p = 0.007) were found to be the powerful prognostic factors for favorable survival in the multivariate analysis. In addition, presence of intratumoral hemorrhage was a statistically significant prognostic factor for survival. Although HCC

  2. Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck—a meta-analysis comparing different imaging modalities

    International Nuclear Information System (INIS)

    Liao, Li-Jen; Lo, Wu-Chia; Hsu, Wan-Lun; Wang, Chi-Te; Lai, Mei-Shu

    2012-01-01

    How to properly manage clinically negative neck of head and neck cancer patients is a controversial topic. Research is now directed toward finding a method sensitive enough to bring the risk of occult metastases below 20%. The aim of this review was to compare the diagnostic accuracy of different imaging modalities, including CT, MRI, PET and US, in clinically N0 head and neck cancer patients. For this systematic review and meta-analysis, PubMed and the Cochrane Database were searched for relevant original articles published up to May 2011. Inclusion criteria were as follows: articles were reported in English; CT, MRI, PET or US were performed to identify cervical metastases in clinically N0 head and neck squamous cell carcinoma; and data were sufficient for the calculation of true-positive or false-negative values. A bivariate random effect model was used to obtain pooled sensitivity and specificity. The positive and negative test probability of neck metastasis was generated based on Bayesian theory and collected data for different pre-test possibilities. Of the 168 identified relevant articles, 7 studies fulfilled all inclusion criteria for CT, 6 studies for MRI, 11 studies for PET and 8 studies for US. There was no difference in sensitivity and specificity among these imaging modalities, except CT was superior to US in specificity. The pooled estimates for sensitivity were 52% (95% confidence interval [CI], 39% ~ 65%), 65% (34 ~ 87%) 66% (47 ~ 80%), and 66% (45 ~ 77%), on a per-neck basis for CT, MRI, PET and US, respectively. The pooled estimates for specificity were 93% (87% ~ 97%), 81% (64 ~ 91%), 87% (77 ~ 93%), and 78% (71 ~ 83%) for CT, MRI, PET and US, respectively. With pre-examination nodal metastasis probabilities set at 10%, 20% and 30%, the post-exam probabilities of positive nodal metastasis rates were 47%, 66% and 77% for CT; 27%, 46% and 59% for MRI; 36%, 56% and 69% for PET; and 25%, 42% and 56% for US, respectively. Negative nodal metastasis

  3. Evaluating human cancer cell metastasis in zebrafish

    International Nuclear Information System (INIS)

    Teng, Yong; Xie, Xiayang; Walker, Steven; White, David T; Mumm, Jeff S; Cowell, John K

    2013-01-01

    In vivo metastasis assays have traditionally been performed in mice, but the process is inefficient and costly. However, since zebrafish do not develop an adaptive immune system until 14 days post-fertilization, human cancer cells can survive and metastasize when transplanted into zebrafish larvae. Despite isolated reports, there has been no systematic evaluation of the robustness of this system to date. Individual cell lines were stained with CM-Dil and injected into the perivitelline space of 2-day old zebrafish larvae. After 2-4 days fish were imaged using confocal microscopy and the number of metastatic cells was determined using Fiji software. To determine whether zebrafish can faithfully report metastatic potential in human cancer cells, we injected a series of cells with different metastatic potential into the perivitelline space of 2 day old embryos. Using cells from breast, prostate, colon and pancreas we demonstrated that the degree of cell metastasis in fish is proportional to their invasion potential in vitro. Highly metastatic cells such as MDA231, DU145, SW620 and ASPC-1 are seen in the vasculature and throughout the body of the fish after only 24–48 hours. Importantly, cells that are not invasive in vitro such as T47D, LNCaP and HT29 do not metastasize in fish. Inactivation of JAK1/2 in fibrosarcoma cells leads to loss of invasion in vitro and metastasis in vivo, and in zebrafish these cells show limited spread throughout the zebrafish body compared with the highly metastatic parental cells. Further, knockdown of WASF3 in DU145 cells which leads to loss of invasion in vitro and metastasis in vivo also results in suppression of metastasis in zebrafish. In a cancer progression model involving normal MCF10A breast epithelial cells, the degree of invasion/metastasis in vitro and in mice is mirrored in zebrafish. Using a modified version of Fiji software, it is possible to quantify individual metastatic cells in the transparent larvae to correlate with

  4. Autopsy findings in carcinoma of the esophagus treated with radiotherapy

    International Nuclear Information System (INIS)

    Hishikawa, Yoshio; Kamikonya, Norihiko; Tanaka, Shinichi; Miura, Takashi

    1988-01-01

    Forty autopsied patients with esophageal carcinoma (35 treated with radiotherapy and 5 with conservative treatment) were analyzed by multiple regression analysis. Local recurrence significantly differed with the treatment method. The lowest rate of local recurrence was observed in the patients treated with high-dose-rate intracavitary irradiation following external irradiation. Mediastinal lymph node metastasis was significantly related to the extent of the primary tumor (T) and the lowest rate of metastasis was seen in the patients with T1. Abdominal lymph node metastasis was significantly related to both the disease stage and treatment method. The lowest rate of metastasis was noted in stage 1 patients, whereas, the rate was high in the patients with high-dose-rate intracavitary irradiation following external irradiation. Distant metastasis was significantly related to disease stage, with stage 1 patients showing the lowest rate of metastasis. Prognosis was significantly related to the treatment method. The average of survival was highest in the patients treated with high-dose-rate intracavitary irradiation following external irradiation. (author)

  5. SU-F-P-52: A Meta-Analysis of Controlled Clinical Trials Comparing Elective Nodal Irradiation with Involved-Field Irradiation for Conformal Or Intensity-Modulated Radiotherapy in Patients with Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bai, W; Zhang, R; Zhou, Z; Qiao, X [The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei (China)

    2016-06-15

    Purpose: To compare elective nodal irradiation with involved-field irradiation for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer by a metaanalysis. Methods: Wanfang, CNKI, VIP, CBM databases, PubMed, Embase and Cochrane Library were searched to identify the controlled clinical trials of elective nodal irradiation with involved-field irradiation for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer. The obtained data were analyzed using Stata 11.0. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (95% CI). Results: A total of 12 controlled clinical trials involving 1095 esophageal cancer patients, which were selected according to inclusion and exclusion criteria, were included in this meta-analysis. The meta-analysis showed that the elective nodal irradiation group reduced the rates of out-field failure comparing with involved-field irradiation group (OR=3.727, P=0.007). However, the rates of ≥grades 3 acute radiation pneumonitis and esophagitis were significantly higher in the elective nodal irradiation group than in the involved-field irradiation group (OR=0.348, P=0.001, OR=0.385, P=0.000). 1-, 2-, 3-year local control rates (OR=0.966, P=0.837, OR=0.946, P=0.781; OR=0.732P=0.098) and 1-, 3-, 5-year survival rates were similar in the two groups ( OR=0.966, P=0.837; OR=0.946, P=0.781; OR=0.732, P=0.098; OR=0.952, P=0.756; OR=1.149, P=0.422; OR=0.768, P=0.120). It is the same with the rates of distant metastasis (OR=0.986, P=0.937). Conclusion: Compared with involved-field irradiation, the elective nodal irradiation can reduce the rates of out-field failure for three-dimensional conformal radiotherapy or intensity-modulated radiotherapy in patients with esophageal cancer. However, its advantage of local control and survival rates is not obvious and it increases the incidence

  6. Update on nodal staging in non-small cell lung cancer with integrated positron emission tomography/computed tomography: a meta-analysis.

    Science.gov (United States)

    Pak, Kyoungjune; Park, Sohyun; Cheon, Gi Jeong; Kang, Keon Wook; Kim, In-Joo; Lee, Dong Soo; Kim, E Edmund; Chung, June-Key

    2015-06-01

    Nowadays, the number of primary studies on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been increasing rapidly. Thus, we updated meta-analysis to evaluate the test performance of FDG PET/CT for nodal staging in non-small cell lung cancer (NSCLC) including the most recent studies. We performed a systematic search of MEDLINE and EMBASE for English publications using keywords "positron emission tomography", "lung cancer", and "lymph node". All searches were limited to human studies. Inclusion criteria were studies of the initial nodal staging of NSCLC with PET/CT. The reasons for exclusion are as follows: (1) studies with PET, (2) previous therapy before PET/CT, (3) nodal staging not confirmed by histology, and (4) reviews, abstracts, and editorial materials. 786 articles were identified through database searching. 28 studies including 3,255 patients and 11,887 lymph nodes (LN) were eligible for this study. The pooled sensitivity was 0.62 (95% CI 0.54-0.70), widely ranging from 0.13 to 0.98. The specificity ranged between 0.72 and 0.98 with an overall estimated specificity of 0.92 (0.88-0.95) for node-based data. The pooled sensitivity, specificity, positive and negative likelihood ratio were 0.67 (0.54-0.79), 0.87 (0.82-0.91), 5.20 (3.59-7.54), and 0.37 (0.25-0.55) for patient-based data. Studies from tuberculosis (Tb) endemic countries showed lower sensitivity (0.56 vs 0.68, p = 0.03) for node-based data and lower specificity (0.83 vs 0.89, p < 0.01) for patient-based ones. PET/CT has a high specificity, but low sensitivity for detecting LN metastasis in patients with NSCLC. Tb might be one of the main reasons for lower sensitivity of PET/CT in several countries. The primary clinicians of lung cancer should be aware of the possibility of hidden metastatic LNs in bilateral FDG uptake of mediastinal and hilar LNs, especially in the Tb endemic countries.

  7. PET-NECK: a multicentre randomised Phase III non-inferiority trial comparing a positron emission tomography-computerised tomography-guided watch-and-wait policy with planned neck dissection in the management of locally advanced (N2/N3) nodal metastases in patients with squamous cell head and neck cancer.

    Science.gov (United States)

    Mehanna, Hisham; McConkey, Chris C; Rahman, Joy K; Wong, Wai-Lup; Smith, Alison F; Nutting, Chris; Hartley, Andrew Gj; Hall, Peter; Hulme, Claire; Patel, Dharmesh K; Zeidler, Sandra Ventorin von; Robinson, Max; Sanghera, Bal; Fresco, Lydia; Dunn, Janet A

    2017-04-01

    Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND. Evidence is sparse and drawn mainly from retrospective single-institution studies, illustrating the need for a prospective randomised controlled trial. To determine the efficacy and cost-effectiveness of PET-CT-guided surveillance, compared with planned ND, in a multicentre, prospective, randomised setting. A pragmatic randomised non-inferiority trial comparing PET-CT-guided watch-and-wait policy with the current planned ND policy in HNSCC patients with locally advanced nodal metastases and treated with radical CRT. Patients were randomised in a 1 : 1 ratio. Primary outcomes were overall survival (OS) and cost-effectiveness [incremental cost per incremental quality-adjusted life-year (QALY)]. Cost-effectiveness was assessed over the trial period using individual patient data, and over a lifetime horizon using a decision-analytic model. Secondary outcomes were recurrence in the neck, complication rates and quality of life. The recruitment of 560 patients was planned to detect non-inferior OS in the intervention arm with a 90% power and a type I error of 5%, with non-inferiority defined as having a hazard ratio (HR) of no higher than 1.50. An intention-to-treat analysis was performed by Cox's proportional hazards model. Thirty-seven head and neck cancer-treating centres (43 NHS hospitals) throughout the UK. Patients with locally advanced nodal metastases of oropharynx, hypopharynx, larynx, oral or occult HNSCC receiving

  8. Recognizing nodal marginal zone lymphoma: recent advances and pitfalls. A systematic review

    Science.gov (United States)

    van den Brand, Michiel; van Krieken, J. Han J.M.

    2013-01-01

    The diagnosis of nodal marginal zone lymphoma is one of the remaining problem areas in hematopathology. Because no established positive markers exist for this lymphoma, it is frequently a diagnosis of exclusion, making distinction from other low-grade B-cell lymphomas difficult or even impossible. This systematic review summarizes and discusses the current knowledge on nodal marginal zone lymphoma, including clinical features, epidemiology and etiology, histology, and cytogenetic and molecular features. In particular, recent advances in diagnostics and pathogenesis are discussed. New immunohistochemical markers have become available that could be used as positive markers for nodal marginal zone lymphoma. These markers could be used to ensure more homogeneous study groups in future research. Also, recent gene expression studies and studies describing specific gene mutations have provided clues to the pathogenesis of nodal marginal zone lymphoma, suggesting deregulation of the nuclear factor kappa B pathway. Nevertheless, nodal marginal zone lymphoma remains an enigmatic entity, requiring further study to define its pathogenesis to allow an accurate diagnosis and tailored treatment. However, recent data indicate that it is not related to splenic or extranodal lymphoma, and that it is also not related to lymphoplasmacytic lymphoma. Thus, even though the diagnosis is not always easy, it is clearly a separate entity. PMID:23813646

  9. A new diffusion nodal method based on analytic basis function expansion

    International Nuclear Information System (INIS)

    Noh, J.M.; Cho, N.Z.

    1993-01-01

    The transverse integration procedure commonly used in most advanced nodal methods results in some limitations. The first is that the transverse leakage term that appears in the transverse integration procedure must be appropriately approximated. In most advanced nodal methods, this term is expanded in a quadratic polynomial. The second arises when reconstructing the pinwise flux distribution within a node. The available one-dimensional flux shapes from nodal calculation in each spatial direction cannot be used directly in the flux reconstruction. Finally, the transverse leakage defined for a hexagonal node becomes so complicated as not to be easily handled and contains nonphysical singular terms. In this paper, a new nodal method called the analytic function expansion nodal (AFEN) method is described for both the rectangular geometry and the hexagonal geometry in order to overcome these limitations. This method does not solve the transverse-integrated one-dimensional diffusion equations but instead solves directly the original multidimensional diffusion equation within a node. This is a accomplished by expanding the solution (or the intranodal homogeneous flux distribution) in terms of nonseparable analytic basis functions satisfying the diffusion equation at any point in the node

  10. Interplay between short-range correlated disorder and Coulomb interaction in nodal-line semimetals

    Science.gov (United States)

    Wang, Yuxuan; Nandkishore, Rahul M.

    2017-09-01

    In nodal-line semimetals, Coulomb interactions and short-range correlated disorder are both marginal perturbations to the clean noninteracting Hamiltonian. We analyze their interplay using a weak-coupling renormalization group approach. In the clean case, the Coulomb interaction has been found to be marginally irrelevant, leading to Fermi liquid behavior. We extend the analysis to incorporate the effects of disorder. The nodal line structure gives rise to kinematical constraints similar to that for a two-dimensional Fermi surface, which plays a crucial role in the one-loop renormalization of the disorder couplings. For a twofold degenerate nodal loop (Weyl loop), we show that disorder flows to strong coupling along a unique fixed trajectory in the space of symmetry inequivalent disorder couplings. Along this fixed trajectory, all symmetry inequivalent disorder strengths become equal. For a fourfold degenerate nodal loop (Dirac loop), disorder also flows to strong coupling, however, the strengths of symmetry inequivalent disorder couplings remain different. We show that feedback from disorder reverses the sign of the beta function for the Coulomb interaction, causing the Coulomb interaction to flow to strong coupling as well. However, the Coulomb interaction flows to strong coupling asymptotically more slowly than disorder. Extrapolating our results to strong coupling, we conjecture that at low energies nodal line semimetals should be described by a noninteracting nonlinear sigma model. We discuss the relation of our results with possible many-body localization at zero temperatures in such materials.

  11. Tumor microvessel density–associated mast cells in canine nodal lymphoma

    Directory of Open Access Journals (Sweden)

    Moges Woldemeskel

    2014-11-01

    Full Text Available Objective: Mast cells are associated in angiogenesis in various human and animal neoplasms. However, association of mast cells with tumor microvessel density in canine lymphoma was not previously documented. The objective of the study is to determine if mast cells are increased in canine nodal lymphomas and to evaluate their correlation with tumor microvessel density and grading of lymphomas. Methods: Nodal lymphomas from 33 dogs were studied and compared with nonneoplastic lymph nodes from 6 dogs as control. Mast cell count was made on Toluidine blue stained sections. Immunohistochemistry using antibody against Factor VIII was employed to visualize and determine microvessel density. Results: The mast cell count in lymphoma (2.95 ± 2.4 was significantly higher (p < 0.05 than that in the control (0.83 ± 0.3 and was positively correlated with tumor microvessel density (r = 0.44, p = 0.009. Significant difference was not observed in mast cell count and tumor microvessel density among different gradings of lymphomas. Conclusions: Mast cells are associated with tumor microvessel density in canine nodal lymphoma with no significant difference among gradings of lymphomas. Mast cells may play an important role in development of canine nodal lymphomas. Further detailed investigation on the role of mast cells as important part of tumor microenvironment in canine nodal lymphomas is recommended.

  12. Sensitivity analysis of MIDAS tests using SPACE code. Effect of nodalization

    International Nuclear Information System (INIS)

    Eom, Shin; Oh, Seung-Jong; Diab, Aya

    2018-01-01

    The nodalization sensitivity analysis for the ECCS (Emergency Core Cooling System) bypass phe�nomena was performed using the SPACE (Safety and Performance Analysis CodE) thermal hydraulic analysis computer code. The results of MIDAS (Multi-�dimensional Investigation in Downcomer Annulus Simulation) test were used. The MIDAS test was conducted by the KAERI (Korea Atomic Energy Research Institute) for the performance evaluation of the ECC (Emergency Core Cooling) bypass phenomenon in the DVI (Direct Vessel Injection) system. The main aim of this study is to examine the sensitivity of the SPACE code results to the number of thermal hydraulic channels used to model the annulus region in the MIDAS experiment. The numerical model involves three nodalization cases (4, 6, and 12 channels) and the result show that the effect of nodalization on the bypass fraction for the high steam flow rate MIDAS tests is minimal. For computational efficiency, a 4 channel representation is recommended for the SPACE code nodalization. For the low steam flow rate tests, the SPACE code over-�predicts the bypass fraction irrespective of the nodalization finesse. The over-�prediction at low steam flow may be attributed to the difficulty to accurately represent the flow regime in the vicinity of the broken cold leg.

  13. Nodalization effects on RELAP5 results related to MTR research reactor transient scenarios

    Directory of Open Access Journals (Sweden)

    Khedr Ahmed

    2005-01-01

    Full Text Available The present work deals with the anal y sis of RELAP5 results obtained from the evaluation study of the total loss of flow transient with the deficiency of the heat removal system in a research reactor using two different nodalizations. It focuses on the effect of nodalization on the thermal-hydraulic evaluation of the re search reactor. The analysis of RELAP5 results has shown that nodalization has a big effect on the predicted scenario of the postulated transient. There fore, great care should be taken during the nodalization of the reactor, especially when the avail able experimental or measured data are insufficient for making a complete qualification of the nodalization. Our analysis also shows that the research reactor pool simulation has a great effect on the evaluation of natural circulation flow and on other thermal-hydraulic parameters during the loss of flow transient. For example, the on set time of core boiling changes from less than 2000 s to 15000 s, starting from the beginning of the transient. This occurs if the pool is simulated by two vertical volumes in stead of one vertical volume.

  14. Tumor microvessel density–associated mast cells in canine nodal lymphoma

    Science.gov (United States)

    Mann, Elizabeth; Whittington, Lisa

    2014-01-01

    Objective: Mast cells are associated in angiogenesis in various human and animal neoplasms. However, association of mast cells with tumor microvessel density in canine lymphoma was not previously documented. The objective of the study is to determine if mast cells are increased in canine nodal lymphomas and to evaluate their correlation with tumor microvessel density and grading of lymphomas. Methods: Nodal lymphomas from 33 dogs were studied and compared with nonneoplastic lymph nodes from 6 dogs as control. Mast cell count was made on Toluidine blue stained sections. Immunohistochemistry using antibody against Factor VIII was employed to visualize and determine microvessel density. Results: The mast cell count in lymphoma (2.95 ± 2.4) was significantly higher (p < 0.05) than that in the control (0.83 ± 0.3) and was positively correlated with tumor microvessel density (r = 0.44, p = 0.009). Significant difference was not observed in mast cell count and tumor microvessel density among different gradings of lymphomas. Conclusions: Mast cells are associated with tumor microvessel density in canine nodal lymphoma with no significant difference among gradings of lymphomas. Mast cells may play an important role in development of canine nodal lymphomas. Further detailed investigation on the role of mast cells as important part of tumor microenvironment in canine nodal lymphomas is recommended. PMID:26770752

  15. Sensitivity analysis of MIDAS tests using SPACE code. Effect of nodalization

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Shin; Oh, Seung-Jong; Diab, Aya [KEPCO International Nuclear Graduate School (KINGS), Ulsan (Korea, Republic of). Dept. of NPP Engineering

    2018-02-15

    The nodalization sensitivity analysis for the ECCS (Emergency Core Cooling System) bypass phe�nomena was performed using the SPACE (Safety and Performance Analysis CodE) thermal hydraulic analysis computer code. The results of MIDAS (Multi-�dimensional Investigation in Downcomer Annulus Simulation) test were used. The MIDAS test was conducted by the KAERI (Korea Atomic Energy Research Institute) for the performance evaluation of the ECC (Emergency Core Cooling) bypass phenomenon in the DVI (Direct Vessel Injection) system. The main aim of this study is to examine the sensitivity of the SPACE code results to the number of thermal hydraulic channels used to model the annulus region in the MIDAS experiment. The numerical model involves three nodalization cases (4, 6, and 12 channels) and the result show that the effect of nodalization on the bypass fraction for the high steam flow rate MIDAS tests is minimal. For computational efficiency, a 4 channel representation is recommended for the SPACE code nodalization. For the low steam flow rate tests, the SPACE code over-�predicts the bypass fraction irrespective of the nodalization finesse. The over-�prediction at low steam flow may be attributed to the difficulty to accurately represent the flow regime in the vicinity of the broken cold leg.

  16. Primary neuroendocrine carcinoma of breast with liver and bone metastasis detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshak; Shibu, Deepu; Radhakrishnan, Edathuruthy Kalarikal; Shinto, Ajit Sugunan

    2014-01-01

    Cases of primary neuroendocrine carcinoma (NEC) of the breast have been reported, though rare. We report the case of a 45-year-old woman presented with jaundice and evaluated to have liver metastasis from neuroendocrine origin. She underwent whole body positron emission tomography/computed tomography, which showed left breast lesion and bone metastasis. Fine-needle aspiration (FNA) of breast revealed a NEC. A diagnosis of a primary NEC of the breast was rendered with hepatic and bone metastasis. She was treated with peptide receptor radionuclide therapy and is on follow-up

  17. Daily concurrent preoperative chemoradiotherapy using new superselective intra-arterial infusion via superficial temporal artery for oral cancer. Cervical lymph node metastasis

    International Nuclear Information System (INIS)

    Yamamoto, Noriyuki; Mitsudo, Kenji; Tohnai, Iwai

    2007-01-01

    Seventeen oral cancer patients with cervical lymph node metastasis were treated by preoperative chemoradiotherapy using superselective intra-arterial infusion via the superficial temporal artery. Radiotherapy (total dose: 40 Gy/4 weeks) and superselective intra-arterial infusion chemotherapy using docetaxel (DOC) (total dose: 60 mg/m 2 , 15 mg/m 2 /week) and cisplatin (CDDP) (total dose: 100 mg/m 2 , 5 mg/m 2 /day) were performed, followed by surgery. The pathological effects of resected lymph node metastasis after surgery were grade III, IV (Oboshi-Shimosato classification) in level I, II. This method is a promising strategy for oral cancer with cervical lymph node metastasis. (author)

  18. Renal Metastasis from Primary Cervical Cancer: A Case Report

    International Nuclear Information System (INIS)

    Jeon, Seong Woo; Kim, See Hyung; Kwon, Sun Young

    2013-01-01

    Metastasis of malignant tumors to the kidney is clinically rare and often discovered by autopsy. Primary lymphoma and lung cancer are known that can metastasize to the kidney. Other malignant tumor metastasis to the kidney is very unusual. Primary cervical cancer metastasis to adjacent pelvic organs and lymph nodes are well known followed by abdominal solid organs such as the liver and adrenal glands. However, reported primary cervical cancer metastasis to the kidney is extremely rare and mostly appeared as bilateral multiple renal masses. We report here on a rare case of unilateral single renal metastasis from primary cervical cancer after concur- rent chemoradiotherapy.

  19. Oligometastatic state predicts a favorable outcome for renal cell carcinoma patients with bone metastasis under the treatment of sunitinib.

    Science.gov (United States)

    Lu, Xiaolin; Gu, Weijie; Zhang, Hailiang; Zhu, Yao; Shi, Guohai; Ye, Dingwei

    2016-05-03

    The aim of the study was to investigate whether RCC patients with oligometastatic state of bone metastasis treated with sunitinib had a favorable clinical outcome. 22 patients were classified into oligometastatic state of bone metastasis with a median OS of 30.1 months (95%CI: 26.3 to 33.8 months). The 45 patients with non-oligometastatic state had a median OS of 12.7 months (95%CI: 9.43 to 16.0 months). Kaplan-Meier analysis showed significant difference between them (Log Rank test p<0.001). When we set patients with only multiple bone (at least 5 sites) metastases as a single group, there was still significant difference between oligometastatic state group and non-oligometastatic state groups. In multivariate Cox proportion hazard ratio analysis, metastatic states (p=0.012), MSKCC score (p=0.002), ECOG (p=0.001) and lymph nodes metastasis (p=0.000) were significantly associated with prognosis. The integration of metastatic state into the MSKCC risk model improved the c-index from 0.651 to 0.752. 67 patients from Fudan University Shanghai Cancer Center with bone metastatic RCC were divided into 2 metastatic states. One included those with oligometastatic state of bone metastasis with less than 5 sites of bone metastasis. The other involved those patients with multiple bone metastases (at least 5 sites) or together with other sites of metastasis. Then patients with only multiple bone (at least 5 sites) metastases were set into a single group. RCC patients with oligometastatic state of bone metastasis treated with sunitinib had a favorable clinical outcome.

  20. Factors associated with peritoneal metastasis in non-serosa-invasive gastric cancer: a retrospective study of a prospectively-collected database

    International Nuclear Information System (INIS)

    Huang, Baojun; Sun, Zhe; Wang, Zhenning; Lu, Chong; Xing, Chengzhong; Zhao, Bo; Xu, Huimian

    2013-01-01

    Peritoneal dissemination is the most common type of recurrence in advanced gastric cancer. The main mechanism is thought to be via the exfoliation of free cancer cells (FCCs) from tumor in the gastric serosa. The frequency of recurrence thus increases once the tumor cells penetrate the serosa. However, this type of recurrence also occurs in patients without serosal invasion, though the mechanisms responsible for have not been fully established. We therefore investigated the factors associated with peritoneal dissemination in patients with non-serosa-invasive gastric cancer. A total of 685 patients with non-serosa-invasive gastric cancer who underwent curative resection with retrieval of more than 15 nodes were selected. The associations between clinicopathological features and peritoneal dissemination were analyzed. Among them, the tumor infiltrating growth pattern (INF) were classified into α, β and γ according to the Japanese Classification of Gastric Carcinoma (JCGC). The overall incidence of peritoneal metastasis was 20% (137/685). Age, Borrmann type, differentiation, INF, nodal status and free cancer cells (FCCs) were correlated with peritoneal dissemination using univariate analysis. However, only INF, Borrmann type and TNM node stage were identified as independent correlated factors with peritoneal metastasis by multivariate analysis when FCCs were excluded, and these were also prognostic factors. Peritoneal dissemination was more common in patients with INFγ, Borrmann III/IV and N3 stage. Among patients without FCCs, nodal involvement or vessel invasion, only INF remained an independent associated factor according to multivariate analysis. Tumor infiltrating growth pattern (INF), together with Borrmann type and TNM node stage, are important factors associated with peritoneal metastasis in non-serosa-invasive gastric cancer