Pyrochemical separations technologies envisioned for the U.S. accelerator transmutation of waste system

International Nuclear Information System (INIS)

Laidler, J. J.

2000-01-01

A program has been initiated for the purpose of developing the chemical separations technologies necessary to support a large Accelerator Transmutation of Waste (ATW) system capable of dealing with the projected inventory of spent fuel from the commercial nuclear power stations in the United States. The baseline process selected combines aqueous and pyrochemical processes to enable the efficient separation of uranium, technetium, iodine, and the transuranic elements from LWR spent fuel. The diversity of processing methods was chosen for both technical and economic factors. A six-year technology evaluation and development program is foreseen, by the end of which an informed decision can be made on proceeding with demonstration of the ATW system

Treatment of the off-gas stream from the HTR reprocessing head-end

International Nuclear Information System (INIS)

Barnert-Wiemer, H.; Juergens, B.; Vijgen, H.

1985-01-01

The AKUT II-facility (nominal throughput 10 m 3 /h, STP) for the clean-up of the burner off-gas has been operated for 20 cold runs in parallel to the JUPITER reprocessing head-end. Two of these runs were continuous operation tests with a duration of 50 and 80 hours, respectively. The facility met or exceeded all design specifications. In a further test series the distillation column alone was run with pure CO 2 and two- and three-component gas mixtures to determine the flooding curves and the stage height (HETP)

Application of the pyrochemical DOS, developed by the CEA, within reprocessing of CERCER transmutation fuel targets

Energy Technology Data Exchange (ETDEWEB)

Mendes, E.; Ducasse, T.; Bertrand, M. [CEA, Centre de Marcoule, Nuclear Energy Division, Radiochemistry and Processes Department, SMCS, LDPS, F-30207 Bagnols-sur-Ceze (France); Miguirditchian, M. [CEA, Centre de Marcoule, Nuclear Energy Division, Radiochemistry and Processes Department, SMCS, LCPE, F-30207 Bagnols-sur-Ceze (France)

2016-07-01

Pyrochemical technology using high-temperature molten salts and molten metal media presents a potential interest for an overall separation and transmutation strategy for long-lived radionuclides. Within the frame of the two French acts on radioactive waste management, a pyrochemical research/development program was launched at the CEA Marcoule in the late 90's. The second step is the actinides back-extraction, which consists in a liquid/liquid oxidative stripping of the An from aluminium matrix into molten chloride media. The DOS process has been successfully demonstrated for treatment of oxide type fuels within the last years: the core of the process has been already assessed and the studies have shown high selectivity and a quantitative recovery of actinides. Within the framework of the SACSESS European research program, the pyrochemical activities focused on applications of the DOS process to reprocess CERCER transmutation targets. These particular types of fuels consist of a mixture of minor actinides (MA) oxides diluted in an inert (oxide MgO) matrices. The behaviour of matrices material was first investigated regarding the solubility in the fluoride salt, starting from both oxide powders or sintered pellets. The saturation of Mg in the salt could be estimated at ∼ 3 wt%. Regarding the reductive extraction, as expected no Mg was reduced by the metallic phase. The present work also highlights that Mg has low impact on the extraction efficiency of U as long as the salt is not saturated. Once the saturation occurs, the efficiency starts to decrease. So we recommend recycling the salt when Mg saturation is reached.

Selection of refractory materials for pyrochemical processing

International Nuclear Information System (INIS)

Axler, K.M.; DePoorter, G.L.; Bagaasen, L.M.

1991-01-01

Several pyrochemical processing operations require containment materials that exhibit minimal chemical interactions with the system, good thermal shock resistance, and reusability. One example is Direct Oxide Reduction (DOR). DOR involves the conversion of PuO 2 to metal by an oxidation/reduction reaction with Ca metal. The reaction proceeds within a molten salt flux at temperatures above 800C. A combination of thermodynamics, system thermodynamic modeling, and experimental investigations are in use to select and evaluate potential containment materials

Materials and coating technology for pyrochemical reprocessing applications

International Nuclear Information System (INIS)

Jayakumar, T.; Kamachi Mudali, U.

2013-01-01

Metallic fuelled fast breeder reactors with co-located pyrochemical reprocessing plants have been proposed as the best option in order to increase the breeding gain, reduce the doubling time of the fuel and reprocess short cooled and high burnup fuel. To establish the pyrochemical reprocessing plants with various unit operations, it is necessary to identify, develop and qualify reliable corrosion resistant materials and coatings for service in molten LiCI-KCI salt and molten uranium environment operating at 773 to 1573 K. Towards materials and coating technology development and testing for molten salt environment a high temperature corrosion testing laboratory was established and studies were initiated. Molten salt test assembly for testing materials and coatings in molten LiCI-KCI salt under controlled ultra high pure (UHP) argon environment at high temperatures has been designed, fabricated, commissioned and tests were carried out on various candidate materials and coatings. Electro-formed (EF) Ni, Ni with Ni-W coating, coatings of ZrN, TiN, HfN and Ti-Si-N on high density (HD) graphite, candidate materials like 2.25Cr-1Mo steel, 9Cr-1Mo steel, 316L stainless steel, Ni base alloys (INCONEL 600, 625 and 690), HD graphite, pyrolytic graphite (PyG), and yttria stabilized zirconia (YSZ) and alumina-40wt% titania thermal barrier coatings were tested for their suitability for molten salt applications. Corrosion studies indicated that YSZ and PyG showed superior corrosion resistance in molten LiCI-KCI salt at 873 K up to 2000 h exposure. Surface modification techniques like annealing, laser remelting and laser shock processing were pursued to consolidate the coatings and improve their high temperature performance. Coating integrity using dielectric electrochemical system and thermal cycling furnace established that, compared to plain 9Cr-1Mo steel YSZ coated 9Cr-1Mo steel performed better from 473 K to 1223 K. The presentation highlights the results of the

Proposed methods for treating high-level pyrochemical process wastes

International Nuclear Information System (INIS)

Johnson, T.R.; Miller, W.E.; Steunenberg, R.K.

1985-01-01

This survey illustrates the large variety and number of possible techniques available for treating pyrochemical wastes; there are undoubtedly other process types and many variations. The choice of a suitable process is complicated by the uncertainty as to what will be an acceptable waste form in the future for both TRU and non-TRU wastes

Preparation of fused chloride salts for use in pyrochemical plutonium recovery operations at Los Alamos

Energy Technology Data Exchange (ETDEWEB)

Fife, K.W.; Bowersox, D.F.; Christensen, D.C.; Williams, J.D.

1986-07-01

The Plutonium Metal Technology Group at Los Alamos routinely uses pyrochemical processes to produce and purify plutonium from impure sources. The basic processes (metal production, metal purification, and residue treatment) involve controlling oxidation and reduction reactions between plutonium and its compounds in molten salts. Current production methods are described, as well as traditional approaches and recent developments in the preparation of solvent salts for electrorefining, molten salt extraction, lean metal (pyroredox) purification, and direct oxide reduction.

Preparation of fused chloride salts for use in pyrochemical plutonium recovery operations at Los Alamos

International Nuclear Information System (INIS)

Fife, K.W.; Bowersox, D.F.; Christensen, D.C.; Williams, J.D.

1986-07-01

The Plutonium Metal Technology Group at Los Alamos routinely uses pyrochemical processes to produce and purify plutonium from impure sources. The basic processes (metal production, metal purification, and residue treatment) involve controlling oxidation and reduction reactions between plutonium and its compounds in molten salts. Current production methods are described, as well as traditional approaches and recent developments in the preparation of solvent salts for electrorefining, molten salt extraction, lean metal (pyroredox) purification, and direct oxide reduction

Aqueous methods for recovery of plutonium from pyrochemical residues

International Nuclear Information System (INIS)

Muscatello, A.C.; Killion, M.E.; Fisher, D.C.

1987-01-01

Studies of the recovery of plutonium from the pyrochemical residue salts from the Direct Oxide Reduction (DOR) and Electrorefining (ER) processes have shown that chloride anion exchange is useful and effective. Our previous studies have defined the operating limits for obtaining low level effluent plutonium losses on the order of 10 -3 g/l. The knowledge obtained in work on DOR salt was extended to ER salt and a process has been demonstrated to be feasible on a larger scale. Studies of oxalate precipitation of plutonium (III) from the eluat exhibit the expected losses to the filtrate as a function of the acidity. Two alternatives to chloride anion exchange, caustic leaching and direct oxalate precipitation are also shown to be feasible for the recovery of plutonium from ER salts. The results of studies of coprocessing DOR and ER residue salts to increase ER salt throughput and decrease HC1 requirements are also presented. The feasibility of coprocessing other pyrochemical residues, such as black salts, anode heel, and ER scrapeout will be discussed

Studies relating to construction materials to be used in different options for head end treatment in reprocessing of mixed carbide fuel of plutonium and uranium

International Nuclear Information System (INIS)

Rajan, S.K.; Palamalai, A.; Ravi, T.N.; Sampath, M.; Raman, V.R.; Balasubramanian, G.R.

1993-01-01

Mixed carbide of uranium and plutonium has been chosen as the fuel for the first core of Fast Breeder Test Reactor, installed in the Indira Gandhi Centre for Atomic Research. Reprocessing of this fuel is one of the vital steps to prove the viability of the fuel cycle. The head end treatment process introduces constraints in the reprocessing of carbide fuel when compared to the commonly used mixed oxide fuel. Three head end processes, namely direct oxidation, pyrohydrolysis and direct dissolution in nitric acid with oxidation of organic acids were considered for study for exercising the choice. The paper briefly describes the three processes. In each process probable material of construction and related problems are discussed. (author). 3 refs, 5 figs, 7 tabs

Mechanical splicing of superelastic Cu–Al–Mn alloy bars with headed ends

Science.gov (United States)

Kise, S.; Mohebbi, A.; Saiidi, M. S.; Omori, T.; Kainuma, R.; Shrestha, K. C.; Araki, Y.

2018-06-01

This paper examines the feasibility of mechanical splicing using a steel coupler to connect headed ends of superelastic Cu–Al–Mn alloy (Camalloy) bars and steel reinforcing bars to be used in concrete structures. Although threading of Camalloy is as easy as that of steel, mechanical splicing using threaded ends requires machining of Camalloy bars into dog-bone shape to avoid brittle fracture at the threaded ends. The machining process requires significant time and cost and wastes substantial amount of the material. This paper attempts to resolve this issue by applying mechanical splicing using steel couplers to connect headed ends of Camalloy and steel reinforcing bars. To study its feasibility, we prepare 3 specimens wherein both ends of each Camalloy bar (13 mm diameter and 300 mm length) are connected to steel reinforcing bars. The specimens are tested under monotonic, single-cycle, and full-cycle tension loading conditions. From these tests, we observed (1) excellent superelasticity with recoverable strain of around 6% and (2) large ductility with fracture strain of over 19%. It should be emphasized here that, in all the specimens, ductile fracture occurred at the locations apart from the headed ends. This is in sharp contrast with brittle fracture of headed superelastic Ni–Ti SMA bars, most of which took place around the headed ends. From the results of the microstructural analysis, we identified the following reasons for avoiding brittle fracture at the headed ends: (1) Precipitation hardening increases the strength around the boundary between the straight and headed (tapered) portions, where stress concentration takes place. (2) The strength of the straight portion does not increase significantly up to the ductile fracture if its grain orientation is close to 〈0 0 1〉.

Immobilization of chloride-rich radioactive wastes produced by pyrochemical operations

International Nuclear Information System (INIS)

McDaniel, E.W.; Terry, J.W.

1997-08-01

A a result of its former role as a producer of nuclear weapons components, the Rocky Flats Environmental Technology Site (RFETS), Golden, Colorado accumulated a variety of plutonium-contaminated materials. When the level of contamination exceeded a predetermined level (the economic discard limit), the materials were classified as residues rather than waste and were stored for later recovery of the plutonium. Although large quantities of residues were processed, others, primarily those more difficult to process, remain in storage at the site. It is planned for the residues with lower concentrations of plutonium to be disposed of as wastes at an appropriate disposal facility, probably the Waste Isolation Pilot Plant (WIPP). Because the plutonium concentration is too high or because the physical or chemical form would be difficult to get into a form acceptable to WIPP, it may not be possible to dispose of a portion of the residues at WIPP. The pyrochemical salts are among the residues that are difficult to dispose of. For a large percentage of the pyrochemical salts, safeguards controls are required, but WIPP was not designed to accommodate safeguards controls. A potential solution would be to immobilize the salts. These immobilized salts would contain substantially higher plutonium concentrations than is currently permissible but would be suitable for disposal at WIPP. This document presents the results of a review of three immobilization technologies to determine if mature technologies exist that would be suitable to immobilize pyrochemical salts: cement-based stabilization, low-temperature vitrification, and polymer encapsulation. The authors recommend that flow sheets and life-cycle costs be developed for cement-based and low-temperature glass immobilization

Pyrochemical recovery of plutonium fluoride reduction slag

International Nuclear Information System (INIS)

Christensen, D.C.; Rayburn, J.A.

1983-07-01

A process was developed for the pyrochemical recovery of plutonium from residues resulting from the PuF 4 reduction process. The process involves crushing the CaF 2 slag and dissolving it at 800 0 C in a CaCl 2 solvent. The plutonium, which exists either as finely divided metal or as incompletely reduced fluoride salt, is reduced to metal and/or allowed to coalesce as a massive button in the bottom of the reaction crucible. The recovery of plutonium in a 1-day cycle averaged 96%; all of the resulting residues were discardable

Vacuum distillation of plutonium pyrochemical salts

International Nuclear Information System (INIS)

Bourges, Gilles; Faure, S.; Fiers, B.; Saintignon, S.; Lemoine, O.; Cardona-Barrau, D.; Devillard, D.

2012-01-01

A pyrochemical process is developed to upgrade the safety of plutonium spent salts interim storage. The feed material, consisting of alkali or alkali-earth chlorides containing various Pu and Am species, is first oxidized to convert the actinides into oxides. Then the chlorides are removed by vacuum distillation which requires temperature from 750 degrees C to 1100 degrees C. After a comprehensive R and D program, full-scale equipment was built to test the distillation of active salts. Tests with NaCl/KCl oxidized spent salt give decontamination factor of chlorides higher than 20000. The distilled salt meets the radiologic requirements to be discarded as low level waste. (authors)

An anthropomorphic multimodality (CT/MRI) head phantom prototype for end-to-end tests in ion radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Gallas, Raya R.; Huenemohr, Nora; Runz, Armin; Niebuhr, Nina I.; Greilich, Steffen [German Cancer Research Center (DKFZ), Heidelberg (Germany). Div. of Medical Physics in Radiation Oncology; National Center for Radiation Research in Oncology, Heidelberg (Germany). Heidelberg Institute of Radiation Oncology (HIRO); Jaekel, Oliver [German Cancer Research Center (DKFZ), Heidelberg (Germany). Div. of Medical Physics in Radiation Oncology; National Center for Radiation Research in Oncology, Heidelberg (Germany). Heidelberg Institute of Radiation Oncology (HIRO); Heidelberg University Hospital (Germany). Dept. of Radiation Oncology; Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg (Germany)

2015-07-01

With the increasing complexity of external beam therapy ''end-to-end'' tests are intended to cover every step from therapy planning through to follow-up in order to fulfill the higher demands on quality assurance. As magnetic resonance imaging (MRI) has become an important part of the treatment process, established phantoms such as the Alderson head cannot fully be used for those tests and novel phantoms have to be developed. Here, we present a feasibility study of a customizable multimodality head phantom. It is initially intended for ion radiotherapy but may also be used in photon therapy. As basis for the anthropomorphic head shape we have used a set of patient computed tomography (CT) images. The phantom recipient consisting of epoxy resin was produced by using a 3D printer. It includes a nasal air cavity, a cranial bone surrogate (based on dipotassium phosphate), a brain surrogate (based on agarose gel), and a surrogate for cerebrospinal fluid (based on distilled water). Furthermore, a volume filled with normoxic dosimetric gel mimicked a tumor. The entire workflow of a proton therapy could be successfully applied to the phantom. CT measurements revealed CT numbers agreeing with reference values for all surrogates in the range from 2 HU to 978 HU (120 kV). MRI showed the desired contrasts between the different phantom materials especially in T2-weighted images (except for the bone surrogate). T2-weighted readout of the polymerization gel dosimeter allowed approximate range verification.

An anthropomorphic multimodality (CT/MRI) head phantom prototype for end-to-end tests in ion radiotherapy

International Nuclear Information System (INIS)

Gallas, Raya R.; Huenemohr, Nora; Runz, Armin; Niebuhr, Nina I.; Greilich, Steffen; Jaekel, Oliver

2015-01-01

With the increasing complexity of external beam therapy ''end-to-end'' tests are intended to cover every step from therapy planning through to follow-up in order to fulfill the higher demands on quality assurance. As magnetic resonance imaging (MRI) has become an important part of the treatment process, established phantoms such as the Alderson head cannot fully be used for those tests and novel phantoms have to be developed. Here, we present a feasibility study of a customizable multimodality head phantom. It is initially intended for ion radiotherapy but may also be used in photon therapy. As basis for the anthropomorphic head shape we have used a set of patient computed tomography (CT) images. The phantom recipient consisting of epoxy resin was produced by using a 3D printer. It includes a nasal air cavity, a cranial bone surrogate (based on dipotassium phosphate), a brain surrogate (based on agarose gel), and a surrogate for cerebrospinal fluid (based on distilled water). Furthermore, a volume filled with normoxic dosimetric gel mimicked a tumor. The entire workflow of a proton therapy could be successfully applied to the phantom. CT measurements revealed CT numbers agreeing with reference values for all surrogates in the range from 2 HU to 978 HU (120 kV). MRI showed the desired contrasts between the different phantom materials especially in T2-weighted images (except for the bone surrogate). T2-weighted readout of the polymerization gel dosimeter allowed approximate range verification.

An anthropomorphic multimodality (CT/MRI) head phantom prototype for end-to-end tests in ion radiotherapy.

Science.gov (United States)

Gallas, Raya R; Hünemohr, Nora; Runz, Armin; Niebuhr, Nina I; Jäkel, Oliver; Greilich, Steffen

2015-12-01

With the increasing complexity of external beam therapy "end-to-end" tests are intended to cover every step from therapy planning through to follow-up in order to fulfill the higher demands on quality assurance. As magnetic resonance imaging (MRI) has become an important part of the treatment process, established phantoms such as the Alderson head cannot fully be used for those tests and novel phantoms have to be developed. Here, we present a feasibility study of a customizable multimodality head phantom. It is initially intended for ion radiotherapy but may also be used in photon therapy. As basis for the anthropomorphic head shape we have used a set of patient computed tomography (CT) images. The phantom recipient consisting of epoxy resin was produced by using a 3D printer. It includes a nasal air cavity, a cranial bone surrogate (based on dipotassium phosphate), a brain surrogate (based on agarose gel), and a surrogate for cerebrospinal fluid (based on distilled water). Furthermore, a volume filled with normoxic dosimetric gel mimicked a tumor. The entire workflow of a proton therapy could be successfully applied to the phantom. CT measurements revealed CT numbers agreeing with reference values for all surrogates in the range from 2 HU to 978 HU (120 kV). MRI showed the desired contrasts between the different phantom materials especially in T2-weighted images (except for the bone surrogate). T2-weighted readout of the polymerization gel dosimeter allowed approximate range verification. Copyright © 2015. Published by Elsevier GmbH.

Pyro-chemistry within the FP7 ACSEPT Project-Program and Objective

Energy Technology Data Exchange (ETDEWEB)

Caravaca, Concha [CIEMAT/Nuclear Fission Division/URAA, Avda. Complutense, 22.Madrid 28040 (Spain); Bourg, Stephane [CEA/DEN/MAR/DRCP, CEA Marcoule. BP17171, 30207 Bagnols sur Ceze Cedex (France)

2008-07-01

Actinide recycling by partitioning and transmutation is considered as one of the most promising strategies to reduce the inventory of radioactive waste, thus contributing to make nuclear energy sustainable. To make advances beyond the current state of the art in pyrochemical separations processes, the Domain 2 (DM2) of ACSEPT has been built on considering a process approach based on system studied. Four work packages that represent the main steps of a process block diagram have been identified: head-end steps, core process development, and salt treatment for recycling and waste conditioning. The results obtained in this domain will be integrated in DM 3 (Process) in order to orientate the R and D studies of DM2 and to propose and validate flowsheets at the end of the project. The state of the art on pyrochemical separation within the European Community and the working program of ACSEPT in pyrometallurgy are presented in this work. (authors)

Head-end process technology for the new reprocessing plants in France and Japan

International Nuclear Information System (INIS)

Saudray, D.; Hugelmann, D.; Cho, A.

1991-01-01

Major technological innovations brought to the new UP3 and UP2-800 reprocessing plants of COGEMA LA HAGUE and also to the JNFS ROKKASHO plant concern the head-end process. The continuous process designed allows for high throughputs whilst meeting stringent safety requirements. The head-end of each plant includes two lines for each operation in order to guarantee availability. This paper presents the T1 head-end facility of the UP3 plant as well as the few adaptations implemented in the ROKKASHO Reprocessing Plant to fulfill the particular design requirements in Japan

RIAR experimental base development concept 1. Multi-purpose pyrochemical complex for experimental justification of innovative closed fuel cycle technologies

Energy Technology Data Exchange (ETDEWEB)

Bychkov, A.V.; Kormilitsyn, M.V. [Research Institute of Atomic Reactors, Dimitrovgrad-10, Ulyanovsk region, 433510 (Russian Federation)

2009-06-15

The principles of closed FC arrangement on the basis of non-aqueous methods allow the development of production addressing two tasks simultaneously: production of fresh fuel and reprocessing of irradiated fuel, that makes it possible to achieve the industrial level of implementation of closed FC of fast reactors of new generation in a series variant of standardized process modules on the basis of innovative pyrochemical high-effective compact technologies. For the purpose of experimental justification of innovative closed FC technologies at the RIAR site, the existing experimental base is being updated and a multi-purpose pyrochemical complex is developed: - Experimental complex of pyrochemical molten salt facilities to reprocess all types of spent fuel (MOX, nitride, metallic, IMF) of fast reactors of new generation (BN-800, MBIR, BREST). - Experimental complex of facilities to master a gas-fluoride technology of reprocessing intractable fuel, research reactors fuel and thermal SNF. - Transition of the existing facility of pyro-electrochemical production of MOX fuel into the mode of reprocessing of the BN-800 MOX SNF. - Renovation of the facilities for production of fuel elements from experimental, re-fabricated, innovative and high-active fuel - a complex of heavy and glove boxes - to produce experimental fuel elements and targets with MAs on the basis of oxides (vibro and pellets), mixed nitrides, metal alloys and inert matrices in heavy boxes. - Upgrading of the complex for mastering and demonstration of the processes for radioactive waste management and spent fuel pyrochemical reprocessing. The report covers main concept and design solutions, plans and schedule of the program for development of pyrochemical complex for experimental justification of innovative closed FC technologies. (authors)

Core characteristics of fast reactor cycle with simple dry pyrochemical processing

International Nuclear Information System (INIS)

Ikegami, Tetsuo

2008-01-01

Fast reactor core concept and core nuclear characteristics are studied for the application of the simple dry pyrochemical processing for fast reactor mixed oxide spent fuels, that is, the Compound Process Fuel Cycle, large FR core with of loaded fuels are recycled by the simple dry pyrochemical processing. Results of the core nuclear analyses show that it is possible to recycle FR spent fuel once and to have 1.01 of breeding ratio without radial blanket region. The comparison is made among three kinds of recycle fuels, LWR UO 2 spent fuel, LWR MOX spent fuel, and FR spent fuel. The recycle fuels reach an equilibrium state after recycles regardless of their starting heavy metal compositions, and the recycled FR fuel has the lowest radio-activity and the same level of heat generation among the recycle fuels. Therefore, the compound process fuel cycle has flexibility to recycle both LWR spent fuel and FR spent fuel. The concept has a possibility of enhancement of nuclear non-proliferation and process simplification of fuel cycle. (author)

Actinide recovery from pyrochemical residues

International Nuclear Information System (INIS)

Avens, L.R.; Clifton, D.G.; Vigil, A.R.

1984-01-01

A new process for recovery of plutonium and americium from pyrochemical waste has been demonstrated. It is based on chloride solution anion exchange at low acidity, which eliminates corrosive HCl fumes. Developmental experiments of the process flowsheet concentrated on molten salt extraction (MSE) residues and gave >95% plutonium and >90% americium recovery. The recovered plutonium contained 6 = from high chloride-low acid solution. Americium and other metals are washed from the ion exchange column with 1N HNO 3 -4.8M NaCl. The plutonium is recovered, after elution, via hydroxide precipitation, while the americium is recovered via NaHCO 3 precipitation. All filtrates from the process are discardable as low-level contaminated waste. Production-scale experiments are now in progress for MSE residues. Flow sheets for actinide recovery from electrorefining and direct oxide reduction residues are presented and discussed

Actinide recovery from pyrochemical residues

International Nuclear Information System (INIS)

Avens, L.R.; Clifton, D.G.; Vigil, A.R.

1985-05-01

We demonstrated a new process for recovering plutonium and americium from pyrochemical waste. The method is based on chloride solution anion exchange at low acidity, or acidity that eliminates corrosive HCl fumes. Developmental experiments of the process flow chart concentrated on molten salt extraction (MSE) residues and gave >95% plutonium and >90% americium recovery. The recovered plutonium contained 6 2- from high-chloride low-acid solution. Americium and other metals are washed from the ion exchange column with lN HNO 3 -4.8M NaCl. After elution, plutonium is recovered by hydroxide precipitation, and americium is recovered by NaHCO 3 precipitation. All filtrates from the process can be discardable as low-level contaminated waste. Production-scale experiments are in progress for MSE residues. Flow charts for actinide recovery from electro-refining and direct oxide reduction residues are presented and discussed

End-stage head and neck cancer coping mechanisms

Directory of Open Access Journals (Sweden)

Bogdan Popescu

2017-10-01

Full Text Available Coping mechanisms are patients’ means of adapting to stressful situations and involve psychological and physical changes in behavior. Patients adapt to head and neck cancer in a variety of ways. Head and neck cancers are extremely debilitating, especially in advanced stages of the disease or in end-of-life situations. While an oncology team needs to address the needs of all oncology patients, the advanced terminal patients require special attention. Most of these patients do not cope well with their situation and have a tendency to cease social interactions. Pain is the most frequentlyexperienced medical disability in patients having an end-stage illness experience, and thus an important medical endeavor is to afford dignity to the dying patient facingan incurable disease. In such cases, the medical community should never refuse therapy or to assist a dying patient.In some instances, the patient and family may derive benefit from their religious beliefs.

Head and Neck Cancer Treatment

Science.gov (United States)

... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

Pyrochemical investigations into recovering plutonium from americium extraction salt residues

International Nuclear Information System (INIS)

Fife, K.W.; West, M.H.

1987-05-01

Progress into developing a pyrochemical technique for separating and recovering plutonium from spent americium extraction waste salts has concentrated on selective chemical reduction with lanthanum metal and calcium metal and on the solvent extraction of americium with calcium metal. Both techniques are effective for recovering plutonium from the waste salt, although neither appears suitable as a separation technique for recycling a plutonium stream back to mainline purification processes. 17 refs., 13 figs., 2 tabs

Deployment of wireless sensor network in pyrochemical processing of metallic fuels

International Nuclear Information System (INIS)

Baghyalakshmi, D.; Shrikrishnan, T.S.; Ebenezer, Jemimah; Madhusoodanan, K.; Satya Murty, S.A.V.; Vannia Perumal, S.; Venkatesh, P.; Prabhakara Reddy, B.

2016-01-01

With the advent of wireless sensor networking technology, industries started adapting the wireless monitoring systems in phases to measure and control various process parameters. To test the feasibility for implementing Wireless Sensor Network to measure the potentials of an electrochemical cell and the temperatures of actinide drawdown process at Pyrochemical process studies laboratory, at Chemistry Group, IGCAR, Kalpakkam, experiments have been carried out. An experimental setup with two Wireless Sensor Networking nodes has been deployed inside argon atmosphere glove boxes. The Electrorefining studies on U and U based alloys and the studies on actinide recovery from the electrolyte salt in actinide drawdown process are carried out in the glove box. The WSN measuring system was tested and validated by measuring the potentials of an electrochemical cell and the temperatures of actinide drawdown process. The WSN system is proposed to be installed in the hot cells of the Chemistry Group where irradiated U-Zr fuel is reprocessed. This paper briefs the need for remote measuring in pyrochemical reprocessing and validation of the remote signals by measuring the potentials of an electrochemical cell and the temperatures of the actinide draw down process. (author)

Uranium transport to solid electrodes in pyrochemical reprocessing of nuclear fuel

International Nuclear Information System (INIS)

Tomczuk, Z.; Ackerman, J.P.; Wolson, R.D.; Miller, W.E.

1992-01-01

A unique pyrochemical process developed for the separation of metallic nuclear fuel from fission products by electrotransport through molten LiCl-KCl eutectic salt to solid and liquid metal cathodes. The process allow for recovery and reuse of essentially all of the actinides in spent fuel from the integral fast reactor (IFR) and disposal of wastes in satisfactory forms. Electrotransport is used to minimize reagent consumption and, consequently, waste volume. In particular, electrotransport to solid cathodes is used for recovery of an essentially pure uranium product in the presence of other actinides; removal of pure uranium is used to adjust the electrolyte composition in preparation for recovery of a plutonium-rich mixture with uranium in liquid cadmium cathodes. This paper presents experiments that delineate the behavior of key actinide and rare-earth elements during electrotransport to a solid electrode over a useful range of PuCl 3 /UCl 3 ratios in the electrolyte, a thermodynamic basis for that behavior, and a comparison of the observed behavior with that calculated from a thermodynamic model. This work clearly established that recovery of nearly pure uranium can be a key step in the overall pyrochemical-fuel-processing strategy for the IFR

Development of system analysis code for pyrochemical process using molten salt electrorefining

International Nuclear Information System (INIS)

Tozawa, K.; Matsumoto, T.; Kakehi, I.

2000-04-01

This report describes accomplishment of development of a cathode processor calculation code to simulate the mass and heat transfer phenomena with the distillation process and development of an analytical model for cooling behavior of the pyrochemical process cell on personal computers. The pyrochemical process using molten salt electrorefining would introduce new technologies for new fuels of particle oxide, particle nitride and metallic fuels. The cathode processor calculation code with distillation process was developed. A code validation calculation has been conducted on the basic of the benchmark problem for natural convection in a square cavity. Results by using the present code agreed well for the velocity-temperature fields, the maximum velocity and its location with the benchmark solution published in a paper. The functions have been added to advance the reality in simulation and to increase the efficiency in utilization. The test run has been conducted using the code with the above modification for an axisymmetric enclosed vessel simulating a cathode processor, and the capability of the distillation process simulation with the code has been confirmed. An analytical model for cooling behavior of the pyrochemical process cell was developed. The analytical model was selected by comparing benchmark analysis with detailed analysis on engineering workstation. Flow and temperature distributions were confirmed by the result of steady state analysis. In the result of transient cooling analysis, an initial transient peak of temperature occurred at balanced heat condition in the steady-state analysis. Final gas temperature distribution was dependent on gas circulation flow in transient condition. Then there were different final gas temperature distributions on the basis of the result of steady-state analysis. This phenomenon has a potential for it's own metastable condition. Therefore it was necessary to design gas cooling flow pattern without cooling gas circulation

Nickel based alloys for molten salt applications in pyrochemical reprocessing applications

International Nuclear Information System (INIS)

Ningshen, S.; Ravi Shankar, A.; Rao, Ch. Jagadeeswara; Mallika, C.; Kamachi Mudali, U.

2016-01-01

Pyrochemical reprocessing route is one of the best option for reprocessing of spent metallic nuclear fuel from future fast breeder in many countries, especially in the US (Integral fast reactor, IFR), Russia (Research Institute of Atomic Reactors, RIAR), Japan, Korea and India. This technology with intrinsic nuclear proliferation resistance is regarded as one of the most promising nuclear fuel cycle technologies of the next-generation. However, the selection of materials of construction for pyrochemical reprocessing plants is challenging because of the extreme environments, i.e., high radiation, corrosive molten salt (LiCl-KCl, LiCl-KCl-CsCl, KCl-NaCl-MgCl 2 , etc.), reactive molten metals, and high temperature. Efforts have been made to develop compatible materials for various unit operations like salt preparation, electrorefining, cathode processing and alloy casting in pyrochemical reprocessing. Nickel and its alloy are the candidate materials for salt purification exposed to molten LiCl-KCl under Cl 2 bubbling, in air or ultra high purity argon environment. In the present study, the corrosion behavior of candidate materials like Inconel 600, Inconel 625, Inconel 690 exposed to molten LiCl-KCl eutectic salt environment at 500 to 600 °C have been carried out. The surface morphology of the exposed samples and scales were examined by SEM/EDX and XRD. The weight loss results indicated that Inconel 600 and Inconel 690 offer better corrosion resistance compared to Inconel 625 in air and chlorine environment. Higher corrosion of Inconel 625 is attributed to development of Mo rich salt layers. However, Ni base alloys exhibited a decreasing trend of weight loss with increasing time of exposure and weight gain was observed under UHP Ar environment. The mechanism of corrosion of Ni base alloys appeared to be due to formation of Cr rich and Ni rich layers of Cr 2 O 3 , NiO and spinel oxides at the surface and subsequent spallation. Based on the present studies, Inconel 690

Pyrochemical and Dry Processing Methods Program. A selected bibliography

Energy Technology Data Exchange (ETDEWEB)

McDuffie, H.F.; Smith, D.H.; Owen, P.T.

1979-03-01

This selected bibliography with abstracts was compiled to provide information support to the Pyrochemical and Dry Processing Methods (PDPM) Program sponsored by DOE and administered by the Argonne National Laboratory. Objectives of the PDPM Program are to evaluate nonaqueous methods of reprocessing spent fuel as a route to the development of proliferation-resistant and diversion-resistant methods for widespread use in the nuclear industry. Emphasis was placed on the literature indexed in the ERDA--DOE Energy Data Base (EDB). The bibliography includes indexes to authors, subject descriptors, EDB subject categories, and titles.

Pyrochemical and Dry Processing Methods Program. A selected bibliography

International Nuclear Information System (INIS)

McDuffie, H.F.; Smith, D.H.; Owen, P.T.

1979-03-01

This selected bibliography with abstracts was compiled to provide information support to the Pyrochemical and Dry Processing Methods (PDPM) Program sponsored by DOE and administered by the Argonne National Laboratory. Objectives of the PDPM Program are to evaluate nonaqueous methods of reprocessing spent fuel as a route to the development of proliferation-resistant and diversion-resistant methods for widespread use in the nuclear industry. Emphasis was placed on the literature indexed in the ERDA--DOE Energy Data Base (EDB). The bibliography includes indexes to authors, subject descriptors, EDB subject categories, and titles

Development of Head-end Pyrochemical Reduction Process for Advanced Oxide Fuels

International Nuclear Information System (INIS)

Park, B. H.; Seo, C. S.; Hur, J. M.; Jeong, S. M.; Hong, S. S.; Choi, I. K.; Choung, W. M.; Kwon, K. C.; Lee, I. W.

2008-12-01

The development of an electrolytic reduction technology for spent fuels in the form of oxide is of essence to introduce LWR SFs to a pyroprocessing. In this research, the technology was investigated to scale a reactor up, the electrochemical behaviors of FPs were studied to understand the process and a reaction rate data by using U 3 O 8 was obtained with a bench scale reactor. In a scale of 20 kgHM/batch reactor, U 3 O 8 and Simfuel were successfully reduced into metals. Electrochemical characteristics of LiBr, LiI and Li 2 Se were measured in a bench scale reactor and an electrolytic reduction cell was modeled by a computational tool

Development of Head-end Pyrochemical Reduction Process for Advanced Oxide Fuels

Energy Technology Data Exchange (ETDEWEB)

Park, B. H.; Seo, C. S.; Hur, J. M.; Jeong, S. M.; Hong, S. S.; Choi, I. K.; Choung, W. M.; Kwon, K. C.; Lee, I. W. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2008-12-15

The development of an electrolytic reduction technology for spent fuels in the form of oxide is of essence to introduce LWR SFs to a pyroprocessing. In this research, the technology was investigated to scale a reactor up, the electrochemical behaviors of FPs were studied to understand the process and a reaction rate data by using U{sub 3}O{sub 8} was obtained with a bench scale reactor. In a scale of 20 kgHM/batch reactor, U{sub 3}O{sub 8} and Simfuel were successfully reduced into metals. Electrochemical characteristics of LiBr, LiI and Li{sub 2}Se were measured in a bench scale reactor and an electrolytic reduction cell was modeled by a computational tool.

Pyrochemical processing automation at Lawrence Livermore National Laboratory

International Nuclear Information System (INIS)

Dennison, D.K.; Domning, E.E.; Seivers, R.

1991-01-01

Lawrence Livermore National Laboratory (LLNL) is developing a fully automated system for pyrochemical processing of special nuclear materials (SNM). The system utilizes a glove box, an automated tilt-pour furnace (TPF), an IBM developed gantry robot, and specialized automation tooling. All material handling within the glove box (i.e., furnace loading, furnace unloading, product and slag separation, and product packaging) is performed automatically. The objectives of the effort are to increase process productivity, decrease operator radiation, reduce process wastes, and demonstrate system reliability and availability. This paper provides an overview of the automated system hardware, outlines the overall operations sequence, and discusses the current status

Advanced hybrid process with solvent extraction and pyro-chemical process of spent fuel reprocessing for LWR to FBR

International Nuclear Information System (INIS)

Fujita, Reiko; Mizuguchi, Koji; Fuse, Kouki; Saso, Michitaka; Utsunomiya, Kazuhiro; Arie, Kazuo

2008-01-01

Toshiba has been proposing a new fuel cycle concept of a transition from LWR to FBR. The new fuel cycle concept has better economical process of the LWR spent fuel reprocessing than the present Purex Process and the proliferation resistance for FBR cycle of plutonium with minor actinides after 2040. Toshiba has been developing a new Advanced Hybrid Process with Solvent Extraction and Pyrochemical process of spent fuel reprocessing for LWR to FBR. The Advanced Hybrid Process combines the solvent extraction process of the LWR spent fuel in nitric acid with the recovery of high pure uranium for LWR fuel and the pyro-chemical process in molten salts of impure plutonium recovery with minor actinides for metallic FBR fuel, which is the FBR spent fuel recycle system after FBR age based on the electrorefining process in molten salts since 1988. The new Advanced Hybrid Process enables the decrease of the high-level waste and the secondary waste from the spent fuel reprocessing plants. The R and D costs in the new Advanced Hybrid Process might be reduced because of the mutual Pyro-chemical process in molten salts. This paper describes the new fuel cycle concept of a transition from LWR to FBR and the feasibility of the new Advanced Hybrid Process by fundamental experiments. (author)

Solidification of metal chloride waste from pyrochemical process via dechlorination-chlorination reaction system

Energy Technology Data Exchange (ETDEWEB)

Park, H.S.; Cho, I.H.; Lee, K.R.; Choi, J.H.; Eun, H.C.; Kim, I.T.; Park, G.I. [Korea Atomic Energy Research Inst., Deajeon (Korea, Republic of)

2014-07-01

The metal chloride wastes generated from the pyro-chemical process to recover uranium and TRUs has been considered as a problematic waste due to the high volatility and low compatibility with conventional silicate glass. Our research group has suggested the dechlorination approach for the solidification of this kind of waste by using a synthetic composite, SAP (SiO{sub 2}-Al{sub 2}O{sub 3}-P{sub 2}O{sub 5}). During the dechlorination, metal elements are chemically interacted with the inorganic composite, SAP, while chlorine is vaporized as gaseous chlorine. Metal elements in the salt were immobilized into phosphate and silicate glass which are uniformly distributed in tens of nm scale. During the dechlorination, gaseous chlorine is captured by Li{sub 2}O-Li{sub 2}O{sub 2} composite that can be converted into metal chloride (LiCl). About 98wt% of oxide composite was converted into LiCl that can be used as an electrolyte in the electrochemical process. The method suggested in this study can provide a chance to minimize the waste volume for the final disposal of salt wastes from a pyro-chemical process. (author)

SU-E-J-25: End-To-End (E2E) Testing On TomoHDA System Using a Real Pig Head for Intracranial Radiosurgery

Energy Technology Data Exchange (ETDEWEB)

Corradini, N; Leick, M; Bonetti, M; Negretti, L [Clinica Luganese, Radiotherapy Center, Lugano (Switzerland)

2015-06-15

Purpose: To determine the MVCT imaging uncertainty on the TomoHDA system for intracranial radiosurgery treatments. To determine the end-to-end (E2E) overall accuracy of the TomoHDA system for intracranial radiosurgery. Methods: A pig head was obtained from the butcher, cut coronally through the brain, and preserved in formaldehyde. The base of the head was fixed to a positioning plate allowing precise movement, i.e. translation and rotation, in all 6 axes. A repeatability test was performed on the pig head to determine uncertainty in the image bone registration algorithm. Furthermore, the test studied images with MVCT slice thicknesses of 1 and 3 mm in unison with differing scan lengths. A sensitivity test was performed to determine the registration algorithm’s ability to find the absolute position of known translations/rotations of the pig head. The algorithm’s ability to determine absolute position was compared against that of manual operators, i.e. a radiation therapist and radiation oncologist. Finally, E2E tests for intracranial radiosurgery were performed by measuring the delivered dose distributions within the pig head using Gafchromic films. Results: The repeatability test uncertainty was lowest for the MVCTs of 1-mm slice thickness, which measured less than 0.10 mm and 0.12 deg for all axes. For the sensitivity tests, the bone registration algorithm performed better than human eyes and a maximum difference of 0.3 mm and 0.4 deg was observed for the axes. E2E test results in absolute position difference measured 0.03 ± 0.21 mm in x-axis and 0.28 ± 0.18 mm in y-axis. A maximum difference of 0.32 and 0.66 mm was observed in x and y, respectively. The average peak dose difference between measured and calculated dose was 2.7 cGy or 0.4%. Conclusion: Our tests using a pig head phantom estimate the TomoHDA system to have a submillimeter overall accuracy for intracranial radiosurgery.

SU-E-J-25: End-To-End (E2E) Testing On TomoHDA System Using a Real Pig Head for Intracranial Radiosurgery

International Nuclear Information System (INIS)

Corradini, N; Leick, M; Bonetti, M; Negretti, L

2015-01-01

Purpose: To determine the MVCT imaging uncertainty on the TomoHDA system for intracranial radiosurgery treatments. To determine the end-to-end (E2E) overall accuracy of the TomoHDA system for intracranial radiosurgery. Methods: A pig head was obtained from the butcher, cut coronally through the brain, and preserved in formaldehyde. The base of the head was fixed to a positioning plate allowing precise movement, i.e. translation and rotation, in all 6 axes. A repeatability test was performed on the pig head to determine uncertainty in the image bone registration algorithm. Furthermore, the test studied images with MVCT slice thicknesses of 1 and 3 mm in unison with differing scan lengths. A sensitivity test was performed to determine the registration algorithm’s ability to find the absolute position of known translations/rotations of the pig head. The algorithm’s ability to determine absolute position was compared against that of manual operators, i.e. a radiation therapist and radiation oncologist. Finally, E2E tests for intracranial radiosurgery were performed by measuring the delivered dose distributions within the pig head using Gafchromic films. Results: The repeatability test uncertainty was lowest for the MVCTs of 1-mm slice thickness, which measured less than 0.10 mm and 0.12 deg for all axes. For the sensitivity tests, the bone registration algorithm performed better than human eyes and a maximum difference of 0.3 mm and 0.4 deg was observed for the axes. E2E test results in absolute position difference measured 0.03 ± 0.21 mm in x-axis and 0.28 ± 0.18 mm in y-axis. A maximum difference of 0.32 and 0.66 mm was observed in x and y, respectively. The average peak dose difference between measured and calculated dose was 2.7 cGy or 0.4%. Conclusion: Our tests using a pig head phantom estimate the TomoHDA system to have a submillimeter overall accuracy for intracranial radiosurgery

Adaptation and validation of a commercial head phantom for cranial radiosurgery dosimetry end-to-end audit.

Science.gov (United States)

Dimitriadis, Alexis; Palmer, Antony L; Thomas, Russell A S; Nisbet, Andrew; Clark, Catharine H

2017-06-01

To adapt and validate an anthropomorphic head phantom for use in a cranial radiosurgery audit. Two bespoke inserts were produced for the phantom: one for providing the target and organ at risk for delineation and the other for performing dose measurements. The inserts were tested to assess their positional accuracy. A basic treatment plan dose verification with an ionization chamber was performed to establish a baseline accuracy for the phantom and beam model. The phantom and inserts were then used to perform dose verification measurements of a radiosurgery plan. The dose was measured with alanine pellets, EBT extended dose film and a plastic scintillation detector (PSD). Both inserts showed reproducible positioning (±0.5 mm) and good positional agreement between them (±0.6 mm). The basic treatment plan measurements showed agreement to the treatment planning system (TPS) within 0.5%. Repeated film measurements showed consistent gamma passing rates with good agreement to the TPS. For 2%-2 mm global gamma, the mean passing rate was 96.7% and the variation in passing rates did not exceed 2.1%. The alanine pellets and PSD showed good agreement with the TPS (-0.1% and 0.3% dose difference in the target) and good agreement with each other (within 1%). The adaptations to the phantom showed acceptable accuracies. The presence of alanine and PSD do not affect film measurements significantly, enabling simultaneous measurements by all three detectors. Advances in knowledge: A novel method for thorough end-to-end test of radiosurgery, with capability to incorporate all steps of the clinical pathway in a time-efficient and reproducible manner, suitable for a national audit.

Recent studies related to head-end fuel processing at the Hanford PUREX plant

Energy Technology Data Exchange (ETDEWEB)

Swanson, J.L.

1988-08-01

This report presents the results of studies addressing several problems in the head-end processing (decladding, metathesis, and core dissolution) of N Reactor fuel elements in the Hanford PUREX plant. These studies were conducted over 2 years: FY 1986 and FY 1987. The studies were divided into three major areas: 1) differences in head-end behavior of fuels having different histories, 2) suppression of /sup 106/Ru volatilization when the ammonia scrubber solution resulting from decladding is decontaminated by distillation prior to being discharged, and 3) suitability of flocculating agents for lowering the amount of transuranic (TRU) element-containing solids that accompany the decladding solution to waste. 16 refs., 43 figs.

Pyrochemical recovery of plutonium from calcium fluoride reduction slag

Science.gov (United States)

Christensen, D.C.

A pyrochemical method of recovering finely dispersed plutonium metal from calcium fluoride reduction slag is claimed. The plutonium-bearing slag is crushed and melted in the presence of at least an equimolar amount of calcium chloride and a few percent metallic calcium. The calcium chloride reduces the melting point and thereby decreases the viscosity of the molten mixture. The calcium reduces any oxidized plutonium in the mixture and also causes the dispersed plutonium metal to coalesce and settle out as a separate metallic phase at the bottom of the reaction vessel. Upon cooling the mixture to room temperature, the solid plutonium can be cleanly separated from the overlying solid slag, with an average recovery yield on the order of 96 percent.

Status of development on simulation technology for pyrochemical reprocessing

International Nuclear Information System (INIS)

Arie, Kazuo; Mizuguchi, Koji; Fujita, Reiko

2004-01-01

Simulation techniques for the elemental behaviors in the pyrochemical reprocessing process of spent nuclear fuels are important for fuel reprocessing and future power station development. The authors developed a simulation code SPR1.0 which can analyze co-occurring electrochemical and chemical reactions simultaneously and which is applicable to know the behavior of any element in the system. The present report describes the status of the code development, the database for fundamental electrochemical reactions, and verification of the code. The code employs TRIAS code for electrochemical reactions and SOLGASMIX-PV for chemical reactions. Electrolytic process for MOX (mixed oxide) fuels with different Pu redox ratios were simulated using the present code and the effect of introducing iron ions was studied. The prospect of future development is also described. (S. Ohno)

Analysis and characterization of plutonium in pyrochemical salt residues

International Nuclear Information System (INIS)

Haschke, John M.; Phillips, Alan G.

2000-01-01

Quantitative measurement of hydrogen produced during salt-catalyzed hydrolysis of plutonium in pyrochemical salt residues show that the metal is present in concentrations of 10 ± 5 mass%. The analytical method is based on stoichiometric reaction of metal with water to form plutonium monoxide monohydride (PuOH) and hydrogen. Results of a kinetic model developed to describe the observed time dependence of the hydrolysis rate shows that metal is present predominately as particles with essentially spherical geometries and diameters near 1 mm. The presence of smaller metallic particles cannot be verified or excluded. Plutonium concentrations measured for residues stored in different configurations suggest that a sizable fraction of the metal has oxidized during storage. Application of the hydrolysis method in determining concentrations and dimensions of metallic plutonium in other nuclear waste forms is proposed

Costs of head-end incineration with respect to Kr separation in the reprocessing of HTR fuel elements

Energy Technology Data Exchange (ETDEWEB)

Barnert-Wiemer, H.; Boehnert, R.

1976-07-15

The C-incinerations and the Kr-separations during head-end incineration in the reprocessing of HTR fuel elements are described. The costs for constructing an operating a head-end incineration of reprocessing capacities with 5,000 to 50,000 MW(e)-HTR power have been determined. The cost estimates are divided into investment and operating costs, further after the fraction of the N/sub 2/-content in the incineration exhaust gas, which strongly affects costs. It appears that, in the case of Kr-separation from the incineration exhaust gas, the investment costs as well as the operating costs of the head-end for N/sub 2/-containing exhaust gas are considerably greater than those for gas without N/sub 2/. The C-incineration of the graphite of the HTR fuel elements should therefore only be performed with influx gas that is free of N/sub 2/.

Development of quantitative analytical methods for the control of actinides in a pyrochemical partitioning process

International Nuclear Information System (INIS)

Abousahl, S.; Belle, P. van; Eberle, H.; Ottmar, H.; Lynch, B.; Vallet, P.; Mayer, K.; Ougier, M.

2005-01-01

Advanced nuclear fuel cycles are being developed in order to reduce the long-term radiotoxicity of highly radioactive waste. Pyrochemical partitioning techniques appear particularly attractive for advanced fuel cycles in which the minor actinides are recycled. The electrochemical processes of practical importance are the electrorefining process and the liquid-liquid extraction of transuranic (TRU) elements from fission products using either non-miscible molten metal or molten salt-metal phases. Analytical methods for the accurate assay of actinide elements in these matrices needed to be developed. A quantitative assay is required in order to establish a material balance for process development and - at a later stage - for accountancy and control purposes. To this end radiometric techniques such as energy-dispersive X-ray fluorescence analysis (XRF), neutron coincidence counting (NCC) and high-resolution gamma spectrometry (HRGS) were extensively employed for the quantitative determination of actinides (U, Np, Pu, Am, Cm) in process samples. Comparative analyses were performed using inductively coupled plasma mass spectrometry (ICP-MS). The respective samples were available in small quantities (≅ 100 mg) either in the form of eutectic salt or in metallic form with Cd, Zr or Bi as major metallic matrix constituents. (orig.)

Transportation of pyrochemical salts from Rocky Flats to Los Alamos

International Nuclear Information System (INIS)

Schreiber, S.B.

1997-01-01

Radioactive legacy wastes or residues are currently being stored on numerous Sites around the former Department of Energy's (DOE) Nuclear Weapons Complex. Since most of the operating facilities were shut down and have not operated since before the declared end to the Cold War in 1993, the historical method for treating these residues no longer exists. The risk associated with continued storage of these residues will dramatically increase with time. Thus, the DOE was directed by the Defense Nuclear Facility Safety Board in its Recommendation 94-1 to address and stabilize these residues and established an eight year time frame for doing so. There are only two options available to respond to this requirement: (1) restart existing facilities to treat and package the residues for disposal or (2) transport the residues to another operating facility within the Complex where they can be treated and packaged for disposal. This paper focuses on one such residue type, pyrochemical salts, produced at one Complex site, the Rocky Flats Plant located northwest of Denver, Colorado. One option for treating the salts is their shipment to Los Alamos, New Mexico, for handling at the Plutonium Facility. The safe transportation of these salts can be accomplished at present with several shipping containers including a DOT 6M, a DOE 9968, Type A or Type B quantity 55-gallon drum overpacks, or even the TRUPACT II. The tradeoffs between each container is examined with the conclusion that none of the available shipping containers is fully satisfactory. Thus, the advantageous aspects of each container must be utilized in an integrated and efficient way to effectively manage the risk involved. 1 fig

Pyrochemical separation of radioactive components from inert materials in ICPP high-level calcined waste

International Nuclear Information System (INIS)

Del Debbio, J.A.; Nelson, L.O.; Todd, T.A.

1995-05-01

Since 1963, calcination of aqueous wastes from reprocessing of DOE-owned spent nuclear fuels has resulted in the accumulation of approximately 3800 m 3 of high-level waste (HLW) at the Idaho Chemical Processing Plant (ICPP). The waste is in the form of a granular solid called calcine and is stored on site in stainless steel bins which are encased in concrete. Due to the leachability of 137 Cs and 90 Sr and possibly other radioactive components, the calcine is not suitable for final disposal. Hence, a process to immobilize calcine in glass is being developed. Since radioactive components represent less than 1 wt % of the calcine, separation of actinides and fission products from inert components is being considered to reduce the volume of HLW requiring final disposal. Current estimates indicate that compared to direct vitrification, a volume reduction factor of 10 could result in significant cost savings. Aqueous processes, which involve calcine dissolution in nitric acid followed by separation of actinide and fission products by solvent extraction and ion exchange methods, are being developed. Pyrochemical separation methods, which generate small volumes of aqueous wastes and do not require calcine dissolution, have been evaluated as alternatives to aqueous processes. This report describes three proposed pyrochemical flowsheets and presents the results of experimental studies conducted to evaluate their feasibility. The information presented is a consolidation of three reports, which should be consulted for experimental details

Dosimetric assessment of the field abutment region in head and neck treatments using a multileaf collimator

Energy Technology Data Exchange (ETDEWEB)

Abdel-Hakim, K.; Nishimura, T.; Sakahara, H. [Dept. of Radiology, Hamamatsu Univ. School of Medicine, Hamamatsu (Japan); Takaih, M.; Suzuki, S. [Dept. of Informatics, Hamamatsu Univ. School of Medicine, Hamamatsu (Japan)

2003-05-01

overdose could be smoothed out by overlaps of both leaf ends by 0.8 mm from both lateral and anterior portals. The ideal jaw position was found to be at 1 mm away from the beam central axis in any combination. Conclusion: The use of MLCs for photon field junction matching is appropriate and represents an alternative approach to the problem of field matching using the asymmetric jaws in head and neck treatments. asymmetric jaws in head and neck treatments. (orig.)

Dosimetric assessment of the field abutment region in head and neck treatments using a multileaf collimator

International Nuclear Information System (INIS)

Abdel-Hakim, K.; Nishimura, T.; Sakahara, H.; Takaih, M.; Suzuki, S.

2003-01-01

out by overlaps of both leaf ends by 0.8 mm from both lateral and anterior portals. The ideal jaw position was found to be at 1 mm away from the beam central axis in any combination. Conclusion: The use of MLCs for photon field junction matching is appropriate and represents an alternative approach to the problem of field matching using the asymmetric jaws in head and neck treatments. asymmetric jaws in head and neck treatments. (orig.)

The GC computer code for flow sheet simulation of pyrochemical processing of spent nuclear fuels

International Nuclear Information System (INIS)

Ahluwalia, R.K.; Geyer, H.K.

1996-01-01

The GC computer code has been developed for flow sheet simulation of pyrochemical processing of spent nuclear fuel. It utilizes a robust algorithm SLG for analyzing simultaneous chemical reactions between species distributed across many phases. Models have been developed for analysis of the oxide fuel reduction process, salt recovery by electrochemical decomposition of lithium oxide, uranium separation from the reduced fuel by electrorefining, and extraction of fission products into liquid cadmium. The versatility of GC is demonstrated by applying the code to a flow sheet of current interest

Automatic planning of head and neck treatment plans

DEFF Research Database (Denmark)

Hazell, Irene; Bzdusek, Karl; Kumar, Prashant

2016-01-01

radiation dose planning (dosimetrist) and potentially improve the overall plan quality. This study evaluates the performance of the Auto-Planning module that has recently become clinically available in the Pinnacle3 radiation therapy treatment planning system. Twenty-six clinically delivered head and neck...... as the previously delivered clinical plans. For all patients, the Auto-Planning tool produced clinically acceptable head and neck treatment plans without any manual intervention, except for the initial target and OAR delineations. The main benefit of the method is the likely improvement in the overall treatment......Treatment planning is time-consuming and the outcome depends on the person performing the optimization. A system that automates treatment planning could potentially reduce the manual time required for optimization and could also pro-vide a method to reduce the variation between persons performing...

Aqueous recovery of plutonium from pyrochemical processing residues

International Nuclear Information System (INIS)

Gray, L.W.; Gray, J.H.

1984-01-01

Pyrochemical processes provide rapid methods to reclaim plutonium from scrap residues. Frequently, however, these processes yield an impure plutonium product and waste residues that are contaminated with actinides and are therefore nondiscardable. The Savannah River Laboratory and Plant and the Rocky Flats Plant are jointly developing new processes using both pyrochemistry and aqueous chemistry to generate pure product and discardable waste. An example of residue being treated is that from the molten salt extraction (MSE), a mixture of NaCl, KCl, MgCl 2 , PuCl 3 , AmCl 3 , PuO 2 , and Pu 0 . This mixture is scrubbed with molten aluminum containing a small amount of magnesium to produce a nonhomogeneous Al-Pu-Am-Mg alloy. This process, which rejects most of the NaCl-KCl-MgCl 2 salts, results in a product easily dissolved in 6M HNO 3 -0.1M HF. Any residual chloride in the product is removed by precipitation with Hg(I) followed by centrifuging. Plutonium and americium are then separated by the standard Purex process. The americium, initially diverted to the solvent extraction waste stream, can either be recovered or sent to waste

End points and assessments in esthetic dental treatment.

Science.gov (United States)

Ishida, Yuichi; Fujimoto, Keiko; Higaki, Nobuaki; Goto, Takaharu; Ichikawa, Tetsuo

2015-10-01

There are two key considerations for successful esthetic dental treatments. This article systematically describes the two key considerations: the end points of esthetic dental treatments and assessments of esthetic outcomes, which are also important for acquiring clinical skill in esthetic dental treatments. The end point and assessment of esthetic dental treatment were discussed through literature reviews and clinical practices. Before designing a treatment plan, the end point of dental treatment should be established. The section entitled "End point of esthetic dental treatment" discusses treatments for maxillary anterior teeth and the restoration of facial profile with prostheses. The process of assessing treatment outcomes entitled "Assessments of esthetic dental treatment" discusses objective and subjective evaluation methods. Practitioners should reach an agreement regarding desired end points with patients through medical interviews, and continuing improvements and developments of esthetic assessments are required to raise the therapeutic level of esthetic dental treatments. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Treatment of recurrences in head and neck cancers occurring in irradiated site

International Nuclear Information System (INIS)

Pernot, M.

1994-01-01

We'll consider as recurrences the elevate relapses occurring at least six months after the first treatment end. The recurrences however frequent it is, is bad codified and everybody does what he can in the presence of a relapse. The number of retreated lesions should be in inverse proportion of the efficiency of the initial treatment. The surgery made large progresses during these last 15 years. The external radiotherapy is seldom a very good treatment indication of head and neck cancer recurrences in previously irradiated site. Iridium 192 wires may be used as implantations with low dose rate. For the cavity proper of mouth, we have counted 159 relapses at the level of the sole primary tumour. The tonsil neoplasms are often treated by a sole external irradiation or in association with curietherapy. For a larynx neoplasm the ideal starting treatment is that one which allows to cure the tumour while protecting the speaking and the swallowing. 83 refs

[Diagnosis and treatment characteristics of head-wind sha in She medicine].

Science.gov (United States)

Zou, Guangyi; Xu, Xiangdong; Zheng, Songming; Yan, Lianhe; Lei, Houxing; Zhang, Qiao-ling; Xiang, Yingmei; Ye, Yiping; Song, Liwei

2015-03-01

The diagnosis and treatment characteristics of head-wind sha in She medicine were analyzed and summarized. By visiting She-nationality villages and towns in Zhejiang province and Fujian province and interviewing hundreds of doctors of She medicine, the sha diagnosis, sha differentiation, experience and theory of treatment were arranged, and a comprehensive summary on theory and application of head-wind sha in She medicine such as pathogeny, name of disease, mechanism, diagnosis, differential diagnosis and treatment was made. It is believed that the methods of diagnosis and treatment in She medicine for head-wind sha could effectively enhance curative effect, safety and patients' quality of life, and the further research should be carried out.

Use of porous MgO in pyrochemical applications

International Nuclear Information System (INIS)

Maiya, P.S.; Sweeney, S.M.; Carroll, L.A.; Dusek, J.T.

1994-11-01

Pyrochemical methods for the extraction of transuranic elements from light water reactor spent fuel require a reduction step in which the oxide fuel is reduced to metals by Li in molten LiCl. The Li 2 O formed is electrolytically reduced to metal in a cell that uses a carbon (or inert) anode and a Li cathode to recycle the salt and minimize the waste. Use of a carbon anode causes carbon dust that interferes with the process. Moreover, current efficiency is reduced as a result of oxidation of Li to Li 2 O by CO 2 . A porous MgO shroud around the anode was found to obviate these problems. Porous MgO crucibles and rectangular bar specimens were fabricated from MgO powders (electrically fused MgO, reagent grade MgO were mixed in appropriate combinations with a binder and lubricant). Particle size, force applied to the powders during cold pressing, and sintering temperature were varied to achieve a total porosity of >45% (mostly open porosity) and to control pore size and pore distribution. Mercury intrusion porosimetry was used to determine the pore size and pore size distribution. Flexural strength is observed to be proportional to the square root of pore size, which is consistent with fracture mechanics

Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

Science.gov (United States)

Dequanter, Didier; Shahla, Mohammad; Paulus, Pascal; Lothaire, Phillippe

2010-01-01

Introduction: The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas. Methods: A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT). Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN) were eligible. Results: There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old). Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months). A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died. Conclusion: Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems not to provide the most benefit for patients with oropharyngeal cancers but will in patients with T4 tumors. However, the median duration of local control was

Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

International Nuclear Information System (INIS)

Dequanter, Didier; Shahla, Mohammad; Paulus, Pascal; Lothaire, Phillippe

2010-01-01

The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas. A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT). Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN) were eligible. There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old). Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months). A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died. Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems not to provide the most benefit for patients with oropharyngeal cancers but will in patients with T4 tumors. However, the median duration of local control was less as described in the clinical trials

Role of awareness in head-neck acceleration in low velocity rear-end impacts.

Science.gov (United States)

Kumar, S; Narayan, Y; Amell, T

2000-03-01

Fourteen normal healthy seated and restrained young adults were delivered rear-end impacts of four intensities of acceleration. The chair was delivered a regulated and controlled pneumatic blow using a 30 cm cylinder to cause an acceleration of 0.5, 0.9, 1.1 and 1.4g. The accelerated chair was stopped suddenly by impacting the stopper at the other end of the 2 m long friction reduced track. In one set of trials, subjects were informed about the impending impact and in the other they were blindfolded and provided with loud auditory input to eliminate cues of the impact. The accelerations of the chair, shoulder and head of the participating subjects were measured triaxially and compared between levels of acceleration and expectation. The multiple analyses of variance revealed that the peak acceleration was significantly affected by the gender (P < 0.01), intensity of impact (P < 0.001), and expectation (P < 0.0001). The accelerations were significantly different in different axes (P < 0.001). A significant two-way interaction between acceleration and expectation (P < 0.03), and expectation and axes of acceleration (P < 0.02) would imply that awareness of the impending impact serves to significantly reduce the level of accelerations of head and neck.

On the possibility of reprocessing of fuel elements of dispersion type with copper matrix by pyrochemical methods

International Nuclear Information System (INIS)

Vasin, B.D.; Ivanov, V.A.; Shchetinskij, A.V.; Vavilov, S.K.; Savochkin, Yu.P.; Bychkov, A.V.; Kormilitsyn, M.V.

2005-01-01

A consideration is given to pyrochemical processes suitable for separation of uranium dioxide from structural materials when reprocessing cermet type fuel elements. The estimation of the possibility to apply liquid antimony and bismuth, potassium and copper chlorides melts is made. The specimens compacted of copper and uranium dioxide powders in a stainless steel can are used as simulators of fuel element sections. It is concluded that the dissolution of structural materials in molten salts at the stage of uranium dioxide concentration is the process of choice for reprocessing of dispersion type fuel elements [ru

Pyrochemical reduction of uranium dioxide and plutonium dioxide by lithium metal

International Nuclear Information System (INIS)

Usami, T.; Kurata, M.; Inoue, T.; Sims, H.E.; Beetham, S.A.; Jenkins, J.A.

2002-01-01

The lithium reduction process has been developed to apply a pyrochemical recycle process for oxide fuels. This process uses lithium metal as a reductant to convert oxides of actinide elements to metal. Lithium oxide generated in the reduction would be dissolved in a molten lithium chloride bath to enhance reduction. In this work, the solubility of Li 2 O in LiCl was measured to be 8.8 wt% at 650 deg. C. Uranium dioxide was reduced by Li with no intermediate products and formed porous metal. Plutonium dioxide including 3% of americium dioxide was also reduced and formed molten metal. Reduction of PuO 2 to metal also occurred even when the concentration of lithium oxide was just under saturation. This result indicates that the reduction proceeds more easily than the prediction based on the Gibbs free energy of formation. Americium dioxide was also reduced at 1.8 wt% lithium oxide, but was hardly reduced at 8.8 wt%

An end-to-end assessment of range uncertainty in proton therapy using animal tissues

Science.gov (United States)

Zheng, Yuanshui; Kang, Yixiu; Zeidan, Omar; Schreuder, Niek

2016-11-01

Accurate assessment of range uncertainty is critical in proton therapy. However, there is a lack of data and consensus on how to evaluate the appropriate amount of uncertainty. The purpose of this study is to quantify the range uncertainty in various treatment conditions in proton therapy, using transmission measurements through various animal tissues. Animal tissues, including a pig head, beef steak, and lamb leg, were used in this study. For each tissue, an end-to-end test closely imitating patient treatments was performed. This included CT scan simulation, treatment planning, image-guided alignment, and beam delivery. Radio-chromic films were placed at various depths in the distal dose falloff region to measure depth dose. Comparisons between measured and calculated doses were used to evaluate range differences. The dose difference at the distal falloff between measurement and calculation depends on tissue type and treatment conditions. The estimated range difference was up to 5, 6 and 4 mm for the pig head, beef steak, and lamb leg irradiation, respectively. Our study shows that the TPS was able to calculate proton range within about 1.5% plus 1.5 mm. Accurate assessment of range uncertainty in treatment planning would allow better optimization of proton beam treatment, thus fully achieving proton beams’ superior dose advantage over conventional photon-based radiation therapy.

Radiotherapy in head and neck: a standard treatment?

International Nuclear Information System (INIS)

Santini Blasco, A; Torres Lopez, M; Apardian Manougian, R

1998-01-01

The present work is an exhaustive revision of the literature regarding the employment of combined treatments of radiochemotherapy in the head and neck neoplasms. The sanitary importance of this group of illnesses starts to become remarkable not only due to their frequency but for the high percentage of patients that present themselves for consultation with an advanced illness where the results of the classic treatments of surgery and radiotherapy are discouraging. These results are poor for the survival as well as in the quality of this. It analyzes the role of the different pharmaceuticals used in patients as well as the fundamentally different associations with radiotherapy: neoadjuvant, adjuvant and concomitant. These results allow to affirm that this treatment form is elected for those patients with advanced tumors of head and neck with a general state that allows to tolerate a bigger toxicity [es

Brachytherapy for head and neck cancer. Treatment results and future prospect

International Nuclear Information System (INIS)

Shibuya, Hitoshi; Yoshimura, Ro-ichi; Miura, Masahiko; Ayukawa, Fumio; Watanabe, Hiroshi

2005-01-01

Following the increasing desire of many patients to keep the form and function of speech and swallowing, interstitial brachytherapy has become the main treatment for head and neck cancer. In addition, aged and physically handicapped patients who are refused general anesthesia have come to be referred to our clinic to receive less invasive and curative treatment. In the field of brachytherapy for head and neck cancers, less complicated and more superior treatment results have been achieved following the introduction of spacers, computer dosimetry and so on. As a result of these efforts, treatment results have come to fulfill the desire of patients and their families. During the past 43 years from 1962 to 2005, we have treated over 2, 100 patients of head and neck cancer including 850 with stage I·II oral tongue carcinoma by brachytherapy and acquired a lot of important and precious data including the treatment results, multiple primary cancers as well as radiation-induced cancers. (author)

SULFUR HEXAFLUORIDE TREATMENT OF USED NUCLEAR FUEL TO ENHANCE SEPARATIONS

Energy Technology Data Exchange (ETDEWEB)

Gray, J.; Torres, R.; Korinko, P.; Martinez-Rodriguez, M.; Becnel, J.; Garcia-Diaz, B.; Adams, T.

2012-09-25

Reactive Gas Recycling (RGR) technology development has been initiated at Savannah River National Laboratory (SRNL), with a stretch-goal to develop a fully dry recycling technology for Used Nuclear Fuel (UNF). This approach is attractive due to the potential of targeted gas-phase treatment steps to reduce footprint and secondary waste volumes associated with separations relying primarily on traditional technologies, so long as the fluorinators employed in the reaction are recycled for use in the reactors or are optimized for conversion of fluorinator reactant. The developed fluorination via SF{sub 6}, similar to the case for other fluorinators such as NF{sub 3}, can be used to address multiple fuel forms and downstream cycles including continued processing for LWR via fluorination or incorporation into a aqueous process (e.g. modified FLUOREX) or for subsequent pyro treatment to be used in advanced gas reactor designs such metal- or gas-cooled reactors. This report details the most recent experimental results on the reaction of SF{sub 6} with various fission product surrogate materials in the form of oxides and metals, including uranium oxides using a high-temperature DTA apparatus capable of temperatures in excess of 1000{deg}C . The experimental results indicate that the majority of the fission products form stable solid fluorides and sulfides, while a subset of the fission products form volatile fluorides such as molybdenum fluoride and niobium fluoride, as predicted thermodynamically. Additional kinetic analysis has been performed on additional fission products. A key result is the verification that SF{sub 6} requires high temperatures for direct fluorination and subsequent volatilization of uranium oxides to UF{sub 6}, and thus is well positioned as a head-end treatment for other separations technologies, such as the volatilization of uranium oxide by NF{sub 3} as reported by colleagues at PNNL, advanced pyrochemical separations or traditional full recycle

Long head of biceps: from anatomy to treatment

Directory of Open Access Journals (Sweden)

Marco Sarmento

2015-01-01

Full Text Available The long head of the biceps (LHB, tendinous structure of the proximal brachial biceps, has its well-known anatomy, which contrasts with its current functional characterization. Various forms of proximal anchor and intra–articular route, important for the correct interpretation of its contribution to the pathology of the shoulder as well as the treatment methodology, are described. Knowledge of its biomechanics results mainly from cadaveric studies that contradict each other. Already the few studies in vivo indicate a depressant and stabilizing action, anterior, for the humeral head. Its pathology is rarely isolated because it is almost always correlated with rotator cuff or labrum pathology. It can be divided into 3 major groups (inflammatory, instability and traumatic and subdivided according to its location. The anterior shoulder pain is the initial symptom of pathology of LHB Its perfect characterization is dependent on the associated injuries. Clinical tests are multiple and only their combination allows better sensitivity and specificity for LHB pathology. The arthro-MRI and dynamic ultrasound are able to increase proper diagnostic of the pathology of LHB. Treatment ranges from conservative and surgical. The latter includes the repair, tenotomy and tenodesis of LHB which can be performed by open or arthroscopic methodology. The author intends to review existing literature on all aspects related to the long head of the biceps from anatomy to treatment, presenting the latest results.

Study of the actinide-lanthanide separation from nuclear waste by a new pyrochemical process

International Nuclear Information System (INIS)

Lemort, F.

1997-01-01

The theoretical extraction and separation of platinoids, actinides and lanthanides is allowed by thermodynamic using two adapted reducing agents: zinc and magnesium. Thereby, a pyrochemical method for the nuclear waste processing has been devised. The high temperature handling of the elements in fluoride forms and their processing by a reactive metallic phase required special precautions. The study of the behavior of matter in exploratory systems allowed the development of an experimental technology for the treatment and contacting of phases. The thermodynamical analysis of the experimental results shows the feasibility of the process. A model was developed to predict the distribution coefficients of zirconium, uranium and lanthanum as a function of the system composition. An estimation method was proposed in order to evaluate the distribution coefficients in diluted solution of all the actinides and lanthanides existing in the fission products between LiF CaF 2 and Zn-Mg at 720 deg C. Coupled with the experimental results, the estimates results may be extrapolated to concentrated solutions allowing predictions of the separation of all actinides and lanthanides. The rapidity of element transfer is induced by a thermal effect caused by the high exothermicity of the reduction by magnesium. The kinetic coefficients have been linked with the reduction enthalpy of each element. Moreover, the kinetics seem limited by chemical reaction and not by mass transfer. (author)

Brachytherapy in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Yoo, Seong Yul

1999-01-01

Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Secondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed

European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project

DEFF Research Database (Denmark)

Plaschke, Christina Caroline; Bertino, Giulia; McCaul, James A.

2017-01-01

Aim Electrochemotherapy is an effective local treatment for cutaneous tumours and metastases. In this prospective trial, six European institutions investigated electrochemotherapy in recurrent, mucosal head and neck tumours. Patient and methods Forty-three patients with recurrent mucosal head....... Primary end-point was local tumour response. Secondary end-points were safety and toxicity, overall and progression free survival, and quality-of-life. Results Thirty-seven patients were evaluable for tumour response, pain score, side-effects and quality of life questionnaires. Six patients were...

Application of molten salts in pyrochemical processing of reactive metals

International Nuclear Information System (INIS)

Mishra, B.; Olson, D.L.; Averill, W.A.

1992-01-01

Various mixes of chloride and fluoride salts are used as the media for conducting pyrochemical processes in the production and purification of reactive metals. These processes generate a significant amount of contaminated waste that has to be treated for recycling or disposal. Molten calcium chloride based salt systems have been used in this work to electrolytically regenerate calcium metal from calcium oxide for the in situ reduction of reactive metal oxides. The recovery of calcium is characterized by the process efficiency to overcome back reactions in the electrowinning cell. A thermodynamic analysis, based on fundamental rate theory, has been performed to understand the process parameters controlling the metal deposition, rate, behavior of the ceramic anode-sheath and influence of the back-reactions. It has been observed that the deposition of calcium is dependent on the ionic diffusion through the sheath. It has also been evidenced that the recovered calcium is completely lost through the back-reactions in the absence of a sheath. A practical scenario has also been presented where the electrowon metal can be used in situ as a reductant to reduce another reactive metal oxide

Pyrochemical recovery of actinide elements from spent light water reactor fuel

International Nuclear Information System (INIS)

Johnson, G.K.; Pierce, R.D.; Poa, D.S.; McPheeters, C.C.

1994-01-01

Argonne National Laboratory is investigating salt transport and lithium pyrochemical processes for recovery of transuranic (TRU) elements from spent light water reactor fuel. The two processes are designed to recover the TRU elements in a form compatible with the Integral Fast Reactor (IFR) fuel cycle. The IFR is uniquely effective in consuming these long-lived TRU elements. The salt transport process uses calcium dissolved in Cu-35 wt % Mg in the presence of a CaCl 2 salt to reduce the oxide fuel. The reduced TRU elements are separated from uranium and most of the fission products by using a MgCl 2 transport salt. The lithium process, which does not employ a solvent metal, uses lithium in the presence of a LiCl salt as the reductant. After separation from the salt, the reduced metal is introduced into an electrorefiner, which separates the TRU elements from the uranium and fission products. In both processes, reductant and reduction salt are recovered by electrochemical decomposition of the oxide reaction product

The thermodynamics of pyrochemical processes for liquid metal reactor fuel cycles

International Nuclear Information System (INIS)

Johnson, I.

1987-01-01

The thermodynamic basis for pyrochemical processes for the recovery and purification of fuel for the liquid metal reactor fuel cycle is described. These processes involve the transport of the uranium and plutonium from one liquid alloy to another through a molten salt. The processes discussed use liquid alloys of cadmium, zinc, and magnesium and molten chloride salts. The oxidation-reduction steps are done either chemically by the use of an auxiliary redox couple or electrochemically by the use of an external electrical supply. The same basic thermodynamics apply to both the salt transport and the electrotransport processes. Large deviations from ideal solution behavior of the actinides and lanthanides in the liquid alloys have a major influence on the solubilities and the performance of both the salt transport and electrotransport processes. Separation of plutonium and uranium from each other and decontamination from the more noble fission product elements can be achieved using both transport processes. The thermodynamic analysis is used to make process design computations for different process conditions

Chemical Engineering Division fuel cycle programs. Quarterly progress report, April-June 1979. [Pyrochemical/dry processing; waste encapsulation in metal; transport in geologic media

Energy Technology Data Exchange (ETDEWEB)

Steindler, M.J.; Ader, M.; Barletta, R.E.

1980-09-01

For pyrochemical and dry processing materials development included exposure to molten metal and salt of Mo-0.5% Ti-0.07% Ti-0.01% C, Mo-30% W, SiC, Si/sub 2/ON/sub 2/, ZrB/sub 2/-SiC, MgAl/sub 2/O/sub 4/, Al/sub 2/O/sub 3/, AlN, HfB/sub 2/, Y/sub 2/O/sub 3/, BeO, Si/sub 3/N/sub 4/, nickel nitrate-infiltrated W, W-coated Mo, and W-metallized alumina-yttria. Work on Th-U salt transport processing included solubility of Th in liquid Cd, defining the Cd-Th and Cd-Mg-Th phase diagrams, ThO/sub 2/ reduction experiments, and electrolysis of CaO in molten salt. Work on pyrochemical processes and associated hardware for coprocessing U and Pu in spent FBR fuels included a second-generation computer model of the transport process, turntable transport process design, work on the U-Cu-Mg system, and U and Pu distribution coefficients between molten salt and metal. Refractory metal vessels are being service-life tested. The chloride volatility processing of Th-based fuel was evaluated for its proliferation resistance, and a preliminary ternary phase diagram for the Zn-U-Pu system was computed. Material characterization and process analysis were conducted on the Exportable Pyrochemical process (Pyro-Civex process). Literature data on oxidation of fissile metals to oxides were reviewed. Work was done on chemical bases for the reprocessing of actinide oxides in molten salts. Flowsheets are being developed for the processing of fuel in molten tin. Work on encapsulation of solidified radioactive waste in metal matrix included studies of leach rate of crystalline waste materials and of the impact resistance of metal-matrix waste forms. In work on the transport properties of nuclear waste in geologic media, adsorption of Sr on oolitic limestone was studied, as well as the migration of Cs in basalt. Fitting of data on the adsorption of iodate by hematite to a mathematical model was attempted.

Autologous Platelet Concentrates as Treatment for Avascular Necrosis of Femoral Head in a Dog.

Science.gov (United States)

Parra, Estefanía; Vergara, Andrea; Silva, Raúl F

2017-03-01

Avascular necrosis of the femoral head is a developmental disturbance that generally affects young dogs of small breeds and produces ischemic necrosis of the femoral head resulting in an incongruous and malformed joint. The most common treatment is the excisional arthroplasty of the head and femoral neck. The aim of this study is to describe the treatment of avascular necrosis in a Yorkshire dog using intra-articular injections of autologous platelet concentrate. Evaluations were made at 0, 15, 30, 60, and 120 days of treatment, describing the following parameters: clinical gait analysis, perimetry, goniometry, and radiographic evaluations. The results obtained in this case suggest that the autologous platelet concentrate may be an alternative for the treatment of avascular necrosis of the femoral head in dogs. Copyright © 2017 Elsevier Inc. All rights reserved.

Exploring the mechanisms of vehicle front-end shape on pedestrian head injuries caused by ground impact.

Science.gov (United States)

Yin, Sha; Li, Jiani; Xu, Jun

2017-09-01

In pedestrian-vehicle accidents, pedestrians typically suffer from secondary impact with the ground after the primary contact with vehicles. However, information about the fundamental mechanism of pedestrian head injury from ground impact remains minimal, thereby hindering further improvement in pedestrian safety. This study addresses this issue by using multi-body modeling and computation to investigate the influence of vehicle front-end shape on pedestrian safety. Accordingly, a simulation matrix is constructed to vary bonnet leading-edge height, bonnet length, bonnet angle, and windshield angle. Subsequently, a set of 315 pedestrian-vehicle crash simulations are conducted using the multi-body simulation software MADYMO. Three vehicle velocities, i.e., 20, 30, and 40km/h, are set as the scenarios. Results show that the top governing factor is bonnet leading-edge height. The posture and head injury at the instant of head ground impact vary dramatically with increasing height because of the significant rise of the body bending point and the movement of the collision point. The bonnet angle is the second dominant factor that affects head-ground injury, followed by bonnet length and windshield angle. The results may elucidate one of the critical barriers to understanding head injury caused by ground impact and provide a solid theoretical guideline for considering pedestrian safety in vehicle design. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical Value of High Mobility Group Box 1 and the Receptor for Advanced Glycation End-products in Head and Neck Cancer: A Systematic Review

Directory of Open Access Journals (Sweden)

Nguyen, Austin

2016-04-01

Full Text Available Introduction High mobility group box 1 is a versatile protein involved in gene transcription, extracellular signaling, and response to inflammation. Extracellularly, high mobility group box 1 binds to several receptors, notably the receptor for advanced glycation end-products. Expression of high mobility group box 1 and the receptor for advanced glycation end-products has been described in many cancers. Objectives To systematically review the available literature using PubMed and Web of Science to evaluate the clinical value of high mobility group box 1 and the receptor for advanced glycation end-products in head and neck squamous cell carcinomas. Data synthesis A total of eleven studies were included in this review. High mobility group box 1 overexpression is associated with poor prognosis and many clinical and pathological characteristics of head and neck squamous cell carcinomas patients. Additionally, the receptor for advanced glycation end-products demonstrates potential value as a clinical indicator of tumor angiogenesis and advanced staging. In diagnosis, high mobility group box 1 demonstrates low sensitivity. Conclusion High mobility group box 1 and the receptor for advanced glycation end-products are associated with clinical and pathological characteristics of head and neck squamous cell carcinomas. Further investigation of the prognostic and diagnostic value of these molecules is warranted.

Treatment of Childhood Head and Neck Cancer - Patient Version

Science.gov (United States)

Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

Preparation of a technology development roadmap for the Accelerator Transmutation of Waste (ATW) System : report of the ATW separations technologies and waste forms technical working group

International Nuclear Information System (INIS)

Collins, E.; Duguid, J.; Henry, R.; Karell, E.J.; Laidler, J.J.; McDeavitt, S.M.; Thompson, M.; Toth, L.M.; Williamson, M.; Willit, J.L.

1999-01-01

In response to a Congressional mandate to prepare a roadmap for the development of Accelerator Transmutation of Waste (ATW) technology, a Technical Working Group comprised of members from various DOE laboratories was convened in March 1999 for the purpose of preparing that part of the technology development roadmap dealing with the separation of certain radionuclides for transmutation and the disposal of residual radioactive wastes from these partitioning operations. The Technical Working Group for ATW Separations Technologies and Waste Forms completed its work in June 1999, having carefully considered the technology options available. A baseline process flowsheet and backup process were identified for initial emphasis in a future research, development and demonstration program. The baseline process combines aqueous and pyrochemical processes to permit the efficient separation of the uranium, technetium, iodine and transuranic elements from the light water reactor (LWR) fuel in the head-end step. The backup process is an all- pyrochemical system. In conjunction with the aqueous process, the baseline flowsheet includes a pyrochemical process to prepare the transuranic material for fabrication of the ATW fuel assemblies. For the internal ATW fuel cycle the baseline process specifies another pyrochemical process to extract the transuranic elements, Tc and 1 from the ATW fuel. Fission products not separated for transmutation and trace amounts of actinide elements would be directed to two high-level waste forms, one a zirconium-based alloy and the other a glass/sodalite composite. Baseline cost and schedule estimates are provided for a RD and D program that would provide a full-scale demonstration of the complete separations and waste production flowsheet within 20 years

Preparation of a technology development roadmap for the Accelerator Transmutation of Waste (ATW) System : report of the ATW separations technologies and waste forms technical working group.

Energy Technology Data Exchange (ETDEWEB)

Collins, E.; Duguid, J.; Henry, R.; Karell, E.; Laidler, J.; McDeavitt, S.; Thompson, M.; Toth, M.; Williamson, M.; Willit, J.

1999-08-12

In response to a Congressional mandate to prepare a roadmap for the development of Accelerator Transmutation of Waste (ATW) technology, a Technical Working Group comprised of members from various DOE laboratories was convened in March 1999 for the purpose of preparing that part of the technology development roadmap dealing with the separation of certain radionuclides for transmutation and the disposal of residual radioactive wastes from these partitioning operations. The Technical Working Group for ATW Separations Technologies and Waste Forms completed its work in June 1999, having carefully considered the technology options available. A baseline process flowsheet and backup process were identified for initial emphasis in a future research, development and demonstration program. The baseline process combines aqueous and pyrochemical processes to permit the efficient separation of the uranium, technetium, iodine and transuranic elements from the light water reactor (LWR) fuel in the head-end step. The backup process is an all- pyrochemical system. In conjunction with the aqueous process, the baseline flowsheet includes a pyrochemical process to prepare the transuranic material for fabrication of the ATW fuel assemblies. For the internal ATW fuel cycle the baseline process specifies another pyrochemical process to extract the transuranic elements, Tc and 1 from the ATW fuel. Fission products not separated for transmutation and trace amounts of actinide elements would be directed to two high-level waste forms, one a zirconium-based alloy and the other a glass/sodalite composite. Baseline cost and schedule estimates are provided for a RD&D program that would provide a full-scale demonstration of the complete separations and waste production flowsheet within 20 years.

Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma

NARCIS (Netherlands)

Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Haigentz, Missak; Takes, Robert P.; Silver, Carl E.; Hartl, Dana M.; Strojan, Primoz; Rinaldo, Alessandra; de Bree, Remco; Dietz, Andreas; Gregoire, Vincent; Paleri, Vinidh; Langendijk, Johannes A.; Vander Poorten, Vincent; Hinni, Michael L.; Rodrigo, Juan P.; Suarez, Carlos; Mendenhall, William M.; Werner, Jochen A.; Genden, Eric M.; Ferlito, Alfio

The management of head and neck squamous cell carcinomas does not end with the completion of ablative therapy. The oncologic objectives of post-treatment follow-up are to detect recurrences and second primary tumors; beyond that, follow-up should evaluate acute and chronic treatment-related side

Treatment of Pediatric Head and Neck Cancer - Health Professional Version

Science.gov (United States)

Find information about prognosis, staging, and treatment for the following head and neck cancer sites in children: esthesioneuroblastoma, larynx and papillomatosis, nasopharynx, oral cavity, and salivary gland.

[SURGICAL HIP DISLOCATION APPROACH FOR TREATMENT OF FEMORAL HEAD FRACTURE].

Science.gov (United States)

Tang, Yanfeng; Liu, Youwen; Zhu, Yingjie; Li, Jianming; Li, Wuyin; Li, Qiyi; Jia, Yudong

2015-11-01

To discuss the value of surgical hip dislocation approach in the treatment of femoral head fracture. A retrospectively analysis was made on the clinical data of 15 patients with femoral head fractures treated through surgical hip dislocation approach between January 2010 and February 2013. There were 11 men and 4 women with an average age of 30.8 years (range, 15-63 years). The causes included traffic accident injury in 9 cases, falling injury from height in 5 cases, and sports injury in 1 case. According to Pipkin typing, 2 cases were rated as type I, 7 cases as type II, 1 case as type III, and 5 cases as type IV. The interval of injury and operation was 2-10 days (mean, 4.1 days). Reduction was performed in 10 patients within 6 hours after injury, and then bone traction was given for 4-6 weeks except 5 patients who received reduction in the other hospital. Primary healing of incision was obtained in all patients after surgery without complications of dislocation and lower limbs deep venous thrombosis. The mean follow-up time was 29.9 months (range, 25-36 months). During follow-up, there was no infection, breakage of internal fixation, or nonunion of femoral greater trochanter fracture. In 3 patients having necrosis of the femoral head, 2 had no obvious symptoms [staging as IIa and IIb respectively according to Association Research Circulation Osseous (ARCO) staging system], and 1 (stage IIIb) had nonunion of the femoral neck fracture, who underwent total hip arthroplasty (THA). In 4 patients having myositis ossificans (2 cases of grade I, 1 case of grade II, and 1 case of grade III based on Brooker grading), no treatment was given in 3 cases and the focus was removed during THA in 1 case. According to the Thompson-Epstein scale at last follow-up, the results were excellent in 9 cases, good in 3 cases, fair in 1 case, and poor in 2 cases, and the excellent and good rate was 80%. Surgical hip dislocation approach can not only protect the residual vessels of the

Femoral head injuries: Which treatment strategy can be recommended?

NARCIS (Netherlands)

Henle, Philipp; Kloen, Peter; Siebenrock, Klaus A.

2007-01-01

Despite different operative and non-operative treatment regimens, the outcome after femoral head fractures has changed little over the past decades. The initial trauma itself as well as secondary changes such as posttraumatic osteoarthritis, avascular necrosis or heterotopic ossification is often

Corrosion resistance of ceramic materials in pyrochemical reprocessing atmosphere by using molten salt for spent nuclear oxide fuel. Corrosion research under chlorine gas condition

International Nuclear Information System (INIS)

Takeuchi, Masayuki; Hanada, Keiji; Koizumi, Tsutomu; Aose, Shinichi; Kato, Toshihiro

2002-12-01

Pyrochemical reprocessing using molten salts (RIAR process) has been recently developed for spent nuclear oxide fuel and discussed in feasibility study. It is required to improve the corrosion resistance of equipments such as electrolyzer because the process is operated in severe corrosion environment. In this study, the corrosion resistance of ceramic materials was discussed through the thermodynamic calculation and corrosion test. The corrosion test was basically carried out in alkali molten salt under chlorine gas condition. And further consideration about the effects of oxygen, carbon and main fission product's chlorides were evaluated in molten salt. The result of thermodynamic calculation shows most of ceramic oxides have good chemical stability on chlorine, oxygen and uranyl chloride, however the standard Gibb's free energies with carbon have negative value. On the other hand, eleven kinds of ceramic materials were examined by corrosion test, then silicon nitride, mullite and cordierite have a good corrosion resistance less than 0.1 mm/y. Cracks were not observed on the materials and flexural strength did not reduce remarkably after 480 hours test in molten salt with Cl 2 -O 2 bubbling. In conclusion, these three ceramic materials are most applicable materials for the pyrochemical reprocessing process with chlorine gas condition. (author)

Spent fuel treatment at ANL-West

International Nuclear Information System (INIS)

Goff, K.M.; Benedict, R.W.; Levinskas, D.

1994-01-01

At Argonne National Laboratory-West (ANL-West) there are several thousand kilograms of metallic spent nuclear fuel containing bond sodium. This fuel will be treated in the Fuel Cycle Facility at ANL-West to produce stable waste forms for storage and disposal. The treatment operations will employ a pyrochemical process that also has applications for treating most of the fuel types within the Department of Energy complex. The treatment equipment is in its last stage of readiness, and operations will begin in the Fall of 1994

Development of the object-oriented analysis code for the estimation of material balance in pyrochemical reprocessing process (2). Modification of the code for the analysis of holdup of nuclear materials in the process

International Nuclear Information System (INIS)

Okamura, Nobuo; Tanaka, Hiroshi

2001-04-01

Pyrochemical reprocessing is thought to be promising process for FBR fuel cycle mainly from the economical viewpoint. However, the material behavior in the process is not clarified enough because of the lack of experimental data. The authors have been developed the object-oriented analysis code for the estimation of material balance in the process, which has the flexible applicability for the change of process flow sheet. The objective of this study is to modify the code so as to analyze the holdup of nuclear materials in the pyrochemical process from the viewpoint of safeguard, because of the possibility of larger amount of the holdup in the process compared with aqueous process. As a result of the modification, the relationship between the production of nuclear materials and its holdup in the process can be evaluated by the code. (author)

An overview of head and neck treatment at the KNH radiotherapy, Nairobi

International Nuclear Information System (INIS)

Mucheusi, L.

2006-01-01

It is known from several studies that precise radical radiotherapy leads to better local control thus increasing overall survival of patients suffering from Head and Neck malignancies if diagnosed early enough. The wide gap in the techniques and equipment used between the developed and the developing world are a source of concern especially in Sub Saharan africa which hardly boasts of even a single linear accelerator. in this presentation, common Head and Neck condition treatment is examined as it is done at the Kenyatta National Hospital. The treatment techniques used the planning process/innovations improvisations-adopted by radiographers at the institution to achieve the prescribed treatment

Treatment of head and neck squamous cell carcinoma in elderly patients

International Nuclear Information System (INIS)

Honda, Keigo; Asato, Ryo; Tsuji, Jun; Kanda, Tomoko; Ushiro, Kohji; Watanabe, Yoshiki; Mori, Yusuke

2010-01-01

The object of this study was to clarify the characteristics of treatment for elderly head and neck squamous cell cancer patients. We conducted a chart review of 177 head and neck squamous cell cancer patients who had been treated at Kyoto Medical Center, from 2005 through 2009. All the collected data were analyzed to compare the clinical features and the treatment outcomes between the younger group ( or =75, EG, n=46). Male to female ratio was lower in EG (5.6:1 vs. 1.7:1, p<0.01). C urative treatment was performed in most of the patients with early disease (stage I-II) in both groups (96.7% vs. 90.5%), while the ratio of curative treatment was significantly lower in EG patients with advanced stage disease (stage III-IV) (92.3% vs. 52.0%, p<0.01). There was no significant difference in the frequency of adopted treatment modality (surgery or radiotherapy) between YG and EG. Adjuvant chemotherapy or postoperative radiotherapy was avoided in most of EG patients. Local complication rates after major surgery for advanced cases were similar in both groups (30.8% vs. 27.3%), while a higher systemic complication rate was observed in EG (0% vs. 27.3%). After curative treatment, there was no difference in disease specific three-year survival rates between YG and EG (100% vs. 100% in early stage disease, 65.2% vs. 60.6% in advanced disease, Kaplan-Meier curve). Although treatment of elderly patients with head and neck cancer can be inhibited by poor performance status and/or concomitant diseases, clinical results after curative treatment are comparable to those of younger patients. (author)

Treatment of Head and Neck Cancer in Adults - Patient Version

Science.gov (United States)

Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

Improving Therapeutic Ratio in Head and Neck Cancer with Adjuvant and Cisplatin-Based Treatments

Directory of Open Access Journals (Sweden)

Loredana G. Marcu

2013-01-01

Full Text Available Advanced head and neck cancers are difficult to manage despite the large treatment arsenal currently available. The multidisciplinary effort to increase disease-free survival and diminish normal tissue toxicity was rewarded with better locoregional control and sometimes fewer side effects. Nevertheless, locoregional recurrence is still one of the main reasons for treatment failure. Today, the standard of care in head and neck cancer management is represented by altered fractionation radiotherapy combined with platinum-based chemotherapy. Targeted therapies as well as chronotherapy were trialled with more or less success. The aim of the current work is to review the available techniques, which could contribute towards a higher therapeutic ratio in the treatment of advanced head and neck cancer patients.

Salt stripping: a pyrochemical approach to the recovery of plutonium electrorefining salt residues

International Nuclear Information System (INIS)

Christensen, D.C.; Mullins, L.J.

1982-10-01

A pyrochemical process has been developed to take the salt residue from the plutonium electrorefining process and strip the plutonium from it. The process, called salt stripping, uses calcium as a reducing/coalescing agent. In a one-day operation, greater than 95% of the plutonium can be recovered as a metallic button. As much as 88% of the residue is either reused as metal or discarded as a clean salt. A thin layer of black salts, which makes up the bulk of the unrecovered Pu, is a by-product of the initial reductions. A number of black salts can be collected together and re-reduced in a second step. Greater than 88% of this plutonium can be successfully recovered in this second stage with the resulting residues being discardable. The processing time, number of processor hours, and the volume of secondary residues are greatly reduced over the classical aqueous recovery methods. In addition, the product metal is of sufficient quality to be fed directly to the electrorefining process for purification. 8 figures, 7 tables

Initial treatment results using cyberknife for head and neck tumor

International Nuclear Information System (INIS)

Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi; Takemoto, Mitsuhiro; Kobayashi, Mitsuru; Kuroda, Masahiro; Hiraki, Yoshio

2002-01-01

The CyberKnife, a medical device for stereotactic radiotherapy, is composed of a combination of a robot manipulator and LINAC. For the treatment of head and neck tumors, this system has been applied. Between June 2000 and January 2001, 18 patients with head and neck tumor were treated with this system because of tumor recurrence, difficulty in surgery or additional increase after external radiotherapy. The median age was 64 years. Primary lesions were skull base (4), nasopharynx (3), paranasal sinus (3), nasal cavity (2), lacrimal gland (1), oropharynx (1), oral floor (1), and buccul mucosa (1), metastatic lymph nodes were found in three. The prescribed dose was 12-38 Gy as for marginal dose. The response rate (CR+PR) was 44.4% and local control rate (CR+PR+NC) was 77.8%. The adverse effects were assessed by the NCI-CTC Version 2.0 and observed grade 3 in two cases. Our early experience indicates that this system could to be feasible for the treatment of locally advanced or recurrent head and neck tumor, and for the reduction of adverse effect and maintenance of useful QOL of patients. (author)

Prevention and treatment of the consequences of head and neck radiotherapy

NARCIS (Netherlands)

Vissink, A; Burlage, FR; Spijkervet, FKL; Jansma, J; Coppes, RP

The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of

Detection of treatment setup errors between two CT scans for patients with head and neck cancer

International Nuclear Information System (INIS)

Ezzell, Leah C.; Hansen, Eric K.; Quivey, Jeanne M.; Xia Ping

2007-01-01

Accuracy of treatment setup for head and neck patients undergoing intensity-modulated radiation therapy is of paramount importance. The conventional method using orthogonal portal images can only detect translational setup errors while the most frequent setup errors for head and neck patients could be rotational errors. With the rapid development of image-guided radiotherapy, three-dimensional images are readily acquired and can be used to detect both translational and rotational setup errors. The purpose of this study is to determine the significance of rotational variations between two planning CT scans acquired for each of eight head and neck patients, who experienced substantial weight loss or tumor shrinkage. To this end, using a rigid body assumption, we developed an in-house computer program that utilizes matrix transformations to align point bony landmarks with an incremental best-fit routine. The program returns the quantified translational and rotational shifts needed to align the scans of each patient. The program was tested using a phantom for a set of known translational and rotational shifts. For comparison, a commercial treatment planning system was used to register the two CT scans and estimate the translational errors for these patients. For the eight patients, we found that the average magnitudes and standard deviations of the rotational shifts about the transverse, anterior-posterior, and longitudinal axes were 1.7±2.3 deg., 0.8±0.7 deg., and 1.8±1.1 deg., respectively. The average magnitudes and standard deviations of the translational shifts were 2.5±2.6 mm, 2.9±2.8 mm, 2.7±1.7 mm while the differences detected between our program and the CT-CT fusion method were 1.8±1.3 mm, 3.3±5.4 mm, and 3.0±3.4 mm in the left-right, anterior-posterior, and superior-inferior directions, respectively. A trend of larger rotational errors resulting in larger translational differences between the two methods was observed. In conclusion, conventional

Liposomal treatment of xerostomia, odor, and taste abnormalities in patients with head and neck cancer.

Science.gov (United States)

Heiser, Clemens; Hofauer, Benedikt; Scherer, Elias; Schukraft, Johannes; Knopf, Andreas

2016-04-01

Smell and taste disorders, sicca symptoms, can be detected in patients with head and neck cancer. The purpose of this study was to assess the utility of local liposomal application in the treatment of patients with head and neck cancers. Ninety-eight patients with head and neck cancer were included in this study. The groups were defined as: group 1 = only surgery; group 2 = surgery + adjuvant radiochemotherapy; and group 3 = primarily radiochemotherapy. All patients had finished cancer treatment and received liposomal sprays for the nose and mouth for 2 months (LipoNasal, LipoSaliva; Optima Pharmaceutical GmbH, Germany) and suffered from taste and smell disorders. We performed tests with "Sniffin' Sticks," "Taste Strips," and a xerostomia questionnaire before and after treatment. After application of liposomes, patients demonstrated a statistically significant increase in smell and taste, and reduced xerostomia. Our results demonstrate that using nonpharmaceutical liposomal sprays improve smell, taste, and symptoms of xerostomia in patients with head and neck cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1232-E1237, 2016. © 2015 Wiley Periodicals, Inc.

Multi-institutional evaluation of end-to-end protocol for IMRT/VMAT treatment chains utilizing conventional linacs.

Science.gov (United States)

Loughery, Brian; Knill, Cory; Silverstein, Evan; Zakjevskii, Viatcheslav; Masi, Kathryn; Covington, Elizabeth; Snyder, Karen; Song, Kwang; Snyder, Michael

2018-03-20

We conducted a multi-institutional assessment of a recently developed end-to-end monthly quality assurance (QA) protocol for external beam radiation therapy treatment chains. This protocol validates the entire treatment chain against a baseline to detect the presence of complex errors not easily found in standard component-based QA methods. Participating physicists from 3 institutions ran the end-to-end protocol on treatment chains that include Imaging and Radiation Oncology Core (IROC)-credentialed linacs. Results were analyzed in the form of American Association of Physicists in Medicine (AAPM) Task Group (TG)-119 so that they may be referenced by future test participants. Optically stimulated luminescent dosimeter (OSLD), EBT3 radiochromic film, and A1SL ion chamber readings were accumulated across 10 test runs. Confidence limits were calculated to determine where 95% of measurements should fall. From calculated confidence limits, 95% of measurements should be within 5% error for OSLDs, 4% error for ionization chambers, and 4% error for (96% relative gamma pass rate) radiochromic film at 3% agreement/3 mm distance to agreement. Data were separated by institution, model of linac, and treatment protocol (intensity-modulated radiation therapy [IMRT] vs volumetric modulated arc therapy [VMAT]). A total of 97% of OSLDs, 98% of ion chambers, and 93% of films were within the confidence limits; measurements were found outside these limits by a maximum of 4%, consistent despite institutional differences in OSLD reading equipment and radiochromic film calibration techniques. Results from this test may be used by clinics for data comparison. Areas of improvement were identified in the end-to-end protocol that can be implemented in an updated version. The consistency of our data demonstrates the reproducibility and ease-of-use of such tests and suggests a potential role for their use in broad end-to-end QA initiatives. Copyright © 2018 American Association of Medical

Kinematics of a Head-Neck Model Simulating Whiplash

Science.gov (United States)

Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

2008-01-01

A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that…

Accuracy of self-reported tobacco assessments in a head and neck cancer treatment population

International Nuclear Information System (INIS)

Warren, Graham W.; Arnold, Susanne M.; Valentino, Joseph P.; Gal, Thomas J.; Hyland, Andrew J.; Singh, Anurag K.; Rangnekar, Vivek M.; Cummings, K. Michael; Marshall, James R.; Kudrimoti, Mahesh R.

2012-01-01

Prospective analysis was performed of self-reported and biochemically confirmed tobacco use in 50 head and neck cancer patients during treatment. With 93.5% compliance to complete weekly self-report and biochemical confirmatory tests, 29.4% of smokers required biochemical assessment for identification. Accuracy increased by 14.9% with weekly vs. baseline self-reported assessments. Data confirm that head and neck cancer patients misrepresent true tobacco use during treatment.

A study on recovery of uranium in the anode basket residues delivered from the pyrochemical process of used nuclear fuel

Science.gov (United States)

Eun, H. C.; Kim, T. J.; Jang, J. H.; Kim, G. Y.; Park, S. B.; Yoon, D. S.; Kim, S. H.; Paek, S. W.; Lee, S. J.

2018-04-01

In this study, the chlorination of uranium oxide (UO2) using ammonium chloride and zirconium as chemical agents was conducted to recover the uranium in the anode basket residues from the pyrochemical process of used nuclear fuel. The chlorination of UO2 was predicted using thermodynamic equilibrium calculations. The experimental conditions for the chlorination were determined using a chlorination test with cerium oxide (CeO2). In the chlorination test, it was confirmed that UO2 was chlorinated into UCl3 at 320 °C, some UO2 remained without changes in the chemical form, and ZrO2, Zr2O, and ZrCl2 were generated as byproducts.

The role of EGFR-targeting strategies in the treatment of head and neck cancer

Directory of Open Access Journals (Sweden)

Dequanter D

2012-07-01

Full Text Available Didier Dequanter, Mohammad Shahla, Pascal Paulus, Philippe H LothaireDepartment of Surgery, CHU Charleroi (Hopital Andre Vésale, Montigny le Tilleul, BelgiumAbstract: With its targeted mechanism of action and synergistic activity with current treatment modalities, cetuximab is a potentially valuable treatment option for patients with recurrent and/or metastatic squamous cell cancer of the head and neck who have progressed on cisplatin-based chemotherapy. The use of cetuximab in combination with radiotherapy as definitive treatment for locoregionally advanced squamous cell cancer of the head and neck is generally restricted to patients unfit to receive cisplatin-based chemoradiation, which is still considered the standard of care. The effect of this epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation.Keywords: cetuximab, SCCHN, radiotherapy

Stem cell treatment for avascular necrosis of the femoral head: current perspectives

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Houdek MT

2014-04-01

Full Text Available Matthew T Houdek,1 Cody C Wyles,2 John R Martin,1 Rafael J Sierra11Department of Orthopedic Surgery, 2School of Medicine, Mayo Clinic, Rochester, MN, USAAbstract: Avascular necrosis (AVN of the femoral head is a progressive disease that predominantly affects younger patients. Although the exact pathophysiology of AVN has yet to be elucidated, the disease is characterized by a vascular insult to the blood supply of the femoral head, which can lead to collapse of the femoral head and subsequent degenerative changes. If AVN is diagnosed in the early stages of the disease, it may be possible to attempt surgical procedures which preserve the hip joint, including decompression of the femoral head augmented with concentrated bone marrow. The use of autologous stem cells has shown promise in halting the progression of AVN of the femoral head, and subsequently preventing young patients from undergoing total hip arthroplasty. The purpose of this study was to review the current use of stem cells for the treatment of AVN of the femoral head.Keywords: avascular necrosis, femoral head, osteonecrosis, stem cells, concentrated bone marrow

Interfacing solvent extraction in the recovery of pyrochemical residues at the Savannah River Plant

International Nuclear Information System (INIS)

Gray, L.W.; Holcomb, H.P.

1986-01-01

The traditional feedstock for plutonium recovery at the Savannah River Plant (SRP) has been spent reactor fuel elements and irradiated targets. Feed sources have included both onsite reactors and a wide variety of domestic and foreign reactors. For the past few years, a growing and increasingly varied mix of unirradiated plutonium residues has been purified through SRP aqueous-based processes. Recently, plutonium residues generated in various chloride salt melts have become a significant offsite source of feed for SRP recovery operations. Impure plutonium metal and plutonium alloys have also been processed. A broader range of molten salt and other high temperature residues is anticipated for the future. The major advantage of solvent extraction for scrap purification is the versatility of the solvent extraction system which allows numerous contaminants to be removed by routine operations. Major concerns are nuclear safety control, corrosion of equipment, and control of releases to the environment. SRP's past, present, and future interfacing of solvent extraction in processing pyrochemical and other plutonium-containing residues is reviewed

In a bad place: Carers of patients with head and neck cancer experiences of travelling for cancer treatment.

Science.gov (United States)

Balfe, Myles; Keohane, Kieran; O' Brien, Katie; Gooberman-Hill, Rachael; Maguire, Rebecca; Hanly, Paul; O' Sullivan, Eleanor; Sharp, Linda

2017-10-01

To explore the effect that treatment-related commuting has on carers of patients with head and neck cancer. Semi-structured interviews, thematically analysed, with 31 carers. Treatment-related commuting had a considerable impact on carers of patients with head and neck cancer, both in practical terms (economic costs, disruption) and also in psychological terms. Many carers of patients with head and neck cancer described becoming distressed by their commute. Some carers from large urban cities appeared to have hidden commuting burdens. Some carers respond to commuting stress by 'zoning out' or becoming 'like zombies'. Treatment-related travel for head and neck cancer can have significant practical and psychological impacts. Health professionals should be aware of the impacts that commuting can have on head and neck caregivers. Health services may be able to take practical steps, such as providing subsidized parking, to address head and neck carergivers' difficulties. Copyright © 2017 Elsevier Ltd. All rights reserved.

Treatment of Head and Neck Cancer in Adults - Health Professional Version

Science.gov (United States)

Find information about prognosis, staging, and treatment for adult head and neck cancer sites: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

Analysis of head motion prior to and during proton beam therapy

International Nuclear Information System (INIS)

Schulte, Reinhard W.; Fargo, Ramiz A.; Meinass, Helmut J.; Slater, Jerry D.; Slater, James M.

2000-01-01

Purpose: We report on the use of a noninvasive patient motion monitoring system to evaluate the amount of head motion prior to and during proton radiation therapy sessions. Methods and Materials: Two optical displacement sensors, placed close to the patient's head, were used for online monitoring of the head position, with submillimeter accuracy. Motion data, including the difference between start and end position (Dx) and the maximum displacement during the recorded session (Dx-max), were acquired for pretreatment sessions to analyze alignment radiographs, and for treatment sessions. We have recorded 102 pretreatment and 99 treatment sessions in 16 patients immobilized with a thermoplastic mask, and 44 pretreatment and 56 treatment sessions in 13 patients immobilized with vacuum-assisted dental fixation. To avoid incorrect data analysis due to replicate observations, only 1 pretreatment and 1 treatment session per patient were selected at random for statistical comparison of mean or median motion parameters in different subgroups. Results: Both techniques showed similar immobilization efficiencies. The median Dx and Dx-max values were 0.18 mm and 0.46 mm, respectively, for 16 treatment sessions with mask immobilization, and 0.22 mm and 0.50 mm, respectively, for 13 treatment sessions with dental immobilization. Motion parameters for pretreatment and treatment sessions were not statistically different. Conclusion: Online verification of patient's head motion is feasible and provides valuable data for confirmation of proper treatment delivery in individual patients, as well as for the evaluation of different immobilization methods

Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

International Nuclear Information System (INIS)

Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

2007-01-01

Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

A Study of the Effect of the Front-End Styling of Sport Utility Vehicles on Pedestrian Head Injuries

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Guanjun Zhang

2018-01-01

Full Text Available Background. The number of sport utility vehicles (SUVs on China market is continuously increasing. It is necessary to investigate the relationships between the front-end styling features of SUVs and head injuries at the styling design stage for improving the pedestrian protection performance and product development efficiency. Methods. Styling feature parameters were extracted from the SUV side contour line. And simplified finite element models were established based on the 78 SUV side contour lines. Pedestrian headform impact simulations were performed and validated. The head injury criterion of 15 ms (HIC15 at four wrap-around distances was obtained. A multiple linear regression analysis method was employed to describe the relationships between the styling feature parameters and the HIC15 at each impact point. Results. The relationship between the selected styling features and the HIC15 showed reasonable correlations, and the regression models and the selected independent variables showed statistical significance. Conclusions. The regression equations obtained by multiple linear regression can be used to assess the performance of SUV styling in protecting pedestrians’ heads and provide styling designers with technical guidance regarding their artistic creations.

Treatment of late sequelae after radiotherapy for head and neck cancer.

Science.gov (United States)

Strojan, Primož; Hutcheson, Katherine A; Eisbruch, Avraham; Beitler, Jonathan J; Langendijk, Johannes A; Lee, Anne W M; Corry, June; Mendenhall, William M; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

2017-09-01

Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss. Copyright © 2017 Elsevier Ltd. All rights reserved.

BONE GRAFTING ENHANCED BY PLATELET-RICH PLASMA IN TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

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A. A. Korytkin

2018-01-01

Full Text Available Treatment of avascular necrosis of the femoral head is an issue of current interest while it affects young and employable people. So far there is no well-defined strategy of management which would help to postpone hip arthroplasty and further revision procedure. Hip sparing surgical treatment of avascular necrosis of the femoral head by bone grafting prior to head collapse proved to be a viable option not only during early stages of disease but also at advanced stages. Platelet-rich plasma (PRP addition to treatment plan potentially helps improving bone regeneration in situ.In this article the authors present a case of a 37 years old patient with avascular necrosis of the femoral head at a fragmentation stage (type 4B by ARCO. The authors centrifuged 15 ml of autologous whole blood (1500 RPM obtained by a special double-contoured syringe. During the surgical stage of treatment PRP and morselized bone graft were mixed to introduce and impact into the debrided zone of avascular necrosis. The authors also introduced 0.3–0.4 ml of PRP into the debrided zone of avascular necrosis after bone grafting. At 6 months follow-up CT images of the studied patient demonstrated signs of bone reorganization and no loss of femoral head sphericity. Preoperative Visual Analogue Scale (VAS, Harris Hip Score (HHS and Hip disability and Osteoarthritis Outcome Score (HOOS prior to treatment were 60, 45 and 33 points respectively. Postoperative VAS, HHS and HOOS scores were 10, 78 and 78 respectively. In the authors’ opinion, impaction bone grafting enhanced by PRP helps obtaining good and excellent outcomes not only at early but also at advanced stages of avascular necrosis.

Characterization of the head end cells at the West Valley Nuclear Fuel Reprocessing Plant

International Nuclear Information System (INIS)

Vance, R.F.

1986-11-01

The head-end cells at the West Valley Nuclear Fuel Reprocessing Plant are characterized in this report. These cells consist of the Process Mechanical Cell (PMC) where irradiated nuclear fuel was trimmed of excess hardware and sheared into short segments; and the General Purpose Cell (GPC) where the segments were collected and stored prior to dissolution, and leached hulls were packaged for disposal. Between 1966 and 1972, while Nuclear Fuels Services operated the plant, these cells became highly contaminated with radioactive materials. The purpose of this characterization work was to develop technical information as a basis of decontamination and decommissioning planning and engineering. It was accomplished by performing remote in-cell visual examinations, radiation surveys, and sampling. Supplementary information was obtained from available written records, out-of-cell inspections, and interviews with plant personnel

Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

International Nuclear Information System (INIS)

Dupin, Charles; Lang, Philippe; Dessard-Diana, Bernadette; Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc

2014-01-01

Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm 3 (range, 0.9-243 cm 3 ) and 116 cm 3 (range, 24-731 cm 3 ), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas

Behavior of molybdenum in pyrochemical reprocessing: A spectroscopic study of the chlorination of molybdenum and its oxides in chloride melts

International Nuclear Information System (INIS)

Volkovicha, Vladimir A.; Griffiths, Trevor R.; Thied, Robert C.; Lewin, Bob

2003-01-01

The high temperature reactions of molybdenum and its oxides with chlorine and hydrogen chloride in molten alkali metal chlorides were investigated between 400 and 700 deg. C. The melts studied were LiCl-KCl, NaCl-CsCl and NaCl-KCl and the reactions were followed by in situ electronic absorption spectroscopy measurements. In these melts Mo reacts with Cl 2 and initially produces MoCl 6 2- and then a mixture of Mo(III) and Mo(V) chlorocomplexes, the final proportion depending on the reaction conditions. The Mo(V) content can be removed as MoCl 5 from the melt under vacuum or be reduced to Mo(III) by Mo metal. The reaction of Mo when HCl gas is bubbled into alkali chloride melts yields only MoCl 6 3- . MoO 2 reacts in these melts with chlorine to form soluble MoOCl 5 2- and volatile MoO 2 Cl 2 . MoO 3 is soluble in chloride melts and then decomposes into the oxychloride MoO 2 Cl 2 , which sublimes or can be sparged from the melt, and molybdate. Pyrochemical reprocessing can thus be employed for molybdenum since, after various intermediates, the end-products are chloride melts containing chloro and oxychloro anions of molybdenum plus molybdate, and volatile chlorides and oxychlorides that can be readily separated off. The reactions were fastest in the NaCl-KCl melt. The X-ray diffraction pattern of MoO 2 Cl 2 is reported for the first time

Patient Choice of Nonsurgical Treatment Contributes to Disparities in Head and Neck Squamous Cell Carcinoma.

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Parhar, Harman S; Anderson, Donald W; Janjua, Arif S; Durham, J Scott; Prisman, Eitan

2018-06-01

Objectives There are well-established outcome disparities among different demographic groups with head and neck squamous cell carcinoma (HNSCC). We aimed to investigate the potential contribution of patient choice of nonsurgical treatment to these disparities by estimating the rate of this phenomenon, identifying its predictors, and estimating the effect on cancer-specific survival. Study Design Retrospective nationwide analysis. Settings Surveillance, Epidemiology, and End Results Database (2004-2014). Subjects and Methods Patients with HNSCC, who were recommended for primary surgery, were included. Multivariable logistic regression was used to identify demographic and clinical factors associated with patient choice of nonsurgical treatment, and Kaplan Meier/Cox regression was used to analyze survival. Results Of 114,506 patients with HNSCC, 58,816 (51.4%) were recommended for primary surgery, and of those, 1550 (2.7%) chose nonsurgical treatment. Those who chose nonsurgical treatment were more likely to be older (67.1 ± 12.6 vs 63.6 ± 13.1, P unmarried (OR married, 0.50; 95% CI, 0.44-0.58), had an advanced tumor, and had a hypopharyngeal or laryngeal primary. Choice of nonsurgical treatment imparted a 2.16-fold (95% CI, 2.02-2.30) increased risk of cancer-specific death. Conclusion Of the patients, 2.7% chose nonsurgical treatment despite a provider recommendation that impairs survival. Choice of nonsurgical treatment is associated with older age, having Black or Asian ethnicity, being unmarried, having an advanced stage tumor, and having a primary site in the hypopharynx or larynx. Knowledge of these disparities may help providers counsel patients and help patients make informed decisions.

Monte Carlo simulation of radiation treatment machine heads

International Nuclear Information System (INIS)

Mohan, R.

1988-01-01

Monte Carlo simulations of radiation treatment machine heads provide practical means for obtaining energy spectra and angular distributions of photons and electrons. So far, most of the work published in the literature has been limited to photons and the contaminant electrons knocked out by photons. This chapter will be confined to megavoltage photon beams produced by medical linear accelerators and 60 Co teletherapy units. The knowledge of energy spectra and angular distributions of photons and contaminant electrons emerging from such machines is important for a variety of applications in radiation dosimetry

Clinical response and safety of malathion shampoo for treatment of head lice in a primary school.

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Wananukul, Siriwan; Chatproedprai, Susheera; Tempark, Therdpong; Wananukul, Winai

2011-04-01

Help eradicate or at least alleviating head lice in a primary school with malathion shampoo and to study clinical response and safety of malathion shampoo. All students were examined by using a fine-toothed lice comb to help detect live lice. Direct visual examination and the collection of nits for microscopic examination were performed to differentiate viable nits from empty nits. Diagnosis of head lice was made by the presence of lice. All students that had lice and/or nits were treated with malathion shampoo. Malathion shampoo was also provided for all family members. Pediculocidal efficacy was by the presence or absence of live lice. Blood for red blood cell cholinesterase activity was drawn in 32 volunteers before treatment and after the second treatment. At the first visit, 629 students were examined and 48 students had live head lice. The infestation rate was 13% in girls and 1.3% in boys. The cure rate was 93% after the first treatment. The reported side effects were nausea, a burning sensation, and irritation that was found in five (4%), 10 (7%) and three (2%) students respectively. The mean of RBC cholinesterase activity before and after two applications showed significant changes (p = 0.03). It was -7.5 +/- 4.1% reduction from the initial, but all were in the normal range. There was no report of clinical manifestation of malathion toxicity. Malathion shampoo is safe and effective in the treatment of head lice. There is significant skin absorption so a scalp examination for head lice should be done before subsequent application to avoid unnecessary exposure.

Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

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Koc, M.; Aktas, E. [Ataturk Univ., Erzurum (Turkey). Medical School

2003-02-01

Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

International Nuclear Information System (INIS)

Koc, M.; Aktas, E.

2003-01-01

Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

End-to-end tests using alanine dosimetry in scanned proton beams

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Carlino, A.; Gouldstone, C.; Kragl, G.; Traneus, E.; Marrale, M.; Vatnitsky, S.; Stock, M.; Palmans, H.

2018-03-01

This paper describes end-to-end test procedures as the last fundamental step of medical commissioning before starting clinical operation of the MedAustron synchrotron-based pencil beam scanning (PBS) therapy facility with protons. One in-house homogeneous phantom and two anthropomorphic heterogeneous (head and pelvis) phantoms were used for end-to-end tests at MedAustron. The phantoms were equipped with alanine detectors, radiochromic films and ionization chambers. The correction for the ‘quenching’ effect of alanine pellets was implemented in the Monte Carlo platform of the evaluation version of RayStation TPS. During the end-to-end tests, the phantoms were transferred through the workflow like real patients to simulate the entire clinical workflow: immobilization, imaging, treatment planning and dose delivery. Different clinical scenarios of increasing complexity were simulated: delivery of a single beam, two oblique beams without and with range shifter. In addition to the dose comparison in the plastic phantoms the dose obtained from alanine pellet readings was compared with the dose determined with the Farmer ionization chamber in water. A consistent systematic deviation of about 2% was found between alanine dosimetry and the ionization chamber dosimetry in water and plastic materials. Acceptable agreement of planned and delivered doses was observed together with consistent and reproducible results of the end-to-end testing performed with different dosimetric techniques (alanine detectors, ionization chambers and EBT3 radiochromic films). The results confirmed the adequate implementation and integration of the new PBS technology at MedAustron. This work demonstrates that alanine pellets are suitable detectors for end-to-end tests in proton beam therapy and the developed procedures with customized anthropomorphic phantoms can be used to support implementation of PBS technology in clinical practice.

What are Head Cavities? - A History of Studies on Vertebrate Head Segmentation.

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Kuratani, Shigeru; Adachi, Noritaka

2016-06-01

Motivated by the discovery of segmental epithelial coeloms, or "head cavities," in elasmobranch embryos toward the end of the 19th century, the debate over the presence of mesodermal segments in the vertebrate head became a central problem in comparative embryology. The classical segmental view assumed only one type of metamerism in the vertebrate head, in which each metamere was thought to contain one head somite and one pharyngeal arch, innervated by a set of cranial nerves serially homologous to dorsal and ventral roots of spinal nerves. The non-segmental view, on the other hand, rejected the somite-like properties of head cavities. A series of small mesodermal cysts in early Torpedo embryos, which were thought to represent true somite homologs, provided a third possible view on the nature of the vertebrate head. Recent molecular developmental data have shed new light on the vertebrate head problem, explaining that head mesoderm evolved, not by the modification of rostral somites of an amphioxus-like ancestor, but through the polarization of unspecified paraxial mesoderm into head mesoderm anteriorly and trunk somites posteriorly.

A randomized controlled trial of positioning treatments in infants with positional head shape deformities.

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Hutchison, B Lynne; Stewart, Alistair W; De Chalain, Tristan B; Mitchell, Edwin A

2010-10-01

Randomized controlled trials of treatment for deformational plagiocephaly and brachycephaly have been lacking in the literature. Infants (n = 126) presenting to a plagiocephaly clinic were randomized to either positioning strategies or to positioning plus the use of a Safe T Sleep™ positioning wrap. Head shape was measured using a digital photographic technique, and neck function was assessed. They were followed up at home 3, 6 and 12 months later. There was no difference in head shape outcomes for the two treatment groups after 12 months of follow-up, with 42% of infants having head shapes in the normal range by that time. Eighty per cent of children showed good improvement. Those that had poor improvement were more likely to have both plagiocephaly and brachycephaly and to have presented later to clinic. Most infants improved over the 12-month study period, although the use of a sleep positioning wrap did not increase the rate of improvement. © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

Evaluation of radiotherapy methods for adaptative head and neck treatment with RapidArc®

International Nuclear Information System (INIS)

Mazaro, Sarah J.; Vasconcellos, Herminiane L.; Silva, Laura E. da; Bastos, Fernanda M.; Silva, Leonardo P. da; Alvaro S; Migoviski, Igor

2015-01-01

Head and neck cancer is considered a public health problem worldwide. The intensity-modulated techniques have shown benefit in the treatment of these sites, particularly with respect to reduction of deterministic effects of risk, such as parotid. Anatomical variations in cases of head and neck are very frequent and may lead, for example, to an overdose in the parotid. This can be mitigated if making use of adaptive radiation therapy. The work aims to analyze a methodology to redo the planning of treatments, through 02 acquisitions of TC. The results showed that, due to a reduction in the volumes of the parotid, the doses delivered to these organs are underestimated, which is relevant to readapt the treatment, with the addition of only a second scan without the need of the third. (author)

Treatment of lymphangiomas of the head and neck in children by intralesional injection of OK-432 (Picibanil).

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Brewis, C; Pracy, J P; Albert, D M

2000-04-01

The treatments previously used for lymphangiomas of the head and neck in children-surgery and intralesional injection of sclerosants-are associated with significant morbidity. A new treatment-intralesional injection of OK-432-was used for lymphangiomas of the head and neck in 11 children. The results were total shrinkage in two, marked shrinkage in two, slight shrinkage in five and no response in two. The results were not affected by previous surgery nor by whether aspiration prior to injection was possible. There were no recurrences in those children in whom shrinkage occurred and no child had subsequent surgery following injection. The results of this series support those of previous series showing that OK-432 injection is an effective and safe treatment for lymphangiomas of the head and neck in children.

The treatment of cancer in the head and neck

International Nuclear Information System (INIS)

Sato, Yasuo; Nomura, Yasunari; Kobayashi, Takeo; Inouye, Kenbun; Kumazawa, Akiyoshi

1979-01-01

1,438 cases of head and neck tumors were seen in our clinic during the period from 1965 - 1978. Under our multidisciplinary treatment, average dosage of radiation for nasal-paranasal tumors was 200 rad, for oral-mesopharyngeal tumors 1,800 rad, for nasopharyngeal tumors 2,400 rad, for laryngeal tumors 3,400 rad and for hypopharyngeal tumors 4,400 rad. After reduction of tumor mass and topical cleaning procedure, 1) a dosage of radiation-number of patients curve shifted to lower left, 2) repeated surgeries for recurrences became less frequent, 3) extended surgeries were unnecessary and 4) social rehabilitation of patients was obtained much easier even in aged. Principles of our treatment were simple: short hospitalization and careful long term follow-up. Treatment plan should be decided according to clinical finding and course of illness in each cases. (author)

Targeted therapies and radiation for the treatment of head and neck cancer

International Nuclear Information System (INIS)

Kim, Gwi Eon

2004-01-01

The purpose of this review is to provide an update on novel radiation treatments for head and neck cancer. Despite the remarkable advances in chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) is an appealing target for novel therapies in head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuximab) and tyrosine kinase inhibitors (ZD1839 and OSI-774) have been assessed and have been most extensively studied in preclinical models and clinical trials. Additional TKIs in clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted in rapid translation into the clinic. Results from initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or in combination with chemotherapy. In this review, we begin with a brief summary of erbB-mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinical and clinical data on the role of EGFR antagonists alone or in combination with radiation in the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR blockade and efforts in the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2

Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

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Dupin, Charles, E-mail: c.dupin@bordeaux.unicancer.fr [Department of Radiotherapy, Comprehensive Cancer Center, Institut Bergonié, Bordeaux (France); Lang, Philippe [Department of Radiotherapy, Pitié Salpétrière, Paris (France); Dessard-Diana, Bernadette [Department of Radiotherapy, Hopital Européen Georges Pompidou, Paris (France); Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc [Department of Radiotherapy, Pitié Salpétrière, Paris (France)

2014-06-01

Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm{sup 3} (range, 0.9-243 cm{sup 3}) and 116 cm{sup 3} (range, 24-731 cm{sup 3}), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas.

Experience of using MOSFET detectors for dose verification measurements in an end-to-end 192Ir brachytherapy quality assurance system.

Science.gov (United States)

Persson, Maria; Nilsson, Josef; Carlsson Tedgren, Åsa

Establishment of an end-to-end system for the brachytherapy (BT) dosimetric chain could be valuable in clinical quality assurance. Here, the development of such a system using MOSFET (metal oxide semiconductor field effect transistor) detectors and experience gained during 2 years of use are reported with focus on the performance of the MOSFET detectors. A bolus phantom was constructed with two implants, mimicking prostate and head & neck treatments, using steel needles and plastic catheters to guide the 192 Ir source and house the MOSFET detectors. The phantom was taken through the BT treatment chain from image acquisition to dose evaluation. During the 2-year evaluation-period, delivered doses were verified a total of 56 times using MOSFET detectors which had been calibrated in an external 60 Co beam. An initial experimental investigation on beam quality differences between 192 Ir and 60 Co is reported. The standard deviation in repeated MOSFET measurements was below 3% in the six measurement points with dose levels above 2 Gy. MOSFET measurements overestimated treatment planning system doses by 2-7%. Distance-dependent experimental beam quality correction factors derived in a phantom of similar size as that used for end-to-end tests applied on a time-resolved measurement improved the agreement. MOSFET detectors provide values stable over time and function well for use as detectors for end-to-end quality assurance purposes in 192 Ir BT. Beam quality correction factors should address not only distance from source but also phantom dimensions. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Evaluation of head movement periodicity and irregularity during locomotion of Caenorhabditis elegans

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Ryuzo eShingai

2013-03-01

Full Text Available Caenorhabditis elegans is suitable for studying the nervous system, which controls behavior. C. elegans shows sinusoidal locomotion on an agar plate. The head moves not only sinusoidally but also more complexly, which reflects regulation of the head muscles by the nervous system. The head movement becomes more irregular with senescence. To date, the head movement complexity has not been quantitatively analyzed. We propose two simple methods for evaluation of the head movement regularity on an agar plate using image analysis. The methods calculate metrics that are a measure of how the head end movement is correlated with body movement. In the first method, the length along the trace of the head end on the agar plate between adjacent intersecting points of the head trace and the quasi-midline of the head trace, which was made by sliding an averaging window of 1/2 the body wavelength, was obtained. Histograms of the lengths showed periodic movement of the head and deviation from it. In the second method, the intersections between the trace of the head end and the trace of the 5 (near the pharynx or 50% (the mid-body point from the head end in the centerline length of the worm image were marked. The length of the head trace between adjacent intersections was measured, and a histogram of the lengths was produced. The histogram for the 5% point showed deviation of the head end movement from the movement near the pharynx. The histogram for the 50% point showed deviation of the head movement from the sinusoidal movement of the body center. Application of these methods to wild type and several mutant strains enabled evaluation of their head movement periodicity and irregularity, and revealed a difference in the age-dependence of head movement irregularity between the strains. A set of five parameters obtained from the histograms reliably identifies differences in head movement between strains.

Audiological findings in patients treated with radio- and concomitant chemotherapy for head and neck tumors

International Nuclear Information System (INIS)

Dell'Aringa, Ana Helena B; Isaac, Myrian L; Arruda, Gustavo V; Esteves, Maria Carolina BN; Dell'Aringa, Alfredo Rafael; Júnior, José Luis S; Rodrigues, Alexandre F

2009-01-01

To evaluate the functionality of the auditory system in patients who underwent radiotherapy and chemotherapy treatment with cisplatin to treat head and neck tumors. Case series with planned data collection. From May 2007 to May 2008 by the Department of Otorhinolaryngology and the Department of Oncology/Radiotherapy at Faculdade de Medicina de Marília. Audiological evaluation (Pure Tone Audiometry (air and bone conduction), Speech Audiometry, Tympanometry, Acoustic Reflex testing and Distortion Product Otoacoustic Emissions) was performed in 17 patients diagnosed with head and neck neoplasia and treated with chemotherapy, using cisplatin, and radiotherapy. 12 left ears (70.5%) and 11 right ears (64.7%) presented bilateral decreased hearing soon after the treatment for the frequency 1 kHz (mild auditory damage) and for the frequency 8 kHz (more significant auditory damage). Patients with head and neck cancer submitted to the conventional radiotherapy treatment, combined with the chemotherapy with cisplatin, presented a high incidence of decreased hearing by the end of treatment. Strong evidence was observed linking auditory alteration to the amount of radiotherapy treatment

Cetuximab: its unique place in head and neck cancer treatment

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Specenier P

2013-04-01

Full Text Available Pol Specenier, Jan B Vermorken Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium Abstract: Head and neck cancer is the sixth most common cancer worldwide. At present, globally about 650,000 new cases of squamous cell carcinoma of the head and neck (SCCHN are diagnosed each year. The epidermal growth factor receptor (EGFR is almost invariably expressed in SCCHN. Overexpression of the EGFR is a strong and independent unfavorable prognostic factor in SCCHN. Cetuximab is a chimeric monoclonal antibody, which binds with high affinity to the extracellular domain of the human EGFR, blocking ligand binding, resulting in inhibition of the receptor function. It also targets cytotoxic immune effector cells towards EGFR-expressing tumor cells (antibody dependent cell-mediated cytotoxicity. The addition of cetuximab to radiotherapy (RT improves locoregional control and survival when compared to RT alone. The addition of cetuximab to platinum-based chemoradiation (CRT is feasible but does not lead to an improved outcome. Cetuximab plus RT has never been compared prospectively to CRT, which therefore remains the standard treatment for patients with locoregionally advanced SCCHN for whom surgery is not considered the optimal treatment, provided they can tolerate CRT. The addition of cetuximab to platinum-based chemotherapy prolongs survival in patients with recurrent or metastatic SCCHN. The combination of a platinum-based regimen and cetuximab should be considered as the standard first line regimen for patients who can tolerate this treatment. Keywords: SCCHN, cetuximab, recurrent metastatic, locoregionally advanced, chemoradiation

Outcomes of Vacuum-Assisted Therapy in the Treatment of Head and Neck Wounds.

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Satteson, Ellen S; Crantford, John Clayton; Wood, Jeyhan; David, Lisa R

2015-10-01

Head and neck wounds can present a reconstructive challenge for the plastic surgeon. Whether from skin cancer, trauma, or burns, there are many different treatment modalities used to dress and manage complex head and neck wounds. Vacuum-assisted closure (VAC) therapy has been used on wounds of nearly every aspect of the body but not routinely in the head and neck area. This study was conducted to demonstrate our results using the VAC in the treatment of complex head and neck wounds. This is an IRB-approved, retrospective review of 69 patients with 73 head and neck wounds that were managed using the VAC between 1999 and 2008. The wound mechanism, location, and size, length of VAC therapy, patient comorbidities, use of radiation, complications, and ultimate outcome were assessed. In this patient population, the VAC was utilized because the standard reconstructive ladder was not a good option or had previously failed. Sixty-nine patients with complex head and neck wounds were treated with the wound VAC. The mean age of the patients was 66 years, with a range of 5-96 years. Males outnumbered females in this study nearly 2:1. Eighty-six percent of patients had wounds secondary to cancer, 8% secondary to trauma, 3% secondary to infection, and 3% secondary to burns. The VAC was used as a dressing over skin grafts in 50%, over Integra in 21%, and over open debrided wounds in 29%. Wounds healed without complication in 44% of the skin grafts, 67% of Integra-covered wounds, and 71% of debrided wounds. Minor complications included failure of complete graft take, failure of granulation tissue formation in open debrided wounds, infection, and hematoma formation under skin grafts. Major complications included positive cancer margins requiring reexcision and death secondary to pulmonary embolism, sepsis, and metastatic cancer. Most complications resolved with dressing changes, repeat grafting, or the administration of antibiotics. Our results demonstrate that the wound VAC

Undesirable financial effects of head and neck cancer radiotherapy during the initial treatment period

Directory of Open Access Journals (Sweden)

Helen Egestad

2015-01-01

Full Text Available Background: Healthcare cost and reforms are at the forefront of international debates. One of the current discussion themes in oncology is whether and how patients’ life changes due to costs of cancer care. In Norway, the main part of the treatment costs is supported by general taxpayer revenues. Objectives: The objective of this study was to clarify whether head and neck cancer patients (n=67 in northern Norway experienced financial health-related quality of life (HRQOL deterioration due to costs associated with treatment. Design: HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30 in the beginning and in the end of radiation treatment in patients treated at the University Hospital in Northern Norway. Changes in financial HRQOL were calculated and compared by paired sample T-tests. Multiple regression analyses were used to examine correlations among gender, marital status, age and treatment with or without additional chemotherapy and changes in the HRQOL domain of financial difficulties. Results: The majority of score results at both time points were in the lower range (mean 15–25, indicating limited financial difficulties. We observed no statistically significant differences by gender, marital status and age. Increasing financial difficulties during treatment were reported by male patients and those younger than 65, that is, patients who were younger than retirement age. The largest effect was seen in singles. However, differences were not statistically significant. Conclusions: During the initial phase of the disease trajectory, no significant increase in financial difficulties was found. This is in line with the aims of the Norwegian public healthcare model. However, long-term longitudinal studies should be performed, especially with regard to the trends we observed in single, male and younger patients.

Conceptual design of the alcohol waste treatment equipment

International Nuclear Information System (INIS)

Fujisawa, Morio; Nitta, Kazuhiko; Morita, Yasuhiro; Nakada, Eiju

2001-01-01

This report describes the result of Conceptual Design of the Alcohol Waste Treatment Equipment. The experimental fast Reactor, JOYO, saves the radioactive alcohol waste at storage tank. As this alcohol waste is not able to treat with existing equipment, it is stored about 5 m 3 . And the amount of this is increasing every year. So it is necessary to treat the alcohol waste by chemical resolution for example. On account of this, the investigative test about filtration and dialyzer, and conceptual design about catalyst oxidation process, which is composed from head end process to resolution, are done. The results of investigation show as follows. 1. Investigative Test about filtration and dialyzer. (1) The electric conduction is suitable for the judgement of alkyl sodium hydrolysis Alkyl sodium hydrolysis is completed below 39% alcohol concentration. (2) The microfiltration is likely to separate the solid in alcohol waste. (3) From laboratory test, the electrodialyzer is effective for sodium separation in alcohol waste. And sodium remove rate, 96-99%, is confirmed. 2. Conceptual Design. The candidate process is as follows. (1) The head end process is electrodialyzer, and chemical resolution process is catalyst oxidation. (2) The head end process is not installed, and chemical resolution process is catalyst oxidation. (3) The head end process is electrodialyzer, and alcohol extracted by pervaporation. In this Conceptual Design, as far these process, the components, treatment ability, properties of waste, chemical mass balance, safety for fire and explosion, and the plot plan are investigated. As a result, remodeling the existing facility into catalyst oxidation process is effective to treat the alcohol waste, and treatment ability is about 1.25 l/h. (author)

[Effect of vascular endothelial growth factor and tumor necrosis factor receptor for treatment of avascular necrosis of the femoral head in rabbits].

Science.gov (United States)

Hu, Zhi-ming; Zhou, Ming-qian; Gao, Ji-min

2008-12-01

To evaluate the therapeutic effect of vascular endothelial growth factor (VEGF) and tumor necrosis factor receptor (TNFR) on avascular necrosis of the femoral head in rabbits. Avascular necrosis of the femoral head was induced in 26 New Zealand white rabbits by injections of horse serum and prednisolone. The rabbits were then divided into VEGF/TNFR treatment group, VEGF treatment group, and untreated model group, with another 4 normal rabbits as the normal control group. In the two treatment groups, the therapeutic agents were injected percutaneously into the femoral head. Enzyme-linked immunosorbent assay was performed to determine the concentration of TNF-alpha in rabbit serum followed by pathological examination of the changes in the bone tissues, bone marrow hematopoietic tissue and the blood vessels in the femoral head. Compared with the model group, the rabbits with both VEGF and TNFR treatment showed decreased serum concentration of TNF-alpha with obvious new vessel formation, decreased empty bone lacunae in the femoral head and hematopoietic tissue proliferation in the bone marrow cavity. Percutaneous injection of VEGF and TNFR into the femoral head can significantly enhance bone tissue angiogenesis and ameliorate osteonecrosis in rabbits with experimental femoral head necrosis.

Study of pneumatic hydropulse filter for feed clarification in reprocessing plant head-end

International Nuclear Information System (INIS)

Siddiqui, I.A.; Shah, B.V.; Salunke, S.U.; Kumar, S.V.

1991-01-01

A Pneumatic Hydropulse (PHP) Filter with sintered stainless steel cartridges was tested for suitability in reprocessing plant head-end filtration. The filter was tested with simulated slurry containing between 25 and 400 ppm of calcium carbonate particulates in the size ranges 45 to 53 micron and 53 to 75 micron at varying flow rates. Procedures were developed for dislodging the layer of solids on the cartidridges and regenerating the filter remotely. Application of 5.4 kg/cm 2 air to the dome of the filter during regenaration was found to be optimum for dislodging the particulate layer on the cartridges. No difficulties due to choking of the filter cartridges were experienced during operation and good regeneration by remote operation was possible. Approach velocity at the filter medium was about 6 cm/min. The efficiency of regeneration was better than 90%. Filtration efficiency was found to be better than 90%. Solid loading capacity was found to increase with increase of particle size and feed concentration. (author). 2 figs., 10 tabs

Interrelation of technologies for RW preparation and sites for final isolation of the wastes from pyrochemical processing of SNF

Energy Technology Data Exchange (ETDEWEB)

Gupalo, V.S.; Chistyakov, V.N. [JSC - Design-Prospecting and Scientific-Research Institute of Industrial Technology -, Kashirskoye Highway, 33, Moscow 115409 (Russian Federation); Kormilitsyn, M.V.; Kormilitsyna, L.A. [JSC - State Scientific Center - Research Institute of Atomic Reactors -, Ulyanovsk region, Dimitrovgrad - 10, 433510 (Russian Federation)

2013-07-01

For the justification of engineering solutions and practical testing of the radiochemical component of the perspective nuclear power complex with on-site variant of nuclear fuel cycle (NFC), it is planned to establish a multi-functional research-development complex (MFCRC) for radiochemical processing of spent nuclear fuels (SNF) from fast reactors. MFCRC is being established at the NIIAR site, it comprises technological process lines, where innovation pyro-electrochemical and hydrometallurgical technologies are realized, with an option for closing the inter-chain material flows for testing the combined radiochemically converted materials. The technological flowchart for processing at the MFCRC is subdivided into 3 segments: -) complex of the lead operations for dismantling the fuel elements (FE) and fuel assemblies (FA), -) pyrochemical extraction flowchart for processing SNF, and -) hydrometallurgical flowchart for processing SNF. The engineered solutions for the management and disposition of the radioactive wastes from MFCRC are reviewed.

Use of curium neutron flux from head-end pyroprocessing subsystems for the High Reliability Safeguards methodology

Energy Technology Data Exchange (ETDEWEB)

Borrelli, R.A., E-mail: r.angelo.borrelli@gmail.com

2014-10-01

The deployment of nuclear energy systems (NESs) is expanding around the world. Nations are investing in NESs as a means to establish energy independence, grow national economies, and address climate change. Transitioning to the advanced nuclear fuel cycle can meet growing energy demands and ensure resource sustainability. However, nuclear facilities in all phases of the advanced fuel cycle must be ‘safeguardable,’ where safety, safeguards, and security are integrated into a practical design strategy. To this end, the High Reliability Safeguards (HRS) approach is a continually developing safeguardability methodology that applies intrinsic design features and employs a risk-informed approach for systems assessment that is safeguards-motivated. Currently, a commercial pyroprocessing facility is used as the example system. This paper presents a modeling study that investigates the neutron flux associated with processed materials. The intent of these studies is to determine if the neutron flux will affect facility design, and subsequently, safeguardability. The results presented in this paper are for the head-end subsystems in a pyroprocessing facility. The collective results from these studies will then be used to further develop the HRS methodology.

[Application of virtual reality in surgical treatment of complex head and neck carcinoma].

Science.gov (United States)

Zhou, Y Q; Li, C; Shui, C Y; Cai, Y C; Sun, R H; Zeng, D F; Wang, W; Li, Q L; Huang, L; Tu, J; Jiang, J

2018-01-07

Objective: To investigate the application of virtual reality technology in the preoperative evaluation of complex head and neck carcinoma and he value of virtual reality technology in surgical treatment of head and neck carcinoma. Methods: The image data of eight patients with complex head and neck carcinoma treated from December 2016 to May 2017 was acquired. The data were put into virtual reality system to built the three-dimensional anatomical model of carcinoma and to created the surgical scene. The process of surgery was stimulated by recognizing the relationship between tumor and surrounding important structures. Finally all patients were treated with surgery. And two typical cases were reported. Results: With the help of virtual reality, surgeons could adequately assess the condition of carcinoma and the security of operation and ensured the safety of operations. Conclusions: Virtual reality can provide the surgeons with the sensory experience in virtual surgery scenes and achieve the man-computer cooperation and stereoscopic assessment, which will ensure the safety of surgery. Virtual reality has a huge impact on guiding the traditional surgical procedure of head and neck carcinoma.

Technical-and-economic analysis and optimization of the full flow charts of processing of radioactive wastes on a polyfunctional plant of pyrochemical processing of the spent nuclear fuel of fast reactors

Science.gov (United States)

Gupalo, V. S.; Chistyakov, V. N.; Kormilitsyn, M. V.; Kormilitsyna, L. A.; Osipenko, A. G.

2015-12-01

When considering the full flow charts of processing of radioactive wastes (RAW) on a polyfunctional plant of pyrochemical processing of the spent nuclear fuel of NIIAR fast reactors, we corroborate optimum technical solutions for the preparation of RAW for burial from a standpoint of heat release, dose formation, and technological storage time with allowance for technical-and-economic and ecological indices during the implementation of the analyzed technologies and equipment for processing of all RAW fluxes.

How word-beginnings constrain the pronunciations of word-ends in the reading aloud of English: the phenomena of head- and onset-conditioning

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Anastasia Ulicheva

2015-12-01

Full Text Available Background. A word whose body is pronounced in different ways in different words is body-inconsistent. When we take the unit that precedes the vowel into account for the calculation of body-consistency, the proportion of English words that are body-inconsistent is considerably reduced at the level of corpus analysis, prompting the question of whether humans actually use such head/onset-conditioning when they read.Methods. Four metrics for head/onset-constrained body-consistency were calculated: by the last grapheme of the head, by the last phoneme of the onset, by place and manner of articulation of the last phoneme of the onset, and by manner of articulation of the last phoneme of the onset. Since these were highly correlated, principal component analysis was performed on them.Results. Two out of four resulting principal components explained significant variance in the reading-aloud reaction times, beyond regularity and body-consistency.Discussion. Humans read head/onset-conditioned words faster than would be predicted based on their body-consistency and regularity only. We conclude that humans are sensitive to the dependency between word-beginnings and word-ends when they read aloud, and that this dependency is phonological in nature, rather than orthographic.

Ipsilateral dislocation of the radial head associated with fracture of distal end of the radius: a case report and review of the literature

Directory of Open Access Journals (Sweden)

Gupta Vinay

2013-06-01

Full Text Available 【Abstract】Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for 3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months’ follow-up, the patient had no residual pain at the elbow with full flexion & extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow. Key words: Radial heads; Dislocations; Radius fractures

Mode of treatment affects quality of life in head and neck cancer survivors: Implications for holistic care.

Science.gov (United States)

Bower, Wendy Fiona; Vlantis, Alexander Christopher; Chung, Tiffany M L; Van Hasselt, C Andrew

2010-10-01

As adverse effects of live-saving treatment are unavoidable surgeons have a duty to address physical changes and quality of life issues that matter to head and neck (H&N) cancer patients. We propose a tailored holistic care package. This study compared the quality of life of H&N cancer survivors managed with different approaches in the follow-up phase after initial treatment and identified factors adversely impacting quality of life parameters. H&N cancer patients studied: 1) surgery only, 2) radiotherapy only, 3) surgery and radiotherapy, and 4) any combination of surgery, chemotherapy or radiotherapy. Patients unable to communicate in Cantonese, with thyroid cancer or end-of-life disease were excluded. EORTC QLQ-H&N35 Cantonese version was administered at least 1 year after initial H&N cancer treatment. Quality of life impairment was worse in all of the domains for combination therapy versus monotherapy patients. Scores between surgery or radiotherapy-only patients were not significantly different. Radiotherapy preceding surgery impacted significantly more on speech than surgery before the radiotherapy. Patients with advanced disease had more impairment of quality of life in each domain than patients with early disease. Coughing, eating problems, sticky saliva, and difficulties with social contact were all significant predictors of problems associated with a dry mouth.

All-in-one theranostic nanoagent for head and neck cancer treatment

Science.gov (United States)

Dreifuss, Tamar; Davidi, Erez Shmuel; Motiei, Menachem; Barnoy, Eran; Bragilovski, Dimitri; Lubimov, Leon; Kindler, Marc Jose Jonathan; Popovtzer, Aron; Popovtzer, Rachela

2018-02-01

Despite the significant improvement in the treatment paradigm of head and neck cancer, owing to advanced radiation techniques in combination with chemotherapy, resistance of tumors remains a critical problem, leading to poor outcomes and negative prognosis. In addition, chemotherapeutic agents result in severe systemic toxicity due to nonselective damaging of normal cells. Recently, nanoparticle-based approaches have gained broad attention for improving both radiation therapy and chemotherapy. In this study, we present a dual effect nanoplatform, consists of gold nanoparticles coated with glucose and cisplatin (CG-GNPs), which simultaneously acts as a radiosensitizer and as a carrier which specifically deliver cisplatin to head and neck tumor. Our CG-GNPs showed significant penetration into tumor cells and similar cellular toxicity as cisplatin alone. Moreover, in combination with radiation treatment, CG-GNPs led to greater tumor reduction than that of free cisplatin with radiation. Furthermore, our CG-GNPs also demonstrated highly efficient imaging capabilities, as they act as ideal tumor-targeted CT contrast agent. Therefore, this single nano-formulation is a promising theranostic agent that has the potential to increase the antitumor effect and allow imaging guided therapy.

Hybrid disassembly system for cellular telephone end-of-life treatment

Energy Technology Data Exchange (ETDEWEB)

Kniebel, M.; Basdere, B.; Seliger, G. [Technical Univ. Berlin, Inst. for Machine Tools and Factory Management, Dept. of Assembly Technology and Factory Management, Berlin (Germany)

2004-07-01

Concern over the negative environmental impacts associated with the production, use, and end-of-life (EOL) of cellular telephones is particularly high due to large production volumes and characteristically short time scales of technological and stylistic obsolescence. Landfilled or incinerated cellular telephones create the potential for release of toxic substances. The European legislation has passed the directive on Waste of Electrical and Electronic Equipment (WEEE) to regulate their collection and appropriate end-of-life treatment. Manufacturers must conduct material recycling or remanufacturing processes to recover resources. While recovery rates can hardly be met economically by material recycling, remanufacturing and reusing cellular phones is developing into a reasonable alternative. Both end-of-life options require disassembly processes for WEEE compliant treatment. Due to the high number of different cell phone variants and their typical design that fits components into tight enclosing spaces, cellular phone disassembly becomes a challenging task. These challenges and the expected high numbers of phones to be returned in the course of the WEEE urges for automated disassembly. A hybrid disassembly system has been developed to ensure the mass-treatment of obsolete cellular phones. It has been integrated into a prototypical remanufacturing factory for cellular phones that has been planned based on market data. (orig.)

Failure pattern and salvage treatment after radical treatment of head and neck cancer

DEFF Research Database (Denmark)

Pagh, Anja; Grau, Cai; Overgaard, Jens

2016-01-01

Purpose The aim of the study was to test the hypothesis that head and neck cancer (HNC) patients benefit from specialized follow-up (FU), as this strategy ensures timely detection of relapses for successful salvage treatment. This was done by evaluation of the pattern of failure, the temporal...... recordings of recurrent disease in 567 patients with primary tumors of the larynx, pharynx, oral cavity, nasal cavity, paranasal sinuses and salivary glands. A review of medical records was performed in order to update and supplement the database. Results Failures of the 567 patients were primarily in T...

Assessment and Treatment Considerations for Post Traumatic Stress Disorder at End of Life.

Science.gov (United States)

Glick, Debra M; Cook, Joan M; Moye, Jennifer; Kaiser, Anica Pless

2018-01-01

Post traumatic stress disorder (PTSD) may first emerge, reemerge, or worsen as individuals approach end of life and may complicate the dying process. Unfortunately, lack of awareness of the occurrence and/or manifestation of PTSD at end of life can lead to PTSD going unaddressed. Even if PTSD is properly diagnosed, traditional evidence-based trauma-focused treatments may not be feasible or advisable with this group as many patients at end of life often lack the physical and mental stamina to participate in traditional psychotherapy. This article reviews the clinical and empirical literature on PTSD at end of life, as well as discusses assessment and psychotherapy treatment issues with this neglected population. In addition, it expands on the current reviews of this literature 1-3 by extrapolating results from nontraditional treatment approaches with other patient populations. Elements of these approaches with patients sharing similar characteristics and/or comorbidities with patients with PTSD at end of life may provide additional benefits for the latter population. Clinical implications and suggestions for interdisciplinary care providers are provided.

Endovascular treatment of head and neck arteriovenous malformations

Energy Technology Data Exchange (ETDEWEB)

Dmytriw, A.A. [University Health Network, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Ter Brugge, K.G.; Krings, T.; Agid, R. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario (Canada)

2014-03-15

Head and neck arteriovenous malformations (H and N AVM) are associated with considerable clinical and psychosocial burden and present a significant treatment challenge. We evaluated the presentation, response to treatment, and outcome of patients with H and N AVMs treated by endovascular means at our institution. Patients with H and N AVMs treated by endovascular means from 1984 to 2012 were evaluated retrospectively. These included AVMs involving the scalp, orbit, maxillofacial, and upper neck localizations. Patient's clinical files, radiological images, catheter angiograms, and surgical reports were reviewed. Eighty-nine patients with H and N AVMs (46 females, 43 males; 48 small, 41 large) received endovascular therapy. The goals of treatment were curative (n = 30), palliative (n = 34), or presurgical (n = 25). The total number of endovascular treatment sessions was 244 (average of 1.5 per patient). The goal of treatment was met in 92.1 % of cases. Eventual cure was achieved in 42 patients accounting for 58.4 % (52/89) of all patients who underwent treatment for any goal. Twenty-eight of these patients were cured by embolization alone (28/89, 31.4 %) of which 18 were single-hole AVFs. Twenty-four were cured by planned surgical excision after presurgical embolization (24/89, 27 %). Seven patients (7/89, 7.2 %) suffered transient and two (2/89, 2.2 %) permanent endovascular treatment complications. Endovascular treatment is effective for H and N AVMs and relatively safe. It is particularly effective for symptom palliation and presurgical aid. Embolization is curative mostly in small lesions and single-hole fistulas. In patients with large non-curable H and N AVMs, endovascular therapy is often the only palliative option. (orig.)

Effect of Pretreatment Anemia on Treatment Outcome of Concurrent Radiochemotherapy in Patients With Head and Neck Cancer

International Nuclear Information System (INIS)

Fortin, Andre; Wang Changshu; Vigneault, Eric

2008-01-01

Purpose: To investigate the effect of anemia on outcome of treatment with radiochemotherapy in patients with head-and-neck cancer. Methods and Materials: The data of 196 patients with Stage II-IV head-and-neck cancer treated with concomitant cisplatin-based radiochemotherapy were retrospectively reviewed. Anemia was defined according to World Health Organization criteria as hemoglobin 140 g/L. Conclusions: Anemia was strongly associated with local control and survival in this cohort of patients with head-and-neck cancer receiving radiochemotherapy

Current state and future of photodynamic therapy for the treatment of head and neck squamous cell carcinoma

Directory of Open Access Journals (Sweden)

Christina Mimikos

2016-06-01

Full Text Available Photodynamic therapy has shown promise in the treatment of early head and neck squamous cell carcinoma (SCC. In photodynamic therapy (PDT, a light sensitive drug (photosensitizer and visible light cause cancer cell death by the creation of singlet oxygen and free radicals, inciting an immune response, and vascular collapse. In this paper, we review several studies that demonstrate the effectiveness of PDT in the treatment of early stage SCC of the head and neck, with some showing a similar response rate to surgery. Two cases are presented to illustrate the effectiveness of PDT. Then, new advances are discussed including the discovery of STAT3 crosslinking as a potential biomarker for PDT response and interstitial PDT for locally advanced cancers. Keywords: Photodynamic therapy, PDT, Squamous cell carcinoma, Head and neck cancer

A tissue engineering strategy for the treatment of avascular necrosis of the femoral head.

Science.gov (United States)

Aarvold, A; Smith, J O; Tayton, E R; Jones, A M H; Dawson, J I; Lanham, S; Briscoe, A; Dunlop, D G; Oreffo, R O C

2013-12-01

Skeletal stem cells (SSCs) and impaction bone grafting (IBG) can be combined to produce a mechanically stable living bone composite. This novel strategy has been translated to the treatment of avascular necrosis of the femoral head. Surgical technique, clinical follow-up and retrieval analysis data of this translational case series is presented. SSCs and milled allograft were impacted into necrotic bone in five femoral heads of four patients. Cell viability was confirmed by parallel in vitro culture of the cell-graft constructs. Patient follow-up was by serial clinical and radiological examination. Tissue engineered bone was retrieved from two retrieved femoral heads and was analysed by histology, microcomputed tomography (μCT) and mechanical testing. Three patients remain asymptomatic at 22- to 44-month follow-up. One patient (both hips) required total hip replacement due to widespread residual necrosis. Retrieved tissue engineered bone demonstrated a mature trabecular micro-architecture histologically and on μCT. Bone density and axial compression strength were comparable to trabecular bone. Clinical follow-up shows this to be an effective new treatment for focal early stage avascular necrosis of the femoral head. Unique retrieval analysis of clinically translated tissue engineered bone has demonstrated regeneration of tissue that is both structurally and functionally analogous to normal trabecular bone. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Evaluation of Radiation-induced Class V Dental Caries in Patients with Head and Neck Cancers Undergoing Radiotherapy.

Science.gov (United States)

Mohammadi, Narmin; Seyednejad, Farshad; Oskoee, Parnian Alizadeh; Savadi Oskoee, Siavash; Ebrahimi Chaharom, Mohammad Esmaeil

2008-01-01

Salivary glands are very susceptible to radiation and any disturbances in their function are detrimental to the hard tissues in the oral cavity. The aim of this study was to evaluate posterior class V dental caries in patients with head and neck cancers undergoing radiotherapy. In this study, twenty seven patients undergoing conventional radiotherapy were included. Class V dental caries of posterior teeth in these patients were evaluated in three intervals: before treatment, 3 weeks after the initiation of the treatment, and at the end of the treatment. Differences of mean caries activity between intervals were evaluated using paired sample t-test. There were no class V decays prior to radiotherapy. Mean percentage of class V caries three weeks after radiotherapy and at the end of radiotherapy were 28.42% ± 14.41 and 67.05% ± 19.02, respectively. There were statistically signifi-cant differences in mean values among three stages (P = 0.00025). The results of the present study re-vealed that radiotherapy in patients with head and neck cancers causes class V dental caries on posteri-or teeth.

A Review of Recent Advances in the Diagnosis and Treatment Modalities for Long Head of Bicep Tendinopathy

Directory of Open Access Journals (Sweden)

Robert B. Lewis

2016-01-01

Full Text Available This article reviews the assessment and management of the pathology of the long head of the biceps tendon, a disease commonly encountered by primary care physicians and orthopedic surgeons. We include a discussion of relevant anatomy, function, pathoanatomy, natural history of the disease, diagnostic methods, and treatment options. Recent literature on the function of the long head of the bicep (LHB is reviewed. Literature on our evolving understanding of the pathoanatomy behind LHB tendinopathy is discussed. We also discuss the effectiveness of current diagnostic and treatment modalities.

Smoking has a negative impact upon health related quality of life after treatment for head and neck cancer

DEFF Research Database (Denmark)

Jensen, Kenneth; Jensen, Anders Bonde; Grau, Cai

2006-01-01

To examine the influence of smoking on observer based morbidity scores and patient assessed health related quality of life after treatment for head and neck cancer. The results of EORTC C30 and H&N35 questionnaires and DAHANCA morbidity scores were studied according to smoking status in 114...... recurrence free head and neck cancer patients. In contrast to observer based toxicity scoring, smoking had a significantly negative influence on 20 of the 33 quality of life scales. Previous smokers had quality of life scores in between never smokers and continuous smokers. Smoking after treatment of head...... and neck cancer adversely influenced a wide range of quality of life endpoints. Quitters had better quality of life than patients who continued to smoke after treatment, suggesting that smoking cessation may improve quality of life in addition to reducing the risk of new cancer. Udgivelsesdato: 2007-Feb...

Poster — Thur Eve — 29: Characterization of Patient Immobilization for Head and Neck Cancer Treatment

International Nuclear Information System (INIS)

Courneyea, L; Mullins, J; Howard, M; Beltran, C; Brinkmann, D; Pafundi, D

2014-01-01

Purpose: Evaluate an immobilization system to determine its adequacy for the reduced margins required for proton therapy. Methods: Twelve head-and-neck cancer patients were immobilized for conventional photon radiotherapy and imaged with pre- and post-treatment cone beam CTs (CBCTs) for each treatment fraction. To quantify the patient positioning reproducibility, each CBCT was registered to the simulation CT offline. Registrations were performed using auto-match tools and a matching volume-of-interest (VOI) consisting of a 5mm expansion around the mandible, occipital bone, C1/C2 and C7/T1. For each registration, the bony anatomy in the VOI was evaluated for agreement with the simulation position using 3 and 5mm margins. Registrations were initially restricted to translational corrections. If the bony anatomy did not agree with the simulation position to within 3mm or 5mm, the auto-match was repeated with 3 additional rotational corrections. Intrafraction motion was calculated as the difference between the pre- and post-treatment CBCT matches. Results: Pre-treatment patient positioning agreed with the simulation CT to within 3mm/5mm for 62%/86% of fractions using translational matching and 84%/100% of fractions when rotations were included. Intrafraction motion averaged 1.1±0.8mm, with 12% of fractions having >2mm intrafraction motion. Post-treatment positioning accuracy was 57%/84% and 80%/100% for registrations without/with rotations. For the mandible, positioning accuracy dropped from 93% pre-treatment to 82% post-treatment. Conclusion: If rotational corrections are available, the immobilization system studied created reproducible patient positioning to within 3mm for 84% of fractions. However, intrafraction motion caused additional anatomy to fall outside the 3mm margin by the end of treatment

Poster — Thur Eve — 29: Characterization of Patient Immobilization for Head and Neck Cancer Treatment

Energy Technology Data Exchange (ETDEWEB)

Courneyea, L; Mullins, J; Howard, M; Beltran, C; Brinkmann, D; Pafundi, D [Mayo Clinic, Rochester, MN (United States)

2014-08-15

Purpose: Evaluate an immobilization system to determine its adequacy for the reduced margins required for proton therapy. Methods: Twelve head-and-neck cancer patients were immobilized for conventional photon radiotherapy and imaged with pre- and post-treatment cone beam CTs (CBCTs) for each treatment fraction. To quantify the patient positioning reproducibility, each CBCT was registered to the simulation CT offline. Registrations were performed using auto-match tools and a matching volume-of-interest (VOI) consisting of a 5mm expansion around the mandible, occipital bone, C1/C2 and C7/T1. For each registration, the bony anatomy in the VOI was evaluated for agreement with the simulation position using 3 and 5mm margins. Registrations were initially restricted to translational corrections. If the bony anatomy did not agree with the simulation position to within 3mm or 5mm, the auto-match was repeated with 3 additional rotational corrections. Intrafraction motion was calculated as the difference between the pre- and post-treatment CBCT matches. Results: Pre-treatment patient positioning agreed with the simulation CT to within 3mm/5mm for 62%/86% of fractions using translational matching and 84%/100% of fractions when rotations were included. Intrafraction motion averaged 1.1±0.8mm, with 12% of fractions having >2mm intrafraction motion. Post-treatment positioning accuracy was 57%/84% and 80%/100% for registrations without/with rotations. For the mandible, positioning accuracy dropped from 93% pre-treatment to 82% post-treatment. Conclusion: If rotational corrections are available, the immobilization system studied created reproducible patient positioning to within 3mm for 84% of fractions. However, intrafraction motion caused additional anatomy to fall outside the 3mm margin by the end of treatment.

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association ... MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging ( ...

Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT

International Nuclear Information System (INIS)

Visser, Ruurd; Wauben, David J.L.; Groot, Martijn de; Steenbakkers, Roel J.H.M.; Bijl, Henk P.; Godart, Jeremy; Veld, Aart A. van’t; Langendijk, Johannes A.; Korevaar, Erik W.

2014-01-01

Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT. Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance. Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure. Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA

Management of somatic pain induced by head-and-neck cancer treatment: definition and assessment. Guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (SFORL).

Science.gov (United States)

Binczak, M; Navez, M; Perrichon, C; Blanchard, D; Bollet, M; Calmels, P; Couturaud, C; Dreyer, C; Espitalier, F; Testelin, S; Albert, S; Morinière, S

2014-09-01

The authors present the guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (Société Française d'Oto-rhino-Laryngologie et de Chirurgie de la Face et du Cou [SFORL]) for the management of somatic pain induced by head-and-neck cancer treatment, and in particular the instruments needed for the definition and initial assessment of the various types of pain. A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. The priority is to eliminate tumoral recurrence when pain reappears or changes following head-and-neck cancer treatment. Neuropathic pain screening instruments and pain assessment scales should be used to assess pain intensity and treatment efficacy. Functional rehabilitation sessions should be prescribed to reduce musculoskeletal pain and prevent ankylosis and postural disorder. Psychotherapy and mind-body therapy, when available, should be provided in case of chronic pain. In case of recalcitrant complex pain, referral should be made to a multidisciplinary pain structure. The management of somatic pain induced by head-and-neck cancer treatment above all requires identifying and assessing the intensity of the various types of pain involved, their functional impact and their emotional component. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

Directory of Open Access Journals (Sweden)

Silveira, Marta Halina

2014-12-01

Full Text Available Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL. Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women who had undergone exclusive radiotherapy (25.5% or concomitant chemoradiotherapy (74.5% from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.

Cryotherapy and radiotherapy combination in extensive and recurrent types of head and neck skin cancer treatment

International Nuclear Information System (INIS)

Pustynskij, I.N.; Paches, A.I.; Tkachev, S.I.; Tabolinovskaya, T.D.; Alieva, S.B.; Yagubov, A.S.; Slanina, S.V.; Bazhutova, G.A.

2007-01-01

The method of infiltrative skin cancer treatment based on different variants of radiotherapy and cryotherapy combination is described. During the period of 1988-2006 the Department of head and neck neoplasms of N. N. Blohin Russian Cancer Research Center provided radiation and cryogenic treatment of 94 patients with locally advanced head and neck epidermoid and basal cell cancer. For this purpose before every radiotherapy session the tumor was exposed to cryo cooling till freezing temperature (-5 degrees C). The total involution of tumors was observed at 91 patients. Residual tumors were removed surgically. The follow-up showed good functional and aesthetic results, retention of local tissues.

Intensity of treatment in Swiss cancer patients at the end-of-life

Directory of Open Access Journals (Sweden)

Bähler C

2018-03-01

Full Text Available Caroline Bähler,1 Andri Signorell,1 Eva Blozik,1,2 Oliver Reich1 1Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland; 2Department of Medicine, University Medical Centre Freiburg, Freiburg im Breisgau, Germany Purpose: Current evidence on the care-delivering process and the intensity of treatment at the end-of-life of cancer patients is limited and remains unclear. Our objective was to examine the care-delivering processes in health care during the last months of life with real-life data of Swiss cancer patients. Patients and methods: The study population consisted of adult decedents in 2014 who were insured at Helsana Group. Data on the final cause of death were provided additionally by the Swiss Federal Statistical Office. Of the 10,275 decedents, 2,710 (26.4% died of cancer. Intensity of treatment and health care utilization (including transitions at their end-of-life were examined. Intensity measures included the following: last dose of chemotherapy within 14 days of death, a new chemotherapy regimen starting <30 days before death, more than one hospital admission or spending >14 days in hospital in the last month, death in an acute care hospital, more than one emergency visit and ≥1 intensive care unit admission in the last month of life. Results: In the last 6 months of life, 89.5% of cancer patients had ≥1 transition, with 87.2% being hospitalized. Within 30 days before death, 64.2% of the decedents had ≥1 intensive treatment, whereby 8.9% started a new chemotherapy. In the multinomial logistic regression model, older age, higher density of nursing home beds and home care nurses were associated with a decrease, while living in the Italian- or French-speaking part of Switzerland was associated with an increase in intensive care. Conclusion: Swiss cancer patients insured by Helsana Group experience a considerable number of transitions and intensive treatments at the end-of-life, whereby treatment intensity

Aging Prisoners' Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?

Science.gov (United States)

Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald

2011-01-01

Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated…

Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting

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Babhulkar Sudhir

2009-01-01

Full Text Available Background: Femoral head-preserving core decompression and bone grafting have shown excellent result in preventing collapse. The use of vascularized grafts have shown better clinical results. The vascular pedicle bone graft is an easy to perform operation and does not require special equipment. We analyzed and report a series of patients of osteonecrosis of femoral head treated by core decompression and vascular pedicle grafting of part of iliac crest based on deep circumflex iliac vessels. Materials and Methods: The article comprises of the retrospective study of 31 patients of osteonecrosis of femoral head in stage II and III treated with core decompression and vascular pedicle grafting by using part of iliac crest with deep circumflex iliac vessels from January 1990 to December 2005. The young patients with a mean age 32 years (18-52 years with a minimum follow-up of five years were included for analysis. Sixteen patients had osteonecrosis following alcohol abuse, 12 patients following corticosteroid consumption, 3 patients had idiopathic osteonecrosis. Nine patients were stage IIB, and 22 patients were stage IIIC according to ARCO′s system. The core decompression and vascular pedicle grafting was performed by anterior approach by using part of iliac crest with deep circumflex iliac vessels. Results: Digital subtraction arteriography performed in 9 patients at the end of 12 weeks showed the patency of deep circumflex artery in all cases, and bone scan performed in 6 other patients showed high uptake in the grafted area of the femoral head proving the efficacy of the operative procedure. Out of 31 patients, only one patient progressed to collapse and total joint replacement was advised. At the final follow up period of 5-8 years, Harris Hip Score improved mean ± SD of 28.2 ± 6.4 ( p < 0.05. Forty-eight percent of patients had an improvement in Harris Hip Score of more that 28 points. Conclusion: The core decompression and vascular pedicle

ACSEPT-Partitioning technologies and actinide science: Towards pilot facilities in Europe

International Nuclear Information System (INIS)

Bourg, S.; Hill, C.; Caravaca, C.; Rhodes, C.; Ekberg, C.; Taylor, R.; Geist, A.; Modolo, G.; Cassayre, L.; Malmbeck, R.; Harrison, M.; Angelis, G. de; Espartero, A.; Bouvet, S.; Ouvrier, N.

2011-01-01

Highlights: → ACSEPT works at developing actinide separation processes for advanced fuel cycles. → ACSEPT develops both aqueous and pyrochemical actinide separation processes. → Homogeneous and heterogeneous recycling strategies are both considered in ACSEPT. → Training and education in actinide chemistry are important issues addressed by ACSEPT. - Abstract: Actinide recycling by separation and transmutation is considered worldwide and particularly in several European countries as one of the most promising strategies to reduce the inventory of radioactive waste and to optimise the use of natural resources. With its multidisciplinary consortium of 34 partners from 12 European countries plus Australia and Japan, the European Research Project ACSEPT (Actinide reCycling by SEParation and Transmutation) aims at contributing to the development of this strategy by studying both hydrometallurgical and pyrochemical partitioning routes. ACSEPT is organised into three technical domains: (i)Considering technically mature aqueous separation processes, ACSEPT works to optimise and select the most promising ones dedicated either to actinide partitioning (for the heterogeneous recycling of actinides in ADS target or specific actinide bearing blanket fuels in fast reactor) or to grouped actinide separation (for the homogeneous recycling of the actinides in fast reactor fuels). In addition, dissolution and conversion studies are underway taking into account the specific requirements of these specific fuels. (ii)Concerning pyrochemical separation processes, ACSEPT focuses on the enhancement of the two reference cores processes selected within FP6-EUROPART. R and D efforts are also devoted to key scientific and technical issues compulsory to set up a complete separation process (head-end steps, salt treatment for recycling and waste management). (iii)By integrating all the experimental results in engineering and system studies, both in hydro and pyro domains, ACSEPT will

Initial results of CyberKnife treatment for recurrent previously irradiated head and neck cancer

International Nuclear Information System (INIS)

Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi

2003-01-01

The purpose of this study was to evaluate the efficacy of CyberKnife for recurrent previously irradiated head and neck cancer. Thirty-one patients with recurrent previously irradiated head and neck cancer were treated with a CyberKnife from July 1999 to March 2002 at Okayama Kyokuto Hospital were retrospectively studied. The accumulated dose was 28-80 Gy (median 60 Gy). The interval between CyberKnife treatment and previous radiotherapy was 0.4-429.5 months (median 16.3 months). Primary lesions were nasopharynx: 7, maxillary sinus: 6, tongue: 5, ethmoid sinus: 3, and others: 1. The pathology was squamous cell carcinoma: 25, adenoid cystic carcinoma: 4, and others: 2. Symptoms were pain: 8, and nasal bleeding: 2. The prescribed dose was 15.0-40.3 Gy (median 32.3 Gy) as for the marginal dose. The response rate (complete response (CR)+partial response (PR)) and local control rate (CR+PR+no change (NC)) was 74% and 94% respectively. Pain disappeared for 4 cases, relief was obtained for 4 cases and no change for 2 cases and nasal bleeding disappeared for 2 cases for an improvement of symptoms. An adverse effects were observed as mucositis in 5 cases and neck swelling in one case. Prognosis of recurrent previously irradiated head and neck cancer was estimated as poor. Our early experience shows that CyberKnife is expected to be feasible treatment for recurrent previously irradiated head and neck cancer, and for the reduction adverse effects and maintenance of useful quality of life (QOL) for patients. (author)

Articular reconstruction of the humeral head with autogenous allograft in the treatment of the osteonecrosis

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Alberto Naoki Miyazaki

Full Text Available ABSTRACT The authors describe a surgical biological reconstruction of the humeral head with frozen autogenous allograft technique for the treatment of young patients with focal osteonecrosis of the humeral head. This represents a possible alternative, maybe even definitive for some patients, when compared to hemiarthroplasty or total shoulder arthroplasty. The technique consists of the fixation of a frozen autogenous allograft with previously-molded articular cartilage from the humeral head, after cleansing the osteonecrotic focus. Five patients under 50 years of age were treated, with three very satisfactory results, one patient was lost to follow-up, and one patient had an unsatisfactory result (converted to hemiarthroplasty. The study describes the technique in detail and the three cases with a longer follow-up time.

Docetaxel in the treatment of squamous cell carcinoma of the head and neck

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Alexander Rapidis

2008-11-01

Full Text Available Alexander Rapidis1, Nicholas Sarlis2, Jean-Louis Lefebvre3, Merrill Kies41Department of Maxillofacial Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece; 2Department of Medical Affairs, Oncology – US Sanofi-Aventis, Bridgewater, NJ, USA; 3Head and Neck Department, Centre Régional de Lutte Contre le Cancer de Lille, Lille, France; 4Department of Thoracic/Head and Neck Medical Oncology, The University of Texas – M.D. Anderson Cancer Center, Houston, TX, USAAbstract: Squamous cell carcinoma of the head and neck (SCCHN presents at a locally advanced (LA stage in many patients. Chemotherapy has been successfully integrated into first-line treatment programs, either during or prior to radiotherapy (RT – the cornerstone modality for local disease control of inoperable disease or when organ preservation is desired. Concomitant chemoradiotherapy (CCRT provides an absolute survival benefit when compared with other types of locoregional therapy that exclude chemotherapy. Nonetheless, distant metastases still represent the most common cause of treatment failure. Consequently, adding induction chemotherapy (ICT to definitive non-surgical local therapies with a curative intent has been vigorously explored in LA SCCHN. Recently, it has been shown that ICT using the combination of the taxane docetaxel with cisplatin–5-fluorouracil provides significant survival benefit over cisplatin–5-FU, when used before either definitive RT (TAX323 trial or carboplatin-based CCRT (TAX324 trial. Docetaxel is also being investigated in metastatic or recurrent (M/R disease, with promising initial results. It is very likely that the future management strategies of SCCHN will incorporate biologic agents as an add-on to docetaxel-containing schemas, administered either as ICT prior to CCRT in the LA setting or for the management of M/R disease.Keywords: chemoradiotherapy, chemotherapy, docetaxel, head and neck carcinoma, induction, locally

Noncompliance to guidelines in head and neck cancer treatment; associated factors for both patient and physician

International Nuclear Information System (INIS)

Dronkers, Emilie A. C.; Mes, Steven W.; Wieringa, Marjan H.; Schroeff, Marc P. van der; Baatenburg de Jong, Robert J.

2015-01-01

Decisions on head and neck squamous cell carcinoma (HNSCC) treatment are widely recognized as being difficult, due to high morbidity, often involving vital functions. Some patients may therefore decline standard, curative treatment. In addition doctors may propose alternative, nonstandard treatments. Little attention is devoted, both in literature and in daily practice, to understanding why and when HNSCC patients or their physicians decline standard, curative treatment modalities. Our objective is to determine factors associated with noncompliance in head and neck cancer treatment for both patients and physicians and to assess the influence of patient compliance on prognosis. We did a retrospective study based on the medical records of 829 patients with primary HNSCC, who were eligible for curative treatment and referred to our hospital between 2010 and 2012. We analyzed treatment choice and reasons for nonstandard treatment decisions, survival, age, gender, social network, tumor site, cTNM classification, and comorbidity (ACE27). Multivariate analysis using logistic regression methods was performed to determine predictive factors associated with non-standard treatment following physician or patient decision. To gain insight in survival of the different groups of patients, we applied a Cox regression analysis. After checking the proportional hazards assumption for each variable, we adjusted the survival analysis for gender, age, tumor site, tumor stage, comorbidity and a history of having a prior tumor. 17 % of all patients with a primary HNSCC did not receive standard curative treatment, either due to nonstandard treatment advice (10 %) or due to the patient choosing an alternative (7 %). A further 3 % of all patients refused any type of therapy, even though they were considered eligible for curative treatment. Elderliness, single marital status, female gender, high tumor stage and severe comorbidity are predictive factors. Patients declining standard treatment

Linking computer-aided design (CAD) to Geant4-based Monte Carlo simulations for precise implementation of complex treatment head geometries

International Nuclear Information System (INIS)

Constantin, Magdalena; Constantin, Dragos E; Keall, Paul J; Narula, Anisha; Svatos, Michelle; Perl, Joseph

2010-01-01

Most of the treatment head components of medical linear accelerators used in radiation therapy have complex geometrical shapes. They are typically designed using computer-aided design (CAD) applications. In Monte Carlo simulations of radiotherapy beam transport through the treatment head components, the relevant beam-generating and beam-modifying devices are inserted in the simulation toolkit using geometrical approximations of these components. Depending on their complexity, such approximations may introduce errors that can be propagated throughout the simulation. This drawback can be minimized by exporting a more precise geometry of the linac components from CAD and importing it into the Monte Carlo simulation environment. We present a technique that links three-dimensional CAD drawings of the treatment head components to Geant4 Monte Carlo simulations of dose deposition. (note)

Fluorination of incinerator ash by hydrofluorination or ammonium bifluoride fusion for plutonium recovery

Energy Technology Data Exchange (ETDEWEB)

Fink, S.D.; Gray, J.H.; Kent, S.J.; Apgar, S.A.

1989-01-01

Incinerator ash containing small quantities of plutonium has been accumulating across the defense complex for many years. Although the total Pu inventory is small, the ash is a nondiscardable residue which presents storage and accountability difficulties. The work discussed here is the result of a joint exploratory effort between members of Savannah River Laboratory and Los Alamos National Laboratory to compare two proposed pyrochemical pretreatments of incinerator ash prior to aqueous processing. These experiments attempted to determine the relative effectiveness of hydrofluorination and ammonium bifluoride fusion as head-end operations for a two step aqueous recovery method. The two pretreatments are being considered as possible second generation enhancements for the New Special Recovery Facility nearing operation at Savannah River Plant. Experimental results and potential engineering concerns are discussed. 3 figs.

Computer-assisted planning and dosimetry for radiation treatment of head and neck cancer in Cameroon

International Nuclear Information System (INIS)

Yomi, J.; Ngniah, A.; Kingue, S.; Muna, W.F.T.; Durosinmi-Etti, F.A.

1995-01-01

This evaluation was part of a multicenter, multinational study sponsored by the International Agency for Atomic Energy (Vienna) to investigate a simple, reliable computer-assisted planning and dosimetry system for radiation treatment of head and neck cancers in developing countries. Over a 13-month period (April 1992-April 1993), 120 patients with histologically-proven head or neck cancer were included in the evaluation. In each patient, planning and dosimetry were done both manually and using the computer-assisted system. The manual and computerized systems were compared on the basis of accuracy of determination of the outer contour, target volume, and critical organs; volume inequality resolution; structure heterogeneity correction; selection of the number, angle, and size of beams; treatment time calculation; availability of dosimetry predictions; and duration and cost of the procedure. Results demonstrated that the computer-assisted procedure was superior over the manual procedure, despite less than optimal software. The accuracy provided by the completely computerized procedure is indispensable for Level II radiation therapy, which is particularly useful in tumors of the sensitive, complex structures in the head and neck. (authors). 7 refs., 3 tabs

[Can the prophylactic treatment of mycotic mucositis improve the time of performing radiotherapy in head and neck tumors?].

Science.gov (United States)

Gava, A; Ferrarese, F; Tonetto, V; Coghetto, F; Marazzato, G; Zorat, P L

1996-04-01

Radiotherapy-related mucositis is the most frequent complication in the patients submitted to irradiation for head and neck cancers. Many such patients may develop mycotic infections which may lead to treatment discontinuation, with possible consequences on the local control of these cancers. In this study, we investigated the efficacy of fluconazole in preventing mycotic mucositis in 80 patients undergoing radiation therapy for head and neck cancers. The patients were randomized to two groups: 41 patients in group A received the supporting treatment we usually administer, plus fluconazole (50 mg/day) starting from the 6th irradiation session throughout the treatment; 39 patients in group B received the same baseline treatment, but were given the drug only when mycotic infections appeared. The clinical characteristics, treated sites, treatment doses and volumes were similar in the two groups of patients. Fluconazole was well tolerated and no early or late toxicity was observed. We had 1 mycotic mucositis and 14 non-scheduled treatment discontinuations in group A, vs. 19 and 30, respectively, in group B. Radiation therapy lasted 52.3 days (mean) in group A and 55.6 days (mean) in group B; the differences were statistically significant. In our experience, fluconazole, used prophylactically from the 6th radiotherapy session on, reduced the number of mycotic infections and improved radiotherapy schedule in our head and neck cancer patients.

Impact of Treatment Subsidies and Cash Payouts on Treatment Choices at the End of Life.

Science.gov (United States)

Finkelstein, Eric; Malhotra, Chetna; Chay, Junxing; Ozdemir, Semra; Chopra, Akhil; Kanesvaran, Ravindran

To examine the extent to which financial assistance, in the form of subsidies for life-extending treatments (LETs) or cash payouts, distorts the demand for end-of-life treatments. A discrete choice experiment was administered to 290 patients with cancer in Singapore to elicit preferences for LETs and only palliative care (PC). Responses were fitted to a latent class conditional logistic regression model. We also quantified patients' willingness to pay to avoid and willingness to accept a less effective LET or PC-only. We then simulated the effects of various LET subsidy and cash payout policies on treatment choices. We identified three classes of patients according to their preferences. The first class (26.1% of the sample) had a strong preference for PC and were willing to give up life expectancy gains and even pay for receiving only PC. The second class (29.8% of the sample) had a strong preference for LETs and preferred to extend life regardless of cost or quality of life. The final class (44.1% of the sample) preferred LETs to PC, but actively traded off costs and length and quality of life when making end-of-life treatment choices. Policy simulations showed that LET subsidies increase demand for LETs at the expense of demand for PC, but an equivalent cash payout was not shown to distort demand. Patients with cancer have heterogeneous end-of-life preferences. LET subsidies and cash payouts have differing effects on the use of LETs. Policymakers should be mindful of these differences when designing health care financing schemes for patients with life-limiting illnesses. Copyright © 2016. Published by Elsevier Inc.

Influence of timer end-effects on Gamma knife (Type B) treatment

International Nuclear Information System (INIS)

Baba, Sadaaki; Ito, Teruo; Toyoda, Tatsuya; Wakamatsu, Osamu; Machida, Toru

2004-01-01

We investigated the influence of timer end-effects retrospectively in cases treated with Gamma knife (Type B) in the first year and in the fifth year after installation. Objects were 113 cases from April 1997 to December 1997 and 230 cases between January 2001 and December 2001. The influence of timer end-effects was calculated in the following formula: influence of timer end-effects=Σ (timer end-effects/shot time)/(number of lesions x number of shots). Ten factors such as the output at the center of polystyrene sphere phantom, the number of lesions, the number of shots, the delivered maximum absorbed dose, total irradiation time and the frequency in the use of each collimator helmet were examined as factors of the influence. The average values of timer end-effects were 4.7±0.27, 4.3±0.27, 3.6±0.24 and 3.5±0.29%/min. for 18, 14, 8 and 4 mm collimator helmets, respectively and depended on field size. We believe that the unit '%/min.' must be accepted instead of '%'. Gamma knife treatment is stereotactic radiosurgery and 40-50 Gy is irradiated within several hours with about ten shots. So the influence of timer end-effects was calculated 0.82±0.80% in 1997 and 0.51±0.41% in 2001 on average. These data suggest that there was little influence on the treatment. These figures were average values per lesion, so the influence may be more complicated in each part of lesions. The difference between the influence of timer end-effects in 1997 and 2001 was considered to be caused by the elongation of shot time according to Cobalt-60 decay, the reduction of the number of shots by frequent use of 14 mm collimator helmet, and the restriction of the number of treated lesions. (author)

Selective Trapping of Volatile Fission Products with an Off-Gas Treatment System

Energy Technology Data Exchange (ETDEWEB)

B.R. Westphal; J.J. Park; J.M. Shin; G.I. Park; K.J. Bateman; D.L. Wahlquist

2008-07-01

A head-end processing step, termed DEOX for its emphasis on decladding via oxidation, is being developed for the treatment of spent oxide fuel by pyroprocessing techniques. The head-end step employs high temperatures to oxidize UO2 to U3O8 resulting in the separation of fuel from cladding and the removal of volatile fission products. Development of the head-end step is being performed in collaboration with the Korean Atomic Energy Research Institute (KAERI) through an International Nuclear Energy Research Initiative. Following the initial experimentation for the removal of volatile fission products, an off-gas treatment system was designed in conjunction with KAERI to collect specific fission gases. The primary volatile species targeted for trapping were iodine, technetium, and cesium. Each species is intended to be collected in distinct zones of the off-gas system and within those zones, on individual filters. Separation of the volatile off-gases is achieved thermally as well as chemically given the composition of the filter media. A description of the filter media and a basis for its selection will be given along with the collection mechanisms and design considerations. In addition, results from testing with the off-gas treatment system will be presented.

Management of somatic pain induced by treatment of head and neck cancer: Postoperative pain. Guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL).

Science.gov (United States)

Espitalier, F; Testelin, S; Blanchard, D; Binczak, M; Bollet, M; Calmels, P; Couturaud, C; Dreyer, C; Navez, M; Perrichon, C; Morinière, S; Albert, S

2014-09-01

To present the guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL) concerning the management of somatic pain induced by the treatment of head and neck cancer, and in particular the management of early and late post-surgical pain. A multidisciplinary work group conducted a review of the scientific literature on the study topic. An editorial group subsequently read the resulting guidelines before validation. It is recommended to prevent onset of pain caused by malpositioning on the operating table, as well as pain related to postoperative care. During surgery, it is recommended to spare nerve and muscle structures as far as possible to limit painful sequelae. Management of early postoperative pain upon tumor resection and flap harvesting sites requires patient-controlled analgesia by morphine pump. Physical therapy is recommended after flap harvesting to minimize painful sequelae. Preventive and curative measures should be undertaken for appropriate management of post-surgical pain in the treatment of head and neck cancers. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Nonsurgical treatment of aggressive fibromatosis in the head and neck

International Nuclear Information System (INIS)

West, C.B. Jr.; Shagets, F.W.; Mansfield, M.J.

1989-01-01

Aggressive fibromatosis is a poorly defined, locally aggressive, yet histologically benign fibroblastic proliferative lesion that may occur in the head and neck. The lesion is highly cellular and locally infiltrative and has a propensity to invade and erode bone, compromising vital structures within the head and neck. However, it is not a true malignancy because it does not have malignant cytologic characteristics nor does it metastasize. We present two cases of aggressive fibromatosis occurring in young adult men. The first case involved a rapidly enlarging mass of the anterior maxilla that involved the upper lip, nasal alae, nasal septum, inferior turbinates, and hard palate. The patient underwent incisional biopsy to confirm the diagnosis. Because of difficulty in determining the actual margins of this extensive lesion and the significant morbidity that would have resulted from surgical resection, we elected to treat this patient with chemotherapy and radiation therapy. The second case was an extensive lesion involving the right temporal bone, pterygomaxillary space, and infratemporal, temporal, and middle cranial fossae. Incisional biopsy confirmed the diagnosis. Because of the lack of functional and cosmetic deficits and the unavoidable morbidity of a surgical resection, this patient was treated with radiation therapy. Although wide field resection is the most satisfactory form of treatment, in situations in which this modality would result in unacceptable morbidity or if surgical margins are positive, then radiation therapy and chemotherapy should be considered. Support for these therapeutic modalities is found in larger series of cases outside the head and neck

Evaluation of radiation-induced Class V dental caries in patients with head and neck cancers undergoing radiotherapy

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Siavash Savadi Oskoee

2008-07-01

Full Text Available Background and aims. Salivary glands are very susceptible to radiation and any disturbances in their function are detrimental to the hard tissues in the oral cavity. The aim of this study was to evaluate posterior class V dental caries in patients with head and neck cancers undergoing radiotherapy. Materials and methods. In this study, twenty seven patients undergoing conventional radiotherapy were included. Class V dental caries of posterior teeth in these patients were evaluated in three intervals: before treatment, 3 weeks after the initiation of the treatment, and at the end of the treatment. Differences of mean caries activity between intervals were evaluated using paired sample t-test. Results. There were no class V decays prior to radiotherapy. Mean percentage of class V caries three weeks after radiotherapy and at the end of radiotherapy were 28.42% ± 14.41 and 67.05% ± 19.02, respectively. There were statistically significant differences in mean values among three stages (P = 0.00025. Conclusion. The results of the present study revealed that radiotherapy in patients with head and neck cancers causes class V dental caries on posterior teeth.

Fission Product Separation from Pyrochemical Electrolyte by Cold Finger Melt Crystallization

Energy Technology Data Exchange (ETDEWEB)

Versey, Joshua R. [Univ. of Idaho, Moscow, ID (United States)

2013-08-01

This work contributes to the development of pyroprocessing technology as an economically viable means of separating used nuclear fuel from fission products and cladding materials. Electrolytic oxide reduction is used as a head-end step before electrorefining to reduce oxide fuel to metallic form. The electrolytic medium used in this technique is molten LiCl-Li2O. Groups I and II fission products, such as cesium (Cs) and strontium (Sr), have been shown to partition from the fuel into the molten LiCl-Li2O. Various approaches of separating these fission products from the salt have been investigated by different research groups. One promising approach is based on a layer crystallization method studied at the Korea Atomic Energy Research Institute (KAERI). Despite successful demonstration of this basic approach, there are questions that remain, especially concerning the development of economical and scalable operating parameters based on a comprehensive understanding of heat and mass transfer. This research explores these parameters through a series of experiments in which LiCl is purified, by concentrating CsCl in a liquid phase as purified LiCl is crystallized and removed via an argon-cooled cold finger.

Experience on treatment of acute head injury combined with optic nerve damage

International Nuclear Information System (INIS)

Gao Heng; Feng Dongxia; Ma Yuanpin; Chen Jinqing

2000-01-01

Objective: To investigate the therapeutic principle for the management of acute head injury combined with optic nerve damage. Method: the clinical data of treatment and prognosis from 24 patients, in which 15 received operative and 9 conservative measures were collected and analyzed. Results: In 15 operated cases, the vision of 10 cases including one with blindness before operation was improved obviously, while those of other 5 did not get any improvement. In 9 conservatively treated cases, the vision was improved in 4 cases, deteriorated in 4 case and no change in 1 case with blindness after injury. Conclusion: One the optic nerve damage has been manifested by clinical or radiological evidences in acute head injury patients, despite it was primary or secondary reason, surgical optic nerve bone canal decompression should be done as soon as possible

General principles for treatment planning for squamous cell carcinoma of the head and neck

International Nuclear Information System (INIS)

Million, R.R.; Bova, F.J.

1987-01-01

Although squamous cell carcinoma of the head and neck represents only 5% of all malignancies, the head and neck area is one of the few anatomical areas remaining where radiotherapy is often used as the only modality for cure and often with substantial doses. There are at least 35 separate anatomical sites for origin of squamous cell carcinoma in the upper respiratory tract, and each site has its own distinctive pattern of spread, incidence of regional and distant metastases, and varying stages of presentation. It would be impossible in this short chapter to cover every contingency for treatment planning, and only general principles are outlined

HPV Positive Head and Neck Cancers: Molecular Pathogenesis and Evolving Treatment Strategies

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Rüveyda Dok

2016-03-01

Full Text Available Head and neck squamous cell carcinoma (HNSCC is a highly heterogeneous disease that is the result of tobacco and/or alcohol abuse or infection with high-risk Human papillomaviruses. Despite the fact that HPV positive HNSCC cancers form a distinct clinical entity with better treatment outcome, all HNSCC are currently treated uniformly with the same treatment modality. At present, biologic basis of these different outcomes and their therapeutic influence are areas of intense investigation. In this review, we will summarize the molecular basis for this different outcome, novel treatment opportunities and possible biomarkers for HPV positive HNSCC. In particular, the focus will be on several molecular targeted strategies that can improve the chemoradiation response by influencing DNA repair mechanisms.

Housing First or no housing? Housing and homelessness at the end of alcohol and drug treatment.

Science.gov (United States)

Dyb, Evelyn

2016-10-01

The rate of alcohol and drug dependency is high among homeless persons in Norway as well as in other Western societies. National homeless surveys also show a certain correlation between discharge from institutions and homelessness. However, the rate of homelessness versus the rate with fixed abode at the end of specialised alcohol and drug treatment has not been examined using quantitative methods. A cross-sectional survey was conducted in alcohol and drug treatment units in the national health services and private clinics. The survey investigates the housing outcome at the end of treatment compared to the situation at the start of treatment using an individual questionnaire for patients ending treatment in a specific time window. Housing outcome is measured by the odds ratio of having a fixed abode at the end of treatment in relation to main intoxicating substance, type of treatment (in- and outpatient), completing versus cutting short the treatment, housing situation at the start of treatment, socioeconomic capital, mental health problems, individual plan, medical assisted treatment, and a set of background variables. The housing versus homeless situation hardly changes during the treatment period. In both a bivariate analysis and a simple multivariate model, principal intoxicating substance is the strongest predictor of having a fixed abode both before and after treatment. However, a more sophisticated analysis indicates that socioeconomic resources and social capital play along with the preferred intoxicating substance as predictors of having permanent housing. After more than a decade of a housing-led national homeless policy, and wide embracement of Housing First approaches in the European Union, homeless persons entering specialised alcohol and drug treatment are likely to return to the streets and hostels at the end of treatment. Access to housing after treatment is very limited for those lacking resources to solve their housing problem without assistance

Open-ended and Open-door Treatment Groups for Young People with Mental Illness.

Science.gov (United States)

Miller, Rachel; Mason, Susan E

2012-01-01

The concept of open-ended groups is expanded to include an open-door model (OEOD) wherein members with severe mental illnesses, including schizophrenia disorders and bi-polar, can join, leave, and re-enter groups as their life circumstances dictate their availability and willingness for treatment. This model is grounded on the work of Schopler and Galinsky's (1984/2006) and Galinsky and Schopler's (1989) theses on the value and processes of open-ended groups and includes perspectives on mutual aid and group development. Groupwork with the OEOD format is illustrated with examples taken from a group of 79 participants diagnosed with first-episode schizophrenia/schizoaffective disorders, 40 of who had co-occurring substance abuse. Of the 79 participants in the OEOD group program, 70 (89%) remained in treatment for the maximum of 3 years. The over-all value of group treatment for this population is reviewed along with the small number of available publications on open-ended and open-door-type groups.

Boron Neutron Capture Therapy in the Treatment of Locally Recurred Head and Neck Cancer

International Nuclear Information System (INIS)

Kankaanranta, Leena; Seppaelae, Tiina; Koivunoro, Hanna; Saarilahti, Kauko; Atula, Timo; Collan, Juhani; Salli, Eero; Kortesniemi, Mika; Uusi-Simola, Jouni; Maekitie, Antti; Seppaenen, Marko; Minn, Heikki; Kotiluoto, Petri; Auterinen, Iiro; Savolainen, Sauli; Kouri, Mauri; Joensuu, Heikki

2007-01-01

Purpose: Head and neck carcinomas that recur locally after conventional irradiation pose a difficult therapeutic problem. We evaluated safety and efficacy of boron neutron capture therapy (BNCT) in the treatment of such cancers. Methods and Materials: Twelve patients with inoperable, recurred, locally advanced (rT3, rT4, or rN2) head and neck cancer were treated with BNCT in a prospective, single-center Phase I-II study. Prior treatments consisted of surgery and conventionally fractionated photon irradiation to a cumulative dose of 56-74 Gy administered with or without concomitant chemotherapy. Tumor responses were assessed using the RECIST (Response Evaluation Criteria in Solid Tumors) criteria and adverse effects using the National Cancer Institute common toxicity grading v3.0. Intravenously administered boronophenylalanine-fructose (BPA-F, 400 mg/kg) was used as the boron carrier. Each patient was scheduled to be treated twice with BNCT. Results: Ten patients received BNCT twice; 2 were treated once. Ten (83%) patients responded to BNCT, and 2 (17%) had tumor growth stabilization for 5.5 and 7.6 months. The median duration of response was 12.1 months; six responses were ongoing at the time of analysis or death (range, 4.9-19.2 months). Four (33%) patients were alive without recurrence with a median follow-up of 14.0 months (range, 12.8-19.2 months). The most common acute adverse effects were mucositis, fatigue, and local pain; 2 patients had a severe (Grade 3) late adverse effect (xerostomia, 1; dysphagia, 1). Conclusions: Boron neutron capture therapy is effective and safe in the treatment of inoperable, locally advanced head and neck carcinomas that recur at previously irradiated sites

Role of growth hormone in stunted head growth after cranial irradiation

Energy Technology Data Exchange (ETDEWEB)

Clayton, P E; Shalet, S M; Price, D A; Surtees, R A; Pearson, D

1987-10-01

The head sizes of 38 patients, growth hormone (GH) deficient following craniospinal (n = 26) or cranial irradiation (n = 12), have been assessed before (n = 38) and on completion of GH therapy (n = 15) or at the end of a similar period of observation without GH (n = 7). These results were compared to the change in head size seen in idiopathic GH deficiency following GH therapy (n = 14). Before GH therapy, the latter had small heads (mean occipitofrontal circumference SD score (SDS) -1), which were relatively large compared to the height deficit (height SDS (CA) -4.7), and they exhibited catch-up growth with GH (delta occipitofrontal circumference SDS + 0.7, final occipitofrontal circumference SDS -0.2). In contrast, over a similar period all patients, who previously had received cranial irradiation in the dosage range 2700-4750 centi-Geigy, irrespective of the radiation schedule or GH treatment, showed a decrease in occipitofrontal circumference SDS (mean delta -0.9), a significant difference to the expected head growth of normal children over a similar period (p less than 0.01). We have noted that restricted head growth occurs in the years following cranial irradiation and is unaffected by GH therapy. Earlier work has shown that cranial irradiation may impair intelligence. The exact relationship between intellectual impairment and stunted head growth remains to be determined.

Electrochemical reduction of CerMet fuels for transmutation using surrogate CeO2-Mo pellets

Science.gov (United States)

Claux, B.; Souček, P.; Malmbeck, R.; Rodrigues, A.; Glatz, J.-P.

2017-08-01

One of the concepts chosen for the transmutation of minor actinides in Accelerator Driven Systems or fast reactors proposes the use of fuels and targets containing minor actinides oxides embedded in an inert matrix either composed of molybdenum metal (CerMet fuel) or of ceramic magnesium oxide (CerCer fuel). Since the sufficient transmutation cannot be achieved in a single step, it requires multi-recycling of the fuel including recovery of the not transmuted minor actinides. In the present work, a pyrochemical process for treatment of Mo metal inert matrix based CerMet fuels is studied, particularly the electroreduction in molten chloride salt as a head-end step required prior the main separation process. At the initial stage, different inactive pellets simulating the fuel containing CeO2 as minor actinide surrogates were examined. The main studied parameters of the process efficiency were the porosity and composition of the pellets and the process parameters as current density and passed charge. The results indicated the feasibility of the process, gave insight into its limiting parameters and defined the parameters for the future experiment on minor actinide containing material.

Swing of the Surgical Pendulum: A Return to Surgery for Treatment of Head and Neck Cancer in the 21st Century?

International Nuclear Information System (INIS)

Holsinger, F. Christopher; Weber, Randal S.

2007-01-01

Treatment for head and neck cancer has evolved significantly during the past 100 years. Beginning with Bilroth's total laryngectomy on New Year's Day in 1873, 'radical' surgery remained the only accepted treatment for head and neck cancer when optimal local and regional control was the goal. Bigger was still better when it came to managing the primary tumor and the neck. The 'commando' procedure and radical neck dissection were the hallmarks of this first generation of treatments of head-and-neck cancer. With the advent of microvascular reconstructive techniques, larger and more comprehensive resections could be performed. Despite these large resections and their 'mutilating' sequelae, overall survival did not improve. Even for intermediate-stage disease in head-and-neck cancer, the 5-year survival rate did not improve >50%. Many concluded that more than the scalpel was needed for optimal local and regional control, especially for intermediate- and advanced-stage disease. Most important, the multidisciplinary teams must identify and correlate biomarkers in the tumor and host that predict for a response to therapy and for optimal functional recovery. As the pendulum swings back, a scientific approach using tissue biomarkers for the response to treatment in the setting of multidisciplinary trials must emerge as the new paradigm. In the postgenomic era, treatment decisions should be made based on functional and oncologic parameters-not just to avoid perceived morbidity

Advanced Cancer and End-of-Life Preferences: Curative Intent Surgery Versus Noncurative Intent Treatment.

Science.gov (United States)

Schubart, Jane R; Green, Michael J; Van Scoy, Lauren J; Lehman, Erik; Farace, Elana; Gusani, Niraj J; Levi, Benjamin H

2015-12-01

People with cancer face complex medical decisions, including whether to receive life-sustaining treatments at the end of life. It is not unusual for clinicians to make assumptions about patients' wishes based on whether they had previously chosen to pursue curative treatment. We hypothesized that cancer patients who initially underwent curative intent surgery (CIS) would prefer more aggressive end-of-life treatments compared to patients whose treatment was noncurative intent (non-CIT). This study was a retrospective review of data from a large, randomized controlled trial examining the use of an online decision aid for advance care planning, "Making Your Wishes Known" (MYWK), with patients who had advanced cancer. We reviewed patients' medical records to determine which patients underwent CIS versus non-CIT. In the parent trial, conducted at an academic medical center (2007-2012), 200 patients were enrolled with stage IV malignancy or other poor prognosis cancer. Patients' preferences for aggressive treatment were measured in two ways: using patient-selected General Wishes statements generated by the decision aid and patient-selected wishes for specific treatments under various hypothetical clinical scenarios (Specific Wishes). We evaluated 79 patients. Of these, 48 had undergone initial CIS and 31 had non-CIT. Cancer patients who initially underwent CIS did not prefer more aggressive end-of-life treatments compared to patients whose treatment was non-CIT. Clinicians should avoid assumptions about patients' preferences for life-sustaining treatment based on their prior choices for aggressive treatment.

A randomized study of accelerated fractionation radiotherapy with and without mitomycin C in the treatment of locally advanced head and neck cancer

DEFF Research Database (Denmark)

Ezzat, M.; Shouman, T.; Zaza, K.

2005-01-01

Objectives: This single-institution study evaluates the feasibility of accelerated fractionation radiotherapy (AF) with and without mitomycin C (MMC) in the treatment of locally advanced head and neck cancer. Patients and Methods: Between May 1998 and October 2001, sixty patients with locally...... advanced stage III and IV of head and neck cancer were randomized into three treatment arms: (1) conventional fractionation radiotherapy (CF) (5 fractions per week); (2) accelerated fractionation radiotherapy (AF) (6 fractions per week); and (3) AF plus Mitomycin C (MMC). Results: The 2-year overall....... Key Words: Head and Neck cancer , Radiotherapy , Altered fractionation , Mitomycin C....

Poster - 44: Development and implementation of a comprehensive end-to-end testing methodology for linac-based frameless SRS QA using a modified commercial stereotactic anthropomorphic phantom

Energy Technology Data Exchange (ETDEWEB)

Liu, Derek; Mutanga, Theodore [University of Toronto, Carlo Fidani Peel Regional Cancer Center (Canada)

2016-08-15

Purpose: An end-to-end testing methodology was designed to evaluate the overall SRS treatment fidelity, incorporating all steps in the linac-based frameless radiosurgery treatment delivery process. The study details our commissioning experience of the Steev (CIRS, Norfolk, VA) stereotactic anthropomorphic head phantom including modification, test design, and baseline measurements. Methods: Repeated MR and CT scans were performed with interchanging inserts. MR-CT fusion accuracy was evaluated and the insert spatial coincidence was verified on CT. Five non-coplanar arcs delivered a prescription dose to a 15 mm spherical CTV with 2 mm PTV margin. Following setup, CBCT-based shifts were applied as per protocol. Sequential measurements were performed by interchanging inserts without disturbing the setup. Spatial and dosimetric accuracy was assessed by a combination of CBCT hidden target, radiochromic film, and ion chamber measurements. To facilitate film registration, the film insert was modified in-house by etching marks. Results: MR fusion error and insert spatial coincidences were within 0.3 mm. Both CBCT and film measurements showed spatial displacements of 1.0 mm in similar directions. Both coronal and sagittal films reported 2.3 % higher target dose relative to the treatment plan. The corrected ion chamber measurement was similarly greater by 1.0 %. The 3 %/2 mm gamma pass rate was 99% for both films Conclusions: A comprehensive end-to-end testing methodology was implemented for our SRS QA program. The Steev phantom enabled realistic evaluation of the entire treatment process. Overall spatial and dosimetric accuracy of the delivery were 1 mm and 3 % respectively.

Weekly Docetaxel, Cisplatin, and Cetuximab in Palliative Treatment of Patients with Squamous Cell Carcinoma of the Head and Neck.

Science.gov (United States)

Trieu, Vanessa; Pinto, Harlan; Riess, Jonathan W; Lira, Ruth; Luciano, Richard; Coty, Jessie; Boothroyd, Derek; Colevas, A Dimitrios

2018-03-14

Chemotherapy for recurrent, metastatic squamous cell carcinoma of the head and neck need not be known for extreme toxicity.The weekly regimen studied here has been demonstrated to be tolerable and effective. The objective of this study was to establish the response rate, progression-free survival (PFS) and overall survival (OS), and safety profile of weekly docetaxel, platinum, and cetuximab (TPC) in patients with relapsed or metastatic squamous cell carcinoma of the head and neck (SCCHN). Twenty-nine patients with metastatic or recurrent SCCHN with an Eastern Cooperative Oncology Group (ECOG) performance status <3 were enrolled in an institutional review board-approved phase II trial. This study permitted prior chemoradiation, radiation, and/or surgery, provided that 3 months had elapsed since the end of the potentially curative treatment. Patients received cisplatin 30 mg/m 2 or carboplatin area under the curve (AUC) 2, docetaxel 30 mg/m 2 , and cetuximab 250 mg/m 2 weekly for 3 weeks, followed by a break during the fourth week, for a 28-day cycle. Planned intrapatient dose modifications were based on individual toxicity. Twenty-seven patients received TPC and were evaluable for response and toxicity. Rates of complete response (CR), partial response (PR), and confirmed PR were 3%, 52%, and 30%, respectively. The overall objective response rate was 56%. Estimated median PFS and OS were 4.8 and 14.7 months, respectively. The rates of grade 3 and 4 worst-grade adverse events (AEs) per patient were 85% and 7%, respectively. Dose density through cycle 4 was preserved for all patients; however, treatment beyond cycle 6 with the TPC regimen proved unfeasible. Weekly docetaxel, cisplatin, and cetuximab is an effective regimen for patients with metastatic or recurrent SCCHN. Response rates, PFS, and OS compare favorably with other combination chemotherapy treatments. Grade 4 toxicity rates observed in this study were substantially lower than those described with regimens

Reactor vessel head permanent shield

International Nuclear Information System (INIS)

Hankinson, M.F.; Leduc, R.J.; Richard, J.W.; Malandra, L.J.

1989-01-01

A nuclear reactor is described comprising: a nuclear reactor pressure vessel closure head; control rod drive mechanisms (CRDMs) disposed within the closure head so as to project vertically above the closure head; cooling air baffle means surrounding the control rod drive mechanisms for defining cooling air paths relative to the control rod drive mechanisms; means defined within the periphery of the closure head for accommodating fastening means for securing the closure head to its associated pressure vessel; lifting lugs fixedly secured to the closure head for facilitating lifting and lowering movements of the closure head relative to the pressure vessel; lift rods respectively operatively associated with the plurality of lifting lugs for transmitting load forces, developed during the lifting and lowering movements of the closure head, to the lifting lugs; upstanding radiation shield means interposed between the cooling air baffle means and the periphery of the enclosure head of shielding maintenance personnel operatively working upon the closure head fastening means from the effects of radiation which may emanate from the control rod drive mechanisms and the cooling air baffle means; and connecting systems respectively associated with each one of the lifting lugs and each one of the lifting rods for connecting each one of the lifting rods to a respective one of each one of the lifting lugs, and for simultaneously connecting a lower end portion of the upstanding radiation shield means to each one of the respective lifting lugs

Impact of dysphagia on quality of life after treatment of head-and-neck cancer

International Nuclear Information System (INIS)

Nguyen, Nam P.; Frank, Cheryl; Moltz, Candace C.; Vos, Paul; Smith, Herbert J.; Karlsson, Ulf; Dutta, Suresh; Midyett, Allan; Barloon, Jessica; Sallah, Sabah

2005-01-01

Purpose: To evaluate the quality of life (QOL) associated with dysphagia after head-and-neck cancer treatment. Methods and materials: Of a total population of 104, a retrospective analysis of 73 patients who complained of dysphagia after primary radiotherapy (RT), chemoradiotherapy, and postoperative RT for head-and-neck malignancies were evaluated. All patients underwent a modified barium swallow examination to assess the severity of dysphagia, graded on a scale of 1-7. QOL was evaluated by the University of Washington (UW) and Hospital Anxiety and Depression questionnaires. The QOL scores obtained were compared with those from the 31 patients who were free of dysphagia after treatment. The QOL scores were also graded according to the dysphagia severity. Results: The UW and Hospital Anxiety and Depression scores were reduced and elevated, respectively, in the dysphagia group compared with the no dysphagia group (p = 0.0005). The UW scores were also substantially lower among patients with moderate-to-severe (Grade 4-7) compared with no or mild (Grade 2-3) dysphagia (p = 0.0005). The corresponding Hospital Anxiety (p = 0.005) and Depression (p = 0.0001) scores were also greater for the moderate-to-severe group. The UW QOL subscale scores showed a statistically significant decrease for swallowing (p = 0.00005), speech (p = 0.0005), recreation/entertainment (p = 0.0005), disfigurement (p = 0.0006), activity (p = 0.005), eating (p = 0.002), shoulder disability (p = 0.006), and pain (p = 0.004). Conclusion: Dysphagia is a significant morbidity of head-and-neck cancer treatment, and the severity of dysphagia correlated with a compromised QOL, anxiety, and depression. Patients with moderate-to-severe dysphagia require a team approach involving nutritional support, physical therapy, speech rehabilitation, pain management, and psychological counseling

Development of a vacuum distillation process for Pu pyro-chemistry spent salts treatment

International Nuclear Information System (INIS)

Bourges, G.; Lambertin, D.; Baudrot, C.; Pescayre, L.; Thiebaut, C.

2004-01-01

The pyrochemical purification of plutonium has generated spent salts, which are disposed in nuclear facility. To reduce stored quantities, the development of a pyrochemical treatment is in progress. The feed salt, typically composed of various Pu and Am species spread into monovalent or divalent chloride matrix, is first oxidized to convert the actinides into oxides. Then the chlorides are separated from the actinide oxides by vacuum distillation. Temperatures higher than 750 deg C for mono-chloride salts mixture NaCl/KCl and higher than 1100 deg C for divalent CaCl 2 base salts, are required to produce an industrial flow of vaporization. Inactive qualification of the process for NaCl/KCl base salt has been carried with lanthanide surrogates. Then, a pilot equipment, called Distillator has been designed and built for production-scale distillation of NaCl/KCl and CaCl 2 oxidized plutonium salts. Industrial flows of vaporization have been obtained with this pilot equipment: about 4 g/cm 2 /h for NaCl/KCl at 800 - 900 deg C and 1 Pa, and more than 1.5 g/cm 2 /h for CaCl 2 base salts between 1000 - 1200 deg C at 0.1 Pa. The last step will be the integration of the Distillator into a glove box. (authors)

A model for emergency department end-of-life communications after acute devastating events--part II: moving from resuscitative to end-of-life or palliative treatment.

Science.gov (United States)

Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

2012-11-01

The model for emergency department (ED) end-of-life communications after acute devastating events addresses decision-making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end-of-life treatments. After completing the steps involved in determining decision-making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end-of-life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them. © 2012 by the Society for Academic Emergency Medicine.

Swallowing therapy and progressive resistance training in head and neck cancer patients undergoing radiotherapy treatment

DEFF Research Database (Denmark)

Hajdú, Sara F; Wessel, Irene; Johansen, Christoffer

2017-01-01

BACKGROUND: Head and neck cancer (HNC) patients are often challenged by treatment induced dysphagia and trismus. Traditionally, rehabilitation is initiated when loss of function has already occurred. There is increasing evidence that it is of benefit to patients to initiate an early rehabilitation...... process before and during treatment. HNC patients have a unique set of functional challenges such as pre- and post-treatment dysphagia, pain and weight loss. The aim of the trial is to investigate the effects of swallowing and mouth-opening exercises combined with progressive resistance training (PRT...

Radiotherapy through intensity modulation (IMRT). A new modality in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Besa de C, Pelayo; Venencia M, Daniel

2006-01-01

Objective: To describe the treatment and evaluate the advantages of IMRT in the treatment of head and neck cancer. Material and methods: Four years ago, at the Cancer Center of the Pontificia Universidad Catolica, the IMRT technique for the treatment of head and neck tumors was implemented. The IMRT technique is based on modifying the intensity of the radiation beam through a multisheet collimator in order to produce a more exact distribution in the radiation doses. The results are evaluated with dose/ volume histograms. The distributions of doses and toxicity for tridimensional con formed therapy (CRT-3D) and IMRT are compared. Results: The distribution of the dose in the dose/volume histograms showed a better coverage of the white volume (PTV), with IMRT. The doses received by the organs under risk: salivary glands, eyes, ears and brain diminish with IMRT. The spinal marrow is protected with IMRT without dividing the treatment area, preventing points with lower dosage that could reduce control of the tumor. Conclusions: IMRT achieves a better conformation of the dose obtaining a better coverage of the tumor and higher protection of the organs under risk

Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

Science.gov (United States)

Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

2017-07-01

The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

Trunnion Failure of the Recalled Low Friction Ion Treatment Cobalt Chromium Alloy Femoral Head.

Science.gov (United States)

Urish, Kenneth L; Hamlin, Brian R; Plakseychuk, Anton Y; Levison, Timothy J; Higgs, Genymphas B; Kurtz, Steven M; DiGioia, Anthony M

2017-09-01

Gross trunnion failure (GTF) is a rare complication in total hip arthroplasty (THA) reported across a range of manufacturers. Specific lots of the Stryker low friction ion treatment (LFIT) anatomic cobalt chromium alloy (CoCr) V40 femoral head were recalled in August 2016. In part, the recall was based out of concerns for disassociation of the femoral head from the stem and GTF. We report on 28 patients (30 implants) with either GTF (n = 18) or head-neck taper corrosion (n = 12) of the LFIT CoCr femoral head and the Accolade titanium-molybdenum-zirconium-iron alloy femoral stems. All these cases were associated with adverse local tissue reactions requiring revision of the THA. In our series, a conservative estimate of the incidence of failure was 4.7% (n = 636 total implanted) at 8.0 ± 1.4 years from the index procedure. Failures were associated with a high-offset 127° femoral stem neck angle and increased neck lengths; 43.3% (13 of 30) of the observed failures included implant sizes outside the voluntary recall (27.8% [5 of 18] of the GTF and 75.0% [8 of 12] of the taper corrosion cases). Serum cobalt and chromium levels were elevated (cobalt: 8.4 ± 7.0 μg/mL; chromium: 3.4 ± 3.3 μ/L; cobalt/chromium ratio: 3.7). The metal artifact reduction sequence magnetic resonance imaging demonstrated large cystic fluid collections typical with adverse local tissue reactions. During revision, a pseudotumor was observed in all cases. Pathology suggested a chronic inflammatory response. Impending GTF could be diagnosed based on aspiration of black synovial fluid and an oblique femoral head as compared with the neck taper on radiographs. In our series of the recalled LFIT CoCr femoral head, the risk of impending GTF or head-neck taper corrosion should be considered as a potential diagnosis in a painful LFIT femoral head and Accolade titanium-molybdenum-zirconium-iron alloy THA with unknown etiology. Almost half of the failures we observed included sizes outside of the

The course of cervical dystonia with head tremor during botulinum toxin type A treatment

Directory of Open Access Journals (Sweden)

A. N. Korenko

2017-01-01

Full Text Available Objective: to evaluate the efficacy and safety of botulinum toxin type A (BTA injections into the neck muscles to reduce dystonic postures, head tremor, and pain syndrome in patients with cervical dystonia (CD within the first 8 cycles of treatment.Patients and methods. The investigation included 76 patients (26 (34% men and 50 (66% women with CD and dystonic head tremor, who were given BTA injections into the neck muscles for the first time. All the 76 patients received at least one cycle of BTA therapy. At the same type, 18 of these patients received 4 cycles of injections and 36 patients had 8 cycles. Injections were given when the symptoms of CD recurred or increased and the patient needed to be retreated. The interval between the injection cycles was arbitrary, but not less than 12 weeks. The doses of BTA agents per treatment cycle were as follows: Dysport was 400 to 1000 U, xeomin was 50 to 300 U, and Botox 200 to 300 U. The symptoms of CD were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS and the Tsui scale before the first injection of BTA and injection cycles 4 and 8; the presence or absence of head tremor was recorded.Results. The TWSTRS severity of CD symptoms decreased from 38 [36; 41] to 30 [27; 33] scores by injection cycle 4 (p < 0.001 and to 26 [23; 27] scores by cycle 8 (p<0.01. The Tsui severity of CD reduced from 9.3 [9; 10] to 7.2 [7; 8] scores by injection cycle 4 (p<0.001 and to 6.7 [6; 7] scores by cycle 8. The Tsui tremor scores decreased from 1.9 [1.6; 2.1] to 1.4 [1.1; 1.6] scores by injection cycle 4 and to 1.1 [0.9;1.4] scores by cycle 8 (p<0.01. Tremor completely disappeared in 6 (11% of patients by injection cycle 4 and in 6 (18% patients by cycle 8. According to Section 3 of the TWSTRS, pain intensity was reduced from 9.9 [8.9; 11.0] to 5.0 [3.3; 6.6] scores by injection cycle 4 (p<0.001 and to 2.1 [0.7; 3.6] scores by cycle 8 (p < 0.01; pain regressed completely in 12 (41

In vivo dosimetry with semiconductor and thermoluminescent detectors applied to head and neck cancer treatment

International Nuclear Information System (INIS)

Viegas, Claudio Castelo Branco

2003-03-01

In vivo dosimetry in radiotherapy, i. e, the assessment of the doses received by patients during their treatments, permits a verification of the therapy quality. A routine of in vivo dosimetry is, undoubtedly, a direct benefit for the patient. Unfortunately, in Brazil and in Latin America this procedure is still a privilege for only a few patients. This routine is of common application only in developed countries. The aim of this work is to show the viability and implementation of a routine in vivo dosimetry, using diodes semiconductors and thermoluminescent dosimeters (TLD), at the radiotherapy section of the National Institute of Cancer in Brazil, in the case of head and neck cancer treatment. In order to reach that aim, the characteristics of the response of diodes ISORAD-p and LiF:Mg;Ti (TLD-100) thermoluminescent detectors in powder form were determined. The performance of those detectors for in vivo dosimetry was tested using an RANDO Alderson anthropomorfic phantom and, once their adequacy proved for the kind of measurements proposed, they were used for dose assessment in the case of tumour treatments in the head and neck regions, for Cobalt-60 irradiations. (author)

Pancreaticoduodenectomy versus duodenum-preserving pancreatic head resection for the treatment of chronic pancreatitis.

Science.gov (United States)

Zheng, Zhenjiang; Xiang, Guangming; Tan, Chunlu; Zhang, Hao; Liu, Baowang; Gong, Jun; Mai, Gang; Liu, Xubao

2012-01-01

The objective of this study was to assess the efficacy and safety of pancreaticoduodenectomy (PD) and duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis (CP). The 123 patients with CP who underwent pancreatic head resection between January 2004 and June 2009 were retrospectively analyzed. The preoperative variables, operative data, postoperative complications, and follow-up information were examined. There were no significant differences in clinical and morphological characteristics, pain relief, and jaundice status between the PD and DPPHR groups. The duration of operation was shorter (251.8 [SD, 43.1] vs 324.5 [SD, 41.4] minutes, P endocrine insufficiency was higher in PD group as compared with DPPHR group. Both procedures are equally effective in pain relief, but DPPHR is superior to PD in operative data, postoperative morbidity, improving quality of life, and preservation of exocrine and endocrine function.

Dissolution of uranium oxide TBP-HNO3 complex

International Nuclear Information System (INIS)

Mizuno, Mineo; Kosaka, Yuji; Mori, Yukihide; Shimada, Takashi

2002-12-01

As a head end process for the pulverization of the spent fuel, the mechanical method (the shredder method) and the pyro-chemical method (oxidisation heat-treatment) have been examined. UO 2 is a main ingredient of Uranium oxide powder by the mechanical method, and U 3 O 8 is that by the pyro-chemical method. Moreover, the particle size of the pulverized powder depend on the conditions of the pulverizing process. As it was considered that the difference of dissolution rates of samples was caused by the difference of sample chemical forms and dissolution temperature, parametric surveys on chemical form and particle size of powder and dissolution temperature were carried out, and the following results were obtained. 1) The remarkable difference of dissolution rate between U 3 O 8 powder (average particle size 3.7 μm) and UO 2 powder (average particle size 2.4 μm) which have comparatively similar particle size was not observed. 2) It was confirmed that the dissolution rate became lower according to the particle size increase (average particle size 2.4 μm-1 mm). And it was considered that dissolution rate had strong dependency on particle size, according to the results that the powder with 1 mm particle size did not dissolute completely after 5 hours test. 3) The temperature dependency of the dissolution rate was confirmed by dissolution test with UO 2 powder (average particle size 2.4 μm-1 mm). The higher dissolution rate was obtained in the higher dissolution temperature, and 11 kcal/mol was obtained as activation energy of dissolution. 4) In the dissolution test of UO 2 powder, the nitric acid concentration started to change earlier than that of U 3 O 8 powder and concentration change range became larger compared with that in the dissolution test of U 3 O 8 powder. It was considered that those differences were caused by difference in mole ratio of Uranium and nitric acid which are consumed in the dissolution reaction (3:7 for U 3 O 8 , 3:8 for UO 2 ). 5) In case

A qualitative study of women's decision-making at the end of IVF treatment.

Science.gov (United States)

Peddie, V L; van Teijlingen, E; Bhattacharya, S

2005-07-01

The decision not to pursue further in vitro fertilization (IVF) after one or more unsuccessful attempts is an important and often difficult one for couples. Relatively little is known about the woman's perception of this decision-making process. The aim of this study was to examine patients' perspectives of decision-making, including circumstances influencing it and satisfaction with the decision-making process. Semi-structured interviews were conducted with a purposive sample of 25 women who had decided to end treatment after unsuccessful IVF treatment. Interviews were tape-recorded and transcribed by means of thematic analysis using the open coding technique. Women experienced difficulty in accepting that their infertility would remain unresolved. Many felt that they had started with unrealistic expectations of treatment success and felt vulnerable to the pressures of both the media and society. Although the decision to end treatment was difficult, it offered many women a way out of the emotional distress caused by IVF; however, the process of decision-making created a sense of 'confrontation' for the women in which they had to address issues they had previously avoided. Adoptive parents perceived less societal pressure than those who remained childless. Efforts to improve the psychological preparation of couples who decide to end IVF treatment should be directed towards examination of the existing system of consultation, which has certain limitations in terms of the quality of communication and the provision of post-treatment support. Further efforts to develop strategies, which facilitate the decision-making process, should be considered.

18F-fluorodeoxyglucose positron tomography is useful in evaluating the efficacy of multidisciplinary treatments for so-called borderline unresectable pancreatic head cancers

International Nuclear Information System (INIS)

Murakami, Makoto; Katayama, Kanji; Yamaguchi, Akio; Iida, Atsushi; Goi, Takanori; Hirono, Yasuo; Nagano, Hideki; Koneri, Kenji

2011-01-01

Currently, computed tomography (CT) is widely used to evaluate the efficacy of treatments on tumor regression in unresectable pancreatic head carcinomas. Recently, 18 F-fluorodeoxyglucose positron emission tomography (PET) examination has been used for the initial diagnosis of pancreatic tumors, for diagnosis of distant metastasis, and for recurrences of pancreatic carcinomas. PET has also been used for the qualitative diagnosis of existing tumors. The current study was designed to observe if PET examination can be used to gauge the efficacy of multidisciplinary treatments, and to estimate the prognosis for unresectable pancreatic head carcinomas in similar clinical stages and during therapy. This was a prospective cohort study and included 18 cases. All cases were unresectable pancreatic head cancers diagnosed as TNM classification stage 3, and had undergone identical multidisciplinary treatment regimens. The level of tumor markers, tumor-size reduction, and maximum standardized uptake values (SUV max ) were correlated with prognosis. Pearson's correlation and Kaplan-Meyer survival rate curves were used for statistical analysis. Tumor-size reduction in CTs and the transition of tumor markers were not related to patient prognosis. Cases in which post-treatment SUV max values were reduced to <3.0 were correlated with a more favorable prognosis and demonstrated extended survival rates. PET examination can be used to estimate the prognosis of unresectable pancreatic head carcinomas which have undergone multidisciplinary treatments. (author)

End-of-treatment abstinence self-efficacy, behavioral processes of change, and posttreatment drinking outcomes in Project MATCH.

Science.gov (United States)

Crouch, Taylor Berens; DiClemente, Carlo C; Pitts, Steven C

2015-09-01

This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was moderated by utilization of behavioral processes of change (coping activities used during a behavior change attempt). It was hypothesized that self-efficacy would be differentially important in predicting posttreatment drinking outcomes depending on the level of behavioral processes, such that the relation between self-efficacy and outcomes would be stronger for individuals who reported low process use. Analyses were also estimated with end-of-treatment abstinence included as a covariate. Data were analyzed from alcohol-dependent individuals in both treatment arms of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N = 1,328), a large alcohol treatment study. Self-efficacy was moderated by behavioral process use in predicting drinking frequency 6 and 12 months posttreatment and drinking quantity 6 months posttreatment such that self-efficacy was more strongly related to posttreatment drinking when low levels of processes were reported than high levels, but interactions were attenuated when end-of-treatment abstinence was controlled for. Significant quadratic relations between end-of-treatment self-efficacy and 6- and 12-month posttreatment drinking quantity and frequency were found (p behavioral processes was attenuated when end-of-treatment abstinence was controlled for, the quadratic effect of self-efficacy on outcomes remained significant. The pattern of these effects did not support the idea of "overconfidence" as a negative indicator. (c) 2015 APA, all rights reserved).

Evaluation of image-guidance protocols in the treatment of head and neck cancers

International Nuclear Information System (INIS)

Zeidan, Omar A.; Langen, Katja M.; Meeks, Sanford L.; Manon, Rafael R.; Wagner, Thomas H.; Willoughby, Twyla R.; Jenkins, D. Wayne; Kupelian, Patrick A.

2007-01-01

Purpose: The aim of this study was to assess the residual setup error of different image-guidance (IG) protocols in the alignment of patients with head and neck cancer. The protocols differ in the percentage of treatment fractions that are associated with image guidance. Using data from patients who were treated with daily IG, the residual setup errors for several different protocols are retrospectively calculated. Methods and Materials: Alignment data from 24 patients (802 fractions) treated with daily IG on a helical tomotherapy unit were analyzed. The difference between the daily setup correction and the setup correction that would have been made according to a specific protocol was used to calculate the residual setup errors for each protocol. Results: The different protocols are generally effective in reducing systematic setup errors. Random setup errors are generally not reduced for fractions that are not image guided. As a consequence, if every other treatment is image guided, still about 11% of all treatments (IG and not IG) are subject to three-dimensional setup errors of at least 5 mm. This frequency increases to about 29% if setup errors >3 mm are scored. For various protocols that require 15% to 31% of the treatments to be image guided, from 50% to 60% and from 26% to 31% of all fractions are subject to setup errors >3 mm and >5 mm, respectively. Conclusion: Residual setup errors reduce with increasing frequency of IG during the course of external-beam radiotherapy for head-and-neck cancer patients. The inability to reduce random setup errors for fractions that are not image guided results in notable residual setup errors

Gait training using a hybrid assistive limb (HAL) attenuates head drop: A case report.

Science.gov (United States)

Miura, Kousei; Koda, Masao; Kadone, Hideki; Kubota, Shigeki; Shimizu, Yukiyo; Kumagai, Hiroshi; Nagashima, Katsuya; Mataki, Kentaro; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Abe, Tetsuya; Sankai, Yoshiyuki; Yamazaki, Masashi

2018-03-31

Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. A standardized treatment strategy for DHS has not been established. To our knowledge, this is the first case report describing the efficacy of gait training using a hybrid assistive limb (HAL) for DHS. A 75-year-old man showed apparent head drop in a standing position, resulting in passively reducible chin-on-chest deformity. A radiograph image showed apparent cervical kyphosis. Center of gravity of the head (CGH)-C7 SVA was +115 mm, CL was -40°, and T1S 39°. The patient underwent a treatment program using HAL, in which gait training was mainly performed, 60 min a day, 5 days a week for 2 weeks (10 sessions). After 2-3 sessions, dropped head started to attenuate. At the end of 10 sessions, the patient was able to walk with normal posture and radiograph images showed cervical kyphosis dramatically decreased because of HAL training. CGH-C7 SVA was 42 mm, CL was -1.7°, and T1S was 30°. Three months' outpatient follow-up revealed a slight deterioration of cervical alignment. However, the patient was able to maintain a better cervical alignment than before HAL training and keep walking with forward vision. There were no complications in any HAL treatment session. In conclusion, gait training using HAL is an option for treatment of DHS in addition to previously reported neck extensor muscle training. Copyright © 2018 Elsevier Ltd. All rights reserved.

Treatment results of chemoradiotherapy with 5-FU/CDGP for head and neck cancer

International Nuclear Information System (INIS)

Himei, Kengo; Katayama, Norihisa; Takemoto, Mitsuhiro; Kuroda, Masahiro; Nomiya, Shigenobu; Onoda, Tomoo; Tominaga, Susumu; Kanazawa, Susumu

2006-01-01

We investigated the safety and efficacy of alternative and concurrent chemoradiotherapy with 5-fluorouracil (FU)/nedaplatin (CDGP) for head and neck cancer. From January 2003 to August 2005, 19 patients with head and neck squamous cell carcinoma were treated in our institution. Alternative chemoradiotherapy (ACRT) was performed for 8 cases of nasopharyngeal cancer. Concurrent chemoradiotherapy (CCRT) was performed for 11 cases of other head and neck cancer. Median total dose of radiotherapy was 63 Gy. ACRT consisted of 5-FU at a dose of 500 mg/m 2 on days 1-5 and 28-32 and CDGP at a dose of 60 mg/m 2 on days 6 and 33. CCRT consisted of 5-FU at a dose of 500 mg/m 2 on days 1-4 and 28-31 and CDGP at a dose of 60 mg/m 2 on days 5 and 32. Median follow-up period was 13 months. CR+PR was admitted in five cases (63%) with ACRT, and in 9 cases (82%) with CCRT. Non-hematological adverse effects of grade 3 were admitted in eight cases (100%) of ACRT, and in 9 cases (82%) of CCRT. Chemoradiotherapy attained good results and non-hematological adverse effects were able to be managed by preserved treatment. (author)

Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

DEFF Research Database (Denmark)

Lyhne, N M; Christensen, A; Alanin, M C

2013-01-01

BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

Energy Technology Data Exchange (ETDEWEB)

Rohde, Max; Godballe, Christian [Odense University Hospital, Department of ORL - Head and Neck Surgery, Odense (Denmark); University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Nielsen, Anne L.; Thomassen, Anders [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Johansen, Joergen; Gyldenkerne, Niels [Odense University Hospital, Department of Oncology, Odense (Denmark); Soerensen, Jens A. [University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Odense University Hospital, Department of Plastic Surgery, Odense (Denmark); Diaz, Anabel; Asmussen, Jon T. [Odense University Hospital, Department of Radiology, Odense (Denmark); Gerke, Oke [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); University of Southern Denmark, Centre of Health Economics Research, Odense (Denmark); Doessing, Helle; Bjoerndal, Kristine [Odense University Hospital, Department of ORL - Head and Neck Surgery, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming [University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

2018-04-15

In patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), we wanted to examine the differences in overall treatment decisions, i.e. curative versus palliative treatment intent, reached by a multidisciplinary team conference (MDTC) based on 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) or chest X-ray + MRI of the head and neck (CXR/MRI). This was a prospective blinded cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative treatment. Based on PET/CT, the MDTC concluded that 278 (91%) patients were suitable for curative treatment and 29 (9%) patients for palliative treatment. The absolute difference of 8% was statistically significant (95% CI: 4.8%-11.5%, p < 0.001). A PET/CT-based imaging strategy significantly changed the decisions regarding treatment intent made by a MDTC for patients diagnosed with HNSCC, when compared with the standard imaging strategy of CXR/MRI. (orig.)

Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

International Nuclear Information System (INIS)

Rohde, Max; Godballe, Christian; Nielsen, Anne L.; Thomassen, Anders; Johansen, Joergen; Gyldenkerne, Niels; Soerensen, Jens A.; Diaz, Anabel; Asmussen, Jon T.; Gerke, Oke; Doessing, Helle; Bjoerndal, Kristine; Hoeilund-Carlsen, Poul Flemming

2018-01-01

In patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), we wanted to examine the differences in overall treatment decisions, i.e. curative versus palliative treatment intent, reached by a multidisciplinary team conference (MDTC) based on 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) or chest X-ray + MRI of the head and neck (CXR/MRI). This was a prospective blinded cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative treatment. Based on PET/CT, the MDTC concluded that 278 (91%) patients were suitable for curative treatment and 29 (9%) patients for palliative treatment. The absolute difference of 8% was statistically significant (95% CI: 4.8%-11.5%, p < 0.001). A PET/CT-based imaging strategy significantly changed the decisions regarding treatment intent made by a MDTC for patients diagnosed with HNSCC, when compared with the standard imaging strategy of CXR/MRI. (orig.)

Salivary flow rate and pH after radiotherapy of the head and neck region

International Nuclear Information System (INIS)

Lima, Antonio Adilson Soares de; Figueiredo, Maria Antonia Zancanaro de; Krapf, Stella Maria Rigo; Souza, Fabiany Rodrigues de

2004-01-01

The most common sequelae in head and neck cancer patients submitted to radiotherapy (60Cobalt) is postirradiation hypo salivation. This leads to a change in oral physiology, and, as a consequence, the irradiated individual is susceptible to infections and caries lesions. The aim of this study was to evaluate the behaviour of stimulated whole saliva flow rate (SWSFR) during and after radiotherapy treatment for head and neck cancer by lateral opposed fields. Six samples of mechanically stimulated whole saliva were collected of each individual and evaluated by gravimetric method.The first sample was collected before radiotherapy; the second one after 1500 cGy dose; the third one after the last dose of treatment and the remainder samples in intervals of subsequent two months up to six months after the end of treatment. The SWSFR decreased in 50% after a dose of 1500 cGy (1/4 of received treatment). After radiation therapy, the SWSFR was 0,33 ml/min and after six months was 0,20 ml/min. These values represented, respectively, a decreasing in 64% and 78% of initial values (ANOVA, Tukey's Test p<0.05).Based in these results, the authors concluded radiotherapy when applied in malign neoplasms of the head and neck region by lateral opposed fields was able to decrease significantly salivary flow rate. Intensive preventive dental care during and after radiotherapy seems to be an useful tool to avoid radiation caries and their complications. (author)

Parotid saliva composition during and after irradiation of head and neck cancer

International Nuclear Information System (INIS)

Funegaard, U.; Franzen, L.; Ericson, Th.; Henriksson, R.

1994-01-01

Parotid saliva composition was studied before, during and up to 18 months after the irradiation period in 16 cancer patients treated for malignancies in the head and neck region. Stimulated parotid saliva was collected prior to radiotherapy and, when possible, weekly during treatment. New samples were taken 2, 4, 6, 12 and 18 months after the end of radiotherapy. Nine of the 16 patients were treated with bilateral irradiation fields and 7 patients with unilateral irradiation fields, with a total dose not exceeding 52 Gy. During the entire irradiation period the fraction of glands producing measurable volumes of saliva decreased to 40%. In the post irradiation period the number of active glands gradually increased and saliva secretion rate returned to an average of 72% of the initial value 18 months after the end of irradiation. The concentrations of the measured variables increased already during the first week of radiotherapy and at the end of the treatment period the concentrations for total protein, salivary peroxidase, hexosamine and salivary IgA were significantly increased. The concentrations for total protein, salivary peroxidase and salivary IgA were still increased 6 months after the end of irradiation. At the 18-months observation all concentrations had returned to normal. (author)

Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer-the SiP study protocol.

Science.gov (United States)

Wells, Mary; King, Emma; Toft, Kate; MacAulay, Fiona; Patterson, Joanne; Dougall, Nadine; Hulbert-Williams, Nick; Boa, Sally; Slaven, Eleanor; Cowie, Julie; McGarva, John; Niblock, Patricia Gail; Philp, Julie; Roe, Justin

2016-01-01

Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallowing intervention. The introduction of

Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer

Energy Technology Data Exchange (ETDEWEB)

Maurer, Julia; Hipp, Matthias; Koelbl, Oliver [Regensburg Univ. Medical Center (Germany). Dept. of Radiotherapy; Schaefer, Christof [Hospital St. Elisabeth Straubing (Germany). Dept. of Radiotherapy

2011-11-15

In the past, xerostomia was considered one of the most important determining factors of quality of life (QoL) after radiotherapy (RT) of the head and neck region. In addition, more recent studies have shown that RT-induced dysphagia has an essential influence on the QoL. Between September 2005 and August 2007, 35 patients with locally advanced squamous cell carcinoma of the head and neck region were included in the prospective study. Patients were treated by IMAT (intensity-modulated arc therapy) or IMRT (intensity-modulated radiotherapy) planned on 3D imaging. A total of 28 patients (80%) received concomitant chemotherapy. The evaluation of QoL (EORTC QLQ - C30, H and N C-35) and toxicities (CTC 2.0) were assessed at the beginning of, during, and after RT as well as up to 12 months after the end of therapy. At the end of therapy, 86% of the patients experienced difficulties in swallowing (62% CTC II-III ). Twelve months after the end of treatment, 15% still suffered from dysphagia CTC II-III . Concomitant chemotherapy exacerbated the incidence and gravity of dysphagia, resulting in increasing dietary problems. QoL (EORTC) was significantly affected by dysphagia. In particular, the global state of health and QoL were influenced at the end of treatment (p = 0.033) and at a later stage (p = 0.050). The findings of this study suggest that more emphasis should be placed on structured clinical diagnostics, therapy, and rehabilitation of deglutition problems. This means in particular to not only spare the parotids while planning the irradiation, but also to take into consideration the important structures for deglutition, like the retropharyngeal muscles. (orig.)

Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer

International Nuclear Information System (INIS)

Maurer, Julia; Hipp, Matthias; Koelbl, Oliver; Schaefer, Christof

2011-01-01

In the past, xerostomia was considered one of the most important determining factors of quality of life (QoL) after radiotherapy (RT) of the head and neck region. In addition, more recent studies have shown that RT-induced dysphagia has an essential influence on the QoL. Between September 2005 and August 2007, 35 patients with locally advanced squamous cell carcinoma of the head and neck region were included in the prospective study. Patients were treated by IMAT (intensity-modulated arc therapy) or IMRT (intensity-modulated radiotherapy) planned on 3D imaging. A total of 28 patients (80%) received concomitant chemotherapy. The evaluation of QoL (EORTC QLQ - C30, H and N C-35) and toxicities (CTC 2.0) were assessed at the beginning of, during, and after RT as well as up to 12 months after the end of therapy. At the end of therapy, 86% of the patients experienced difficulties in swallowing (62% CTC II-III ). Twelve months after the end of treatment, 15% still suffered from dysphagia CTC II-III . Concomitant chemotherapy exacerbated the incidence and gravity of dysphagia, resulting in increasing dietary problems. QoL (EORTC) was significantly affected by dysphagia. In particular, the global state of health and QoL were influenced at the end of treatment (p = 0.033) and at a later stage (p = 0.050). The findings of this study suggest that more emphasis should be placed on structured clinical diagnostics, therapy, and rehabilitation of deglutition problems. This means in particular to not only spare the parotids while planning the irradiation, but also to take into consideration the important structures for deglutition, like the retropharyngeal muscles. (orig.)

The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

International Nuclear Information System (INIS)

Shaikh, Talha; Handorf, Elizabeth A.; Murphy, Colin T.; Mehra, Ranee; Ridge, John A.; Galloway, Thomas J.

2016-01-01

Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as 49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ"2 tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

Migration from full-head mask to "open-face" mask for immobilization of patients with head and neck cancer.

Science.gov (United States)

Li, Guang; Lovelock, D Michael; Mechalakos, James; Rao, Shyam; Della-Biancia, Cesar; Amols, Howard; Lee, Nancy

2013-09-06

To provide an alternative device for immobilization of the head while easing claustrophobia and improving comfort, an "open-face" thermoplastic mask was evaluated using video-based optical surface imaging (OSI) and kilovoltage (kV) X-ray radiography. A three-point thermoplastic head mask with a precut opening and reinforced strips was developed. After molding, it provided sufficient visible facial area as the region of interest for OSI. Using real-time OSI, the head motion of ten volunteers in the new mask was evaluated during mask locking and 15minutes lying on the treatment couch. Using a nose mark with reference to room lasers, forced head movement in open-face and full-head masks (with a nose hole) was compared. Five patients with claustrophobia were immobilized with open-face masks, set up using OSI and kV, and treated in 121 fractions, in which 61 fractions were monitored during treatment using real-time OSI. With the open-face mask, head motion was found to be 1.0 ± 0.6 mm and 0.4° ± 0.2° in volunteers during the experiment, and 0.8 ± 0.3 mm and 0.4° ± 0.2° in patients during treatment. These agree with patient motion calculated from pre-/post-treatment OSI and kV data using different anatomical landmarks. In volunteers, the head shift induced by mask-locking was 2.3 ± 1.7 mm and 1.8° ± 0.6°, and the range of forced movements in the open-face and full-head masks were found to be similar. Most (80%) of the volunteers preferred the open-face mask to the full-head mask, while claustrophobic patients could only tolerate the open-face mask. The open-face mask is characterized for its immobilization capability and can immobilize patients sufficiently (< 2 mm) during radiotherapy. It provides a clinical solution to the immobilization of patients with head and neck (HN) cancer undergoing radiotherapy, and is particularly beneficial for claustrophobic patients. This new open-face mask is readily adopted in radiotherapy clinic as a superior alternative to

Oral cavity changes following treatment of oncologic patients with tumors of the head and neck

International Nuclear Information System (INIS)

Lyubenov, T.; Vasilev, V.; Boneva, I.

1982-01-01

Changes mainly in the soft tissue structures of the oral cavity (salivary glands and mucosa, following ionizing radiation treatment of tumors of the head and neck), were studied. The relationship between the morphologic characteristics of the lesions and the dose and, on the other hand, the correlation with the clinical symptoms are discussed. (authors)

Estimation of centerline temperature of the waste form for the rare earth waste generated from pyrochemical process

Energy Technology Data Exchange (ETDEWEB)

Choi, Jung-Hoon, E-mail: mrchoijh@kaeri.re.kr; Eun, Hee-Chul; Lee, Tae-Kyo; Lee, Ki-Rak; Han, Seung-Youb; Jeon, Min-Ku; Park, Hwan-Seo; Ahn, Do-Hee

2017-01-15

Estimation of centerline temperature of nuclear glass waste form for each waste stream is very essential in the period of storage because the centerline temperature being over its glass transition temperature results in the increase of leaching rate of radioactive nuclides due to the devitrification of glass waste form. Here, to verify the effects of waste form diameter and transuranic element content in the rare earth waste on the centerline temperature of the waste form, the surrogate rare earth glass waste generated from pyrochemical process was immobilized with SiO{sub 2}−Al{sub 2}O{sub 3}−B{sub 2}O{sub 3} glass frit system, and thermal properties of the rare earth glass waste form were determined by thermomechanical analysis and thermal conductivity analysis. The estimation of centerline temperature was carried out using the experimental thermal data and steady-state conduction equation in a long and solid cylinder type waste form. It was revealed that thermal stability of waste form in case of 0.3 m diameter was not affected by the TRU content even in the case of 80% TRU recovery ratio in the electrowinning process, meaning that the waste form of 0.3 m diameter is thermally stable due to the low centerline temperature relative to its glass transition temperature of the rare earth glass waste form.

Management of osteonecrosis of the femoral head: A novel technique

Directory of Open Access Journals (Sweden)

Ahmed M Samy

2016-01-01

Full Text Available Background: Osteonecrosis of the femoral head (ONFH is a debilitating disease in orthopedics, frequently progressing to femoral head collapse and osteoarthritis. It is thought to be a multifactorial disease. ONFH ultimately results in femoral head collapse in 75-85% of untreated patients. Total hip arthroplasty (THA yields satisfactory results in the treatment of the end stage of the disease. However, disease typically affects males between the ages of 20 and 40 years and joint replacement is not the ideal option for younger patients. Recently, mesenchymal stem cells and platelet rich plasma (PRP have been used as an adjunct to core decompression to improve clinical success in the treatment of precollapse hips. Materials and Methods: A prospective study of 40 hips in 30 patients was done. There were 19 males and 11 females with a mean age 36.7 ± 6.93 years. The indication for the operation was restricted primarily to modified Ficat stages IIb and III. 16 hips (40% had stage IIb and 24 hips (60% had stage III ONFH. The period of follow up ranged between 36-50 months with a mean 41.4 ± 3.53 months. All patients were assessed clinically during pre- and post-operative period according to the Harris Hip Score (HHS, Visual Analog Score (VAS and radiologically by X-rays. Magnetic resonance imaging (MRI was done preoperatively to confirm the diagnosis and every 6 months postoperatively for assessment of healing. The operative procedure include removal of necrotic area with drilling then the cavity was filled with a composite of bone graft mixed with PRP. Results: The mean HHS improved from 46.0 ± 7.8 preoperatively to 90.28 ± 19 at the end of followup ( P < 0.0001. The mean values of VAS were 78 ± 21 and 35 ± 19 at preoperatively period and final followup, respectively, with an average reduction of 43 points. Conclusion: We found that the use of PRP with collagen sheet can increase the reparable capacity after drilling of necrotic segment in stage

The comparison of 5-field conformal radiotherapy techniques for the treatment of prostate cancer: The best for femoral head sparing

International Nuclear Information System (INIS)

Zare, Mahkameh; Lashkari, Marzieh; Ghalehtaki, Reza; Ghasemi, Arash; Dehghan Manshadi, Hamidreza; Mir, Ali; Noorollahi, Somayeh; Alamolhoda, Mahboobeh

2016-01-01

External radiotherapy is a standard treatment procedure for localized prostate cancer. Given the relatively high long term survival treatment complications have been brought in center of attention. In this planning study, between 2012 and 2014, CT simulation data of 90 consecutive high-risk prostate cancer patients were collected. In the first phase, all were planned for whole pelvis irradiation up to 46Gy in 23 daily fractions. In the second phase, only the prostate gland was the target of radiation. Next, the subjects were divided randomly into three groups and each received a unique 5field conformal radiation plan including Plan A (Gantry angle: 0, 60, 120, 240, and 300), Plan B (Gantry angles: 0, 90, 120, 240, and 270) and Plan C (Gantry angles: 0, 60, 90, 270, and 300). The total dose was 70Gy. For each patient, the rectum, bladder, and both femoral heads were contoured as the at risk organs (OAR). From dose volume histograms, the proportional dose of PTV V100, the bladder and rectum V80 and V90 and femoral head V50 and V100 were calculated in all subjects and compared across plans. A statistically significant difference in the femoral head V50 and V100 was found between our studied 5field plans so that in Plan A (beam angles: 0, 60, 120, 240 and 300) less dose was received by both heads of femur. This study suggests that 5 field treatment planning including an anterior, two anterior oblique and two posterior oblique portals to be more proper for 3D conformal radiotherapy in order to spare femoral head with acceptable PTV coverage, and bladder and rectal doses.

[Acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages:a clinical randomized controlled trial].

Science.gov (United States)

Wang, Zhanyou; Zhou, Xuelong; Xie, Lishuang; Liang, Dongyue; Wang, Ying; Zhang, Hong-An; Zheng, Jinghong

2016-10-12

To compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages. The randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group, ashi points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups. Harris hip score was improved significantly after treatment in the two groups (both P avascular necrosis of femoral head at the early and middle stages.

Picibanil (OK-432) in the treatment of head and neck lymphangiomas in children

OpenAIRE

Rebuffini, Elena; Zuccarino, Luca; Grecchi, Emma; Carinci, Francesco; Merulla, Vittorio Emanuele

2012-01-01

Background: Picibanil (OK-432) is a lyophilized mixture of group A Streptococcus pyogenes with antineoplastic activity. Because of its capacity to produce a selective fibrosis of lymphangiomas (LMs), it has been approved by Japanese administration in 1995 for the treatment of LMs. Materials and Methods: We treated 15 children (age range: 6-60 months) affected by head and neck macrocystic LMs with intracystic injections (single dose of 0.2 mL) of Picibanil (1-3 injections). Results: Co...

Leakage pattern of linear accelerator treatment heads from multiple vendors

International Nuclear Information System (INIS)

Lonski, P.R.; Taylor, M.L.; Franich, R.D.; Harty, P.; Clements, N.; Kron, T.

2011-01-01

Full text: Patient life expectancy post-radiotherapy is becoming longer. Therefore, secondary cancers caused by radiotherapy treatment have more time to develop. Increasing attention is being given to out-of-field dose resulting from scatter and accelerator head leakage. Dose leakage from equivalent positions on Varian600C, Varian21-X, Siemens Primus and Elekta Synergy-II linacs were measured with TLD 1 00 H dosimeter chips and compared. Treatment parameters such as field size and beam energy were altered. Leakage doses are presented as a percentage of the dose to isocentre (5 Gy). Results illustrate significant variations in leakage dose between linac models where no model emits consistently lower amounts of radiation leakage for all treatment parameters. Results are shown below. Leakage through the collimator assembly in different units is varying as a function of location and unit design by more than a factor of 10. Differences are more pronounced in comparing Varian or Elekta models, which are fitted with an additional collimator separate from the MLC leaves, to the Siemens model, which uses MLC leaves as its only secondary collimator. Further measurements are currently being taken at the patient plane with a directional detector system to determine the spatial distribution of high leakage sources.

Design and Computational Fluid Dynamics Optimization of the Tube End Effector for Reactor Pressure Vessel Head Type VVER-1000

International Nuclear Information System (INIS)

Novosel, D.

2006-01-01

In this paper is presented development and optimization of the tube end effector design which should consist of 4 ultrasonic transducers, 4 Eddy Current's transducers and Radiation Proof Dot Camera. Basically, designing was conducted by main input requests, such as: inner diameter of a tested reactor pressure vessel head penetration tube, dimensions of a transducers and maximum allowable vertical movement of a manipulator connection rod in order to cover all inner tube surface. As is obvious, for ultrasonic testing should be provided the thin layer of liquid material (in our case water was chosen) which is necessary to make physical contact between transducer surface and investigated inner tube surface. By help of Computational Fluid Dynamics, determined were parameters of geometry, as the most important factor of transducer housing, hydraulically parameters for water supply and primary drain together implemented into this housing, movement of the end effectors (vertical and cylindrical) and finally, necessary equipment which has to provide all hydraulically and pneumatic requirements. As the cylindrical surface of the inner tube diameter was liquefied and contact between transducer housing and tested tube wasn't ideally covered, water leakage could occur in downstream direction. To reduce water leakage, which is highly contaminated, developed was second water drain by diffuser assembly which is driven by Venturi pipe, commercially called vacuum generator. Using the Computational Fluid Dynamic, obtained was optimized geometry of diffuser control volume with the highest efficiency, in other words, unobstructed fluid flux. Afterwards, the end effectors system was synchronized to the existing operable system for NDT methods all invented and designed by INETEC. (author)

Clinical analysis of interventional treatment for avascular necrosis of femoral head in adults

International Nuclear Information System (INIS)

Cao Dianbo; Yang Haishan; Zhao Yongsheng; Cheng Tilong

2001-01-01

Objective: To study the method and efficacy of interventional therapy for avascular necrosis of femoral head. Methods: A 5.0 F Cobra duct was first super selected into circumflex artery by applying Seldinger's technique and vasoactive drugs were perfused, then into inferior gluteal or obturator artery that are the branches of internal iliac artery. Dissolving and dilative drugs were perfused through micro-artery pump linked to the duct for three days on 30 cases (total 51 heads of femur). Results: Following interventional treatment, there were marked improvement of clinical symptoms, with relief or disappearance of pain (92.2%) and functional improvement in hip joint (87.5%). Increase of vessel numbers, disappearance of blank space, richness of parenchymal staining and establishment of collateral circulations were found around the hip joint. Repair of osteonecrosis at different degrees was observed on regular reexamination. Conclusion: Interventional therapy for ANFH had a significantly therapeutic effect after short-term follow-up

End-of-life content in treatment guidelines for life-limiting diseases.

Science.gov (United States)

Mast, Kimberly R; Salama, Marybeth; Silverman, Gabriel K; Arnold, Robert M

2004-12-01

Clinical guidelines are systematically developed statements that influence medical practice, education, and funding. Guidelines represent the consensus of leaders, often based on systematic reviews of the literature, regarding the "state of the art." To assess the degree to which end-of-life care is integrated into nationally developed guidelines for chronic, noncurable, life-limiting diseases. Four compendia were reviewed: The Healthcare Standards Directory ECRI, 2001; the Clinical Practice Guidelines Directory, 2000 edition; the National Guidelines Clearinghouse, (guideline.gov); and the National Library of Medicine's MEDLINE database on the OVID platform for guidelines on nine chronic diseases (chronic obstructive pulmonary disease, end-stage liver disease, amyotrophic lateral sclerosis, congestive heart failure, dementia, cerebrovascular accident, end-stage renal disease, cancer [breast, colon, prostate, lung], and human immunodeficiency virus). They were assessed by two reviewers for end-of-life content in 15 domains (e.g., epidemiology of death, symptom management, spiritual, family roles, and settings of care), the presence of eight specific terms dealing with palliative care, integration of palliative care information into the guideline, and descriptive variables. Not available. Each guideline was examined and rated on a 0-2 scale (0, absent content; 1, minimal content; 2, helpful content) using 15 end-of-life content domains. Scores from domains were summed and classified into 3 categories: 4 or less, minimal; 5-12, moderate; and more than 12, significant content. Ten percent of guidelines had significant palliative care content, 64% had minimal content, and 26% had moderate content. The least addressed domains dealt with spirituality, ethics, advocacy and family roles. When guidelines that dealt solely with prevention, acute exacerbations or complications of an illness, or specific treatment modalities were excluded 28% and 16% of these general guidelines

Geographic region: Does it matter in cutaneous melanoma of the head and neck?

Science.gov (United States)

Kılıç, Suat; Unsal, Aykut A; Chung, Sei Y; Samarrai, Ruwaa; Kılıç, Sarah S; Baredes, Soly; Eloy, Jean Anderson

2017-12-01

The head and neck are two of the most common locations for cutaneous melanoma. We present the first population-based analysis of geographic differences in anatomic subsite, clinicopathologic and demographical traits, histopathologic subtype, treatment modality, and disease-specific survival (DSS) of cutaneous head and neck melanoma (CHNM). Retrospective database analysis. The Surveillance, Epidemiology, and End Results database was queried for cases of CHNM reported between 2000 and 2013. Patients were grouped into East, Midwest, South, and West regions of the United States. Overall incidence, demographic traits, primary tumor site, clinicopathologic traits, histopathologic subtype, treatment modality, and DSS were compared among regions. There were 49,365 patients with CHNM identified. The West (4.60) and the South (4.42) had significantly higher incidence (per 100,000) than the East (3.84) and Midwest (3.65) (P regions (P region may play a significant role in CHNM. Incidence is higher in the South and the West. Incidence, histologic subtype, treatment modality, and DSS vary among regions. DSS is lower in the South than the West, even after accounting for other major prognostic factors. 4. Laryngoscope, 127:2763-2769, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Recent results of cetuximab use in the treatment of squamous cell carcinoma of the head and neck

Directory of Open Access Journals (Sweden)

Francesco Perri

2009-08-01

Full Text Available Francesco Perri1, Francesco Longo2, Franco Ionna2, Francesco Caponigro11Head and Neck Medical Oncology Unit, 2Head and Neck Surgery Unit, National Tumor Institute of Naples, Naples, ItalyAbstract: Cetuximab is a chimeric monoclonal antibody that targets the epidermal growth factor receptor. The role of cetuximab is paramount in several subsets of head and neck cancer. In particular, the EXTREME study has indicated cetuximab as the only drug to improve survival when associated with cisplatin and 5-fluorouracil in patients with recurrent/metastatic disease. Furthermore, cetuximab, both alone and in combination with cisplatin, is active in patients with recurrent/metastatic disease who have failed prior platinum-based chemotherapy. Cetuximab, given in association with radiation therapy, is a treatment of choice in first-line therapy of patients with locally advanced inoperable disease. In the same setting, the role of induction chemotherapy has gained considerable interest over the last few years and a number of efforts are being pursued to optimally integrate induction chemotherapy with radiation therapy plus cetuximab. The combination of cetuximab and other targeted therapies is among the most promising new perspectives for patients with head and neck cancer.Keywords: cetuximab, head and neck cancer, locally advanced, recurrent/metastatic

Prevention and control of sequels in the mouth of patients treated with radiation therapy for head and neck tumors

International Nuclear Information System (INIS)

Cardoso, Maria de Fatima Aparecida; Novikoff, Silviene; Tresso, Adriana; Segreto, Roberto Araujo; Cervantes, Onivaldo

2005-01-01

Surgery and radiation therapy are de main treatments for head and neck cancer. The side effects of the interaction of ionizing radiation on the tissues include dermatitis, mucositis, xerostomia, candidiasis, dysgeusia, dysphagia, caries, trismus, osteoradionecrosis. Objective: To assess dental condition of the patients using a protocol which allows avoiding or reducing the effects of radiation in the tissues of the oral cavity. Materials And Methods: Dental follow-up was performed before, during and up to 180 days after radiation therapy in 12 patients submitted to surgery and radiation therapy or radiation therapy alone. Results: The proportion of effects such as dermatitis, mucositis, dysgeusia, and dysphagia increased from the second week of the treatment until the end of the administrations. There was a clear decrease at the end of the treatment which was close to baseline values after 180 days. The reduction of xerostomia was slower and less effective. No case of caries, trismus, and osteoradionecrosis were observed during the assessment period. Conclusion: Regular dental follow-up associated with preventive measures such as prophylactic management of dental and oral diseases, adequate hygiene, mouth-washing with bicarbonate water and chamomile tea, and topic fluorine application contributed to improve the recovery conditions of patients with cancer of head and neck submitted to radiation therapy. (author)

Nutritional supplement during the treatment with ionizing radiations in patients with head and neck tumors in advanced stages

International Nuclear Information System (INIS)

Chon Rivas, Ivonne; Roca Muchuli, Carlos; Vilau Prieto, Luis; Rubio Hernandez, Maria C.; Rodriguez Diaz, Ronald; Leon, Roberto; Rodriguez Abascal, Alicia; Mederos, Nuria

2005-01-01

Malnutrition in the patient with advanced cancer favors immunosuppression and implies a low Karnofsky index, poor tolerance and response to the onco specific curative or palliative treatments, high susceptibility to infections and, as a result, a decline of the quality of life. Patients with head and neck tumors in advanced stages (III-IV) are one of the groups of high risk for malnutrition due to the reduction of the intake of nutrients, anorexia, alterations of the deglutition mechanism, and mechanical obstruction of the upper digestive tract, among other causes.Numerous studies show the convenience of the nutritional supplement in these patients during the onco specific treatment. A prospective study that included 15 patients with head and neck neoplasia in advanced stages, and with clinical signs of malnutrition, was conducted in order to evaluate the necessary calorie-energy supplement. All of them were administered an oral nutritional supplement (Adn-22 %) during the radiation treatment to assess the possibility of improving their tolerance and response to the treatment. Of the 15 studied cases, 13 presented complications in connection with the treatment, but most them were mild, and they did not affect in a significant way the time of duration and the total dose of treatment. There was a favorable response in relation to the tumor

Pyrochemical processes for the recovery of weapons grade plutonium either as a metal or as PuO2 for use in mixed oxide reactor fuel pellets

International Nuclear Information System (INIS)

Colmenares, C.A.; Ebbinghaus, B.B.; Bronson, M.C.

1995-01-01

The authors have developed two processes for the recovery of weapons grade Pu, as either Pu metal or PuO 2 , that are strictly pyrochemical and do not produce any liquid waste. Large amounts of Pu metal (up to 4 kg.), in various geometric shapes, have been recovered by a hydride/dehydride/casting process (HYDEC) to produce metal ingots of any desired shape. The three processing steps are carried out in a single compact apparatus. The experimental technique and results obtained will be described. The authors have prepared PuO 2 powders from weapons grade Pu by a process that hydrides the Pu metal followed by the oxidation of the hydride (HYDOX process). Experimental details of the best way to carry out this process will be presented, as well as the characterization of both hydride and oxide powders produced

Study of the actinide-lanthanide separation from nuclear waste by a new pyrochemical process; Etude de la separation actinides-lanthanides des dechets nucleaires par un procede pyrochimique nouveau

Energy Technology Data Exchange (ETDEWEB)

Lemort, F. [CEA Marcoule, Departement de Retraitement, des Dechets et du Demantelement, 30 - Bagnols-sur-Ceze (France)]|[Institut National Polytechnique, 38 - Grenoble (France)

1997-01-01

The theoretical extraction and separation of platinoids, actinides and lanthanides is allowed by thermodynamic using two adapted reducing agents: zinc and magnesium. Thereby, a pyrochemical method for the nuclear waste processing has been devised. The high temperature handling of the elements in fluoride forms and their processing by a reactive metallic phase required special precautions. The study of the behavior of matter in exploratory systems allowed the development of an experimental technology for the treatment and contacting of phases. The thermodynamical analysis of the experimental results shows the feasibility of the process. A model was developed to predict the distribution coefficients of zirconium, uranium and lanthanum as a function of the system composition. An estimation method was proposed in order to evaluate the distribution coefficients in diluted solution of all the actinides and lanthanides existing in the fission products between LiF CaF{sub 2} and Zn-Mg at 720 deg C. Coupled with the experimental results, the estimates results may be extrapolated to concentrated solutions allowing predictions of the separation of all actinides and lanthanides. The rapidity of element transfer is induced by a thermal effect caused by the high exothermicity of the reduction by magnesium. The kinetic coefficients have been linked with the reduction enthalpy of each element. Moreover, the kinetics seem limited by chemical reaction and not by mass transfer. (author) 66 refs.

Kleptomania after head trauma: two case reports and combination treatment strategies.

Science.gov (United States)

Aizer, Anat; Lowengrub, Katherine; Dannon, Pinhas N

2004-01-01

The purpose of this paper is to add to the growing number of reports about kleptomania occurring in relation to brain injury as well as to present the authors' findings regarding treatment strategies. The authors present two case reports of patients who developed the new onset of kleptomania after closed head trauma. Both patients had comorbid psychiatric symptoms associated with the kleptomania. Antidepressant monotherapy was not beneficial in reducing kleptomania in either patient. Kleptomanic behavior was successfully treated in both patients, however, through combination treatment using an antidepressant agent together with adjunctive cognitive behavioral therapy or adjunctive naltrexone. In one patient, single photon emission tomography showed a perfusion deficit in the left temporal lobe. Various hypotheses regarding this finding and the etiopathology of kleptomania are discussed. Review of current work in the field suggests that kleptomania is a heterogeneous disorder that shares features of both impulse and addiction disorders as well as affective spectrum disorders.

Characterization of changes in total body composition for patients with head and neck cancer undergoing chemoradiotherapy using dual-energy x-ray absorptiometry.

Science.gov (United States)

Jackson, William; Alexander, Neil; Schipper, Matthew; Fig, Lorraine; Feng, Felix; Jolly, Shruti

2014-09-01

Patients with head and neck cancer experience significant weight loss secondary to concurrent chemoradiotherapy (CCRT). Using dual-energy X-ray absorptiometry (DEXA) scans, we characterize total body composition changes during and after CCRT in order to develop novel clinical care models that will improve the patient's quality of life (QOL). Sixty DEXA scans were obtained from 12 patients undergoing CCRT for locally advanced squamous cell head and neck cancer. DEXAs were performed at baseline, during treatment, completion of CCRT, and then 1 and 2 months posttreatment. Mean weight loss by treatment end was 9.5 kg (10.2%; p = .0002). On average, lean body mass (LBM) decreased 10.2% (p = .001), and fat body mass (FBM) decreased 11.1% (p = .001) during CCRT. LBM began to normalize after completion of treatment, whereas FBM continued to decline. Substantial loss of muscle and FBM occurs in patients undergoing CCRT for head and neck cancer. To prevent long-term disability and QOL decline after curative CCRT, clinical care interventions incorporating aggressive nutrition/exercise counseling are needed. Copyright © 2013 Wiley Periodicals, Inc.

Phase II trial of combination treatment with paclitaxel, carboplatin and cetuximab (PCE) as first-line treatment in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CSPOR-HN02).

Science.gov (United States)

Tahara, M; Kiyota, N; Yokota, T; Hasegawa, Y; Muro, K; Takahashi, S; Onoe, T; Homma, A; Taguchi, J; Suzuki, M; Minato, K; Yane, K; Ueda, S; Hara, H; Saijo, K; Yamanaka, T

2018-04-01

The standard of care for first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) is combination treatment with platinum, 5-FU and cetuximab (PFE). However, this regimen requires hospitalization to ensure proper hydration and continuous infusion of 5-FU, and causes severe nausea and anorexia. We evaluated the efficacy and safety of paclitaxel, carboplatin and cetuximab (PCE) as first-line treatment in patients with R/M SCCHN. Eligibility criteria included recurrent and/or metastatic, histologically proven SCC of the oropharynx, oral cavity, hypopharynx or larynx; PS 0-1; adequate organ function; no suitable local therapy for R/M SCCHN; and no prior systemic chemotherapy for R/M SCCHN. Chemotherapy consisted of paclitaxel 100 mg/m2 on days 1, 8; carboplatin area under the blood concentration-time curve 2.5 on days 1, 8, repeated every 3 weeks for up to 6 cycles; and cetuximab at an initial dose of 400 mg/m2, followed by 250 mg/m2 weekly until disease progression or unacceptable toxicities. Primary end point was overall response rate. Secondary end points were safety, treatment completion rate, progression-free survival, overall survival, and clinical benefit rate. Planned sample size was 45 patients. Forty-seven subjects were accrued from July 2013 to October 2014. Of 45 evaluable, 40 were male; median age was 63 years; Eastern Cooperative Oncology Group Performance Status was 0/1 in 23/22 cases; site was the hypopharynx/oropharynx/oral cavity/larynx in 17/11/10/7 cases; and 36/9 cases were smokers/nonsmokers, respectively. Overall response rate, the primary end point, was 40%. Median overall survival was 14.7 months and progression-free survival was 5.2 months. Grade 3/4 adverse events included neutropenia (68%), skin reaction (15%), fatigue (9%) and febrile neutropenia (9%). A potentially treatment-related death occurred in one patient with intestinal pneumonia. The PCE regimen shows promising

The exploding head syndrome.

Science.gov (United States)

Green, M W

2001-06-01

This article reviews the features of an uncommon malady termed "the exploding head syndrome." Sufferers describe terrorizing attacks of a painless explosion within their head. Attacks tend to occur at the onset of sleep. The etiology of attacks is unknown, although they are considered to be benign. Treatment with clomipramine has been suggested, although most sufferers require only reassurance that the spells are benign in nature.

Pre-Radiotherapy dental evaluation criteria and treatment needs of oral side effects after head and neck radiotherapy

International Nuclear Information System (INIS)

Gonzalez-Arriagada, Wilfredo Alejandro; Santos-Silva, Alan Roger; Carvalho de Andrade, Marco Aurelio; De Andrade Elias, Rogerio; Ajudarte Lopes, Marcio

2010-01-01

The objective of this review is to present pre-radiotherapy evaluation criteria and the main needs for treatment of these patients after the radiation therapy. Were revised articles in English, Spanish and Portuguese language between 1995 and 2009 indexed in Pubmed and Scielo. The keywords were oral cancer and radiotherapy, complications in head and neck radiotherapy, oral pre-radiotherapy evaluation.The adverse complications of radiotherapy in head and neck area could be temporary or late. The late effects, such as radiation caries and osteorradionecrosis could be directly associated with the fact that previous dental evaluation was not performed and can severely affect the post-operatory quality of life. The participation of the dentist in the multidisciplinary team and dental evaluation of the patients that will receive radiotherapy in the head and neck area are of vital importance to improve the post-operatory quality of life of these patients

Head and Neck Cancer—Patient Version

Science.gov (United States)

Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

Overview of the Main Achievements of the FP7 EURATOM Collaborative Project ACSEPT

International Nuclear Information System (INIS)

Bourg, S.; Geist, A.; Cassayre, L.; Rhodes, C.; Ekberg, C.

2015-01-01

Nuclear power plays a key role in limiting European Union’s greenhouse gases emissions, and makes an important contribution to improve EU’s independence, security and diversity of energy supply. However, its social acceptance is closely linked to an enhanced safety in the management of long-lived radioactive waste contributing to resource efficiency and cost-effectiveness of this energy and ensuring a robust and socially acceptable system of protection of man and environment. Among the different strategies, partitioning and transmutation (P&T) allows a reduction of the amount, the radiotoxicity and the thermal power of these wastes, leading to an optimal use of geological repository sites. ACSEPT successfully addressed the partitioning issues by focusing on the development of advanced separation processes, both aqueous and pyrochemical. Head-end steps, fuel refabrication, solvent treatment, waste management were also taken into account. In aqueous process development, the SANEX, innovative SANEX and GANEX flowsheets were designed and tested in hot cells. In pyrometallurgy, studies on actinide back-extraction from aluminium and exhaustive electrolysis allowed the validation of two flowsheets developed from more then 10 years in Europe. A training and education program including seminars, workshops, brainstorming meeting but also student exchanges and support to post-doctorate fellowships was a key point for maintaining and increasing a high expertise level in actinide separation sciences in Europe. Six month after the end of ACSEPT, and when its follow-up, SACSESS, just begins, it is time to highlight its main achievements. (author)

Feasibility of Multimodal Deformable Registration for Head and Neck Tumor Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Fortunati, Valerio, E-mail: v.fortunati@erasmusmc.nl [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Verhaart, René F. [Hyperthermia Unit, Department of Radiation Oncology, Erasmus MC University Medical Center Cancer Institute, Rotterdam (Netherlands); Angeloni, Francesco [Istituto di Ricovero e Cura a Carattere Scientifico Foundation SDN for Research and High Education in Nuclear Diagnostics, Naples (Italy); Lugt, Aad van der [Department of Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Niessen, Wiro J. [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Faculty of Applied Sciences, Delft University of Technology, Delft (Netherlands); Veenland, Jifke F. [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Paulides, Margarethus M. [Hyperthermia Unit, Department of Radiation Oncology, Erasmus MC University Medical Center Cancer Institute, Rotterdam (Netherlands); Walsum, Theo van [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands)

2014-09-01

Purpose: To investigate the feasibility of using deformable registration in clinical practice to fuse MR and CT images of the head and neck for treatment planning. Method and Materials: A state-of-the-art deformable registration algorithm was optimized, evaluated, and compared with rigid registration. The evaluation was based on manually annotated anatomic landmarks and regions of interest in both modalities. We also developed a multiparametric registration approach, which simultaneously aligns T1- and T2-weighted MR sequences to CT. This was evaluated and compared with single-parametric approaches. Results: Our results show that deformable registration yielded a better accuracy than rigid registration, without introducing unrealistic deformations. For deformable registration, an average landmark alignment of approximatively 1.7 mm was obtained. For all the regions of interest excluding the cerebellum and the parotids, deformable registration provided a median modified Hausdorff distance of approximatively 1 mm. Similar accuracies were obtained for the single-parameter and multiparameter approaches. Conclusions: This study demonstrates that deformable registration of head-and-neck CT and MR images is feasible, with overall a significanlty higher accuracy than for rigid registration.

Feasibility of Multimodal Deformable Registration for Head and Neck Tumor Treatment Planning

International Nuclear Information System (INIS)

Fortunati, Valerio; Verhaart, René F.; Angeloni, Francesco; Lugt, Aad van der; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; Walsum, Theo van

2014-01-01

Purpose: To investigate the feasibility of using deformable registration in clinical practice to fuse MR and CT images of the head and neck for treatment planning. Method and Materials: A state-of-the-art deformable registration algorithm was optimized, evaluated, and compared with rigid registration. The evaluation was based on manually annotated anatomic landmarks and regions of interest in both modalities. We also developed a multiparametric registration approach, which simultaneously aligns T1- and T2-weighted MR sequences to CT. This was evaluated and compared with single-parametric approaches. Results: Our results show that deformable registration yielded a better accuracy than rigid registration, without introducing unrealistic deformations. For deformable registration, an average landmark alignment of approximatively 1.7 mm was obtained. For all the regions of interest excluding the cerebellum and the parotids, deformable registration provided a median modified Hausdorff distance of approximatively 1 mm. Similar accuracies were obtained for the single-parameter and multiparameter approaches. Conclusions: This study demonstrates that deformable registration of head-and-neck CT and MR images is feasible, with overall a significanlty higher accuracy than for rigid registration

Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results.

Science.gov (United States)

Žiak, Peter; Holm, Anders; Halička, Juraj; Mojžiš, Peter; Piñero, David P

2017-06-28

The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment. A total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17-69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR). Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence. Trial ID: ISRCTN62086471 . Date registered: 13/06/2017. Retrospectively registered.

Tackling the challenges of fully immersive head-mounted AR devices

Science.gov (United States)

Singer, Wolfgang; Hillenbrand, Matthias; Münz, Holger

2017-11-01

The optical requirements of fully immersive head mounted AR devices are inherently determined by the human visual system. The etendue of the visual system is large. As a consequence, the requirements for fully immersive head-mounted AR devices exceeds almost any high end optical system. Two promising solutions to achieve the large etendue and their challenges are discussed. Head-mounted augmented reality devices have been developed for decades - mostly for application within aircrafts and in combination with a heavy and bulky helmet. The established head-up displays for applications within automotive vehicles typically utilize similar techniques. Recently, there is the vision of eyeglasses with included augmentation, offering a large field of view, and being unobtrusively all-day wearable. There seems to be no simple solution to reach the functional performance requirements. Known technical solutions paths seem to be a dead-end, and some seem to offer promising perspectives, however with severe limitations. As an alternative, unobtrusively all-day wearable devices with a significantly smaller field of view are already possible.

Migration from full‐head mask to “open‐face” mask for immobilization of patients with head and neck cancer

Science.gov (United States)

Lovelock, D. Michael; Mechalakos, James; Rao, Shyam; Della‐Biancia, Cesar; Amols, Howard; Lee, Nancy

2013-01-01

To provide an alternative device for immobilization of the head while easing claustrophobia and improving comfort, an “open‐face” thermoplastic mask was evaluated using video‐based optical surface imaging (OSI) and kilovoltage (kV) X‐ray radiography. A three‐point thermoplastic head mask with a precut opening and reinforced strips was developed. After molding, it provided sufficient visible facial area as the region of interest for OSI. Using real‐time OSI, the head motion of ten volunteers in the new mask was evaluated during mask locking and 15 minutes lying on the treatment couch. Using a nose mark with reference to room lasers, forced head movement in open‐face and full‐head masks (with a nose hole) was compared. Five patients with claustrophobia were immobilized with open‐face masks, set up using OSI and kV, and treated in 121 fractions, in which 61 fractions were monitored during treatment using real‐time OSI. With the open‐face mask, head motion was found to be 1.0 ± 0.6 mm and 0.4° ± 0.2° in volunteers during the experiment, and 0.8 ± 0.3 mm and 0.4° ± 0.2° in patients during treatment. These agree with patient motion calculated from pre‐/post‐treatment OSI and kV data using different anatomical landmarks. In volunteers, the head shift induced by mask‐locking was 2.3 ± 1.7 mm and 1.8° ± 0.6°, and the range of forced movements in the open‐face and full‐head masks were found to be similar. Most (80%) of the volunteers preferred the open‐face mask to the full‐head mask, while claustrophobic patients could only tolerate the open‐face mask. The open‐face mask is characterized for its immobilization capability and can immobilize patients sufficiently (face mask is readily adopted in radiotherapy clinic as a superior alternative to the standard full‐head mask. PACS numbers: 87.19.xj, 87.63.L‐, 87.59.‐e, 87.55.tg, 87.55.‐x PMID:24036878

Psychological Factors Associated with Head and Neck Cancer Treatment and Survivorship : Evidence and Opportunities for Behavioral Medicine

Science.gov (United States)

Howren, M. Bryant; Christensen, Alan J.; Karnell, Lucy Hynds; Funk, Gerry F.

2013-01-01

Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately…

Development of an Inflatable Head/Neck Restraint System for Ejection Seats

Science.gov (United States)

1977-02-28

crewman’s head . It has been observed that low pressures, about 2 psi (1.38 nt/cm2 ) to 4 psi (2.76 nt/cm2 ), create some "spring back" or trampoline ...neck ring Neck injury Head rotation 210 ABSTRACT (Continue on rev’erse side If necessary end identify by block number) 4A ringý-shaped inflatable head ...injuries due to violent forward head rotation at the time of ejection thrust and parachute opening shock. Inflation of the neck ring will,’ be conducted by a

Exploding head syndrome.

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Sharpless, Brian A

2014-12-01

Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear and distress. In spite of the fact that its characteristic symptomatology was first described approximately 150 y ago, exploding head syndrome has received relatively little empirical and clinical attention. Therefore, a comprehensive review of the scientific literature using Medline, PsycINFO, Google Scholar, and PubMed was undertaken. After first discussing the history, prevalence, and associated features, the available polysomnography data and five main etiological theories for exploding head syndrome are summarized. None of these theories has yet reached dominance in the field. Next, the various methods used to assess and treat exploding head syndrome are discussed, as well as the limited outcome data. Finally, recommendations for future measure construction, treatment options, and differential diagnosis are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Shaikh, Talha [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Murphy, Colin T. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Mehra, Ranee [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ridge, John A. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Galloway, Thomas J., E-mail: Thomas.Galloway@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

2016-12-01

Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as <47 days, and standard RTT was defined as 47 to 56 days. In the postoperative setting, prolonged RTT was defined as >49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ{sup 2} tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

Erosion estimation of guide vane end clearance in hydraulic turbines with sediment water flow

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Han, Wei; Kang, Jingbo; Wang, Jie; Peng, Guoyi; Li, Lianyuan; Su, Min

2018-04-01

The end surface of guide vane or head cover is one of the most serious parts of sediment erosion for high-head hydraulic turbines. In order to investigate the relationship between erosion depth of wall surface and the characteristic parameter of erosion, an estimative method including a simplified flow model and a modificatory erosion calculative function is proposed in this paper. The flow between the end surfaces of guide vane and head cover is simplified as a clearance flow around a circular cylinder with a backward facing step. Erosion characteristic parameter of csws3 is calculated with the mixture model for multiphase flow and the renormalization group (RNG) k-𝜀 turbulence model under the actual working conditions, based on which, erosion depths of guide vane and head cover end surfaces are estimated with a modification of erosion coefficient K. The estimation results agree well with the actual situation. It is shown that the estimative method is reasonable for erosion prediction of guide vane and can provide a significant reference to determine the optimal maintenance cycle for hydraulic turbine in the future.

The impact of use of Glutamine on patients with head and neck tumors in radiotherapy and chemotherapy treatment

International Nuclear Information System (INIS)

Boligon, Caroline Schardong; Huth, Adriane

2011-01-01

Introduction: patients with head and neck neoplasia usually show malnutrition or a nutritional risk, because of common symptoms like: dysphagia, odynophagia and xerostomia. Objective: this study aimed to verify the impact of using amino glutamine in patients with head and neck neoplasia and under radiotherapy and chemotherapy treatment concomitantly. Methods: the research was quantitative, cross-sectional, descriptive and exploratory. The data was collected from nutritional evaluation, and patients chart consultation. The patients were divided in a control group (without use of glutamine) and a test group (with use of glutamine). 16 patients, 13 of which were men and three were women, participated in the research. Results: The control group presented mucositis grades I to IV while patients who used the amino glutamine showed mucositis grades I to II only. It could be observed that the Nutritional Risk Index decreased, which represents higher nutritional risk in patients from the control group only. In patients who used glutamine, this decrease was not significant. Conclusion: these results suggest that the use of glutamine in patients with head and neck tumors and under antineoplastic therapy helps to maintain their nutritional stage and to prevent mucositis throughout their treatment, mainly grades III and IV, which prevents adequate and regular eating and nourishment. (author)

Picibanil (OK-432) in the treatment of head and neck lymphangiomas in children.

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Rebuffini, Elena; Zuccarino, Luca; Grecchi, Emma; Carinci, Francesco; Merulla, Vittorio Emanuele

2012-12-01

Picibanil (OK-432) is a lyophilized mixture of group A Streptococcus pyogenes with antineoplastic activity. Because of its capacity to produce a selective fibrosis of lymphangiomas (LMs), it has been approved by Japanese administration in 1995 for the treatment of LMs. We treated 15 children (age range: 6-60 months) affected by head and neck macrocystic LMs with intracystic injections (single dose of 0.2 mL) of Picibanil (1-3 injections). Complete disappearance of the lesion was noticed in eight (53.33%) cases, a marked (>50%) reduction of LMs was found five (33.33%) cases, while a moderate (Picibanil side effects included fever, local inflammation, and transitory increase of blood platelets' concentration; a single case of anemia was resolved with concentrated red blood cells transfusion. Intracystic injection of Picibanil is an effective and safe treatment for macrocystic LMs in pediatric patients and may represent the treatment of choice in such cases, especially where surgical excision is associated with the risk of functional/cosmetic side effects.

Development of a head and neck companion module for the quality of life-radiation therapy instrument (QOL-RTI)

International Nuclear Information System (INIS)

Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Sauder, Bonnie; Cantor, Alan; Pearlman, James

1998-01-01

Purpose/Objective: A review of available head and neck quality of life (QOL) instruments reveals them to inadequately address important radiation related side effects, or to be too cumbersome for routine use. The purpose of this study was to develop a head and neck disease specific module as a companion to the previously developed quality of life - radiation therapy instrument (QOL-RTI). The goal was to create a more complete, yet concise, head and neck site-specific module geared toward patients receiving radiation therapy for head and neck cancer. Methods and Materials: This exploratory study included 34 consecutive patients undergoing definitive radiotherapy over a 6-7 week course (60-79.8 Gy). We developed and administered a 14-item questionnaire to all eligible patients treated with radiotherapy for head and neck cancer who were not already registered in another research study assessing quality of life (e.g., RTOG). During the treatment period, the QOL-RTI general tool and the head and neck (H and N) module were administered as follows: at baseline, at week four (for test-retest), and at the end of the treatment period. For validation purposes the QOL-RTI/H and N was compared to the functional assessment cancer tool head and neck (FACT-H and N) questionnaire. The FACT-H and N was administered one time at week 4, on the same day as the QOL-RTI/H and N. This report includes the treatment phase of the study (during the course of radiation). Results: Mean age was 62 years (range 40-75). Internal consistency of the module was satisfactory (Chronbach's α = 0.85). Test-retest yielded a correlation coefficient of 0.90 (p < 0.001). Concurrent validity, established by comparing the module to the FACT/H and N , yielded a correlation coefficient of 0.85. Significant changes in quality of life scores during a course of radiation was noted for both general quality of life tool and the site specific module. For the head and neck module, the difference in the mean baseline

[Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznań University of Medical Sciences, Poland].

Science.gov (United States)

Wróbel, Maciej; Kopeć, Tomasz; Juszkat, Robert; Szyfterl, Witold; Borucki, Łukasz

2008-01-01

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

Botulinum toxin for treatment of restrictive strabismus.

Science.gov (United States)

Merino, Pilar S; Vera, Rebeca E; Mariñas, Laura G; Gómez de Liaño, Pilar S; Escribano, Jose V

To study the types of acquired restrictive strabismus treated in a tertiary hospital and the outcome of treatment with botulinum toxin. We performed a 10-year retrospective study of patients with restrictive strabismus aged ≥18 years who were treated with botulinum toxin. Treatment was considered successful if the final vertical deviation was ≤5 PD, horizontal deviation ≤10 PD, with no head turn or diplopia. We included 27 cases (mean age, 61.9 years). Horizontal strabismus was diagnosed in 11.1%, vertical in 51.9%, and mixed in 37%. Strabismus was secondary to cataract surgery in 6 cases, high myopia in 6, orbital fractures in 5, retinal surgery in 5, Graves ophthalmopathy in 4, and repair of conjunctival injury in 1 case. Diplopia was diagnosed in all patients, head turn in 33.3%. The initial deviation was 14 PD (range, 2-40), the mean number of injections per patient was 1.6 (range, 1-3), and the mean dose was 9.5 IU (range, 2.5-22.5). At the end of follow-up, diplopia was recorded in 59.3%, head turn in 18.5%, surgical treatment in 51.9%, and need for prism glasses in 14.8%. Outcome was successful in 37% of patients (4 high myopia, 3 orbital fractures, 2 post-surgical retinal detachment, and 1 post-cataract surgery). Mean follow-up was 3±1.8 years. Vertical deviation was observed in half of the sample. The most frequent deviation was secondary to cataract surgery and high myopia. Treatment with botulinum toxin was successful in one-third of the patients at the end of follow-up. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Spanish Instruction in Head Start and Dual Language Learners' Academic Achievement.

Science.gov (United States)

Miller, Elizabeth B

2017-09-01

Data from the Head Start Impact Study ( N = 1,141) and the Head Start Family and Child Experiences Survey, 2009 Cohort ( N = 825) were used to investigate whether Spanish instruction in Head Start differentially increased Spanish-speaking Dual Language Learners' (DLLs) academic achievement. Although hypothesized that Spanish instruction would be beneficial for DLLs' early literacy and math skills, results from residualized growth models showed there were no such positive associations. Somewhat surprisingly, DLL children instructed in Spanish had higher English receptive vocabulary skills at the end of the Head Start year than those not instructed, with children randomly assigned to Head Start and instructed in Spanish having the highest scores. Policy implications for Head Start-eligible Spanish-speaking DLLs are discussed.

Aging Prisoners’ Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?

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Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald

2011-01-01

Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder. Design and Methods: Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68). Results: We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled. Implications: End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates’ desire for active treatment or days of desired life in the future. PMID:21593007

A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Nill, Simeon [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Huber, Peter E. [Clinical Co-Operation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Bendl, Rolf [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Debus, Juergen; Muenter, Marc W. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)

2012-02-01

Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

International Nuclear Information System (INIS)

Jensen, Alexandra D.; Nill, Simeon; Huber, Peter E.; Bendl, Rolf; Debus, Jürgen; Münter, Marc W.

2012-01-01

Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006–2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

A clinical concept for interfractional adaptive radiation therapy in the treatment of head and neck cancer.

Science.gov (United States)

Jensen, Alexandra D; Nill, Simeon; Huber, Peter E; Bendl, Rolf; Debus, Jürgen; Münter, Marc W

2012-02-01

To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant

Impact of comorbidity on treatment outcome in head and neck squamous cell carcinoma – A systematic review

International Nuclear Information System (INIS)

Bøje, Charlotte Rotbøl

2014-01-01

The significant association with tobacco and alcohol combined with advanced age at time of diagnosis predispose head and neck squamous cell carcinoma (HNSCC) patients to increased risk of comorbidities. The presence of comorbidity affects treatment, treatment selection and subsequent outcome. Multiple studies have demonstrated comorbidity to be a strong prognostic factor for survival, and therefore comorbidity can be a major confounder in clinical trials. This review provides a summary of the current literature on comorbidity in head and neck cancer, measurements of comorbidity, the impact of comorbidity on treatment, treatment selection, and survival. A systematic search was performed in six electronic databases. In all, 31 papers were selected for this review. A meta-analysis on the prognostic impact of comorbidity was performed including 10 studies. Furthermore, 21 studies concerning comorbidity were reviewed. Several valid indices to classify comorbidity were described in the literature, none proven to be superior over the other. The prevalence of comorbidity increased with age and the presence of comorbidity influenced treatment and treatment selection. Furthermore, comorbidity was associated with lower socio economic status and increased the risk of early retirement after treatment. The meta-analysis on comorbidity as a prognostic factor, including 22,932 patients, showed that overall survival was significantly worsened among patients with comorbidity (HR = 1.38 (1.32–1.43)). Increasing comorbidity-score was associated with increased risk of death. Comorbidity is important in HNSCC and significantly impacts on overall survival. Trials concerning HNSCC should always include information on comorbidity and randomized trials should stratify patients according to comorbidity in order to avoid bias in the study

Primary tendinitis of the long head of the biceps.

Science.gov (United States)

Post, M; Benca, P

1989-09-01

Seventeen patients with chronic painful shoulders who showed evidence of isolated bicipital tendinitis involving only the extracapsular, intertubercular portion of the long head of the biceps were chosen for surgical treatment when conservative treatment failed. The patients were thought to have primary bicipital tendinitis. The latter condition is secondary to other shoulder pathologies. Thirteen patients had tenodeses and four patients had transfer of the long head of the biceps to the origin of the conjoined tendon. Overall, excellent and good results were noted in 94% of both groups of patients when the long head of the biceps was tenodesed or transferred. Whether or not the long head of the biceps is a significant depressor of the humeral head requires further investigation.

Characteristics and intraoperative treatments associated with head and neck free tissue transfer complications and failures.

Science.gov (United States)

Hand, William R; McSwain, Julie R; McEvoy, Matthew D; Wolf, Bethany; Algendy, Abdalrahman A; Parks, Matthew D; Murray, John L; Reeves, Scott T

2015-03-01

To investigate the association between perioperative patient characteristics and treatment modalities (eg, vasopressor use and volume of fluid administration) with complications and failure rates in patients undergoing head and neck free tissue transfer (FTT). A retrospective review of medical records. Perioperative hospitalization for head and neck FTT at 1 tertiary care medical center between January 1, 2009, and October 31, 2011. Consecutive patients (N=235) who underwent head and neck FTT. Demographic, patient characteristic, and intraoperative data were extracted from medical records. Complication and failure rates within the first 30 days were collected In a multivariate analysis controlling for age, sex, ethnicity, reason for receiving flap, and type and volume of fluid given, perioperative complication was significantly associated with surgical blood loss (P=.019; 95% confidence interval [CI], 1.01-1.16), while the rate of intraoperative fluid administration did not reach statistical significance (P=.06; 95% CI, 0.99-1.28). In a univariate analysis, FTT failure was significantly associated with reason for surgery (odds ratio, 5.40; P=.03; 95% CI, 1.69-17.3) and preoperative diagnosis of coronary artery disease (odds ratio, 3.60; P=.03; 95% CI, 1.16-11.2). Intraoperative vasopressor administration was not associated with either FTT complication or failure rate. FTT complications were associated with surgical blood loss but not the use of vasoactive drugs. For patients undergoing FTT, judicious monitoring of blood loss may help stratify the risk of complication and failure. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Simulation of saltwater movement in the Floridan aquifer system, Hilton Head Island, South Carolina

Science.gov (United States)

Bush, Peter W.

1988-01-01

Freshwater to supply Hilton Head Island, S.C., is obtained from the upper permeable zone of the Upper Floridan aquifer. Long-term pumping at Savannah, Ga., and the steadily increasing pumping on Hilton Head Island, have lowered Upper Floridan heads near the center of the island from about 10 feet above sea level to about 6 to 7 feet below sea level. The seaward hydraulic gradient that existed before pumping began has been reversed, thus increasing the potential for saltwater intrusion. Simulations of predevelopment, recent, and future ground-water flow in the Floridan aquifer system beneath the north end of Hilton Head Island and Port Royal Sound are presented. A finite-element model for fluid-density-dependent ground-water flow and solute transport was used in cross section. The general configuration of the simulated predevelopment flowfield is typical of a coastal aquifer having a seaward gradient in the freshwater. The freshwater flows toward Port Royal Sound over an intruding wedge of saltwater. The simulated flowfield at the end of 1983 shows that ground water in the Floridan aquifer system beneath most of Hilton Head Island has reversed its predevelopment direction and is moving toward Savannah. The distribution of chloride concentrations, based on simulation at the end of 1983, is about the same as the predevelopment distribution of chloride concentrations obtained from simulation. Results of two 50-year simulations from 1983 to 2034 suggest that there will be no significant threat of saltwater intrusion into the upper permeable zone of the Upper Floridan aquifer if heads on Hilton Head Island remain at current levels for the next 45 to 50 years. However, if head decline continues at the historical rate, any flow that presently occurs from the north end of the island toward Port Royal Sound will cease, allowing lateral intrusion of saltwater to proceed. Even under these conditions, chloride concentrations in the upper permeable zone of the Upper Floridan

Head and Neck Cancer—Health Professional Version

Science.gov (United States)

Head and neck cancers include hypopharyngeal, laryngeal, lip and oral cavity, metastatic squamous neck, nasopharyngeal, oropharyngeal, paranasal sinus, and salivary gland cancers. Find evidence-based information on head and neck cancer treatment, causes and prevention, research, screening, and statistics.

Head and neck: treatment of primary and relapsed nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wang, C.C.

1995-01-01

Purpose/Objective: Nasopharyngeal carcinoma (NPC) is not a common malignancy of the head and neck in the United States and presents a great challenge to the radiation oncologists in this country. Its management is radiotherapeutic and technically demanding and calls for careful treatment techniques to include the primary and the lymphatic drainage areas to high doses while sparing the neighboring organs such as the spinal cord, eyes, temporal lobes and midrain. This refresher course will review the clinical course, pattern of spread with manifestations of various neurologic syndromes of the disease. The radiotherapeutic management of primary lesion will be discussed in detail including the treatment techniques, placement of the irradiation portals, dose levels, etc. Treatment results as reported in the literature as well as those achieved at the MGH will be presented. Special emphasis will be placed on the routine use of intracavitary implant to boost the primary site and its technical aspects. Relapsed NPC after previous radiation therapy presents a difficult problem in management, but can be re-irradiated with occasional success by observing careful technique and fractionated intracavitary brachytherapy and the local control rates will be briefly covered. Recurrent disease in the neck will be managed by neck dissection. Xerostomia is undesirable and common sequelae following radical radiation therapy for NPC. Efforts are being made to decrease its magnitude by using higher energies of photons, i.e. 10 MV to spare a portion of the parotid glands with some promising results. Because of the unique location of the primary lesion, currently a modified BID program (MBID) is used and its techniques and treatment concept are discussed

The Natural History and Treatment Outcomes of Perineural Spread of Malignancy within the Head and Neck.

Science.gov (United States)

Warren, Timothy A; Nagle, Christina M; Bowman, James; Panizza, Benedict J

2016-04-01

Understanding the natural history of diseases enables the clinician to better diagnose and treat their patients. Perineural spread of head and neck cancers are poorly understood and often diagnosis is delayed resulting in poorer outcomes and more debilitating treatments. This article reviews a large personal series of head and neck malignancy presenting with perineural spread along almost exclusively the trigeminal and/or facial nerves. A detailed analysis of squamous cell carcinoma of cutaneous origin is presented including an analysis of likely primaries, which most often have occurred months to years prior. The importance of early detection is reinforced by the highly significant (p < 0.0001) differences in disease specific survival, which occur, depending on how far along a cranial nerve the disease has been allowed to spread.

Management of radiation therapy-induced mucositis in head and neck cancer patients. Part II: supportive treatments

Directory of Open Access Journals (Sweden)

Wei Cheong Ngeow

2011-12-01

Full Text Available Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken systematic reviews or issued guidelines on the management of mucositis, it is the aim of this review instead, to provide an overview of all the remedies and pharmaceutical agents available, as well as highlighting to researchers the gaps that need to be filled.

Prevalence and clinical significance of cancer cachexia based on time from treatment in advanced-stage head and neck squamous cell carcinoma.

Science.gov (United States)

Kwon, Minsu; Kim, Rock Bum; Roh, Jong-Lyel; Lee, Sang-Wook; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

2017-04-01

The purpose of this study was to identify the prevalence of cancer cachexia and its prognostic impact in patients with advanced head and neck squamous cell carcinoma (HNSCC). The prevalence of cancer cachexia was analyzed according to the follow-up periods during the first year after curative initial treatment. Recurrences, noncancer health events (NCHEs), and cause-specific survival outcomes were also analyzed according to the incidence of cancer cachexia during follow-up. Cancer cachexia was identified in 22 (6.1%), 148 (41%), 66 (18.4%), and 65 (18.7%) of 361 enrolled patients at pretreatment, immediately after treatment, 6-months after treatment, and 12-months after treatment, respectively. Sustained or newly developed cachexia at 6 and 12 months showed a significant association with recurrence and NCHE occurrence (p cachexia had a higher probability of cancer-specific death, noncancerous death, and overall death (p Cachexia prevalence at 6 and 12 months after treatment for HNSCC indicates a higher chance of recurrence, NCHE, and death. © 2016 Wiley Periodicals, Inc. Head Neck 39: 716-723, 2017. © 2016 Wiley Periodicals, Inc.

Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

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Pouya, Farzaneh; Kerachian, Mohammad Amin

2015-01-01

Avascular necrosis of the femoral head (ANFH) is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continues to be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse. PMID:26213697

One trial treatment for postoperative fistulas of irradiated malignant tumors in the head and neck

International Nuclear Information System (INIS)

Sakai, Noboru; Nagahashi, Tatsumi; Nakamaru, Yuji; Asai, Toshiyuki; Kurihara, Hideo; Katoh, Akio; Yokohama, Masaki; Gotohda, Hiroyuki; Inuyama, Yukio

1995-01-01

It is very difficult to treat postoperative fistulas of irradiated malignant tumors in the head and neck. These fistulas generally require either surgical or conservative therapy, but the poor healing induced by irradiation means that a long time is required to obtain a complete cure. As one of the conservative therapies for these wounds, we first applied alcloxa powder which had been used as the treatment of either decubitis or ulcers, and we thus were able to obtain a complete cure in 8 patients without the need for any reconstructive surgery. The number of days required to obtain a complete cure of the fistulas ranged from 9 to 84 days, with an average of 39.8 days. These results indicated that this powder had an excellent efficacy on wound healing, and it should thus be used frequently on incurable postoperative fistulas after irradiation in head and neck malignancies. (author)

One trial treatment for postoperative fistulas of irradiated malignant tumors in the head and neck

Energy Technology Data Exchange (ETDEWEB)

Sakai, Noboru; Nagahashi, Tatsumi; Nakamaru, Yuji; Asai, Toshiyuki; Kurihara, Hideo; Katoh, Akio; Yokohama, Masaki; Gotohda, Hiroyuki; Inuyama, Yukio [Hokkaido Univ., Sapporo (Japan). School of Medicine

1995-03-01

It is very difficult to treat postoperative fistulas of irradiated malignant tumors in the head and neck. These fistulas generally require either surgical or conservative therapy, but the poor healing induced by irradiation means that a long time is required to obtain a complete cure. As one of the conservative therapies for these wounds, we first applied alcloxa powder which had been used as the treatment of either decubitis or ulcers, and we thus were able to obtain a complete cure in 8 patients without the need for any reconstructive surgery. The number of days required to obtain a complete cure of the fistulas ranged from 9 to 84 days, with an average of 39.8 days. These results indicated that this powder had an excellent efficacy on wound healing, and it should thus be used frequently on incurable postoperative fistulas after irradiation in head and neck malignancies. (author).

Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

International Nuclear Information System (INIS)

Vargas, Nicolas M.; Garcia, Marcia; Piriz, Gustavo; Perez, Niurka

2011-01-01

Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

Energy Technology Data Exchange (ETDEWEB)

Vargas, Nicolas M.; Garcia, Marcia, E-mail: nimoralesv@gmail.com [Universidad de La Frontera, Temuco (Chile). Dept. de Ciencias Fisicas; Piriz, Gustavo [Instituto Nacional del Cancer, Santiago (Chile). Fisica Medica; Perez, Niurka [Instituto de Salud Publica, Santiago (Chile). QA Radioterapia. Inst. de Salud Publica

2011-07-01

Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

Drug treatment at the end of life: an epidemiologic study in nursing homes.

Science.gov (United States)

Jansen, Kristian; Schaufel, Margrethe Aase; Ruths, Sabine

2014-12-01

To examine drug treatment in nursing home patients at the end of life, and identify predictors of palliative drug therapy. A historical cohort study. Three urban nursing homes in Norway. All patients admitted from January 2008 and deceased before February 2013. Drug prescriptions, diagnoses, and demographic data were collected from electronic patient records. Palliative end-of-life drug treatment was defined on the basis of indication, drug, and formulation. 524 patients were included, median (range) age at death 86 (19-104) years, 59% women. On the day of death, 99.4% of the study population had active prescriptions; 74.2% had palliative drugs either alone (26.9%) or concomitantly with curative/preventive drugs (47.3%). Palliative drugs were associated with nursing home, length of stay > 16 months (AOR 2.10, 95% CI 1.12-3.94), age (1.03, 1.005-1.05), and a diagnosis of cancer (2.12, 1.19-3.76). Most initiations of palliative drugs and withdrawals of curative/preventive drugs took place on the day of death. Palliative drug therapy and drug therapy changes are common for nursing home patients on the last day of life. Improvements in end-of-life care in nursing homes imply addressing prognostication and earlier response to palliative needs.

Treatment of lymphatic malformations of head and neck with OK-432 sclerotherapy induce systemic inflammatory response.

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Närkiö-Mäkelä, Mervi; Mäkelä, Teppo; Saarinen, Pia; Salminen, Päivi; Julkunen, Ilkka; Pitkäranta, Anne

2011-01-01

Systemic immune responses after OK-432 (Picibanil) sclerotherapy in patients with head and neck lymphatic malformations (LM) were examined to achieve a better understanding of the mechanism of OK-432 sclerotherapy and to evaluate the long-term treatment outcome. Serum samples from 17 consecutive patients with head and neck LMs were collected during a total of 26 OK-432 treatment episodes. Serum C-reactive protein (CRP), interleukins (IL) 1β, 6, 8, 10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, RANTES, immune protein (IP)-10 and macrophage chemoattractant protein (MCP)-1 as well as blood leukocyte counts were determined. Clinical outcome of the treatment was evaluated at the last visit and from patient files. Elevated serum levels of IP-10 (means at baseline 702 ng/L, after 1 day 1180 ng/L, after 4 weeks 691 ng/L) were seen on day one after OK-432 sclerotherapy (p < 0.05). C-reactive protein and leukocyte counts 1 day after treatment differed statistically significantly (p < 0.05) from the baseline. No significant differences with other cytokines investigated were observed. Patients with macrocystic LM responded better than patients with microcystic LM (p = 0.01). The elevated levels of IP-10, C-reactive protein and leukocyte levels indicate that OK-432 sclerotherapy induces systemic immune responses in patients with LM. The mechanisms of OK-432 sclerotherapy are still not precisely understood, but the IP-10 elevation may reflect local antiangiogenetic properties of immunoactivation induced by OK-432.

Ketamine PCA for treatment of end-of-life neuropathic pain in pediatrics.

Science.gov (United States)

Taylor, Matthew; Jakacki, Regina; May, Carol; Howrie, Denise; Maurer, Scott

2015-12-01

Control of neuropathic pain (NP) for children at end of life is challenging. Ketamine improves control of NP, but its use in children is not well described. We describe a retrospective case review of 14 children with terminal prognoses treated with ketamine patient-controlled analgesia (PCA) for management of opioid-refractory NP at the end of life. Median ketamine dose was 0.06 mg/kg/h (range 0.014-0.308 mg/kg/h) with a 0.05 mg/kg (range 0.03-0.5mg/kg) demand dose available every 15 minutes (range 10-60 minutes). All patients noted subjective pain relief with ketamine, and 79% had no adverse effects. Benzodiazepines limited neuropsychiatric side effects. Ketamine treatment arrested dose escalation of opioids in 64% of patients, and 79% were discharged to home hospice. Ketamine PCA is an effective, well-tolerated therapy for opioid-refractory NP in pediatric end-of-life care. © The Author(s) 2014.

Volumetric visualization of head and neck CT data for treatment planning

International Nuclear Information System (INIS)

Lee, Jean S.; Jani, Ashesh B.; Pelizzari, Charles A.; Haraf, Daniel J.; Vokes, Everett E.; Weichselbaum, Ralph R.; Chen, George T.Y.

1999-01-01

Purpose: To demonstrate the utility of volume rendering, an alternative visualization technique to surface rendering, in the practice of CT based radiotherapy planning for the head and neck. Methods and Materials: Rendo-avs, a volume visualization tool developed at the University of Chicago, was used to volume render head and neck CT scans from two cases. Rendo-avs is a volume rendering tool operating within the graphical user interface environment of AVS (Application Visualization System). Users adjust the opacity of various tissues by defining the opacity transfer function (OTF), a function which preclassifies voxels by opacity prior to rendering. By defining the opacity map (OTF), the user selectively enhances and suppresses structures of various intensity. Additional graphics tools are available within the AVS network, allowing for the manipulation of perspective, field of view, data orientation. Users may draw directly on volume rendered images, create a partial surface, and thereby correlate objects in the 3D scene to points on original axial slices. Information in volume rendered images is mapped into the original CT slices via a Z buffer, which contains the depth information (Z coordinate) for each pixel in the rendered view. Locally developed software was used to project conventionally designed GTV contours onto volume rendered images. Results: The lymph nodes, salivary glands, vessels, and airway are visualized in detail without prior manual segmentation. Volume rendering can be used to explore the finer anatomic structures that appear on consecutive axial slices as 'points'. Rendo-avs allowed for acceptable interactivity, with a processing time of approximately 5 seconds per 256 x 256 pixel output image. Conclusions: Volume rendering is a useful alternative to surface rendering, offering high-quality visualization, 3D anatomic delineation, and time savings to the user, due to the elimination of manual segmentation as a preprocessing step. Volume rendered

Modifications to advanced Core decompression for treatment of Avascular necrosis of the femoral head

OpenAIRE

Landgraeber, Stefan; Warwas, Sebastian; Claßen, Tim; Jäger, Marcus

2017-01-01

Background “Advanced Core Decompression” (ACD) is a new technique for treatment of osteonecrosis of the femoral head (ONFH) that includes removal of the necrotic tissue using a percutaneous expandable reamer followed by refilling of the drill hole and the defect with an injectable, hard-setting, composite calcium sulphate (CaSO4)-calcium phosphate (CaPO4) bone graft substitute. As autologous bone has been shown to be superior to all other types of bone grafts, the aim of the study is to prese...

Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

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Dong Sun

2013-12-01

Full Text Available OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery. CONCLUSIONS: Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection.

Collagen Type III Metabolism Evaluation in Patients with Malignant Head and Neck Cancer Treated with Radiotherapy

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Klaudia Mazurek

2018-01-01

Full Text Available Ionizing radiation affects the metabolism of key proteins of extracellular matrix including type III collagen, an important component of human skin. The aim of the work is an analysis of the impact of radical and palliative radiotherapy on collagen type III synthesis in patients with head and neck cancer. The test group consisted of 56 males with histopathologically confirmed head and neck cancer, for whom radiotherapy was applied as a form of radical or palliative treatment. The level of procollagen III aminoterminal propeptide (PIIINP, which is a marker of collagen type III synthesis, was determined in blood serum before radiotherapy, immediately following radiotherapy, and 3 months after it was finished. As a result of radical radiotherapy a statistically significant decrease of PIIINP levels in serum (p<0.0001 was observed, both immediately after the radiotherapy and 3 months after the end of the treatment. Also the palliative radiotherapy caused a significant decrease of PIIINP right after the treatment (p=0.0052, as well as during the examination performed 3 months later (p=0.0004. The achieved results suggest that PIIINP can be used as a marker helpful in assessing radiation damage to connective tissue.

[Treatment of painful neuromas via end-to-side neurorraphy].

Science.gov (United States)

Aszmann, O C; Moser, V; Frey, M

2010-08-01

Management of the painful neuroma has been subject to controversy since the earliest descriptions of this disabling problem. Today, treatment is limited to resection of the neuroma and implantation of the nerve in a muscle at a location where it is safe from irritation and trauma. This however is not attainable in many cases and it is our clinical experience, that nerves without a target remain a source of constant discomfort and pain. Recently we reported of the feasibility of neuroma prevention through end-to-side neurorraphy into adjacent sensory and/or motor nerves to provide a target for axons deprived of their endorgan. Here we report of our first clinical experience with this method in sixteen patients with longstanding upper and lower extremity neuromas. 16 patients were included in this study. All had neuromas of different sensory nerves of both the upper and lower extremity. 11 were of iatrogenic origin, 5 were caused by different traumas. 8 had previous attempts to surgically treat the neuroma. Finally, all were treated by end-to-side neurorraphy into adjacent nerves. Postoperatively quantitative sensorymotor testing was performed to evaluate possible changes of nerve function of the recipient nerves. Pain was evaluated by visual analogue score and changes in pain medication. In no patient a sensory or motor deficit or painful sensations were induced in the target area of the recipient nerve. Some had dysaesthesias for about 6 months, which finally subsided. All but 1 patient improved in their symptoms at a follow-up of more than 2 years. Previous experimental work and present clinical results suggest that axons of a severed peripheral nerve that are provided with a pathway and target through an end-to-side coaptation will either be pruned or establish some type of end-organ contact so that a neuroma can be prevented without inducing sensory or motor dysfunctions in the recipient nerve. Georg Thieme Verlag KG Stuttgart New York.

General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

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Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de [Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany); Buchholz, G. [Ludwig-Maximilians-University Hospital, Department of Neurology (Germany); Killer, M. [Paracelsus Medical University, Neurology/Research Institute of Neurointervention (Austria); Ertl, L.; Brückmann, H. [Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany); Lutz, J. [Ingolstadt Hospital, Department of Neuroradiology (Germany)

2016-09-15

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.

General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

International Nuclear Information System (INIS)

Janssen, H.; Buchholz, G.; Killer, M.; Ertl, L.; Brückmann, H.; Lutz, J.

2016-01-01

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.

Fuel rod pellet loading head

International Nuclear Information System (INIS)

Howell, T.E.

1975-01-01

An assembly for loading nuclear fuel pellets into a fuel rod comprising a loading head for feeding pellets into the open end of the rod is described. The pellets rest in a perforated substantially V-shaped seat through which air may be drawn for removal of chips and dust. The rod is held in place in an adjustable notched locator which permits alignment with the pellets

Treatment modalities of oral mucositis after radiation of head and neck cancers

International Nuclear Information System (INIS)

Lapeyre, M.; Charra-Brunaud, C.; Kaminsky, M.C.; Geoffrois, L.; Dolivet, G.; Pourel, N.; Marchal, C.; Bey, P.; Maire, F.; Simon, M.; Toussaint, B.

2001-01-01

Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

Physics of radiation therapy of head and neck tumors

International Nuclear Information System (INIS)

Almond, P.R.

1987-01-01

Radiotherapy treatment of head and neck cancers probably requires more individual planning than for any other cancer site because of the large number of variables that exist. The fact that tumors may be superficial or relatively deep-seated, the complex shape of the head and neck region, the presence of significant inhomogeneities such as bone and air spaces, and the need to spare critical structures such as the eyes or central nervous system all add to the need for careful considerations of the physical parameters involved in radiotherapy. In addition, the high mobility of the head allows it to assume a wide variety of positions so that techniques have had to be developed for careful simulation, repositioning, and immobilization during treatment. In the head and neck region shaping of the beam becomes important, and therefore, blocked fields, compensators, or wedges are often used. Although the specific radiotherapy techniques for each site of head and neck cancer are described in the various chapters of this book, a general description of the various types of radiation beams, radioactive sources, beam modifiers, treatment planning techniques, and treatment implementation is given in this chapter. The discussion is divided into three main categories: (1) external beam, (2) brachytherapy, and (3) simulation and immobilization

Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome

Directory of Open Access Journals (Sweden)

Cotic Jasna

2016-02-01

Full Text Available Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy.

A virtual phantom library for the quantification of deformable image registration uncertainties in patients with cancers of the head and neck.

Science.gov (United States)

Pukala, Jason; Meeks, Sanford L; Staton, Robert J; Bova, Frank J; Mañon, Rafael R; Langen, Katja M

2013-11-01

Deformable image registration (DIR) is being used increasingly in various clinical applications. However, the underlying uncertainties of DIR are not well-understood and a comprehensive methodology has not been developed for assessing a range of interfraction anatomic changes during head and neck cancer radiotherapy. This study describes the development of a library of clinically relevant virtual phantoms for the purpose of aiding clinicians in the QA of DIR software. These phantoms will also be available to the community for the independent study and comparison of other DIR algorithms and processes. Each phantom was derived from a pair of kVCT volumetric image sets. The first images were acquired of head and neck cancer patients prior to the start-of-treatment and the second were acquired near the end-of-treatment. A research algorithm was used to autosegment and deform the start-of-treatment (SOT) images according to a biomechanical model. This algorithm allowed the user to adjust the head position, mandible position, and weight loss in the neck region of the SOT images to resemble the end-of-treatment (EOT) images. A human-guided thin-plate splines algorithm was then used to iteratively apply further deformations to the images with the objective of matching the EOT anatomy as closely as possible. The deformations from each algorithm were combined into a single deformation vector field (DVF) and a simulated end-of-treatment (SEOT) image dataset was generated from that DVF. Artificial noise was added to the SEOT images and these images, along with the original SOT images, created a virtual phantom where the underlying "ground-truth" DVF is known. Images from ten patients were deformed in this fashion to create ten clinically relevant virtual phantoms. The virtual phantoms were evaluated to identify unrealistic DVFs using the normalized cross correlation (NCC) and the determinant of the Jacobian matrix. A commercial deformation algorithm was applied to the virtual

An initial experience using concurrent paclitaxel and radiation in the treatment of head and neck malignancies

International Nuclear Information System (INIS)

Tishler, Roy B.; Busse, Paul M.; Norris, Charles M.; Rossi, Rene; Poulin, Mark; Thornhill, Lee; Costello, Rosemary; Peters, Edward S.; Colevas, A. Dimitrios; Posner, Marshall R.

1999-01-01

Background: Combined modality therapy plays a central role in the management of head and neck malignancies. This study examined the feasibility and preliminary results of treating a group of patients using concurrent bolus paclitaxel (Taxol TM ) and radiation therapy. Methods: Fourteen patients with a median age of 56 years (range 42-81) were treated. Paclitaxel was given every 3 weeks at a dose of 100 mg/m 2 concurrently with external beam radiation. The patients treated included those who had failed to achieve a complete response (CR) to induction chemotherapy with cisplatin, 5-fluorouracil, and leucovorin (PFL), or who had locally advanced disease not previously treated. Results: Median follow-up from the initiation of treatment is 40 months (range 23-48). The majority of patients (13/14) achieved clinical CRs at the primary site. The development of responses was characterized by a long time course. Three patients who were nonresponders (NRs) to induction PFL chemotherapy were treated. One was a clinical CR at the primary site, one did not achieve a CR, and the other had residual disease in the neck. Four patients have failed, one with local-regional disease, one with a marginal failure, one with distant metastases, and one was not rendered disease-free by the treatment. As expected, significant local toxicity was observed. Most patients were managed with the aid of a percutaneous endoscopic gastrostomy (PEG). Two patients experienced significant moist desquamation and required treatment breaks of greater than 1 week. Conclusion: Paclitaxel can be given on a 3-week schedule at 100 mg/m 2 concurrently with radiation. The preliminary results indicate good local responses and acceptable toxicity. This treatment approach merits further study in the treatment of head and neck malignancies, and should be considered as an option in other sites

Effect of Radiotherapy Interruptions on Survival in Medicare Enrollees With Local and Regional Head-and-Neck Cancer

International Nuclear Information System (INIS)

Fesinmeyer, Megan Dann; Mehta, Vivek; Blough, David; Tock, Lauri; Ramsey, Scott D.

2010-01-01

Purpose: To investigate whether interruptions in radiotherapy are associated with decreased survival in a population-based sample of head-and-neck cancer patients. Methods and Materials: Using the Surveillance, Epidemiology, and End Results-Medicare linked database we identified Medicare beneficiaries aged 66 years and older diagnosed with local-regional head-and-neck cancer during the period 1997-2003. We examined claims records of 3864 patients completing radiotherapy for the presence of one or more 5-30-day interruption(s) in therapy. We then performed Cox regression analyses to estimate the association between therapy interruptions and survival. Results: Patients with laryngeal tumors who experienced an interruption in radiotherapy had a 68% (95% confidence interval, 41-200%) increased risk of death, compared with patients with no interruptions. Patients with nasal cavity, nasopharynx, oral, salivary gland, and sinus tumors had similar associations between interruptions and increased risk of death, but these did not reach statistical significance because of small sample sizes. Conclusions: Treatment interruptions seem to influence survival time among patients with laryngeal tumors completing a full course of radiotherapy. At all head-and-neck sites, the association between interruptions and survival is sensitive to confounding by stage and other treatments. Further research is needed to develop methods to identify patients most susceptible to interruption-induced mortality.

Cytogenetic damage in circulating lymphocytes and buccal mucosa cells of head-and-neck cancer patients undergoing radiotherapy

International Nuclear Information System (INIS)

Minicucci, E.M.; Ribeiro, L.R.; Camargo, J.L.V. de; Salvadori, D.M.F.

2005-01-01

This study evaluated cytogenetic damage by measuring the frequency of micronucleated cells (MNC) in peripheral blood and buccal mucosa of head-and-neck cancer patients undergoing radiotherapy. MNC frequencies were assessed in 31 patients before, during, and after radiotherapy, and in 17 healthy controls matched for gender, age, and smoking habits. Results showed no statistically significant difference between patients and controls prior to radiotherapy in cytokinesis-blocked lymphocytes or buccal mucosa cells. During treatment, increased MNC frequencies were observed in both cell types. Micronucleated lymphocyte levels remained high in samples collected 30 to 140 days after the end of treatment, while MNC frequency in buccal mucosa decreased to values statistically similar to baseline values. There is controversy over the effects of age, smoking habit, tumor stage, and/or metastasis on MNC frequency. However, increased frequency of micronucleated buccal mucosa cells was seen in patients under 60 years old and in those with tumors >4 cm. In conclusion, the data show that radiotherapy has a potent clastogenic effect in circulating lymphocytes and buccal mucosa cells of head-and-neck cancer patients, and that the baseline MNC frequency in these two tissues is not a sensitive marker for head-and neck neoplasm. (author)

Coordination of head movements and speech in first encounter dialogues

DEFF Research Database (Denmark)

Paggio, Patrizia

2015-01-01

This paper presents an analysis of the temporal alignment be- tween head movements and associated speech segments in the NOMCO corpus of first encounter dialogues [1]. Our results show that head movements tend to start slightly before the onset of the corresponding speech sequence and to end...... slightly after, but also that there are delays in both directions in the range of -/+ 1s. Various factors that may influence delay duration are investigated. Correlations are found between delay length and the duration of the speech sequences associated with the head movements. Effects due to the different...

End-of-treatment and serial PET imaging in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R: A paradigm shift in clinical decision making.

Science.gov (United States)

Melani, Christopher; Advani, Ranjana; Roschewski, Mark; Walters, Kelsey M; Chen, Clara C; Baratto, Lucia; Ahlman, Mark A; Miljkovic, Milos D; Steinberg, Seth M; Lam, Jessica; Shovlin, Margaret; Dunleavy, Kieron; Pittaluga, Stefania; Jaffe, Elaine S; Wilson, Wyndham H

2018-05-10

Dose-adjusted-EPOCH-R obviates the need for radiotherapy in most patients with primary mediastinal B-cell lymphoma. End-of-treatment PET, however, does not accurately identify patients at risk of treatment failure, thereby confounding clinical decision making. To define the role of PET in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R, we extended enrollment and follow-up on our published phase II trial and independent series. Ninety-three patients received dose-adjusted-EPOCH-R without radiotherapy. End-of-treatment PET was performed in 80 patients, of whom 57 received 144 serial scans. One nuclear medicine physician from each institution blindly reviewed all scans from their respective institution. End-of-treatment PET was negative (Deauville 1-3) in 55 (69%) patients with one treatment failure (8-year event-free and overall survival of 96.0% and 97.7%). Among 25 (31%) patients with a positive (Deauville 4-5) end-of-treatment PET, there were 5 (20%) treatment failures (8-year event-free and overall survival of 71.1% and 84.3%). Linear regression analysis of serial scans showed a significant decrease in SUVmax in positive end-of-treatment PET non-progressors compared to an increase in treatment failures. Among 6 treatment failures, the median end-of-treatment SUVmax was 15.4 (range, 1.9-21.3) and 4 achieved long-term remission with salvage therapy. Virtually all patients with a negative end-of-treatment PET following dose-adjusted-EPOCH-R achieved durable remissions and should not receive radiotherapy. Among patients with a positive end-of-treatment PET, only 5/25 (20%) had treatment-failure. Serial PET imaging distinguished end-of-treatment PET positive patients without treatment failure, thereby reducing unnecessary radiotherapy by 80%, and should be considered in all patients with an initial positive PET following dose-adjusted-EPOCH-R (NCT00001337). Copyright © 2018, Ferrata Storti Foundation.

Small cell carcinoma of the head and neck: A comparative study by primary site based on population data.

Science.gov (United States)

Kuan, Edward C; Alonso, Jose E; Tajudeen, Bobby A; Arshi, Armin; Mallen-St Clair, Jon; St John, Maie A

2017-08-01

Small cell carcinoma (SmCC) of the head and neck is an extremely rare neuroendocrine malignancy. In this study, we describe the incidence and determinants of survival of patients with SmCC of the head and neck between the years of 1973 and 2012 using the Surveillance, Epidemiology, and End Results database as differed by primary site. Retrospective, population-based cohort study. A total of 237 cases of SmCC of the head and neck were identified, which was divided into sinonasal primaries (n = 82) and all other head and neck primaries (n = 155). Clinicopathologic and epidemiologic variables were analyzed as predictors of overall survival (OS) and disease-specific survival (DSS) based on the Kaplan-Meier method. More than half of sinonasal primaries presented with Kadish stage C or D. On multivariate analysis, surgery was the only independent predictor of improved DSS (P = .008) for sinonasal primaries; in contrast, radiation therapy was a favorable prognosticator for OS (P = .007) and DSS (P = .043) in extrasinonasal sites. Comparison of survival between sinonasal primaries and all other sites demonstrated that sinonasal SmCC had uniformly better OS (P = .002) and DSS (P = .006). SmCC in the head and neck remains rare, and sinonasal primaries appear to have improved survival compared to other sites. Based on these results, optimal treatment for sinonasal SmCC appears to be surgical therapy, whereas radiation therapy is the preferred treatment for SmCC of other primary sites, particularly the larynx. 4. Laryngoscope, 127:1785-1790, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Nineteenth annual actinide separations conference: Conference program and abstracts

International Nuclear Information System (INIS)

Bronson, M.

1995-01-01

This report contains the abstracts from the conference presentations. Sessions were divided into the following topics: Waste treatment; Spent fuel treatment; Issues and responses to Defense Nuclear Facility Safety Board 94-1; Pyrochemical technologies; Disposition technologies; and Aqueous separation technologies

Nineteenth annual actinide separations conference: Conference program and abstracts

Energy Technology Data Exchange (ETDEWEB)

Bronson, M. [ed.

1995-12-31

This report contains the abstracts from the conference presentations. Sessions were divided into the following topics: Waste treatment; Spent fuel treatment; Issues and responses to Defense Nuclear Facility Safety Board 94-1; Pyrochemical technologies; Disposition technologies; and Aqueous separation technologies.

The value of routine follow-up after treatment for head and neck cancer. A National Survey from DAHANCA

DEFF Research Database (Denmark)

Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch

2013-01-01

The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side effects....... In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients....

Rotating head for air, gas and mud drilling

Energy Technology Data Exchange (ETDEWEB)

Pruitt, A.B.

1983-05-17

A rotating head assembly having roller thrust bearings rotatably journaling an inner barrel is provided with pump means for continuous forced circulation of lubricating oil to, and around, the thrust bearings during operation. A lubricating oil chamber substantially surrounds the bearings, which chamber is effectively sealed against leakage of oil fluids, and other debris, into the chamber and lubricating oil out of the chamber. The lower end of the rotatably journaled inner barrel is provided with a stripper rubber structured to enable use of the head with drill pipe of diverse outer diameters.

[Treatment of adult congenital muscular torticollis by multiple sternocleidomastoid head amputation].

Science.gov (United States)

Fu, Ronggang; Yin, Xiuqing; Yu, Rong

2012-02-01

To investigate the therapeutic method and effectiveness of multiple sternocleidomastoid head amputation for adult congenital muscular torticollis. Between March 2009 and February 2011, 19 patients with congenital muscular torticollis were treated with multiple sternocleidomastoid head amputation. There were 13 males and 6 females, aged 16-32 years (mean, 23.5 years). The X-ray films showed that 12 cases were accompanied with some extent cervical lateral bending and wedge change. Ten patients were with ipsilateral facial bradygenesis. Four patients had received single sternocleidomastoid head amputation. All of the 19 patients were treated with multiple sternocleidomastoid head amputation, then plaster support and neck collar were used after operation for 3-6 months. The wounds of all the 19 patients healed primarily, without infection or hematoma. Sixteen patients were followed up 5 months to 2 years (mean, 8 months). The head and neck malformations were ameliorated significantly. The effectiveness was assessed 2 weeks later, in 7 patients without cervical vertebral malformation results were excellent; in 12 patients with cervical vertebral malformation, the results were excellent in 1 case, good in 7 cases, and fair in 4 cases. The length between mastoid process and sternoclavicular joints was elongated (1.88 +/- 0.30) cm significantly after operation in patients without cervical vertebral malformation (t = 6.24, P = 0.00), showing no significant difference when compared with normal value (t = 1.87, P = 0.11); the length was elongated (3.38 +/- 0.30) cm significantly (t = 11.37, P = 0.00) after operation in patients with cervical vertebral malformation, but it was significant shorter than normal value (t = 12.19, P = 0.00). Multiple sternocleidomastoid head amputation is a safe and effective method for adult congenital muscular torticollis, which can improve the neck rotation function.

Accounting for the fringe magnetic field from the bending magnet in a Monte Carlo accelerator treatment head simulation.

Science.gov (United States)

O'Shea, Tuathan P; Foley, Mark J; Faddegon, Bruce A

2011-06-01

Monte Carlo (MC) simulation can be used for accurate electron beam treatment planning and modeling. Measurement of large electron fields, with the applicator removed and secondary collimator wide open, has been shown to provide accurate simulation parameters, including asymmetry in the measured dose, for the full range of clinical field sizes and patient positions. Recently, disassembly of the treatment head of a linear accelerator has been used to refine the simulation of the electron beam, setting tightly measured constraints on source and geometry parameters used in simulation. The simulation did not explicitly include the known deflection of the electron beam by a fringe magnetic field from the bending magnet, which extended into the treatment head. Instead, the secondary scattering foil and monitor chamber were unrealistically laterally offset to account for the beam deflection. This work is focused on accounting for this fringe magnetic field in treatment head simulation. The magnetic field below the exit window of a Siemens Oncor linear accelerator was measured with a Tesla-meter from 0 to 12 cm from the exit window and 1-3 cm off-axis. Treatment head simulation was performed with the EGSnrc/BEAMnrc code, modified to incorporate the effect of the magnetic field on charged particle transport. Simulations were used to analyze the sensitivity of dose profiles to various sources of asymmetry in the treatment head. This included the lateral spot offset and beam angle at the exit window, the fringe magnetic field and independent lateral offsets of the secondary scattering foil and electron monitor chamber. Simulation parameters were selected within the limits imposed by measurement uncertainties. Calculated dose distributions were then compared with those measured in water. The magnetic field was a maximum at the exit window, increasing from 0.006 T at 6 MeV to 0.020 T at 21 MeV and dropping to approximately 5% of the maximum at the secondary scattering foil. It

Heading and head injuries in soccer.

Science.gov (United States)

Kirkendall, D T; Jordan, S E; Garrett, W E

2001-01-01

In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

Screening of Serum Protein Markers for Avascular Osteonecrosis of Femoral Head Differentially Expressed after Treatment with Yuanshi Shengmai Chenggu Tablets

Directory of Open Access Journals (Sweden)

Peng Deng

2018-01-01

Full Text Available Avascular necrosis of the femoral head (ANFH is an a frequently occurring orthopaedic disease with high morbidity. Traditional Chinese Medicine (TCM Yuanshi Shengmai Chenggu Tablet is a valid prescription for treating steroid-induced femoral head necrosis. However, there are rare investigations about the serum protein marker expression after the acting of drugs on hormone and TCM. In the present study, we aimed to systematically discover and validate the serum biomarkers expression difference in patients with steroid-induced avascular necrosis of femoral head (SANFH after taking Yuanshi Shengmai Chenggu Tablets (SANFH-TCM, so as to reveal the action mechanism of TCM from the molecular level by using isobaric tags for relative and absolute quantification (iTRAQ with multiple reaction monitoring quantification. Significant differences in fibrinogen alpha, fibrinogen beta, fibrinogen gamma, fibronectin, C-reactive protein, apolipoprotein A, apolipoprotein D, and apolipoprotein E were found among SANFH, SANFH-TCM, and healthy controls. Therefore, our study proposes potential biomarkers for SANFH diagnosis and for the prognosis of femoral head necrosis after Traditional Chinese Medicine treatment.

A multicentre ‘end to end’ dosimetry audit for cervix HDR brachytherapy treatment

International Nuclear Information System (INIS)

Palmer, Antony L.; Diez, Patricia; Gandon, Laura; Wynn-Jones, Andrea; Bownes, Peter; Lee, Chris; Aird, Edwin; Bidmead, Margaret; Lowe, Gerry; Bradley, David; Nisbet, Andrew

2015-01-01

Purpose: To undertake the first multicentre fully ‘end to end’ dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. Materials and methods: A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. Results: The mean difference between planned and measured dose at Point A was −0.6% for plastic applicators and −3.0% for metal applicators, at standard uncertainty 3.0% (k = 1). Isodose distributions agreed within 1 mm over a dose range 2–16 Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2 mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. Conclusions: The concept of ‘end to end’ dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved

Computed Tomography (CT) -- Head

Medline Plus

Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head ...

Treatment of locally advanced adenoid cystic carcinoma of the head and neck with neutron radiotherapy

International Nuclear Information System (INIS)

Douglas, James G.; Laramore, George E.; Austin-Seymour, Mary; Koh Wuijin; Stelzer, Keith; Griffin, Thomas W.

2000-01-01

Purpose: To examine the efficacy of fast neutron radiotherapy for the treatment of locally advanced and/or recurrent adenoid cystic carcinoma of the head and neck and to identify prognostic variables associated with local-regional control and survival. Methods and Materials: One hundred fifty-nine patients with nonmetastatic, previously unirradiated, locally advanced, and/or recurrent adenoid cystic carcinoma (ACC) of the head and neck region were treated with fast neutron radiotherapy during the years 1985-1997. One hundred fifty-one patients had either unresectable disease, or gross residual disease (GRD) after an attempted surgical extirpation. Eight patients had microscopic residual disease and were analyzed separately. Sixty-two percent of patients had tumors arising in minor salivary glands, 29% in major salivary glands, and 9% in other sites such as the lacrimal glands, tracheal-bronchial tree, etc. Fifty-five percent of patients were treated for postsurgical recurrent disease and 13% of patients had lymph node involvement at the time of treatment. The median duration of follow-up was 32 months (range 3-142 months). Actuarial curves for survival, cause-specific survival, local-regional control, and the development of distant metastases are presented for times out to 11 years. Results: The 5-year actuarial local-regional tumor control rate for the 151 patients with GRD was 57%; the 5-year actuarial overall survival rate was 72%; and the 5-year actuarial cause-specific survival rate was 77%. Variables associated with decreased local-regional control in the patients with GRD as determined by multivariate analysis included base of skull involvement (p < 0.01) and biopsy only versus an attempted surgical resection prior to treatment (p = 0.03). Patients without these negative factors had an actuarial local-regional control rate of 80% at 5 years. Patients with microscopic residual disease (n = 8) had a 5-year actuarial local-regional control rate of 100%. Base of

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.

Science.gov (United States)

Morand, G B; Madana, J; Da Silva, S D; Hier, M P; Mlynarek, A M; Black, M J

2016-04-01

Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere. A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan-Meier method. Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis. Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.

Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment

Energy Technology Data Exchange (ETDEWEB)

NONE

1985-07-01

Topics covered during the 'Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment' were as follows: Selection of constructions and materials, fuel element development concepts; Fabrication of spherical coated fuel particles and fuel element on their base; investigation of fuel properties; Spent fuel treatment and storage; Head-end processing of HTGR fuel elements; investigation of HTGR fuel regeneration process; applicability of gas-fluorine technology of regeneration of spent HTGR fuel elements.

Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment

International Nuclear Information System (INIS)

1985-01-01

Topics covered during the 'Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment' were as follows: Selection of constructions and materials, fuel element development concepts; Fabrication of spherical coated fuel particles and fuel element on their base; investigation of fuel properties; Spent fuel treatment and storage; Head-end processing of HTGR fuel elements; investigation of HTGR fuel regeneration process; applicability of gas-fluorine technology of regeneration of spent HTGR fuel elements

MODIFIED USE OF A DYNAMIC BITE OPENER - TREATMENT AND PREVENTION OF TRISMUS IN A CHILD WITH HEAD AND NECK-CANCER - A CASE-REPORT

NARCIS (Netherlands)

DIJKSTRA, PU; KROPMANS, TJB; TAMMINGA, RYJ

1992-01-01

Trismus may be a complication arising during or after treatment of patients with head and neck cancer. Treatment of trismus is difficult, making prevention very important. To prevent and treat trismus in a patient with a nasopharyngeal tumor, the Contract-Relax-Antagonist-Contract (CRAC) technique

Monoisocentric three-beam split field technique for conventional treatment in the head and neck cancer using asymmetrical collimators

International Nuclear Information System (INIS)

Sriram Prasath, S.; Prabagaran, C.; Sanyal, B.; Sarkar, B.

2008-01-01

The importance of treatment planning of head and neck malignancies arises from the necessity to achieve homogenous doses to localized target volume surrounded by normal structures, which can produce acute and long-term morbidity. In many radiotherapy departments, a commonly employed strategy is a 3-field technique. Bilateral parallel-opposed fields are matched to anterior lower neck field. When the target extends to the lower neck regions, abutment of upper and lower neck fields is required. Field matching represents a technical challenge for the Medical Physicist and Radiation Oncologist to treat multiple fields while avoiding their overlap on the spinal cord. The aim of this work is to review merits, limitations and recent approaches to optimize matchline dose in Monoisocentric technique in conventional treatment for head and neck cancers. Although the technique has many advantages, it is subjected to some systematic and random errors due to equipment and patient setup accuracies. To decrease the magnitude of matchline inhomogeneities, multi leaf collimator have been used. This method is viable and represents alternative approaches to the problem of field matching using the asymmetric jaws

Afatinib versus methotrexate as second-line treatment in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 1)

DEFF Research Database (Denmark)

Machiels, Jean-Pascal H; Haddad, Robert I; Fayette, Jérôme

2015-01-01

BACKGROUND: Patients with recurrent or metastatic squamous-cell carcinoma of the head and neck (HNSCC) progressing after first-line platinum regimens have a poor prognosis and few treatment options. Afatinib, an irreversible ERBB family blocker, has shown efficacy in a phase 2 study in this setting......%]), and neutropenia (1 [... provide important new insights into the treatment of this patient population and support further investigations with irreversible ERBB family blockers in HNSCC. FUNDING: Boehringer Ingelheim....

Chemistry of pyroprocessing for nuclear waste transmutation

Energy Technology Data Exchange (ETDEWEB)

Ackerman, J.P. [Argonne National Laboratory, IL (United States)

1995-10-01

Pyrochemical treatment of spent nuclear fuel is an attractive approach for separating the transuranium (TRU) elements neptunium, plutonium, americium, and curium because of its simplicity, diversion resistance, and potentially low cost.

Dosimetric evaluation of abutted fields using asymmetric collimators for treatment of head and neck

International Nuclear Information System (INIS)

Saw, Cheng B.; Krishna, Komanduri V.; Enke, Charles A.; Hussey, David H.

2000-01-01

Purpose: The objective of this study was to reevaluate the dose nonuniformity of abutted fields defined using asymmetric collimators and one isocenter for treatment of the head and neck region. Methods and Materials: Bilateral parallel-opposed fields abutted to the anterior field at one isocenter were implemented in the treatment of head and neck. The effect of digital display tolerance can produce dose nonuniformity at the junction of the abutted fields. The amount of dose nonuniformity was quantified using both mathematical summation of dose profiles and by direct measurement of doses at the junction of the two abutted fields. The dose nonuniformity was obtained by irradiating the superior part of a film using bilateral parallel-opposed fields and the inferior part by an anterior field with a gap or an overlap. Dose profiles were taken at the depth of maximum dose for the anterior field across the abutted fields. The dose nonuniformity was determined for the case where the asymmetric jaw was set at -2 mm, -1 mm, 0, +1 mm, and +2 mm from the beam central axis. Results: The dose at the junction increases systematically as the abutment of the fields changes from a gap to an overlap. The dose nonuniformity with 1-mm gap and 1-mm overlap is about 15% underdose and overdose, respectively. Conclusion: Imperfect abutment of split fields due to digital display tolerance (no. +-no. 1 mm) of asymmetric collimator can cause an underdose or overdose of 15% of the delivered dose

NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

Science.gov (United States)

Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

2015-06-01

The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

The current status of oncolytic viral therapy for head and neck cancer

Directory of Open Access Journals (Sweden)

Matthew O. Old

2016-06-01

Full Text Available Objective: Cancer affects the head and neck region frequently and leads to significant morbidity and mortality. Oncolytic viral therapy has the potential to make a big impact in cancers that affect the head and neck. We intend to review the current state of oncolytic viruses in the treatment of cancers that affect the head and neck region. Method: Data sources are from National clinical trials database, literature, and current research. Results: There are many past and active trials for oncolytic viruses that show promise for treating cancers of the head and neck. The first oncolytic virus was approved by the FDA October 2015 (T-VEC, Amgen for the treatment of melanoma. Active translational research continues for this and many other oncolytic viruses. Conclusion: The evolving field of oncolytic viruses is impacting the treatment of head and neck cancer and further trials and agents are moving forward in the coming years. Keywords: Head and neck squamous cell carcinoma, Oncolytic viruses, Clinical trials, Novel therapeutics

The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study

DEFF Research Database (Denmark)

Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch

BACKGROUND: The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side...... effects. In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients. PATIENTS AND METHODS: During a period of six weeks a prospective national cross section cohort...

Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits of duodenum-preserving pancreatic head resection.

Science.gov (United States)

Schlosser, W; Rau, B M; Poch, B; Beger, H G

2005-01-01

Pancreas divisum (PD) represents a duct anomaly in the pancreatic head ducts, leading frequently leading to recurrent acute pancreatitis (rAP) or chronic pancreatitis (CP). Based on endoscopic retrograde cholangiopancreatography, pancreas divisum can be found in 1% to 6% of patients with pancreatitis. The correlation of this abnormality with pancreatic disease is an issue of continuing controversy. Because of the underlying duct anomalies and major pathomorphological changes in the pancreatic head, duodenum-preserving pancreatic head resection (DPPHR) offers an option for causal treatment. Thirty-six patients with pancreatitis caused by PD were treated surgically. Thirty patients suffered from CP, 6 from rAP. The mean duration of the disease was 47.5 and 49.8 months, respectively. The age at the time of surgery was 39.2 years in the CP group, and 27.6 years in the rAP group. Median hospitalization since diagnosis was 18.8 weeks for CP patients and 24.6 weeks for rAP patients. Previous procedures performed in these patients included endoscopic papillotomy (30%), duct stenting (14%), and surgical treatment (17%). The median preoperative pain score was 8 on a visual analog scale. According to the classification of pancreas divisum, 10 patients demonstrated a complete PD, 25 had a functionally incomplete PD, and 1 had a dorsal duct type. The pain status as well as the endocrine (oral glucose tolerance test) and exocrine (pancreolauryl test) function were evaluated preoperatively and early and late postoperatively with a median follow-up time of 39.3 months. There was no operative-related mortality. The follow-up was 100%; 4 patients died (1 from suicide, 1 from cardiac arrest, and 2 from cancer of the esophagus). Fifty percent of the patients were completely pain-free, 31% had a significant reduction of pain with a median pain score of 2 (P pancreatitis with a need for hospitalization. DPPHR reduced pain and preserved the endocrine function in the majority of patients

Anti EGFR therapy in the treatment of non-metastatic head and neck squamous cell carcinoma: The current evidence

Directory of Open Access Journals (Sweden)

Rony Benson

2016-09-01

Full Text Available Head and neck squamous cell carcinoma (HNSCC accounts for a large oncologic burden in the developing countries. In patients with locally advanced head and neck cancer multimodality treatment is warranted. Radiation therapy with concurrent chemotherapy has long been considered the standard for patients with disease involving the oropharynx, larynx and hypopharynx. However, addition of chemotherapy to radiotherapy increases treatment related toxicity by many folds and compliance rates decrease. In this context a systemic therapy, which when used concurrent with radiation with favorable toxicity profile is of great importance for improving disease control in locally advanced HNSCC. Anti-epithelial growth factor receptor targeted therapy emerged as a potential treatment option. In recent years many trials were conducted to find the optimum treatment option with the combination of these targeted agents. The initial trials showed excellent results with minimal morbidity and led to great enthusiasm across the globe to incorporate these regimens as a standard of care. However, subsequently many trials failed to maintain such results and now there is little agreement to the initial results achieved with these drugs. Based on the current evidence we cannot recommend the replacement of cisplatin with targeted therapy in concurrent setting. It may be considered in patients with altered renal parameters, hypersensitivity or intolerance to cisplatin. The addition of targeted therapy in addition to chemotherapy in the concurrent setting can’t also be recommended as the benefit is doubtful and is associated with a significant increase in toxicity.

Does hyperbaric oxygen treatment have the potential to increase salivary flow rate and reduce xerostomia in previously irradiated head and neck cancer patients? A pilot study

DEFF Research Database (Denmark)

Forner, Lone; Hansen, Ole Hyldegaard; von Brockdorff, Annet Schack

2011-01-01

in irradiated head and neck cancer patients. Eighty patients eligible for HBO treatment on the indication of prevention/treatment of osteoradionecrosis or soft tissue radiation injury were consecutively sampled, of whom 45 had hyposalivation (i.e. unstimulated whole saliva (UWS) flow rate......Irradiated head and neck cancer survivors treated in the Hyperbaric Oxygen (HBO) Unit, Copenhagen University Hospital, spontaneously reported improvement of radiation-induced dry mouth feeling. The aim of this pilot study was to evaluate salivary flow rate and xerostomia before and after HBO...

Effect of head size on 10B dose distribution

International Nuclear Information System (INIS)

Gupta, N.; Blue, T.E.; Gahbauer, R.

1992-01-01

Boron neutron capture therapy (BNCT) for treatment of brain tumors is based on the utilization of large epithermal-neutron fields. Epithermal neutrons thermalize at depths of ∼2.5 cm inside the head and provide a maximum thermal fluence at deep-seated tumor sites with minimum damage to normal tissue. Brain tissue is a highly scattering medium for epithermal and thermal neutrons; therefore, a broad treatment field enables epithermal neutrons to enter the head over a large area. These neutrons slow down as they undergo scattering collisions and contribute to the thermal-neutron fluence at the tumor location. With the use of large neutron fields, the size of the head affects the thermal-neutron distribution and thereby the 10 B absorbed dose distribution inside the head. In this paper, the authors describe measurements using a boron trifluoride (BF 3 )-filled proportional counter to determine the effect of head size on 10 B absorbed dose distributions for a broad field accelerator epithermal-neutron source

Evaluation of an automated knowledge based treatment planning system for head and neck

International Nuclear Information System (INIS)

Krayenbuehl, Jerome; Norton, Ian; Studer, Gabriela; Guckenberger, Matthias

2015-01-01

This study evaluated an automated inverse treatment planning algorithm, Pinnacle Auto-Planning (AP), and compared automatically generated plans with historical plans in a large cohort of head and neck cancer patients. Fifty consecutive patients treated with volumetric modulated arc therapy (Eclipse, Varian Medical System, Palo Alto, CA) for head and neck were re-planned with AP version 9.10. Only one single cycle of plan optimization using one single template was allowed for AP. The dose to the planning target volumes (PTV’s; 3–4 dose levels), the organs at risk (OAR’s) and the effective working time for planning was evaluated. Additionally, two experienced radiation oncologists blind-reviewed and ranked 10 plans. Dose coverage and dose homogeneity of the PTV were significantly improved with AP, however manually optimized plans showed significantly improved dose conformity. The mean dose to the parotid glands, oral mucosa, swallowing muscles, dorsal neck tissue and maximal dose to the spinal cord were significantly reduced with AP. In 64 % of the plans, the mean dose to any OAR (spinal cord excluded) was reduced by >20 % with AP in comparison to the manually optimized plans. In 12 % of the plans, the manually optimized plans showed reduced doses by >20 % in at least one OAR. The experienced radiation oncologists preferred the AP plan and the clinical plan in 80 and 20 % of the cases, respectively. The average effective working time was 3.8 min ± 1.1 min in comparison to 48.5 min ± 6.0 min using AP compared to the manually optimized plans, respectively. The evaluated automated planning algorithm achieved highly consistent and significantly improved treatment plans with potentially clinically relevant OAR sparing by >20 % in 64 % of the cases. The effective working time was substantially reduced with Auto-Planning

Clinical features of the exploding head syndrome.

Science.gov (United States)

Pearce, J M

1989-07-01

Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

Clinical features of the exploding head syndrome.

OpenAIRE

Pearce, J M

1989-01-01

Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

Progress in treatment of head and neck cancer. Pt. 1. Chemotherapy

International Nuclear Information System (INIS)

Stupp, R.; Vokes, E.E.; Chicago Univ., IL

1995-01-01

Cancer of the head and neck is commonly diagnosed in an advanced stage with a poor prognosis. New active agents and combinations have recently been identified. By adding chemotherapy to a multimodality approach with surgery and radiation therapy the outcome may be altered. We reviewed the more recently published literature on induction and adjuvant chemotherapy. No survival advantage has been shown for adjuvant chemotherapy. Organ preservation can be achieved with induction chemotherapy followed by limited surgery and radiation in approximately two thirds of the patients with laryngeal carcinoma. Patients achieving a complete response after induction chemotherapy have a better prognosis. Chemotherpy has consistently shown to reduce the frequency of distant metastases. Chemotherapy is indicated only in recurrent or metastatic disease. Induction chemotherapy is limited to laryngeal carcinoma with organ preservation as intent. Local recurrences and intercurrent morbidity are the main reasons for treatment failures. (orig.) [de

Users’ Perceptions Using Low-End and High-End Mobile-Rendered HMDs: A Comparative Study

Directory of Open Access Journals (Sweden)

M.-Carmen Juan

2018-02-01

Full Text Available Currently, it is possible to combine Mobile-Rendered Head-Mounted Displays (MR HMDs with smartphones to have Augmented Reality platforms. The differences between these types of platforms can affect the user’s experiences and satisfaction. This paper presents a study that analyses the user’s perception when using the same Augmented Reality app with two MR HMD (low-end and high-end. Our study evaluates the user’s experience taking into account several factors (control, sensory, distraction, ergonomics and realism. An Augmalpha-lowerented Reality app was developed to carry out the comparison for two MR HMDs. The application had exactly the same visual appearance and functionality for both devices. Forty adults participated in our study. From the results, there were no statistically significant differences for the users’ experience for the different factors when using the two MR HMDs, except for the ergonomic factors in favour of the high-end MR HMD. Even though the scores for the high-end MR HMD were higher in nearly all of the questions, both MR HMDs provided a very satisfying viewing experience with very high scores. The results were independent of gender and age. The participants rated the high-end MR HMD as the best one. Nevertheless, when they were asked which MR HMD they would buy, the participants chose the low-end MR HMD taking into account its price.

Research and advancement of treating avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Wang Kaibing; Bai Bin; Wang Honghui; Sui Hong

2006-01-01

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head. After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed, commonly according to the staging of necrosis. Conservative therapy is suitable for stage 0-I, interventional therapy is suitable for stage II-III, operation is adapted for stage II-III and femoral head collapse or degenerative changes. Avascular necrosis of the femoral head is a chronic and dysfunctional illness. Comprehensive treatment according to different stage is now the most popular. Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile. (authors)

Successful treatment of pill-swallowing difficulties with head posture practice.

Science.gov (United States)

Kaplan, Bonnie J; Steiger, Roberta A; Pope, Jamie; Marsh, Ashley; Sharp, Maegan; Crawford, Susan G

2010-05-01

Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful. To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture. A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice. EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful. Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.

Development of a head and neck companion module for the quality of life - radiation therapy instrument (QOL-RTI)

International Nuclear Information System (INIS)

Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Cantor, Alan

1997-01-01

Purpose/Objective: The purpose of this study is to develop a Likert version, disease specific module for the Quality of Life - Radiation Therapy Instrument (QOL-RTI) for head and neck patients. This module combined with the QOL-RTI may help us to determine what changes, if any, occur in the quality of life of patients receiving primary radiation therapy for head and neck cancer. A compelling reason to study head and neck patients is because of the extensive difficulties these patients experience while undergoing radiotherapy. Their psychological and emotional well-being may also have an adverse affect on their quality of life as they strive to cope with both a life-threatening disease and with the prospect of disfigurement or dysfunction that cannot be hidden from view. Many tools have been developed to measure quality of life, however, previously published literature has focused on quantifying functional status and toxicity assessment rather than the alteration of quality of life as perceived by the patient. This study, limited to patients receiving primary radiation, is expected to yield a tool that is applicable to the patient receiving multi-modality treatment for head and neck cancer and will be useful to the physician/nurse in determining interventions for these patients. Materials and Methods: This study is an uncontrolled, non-randomized exploratory study, including fifty (50) consecutive eligible patients undergoing definitive primary radiotherapy. The questionnaires were given to all eligible patients being treated with radiotherapy for head and neck cancer who are not already registered on another research study assessing Quality of Life (i.e. RTOG). During the 5-8 week treatment period, the QOL-RTI/H and N instrument is administered as follows: at baseline evaluation (immediately prior to the beginning of radiotherapy), at week four (4) two days in a row (for test-retest) and at the end of the treatment period. For validation purposes the QOL-RTI/H and

Comparison of end-of-life tire treatment technologies: a Chinese case study.

Science.gov (United States)

Li, Xingfu; Xu, He; Gao, Yingnan; Tao, Yijun

2010-11-01

The aim of this paper is to compare different end-of-life tire (ELT) treatment technologies in China from an environmental and economic perspective. Four treatment technologies were evaluated: ambient grinding, devulcanization, pyrolysis and illegal tire oil extraction. Life cycle assessment (LCA) was applied to evaluate the potential environmental impact of each treatment based on the Eco-indicator 99 (Hierarchist approach) method provided by GaBi 4 software. The final result shows that pyrolysis represents the environmentally benign option while illegal tire oil extraction caused the worst damages. For the three legal treatments, although high credit was obtained when considering avoided impacts from recycled materials and energy, they have great impact as to respiratory effects (inorganic) dominantly contributed by energy production stage, which implies that the emphasis on environmental policies related to ELT treatment should shift from the control of emissions from treatment process to the reduction of energy consumption. A simplified comparison of net benefits and total impacts shows that the most eco-effective ELT treatment technology is pyrolysis, followed by dynamic devulcanization and ambient grinding. The illegal tire oil extraction, however, must be prohibited immediately because of its highest environmental pollution and lowest net benefit. Copyright © 2010 Elsevier Ltd. All rights reserved.

A prospective comparison of times to presentation and treatment of regional and remote head and neck patients in North Queensland, Australia.

Science.gov (United States)

Tan, J Y-A; Otty, Z A; Vangaveti, V N; Buttner, P; Varma, S C; Joshi, A J; Kelly, J; Collins, M; Sabesan, S S

2016-08-01

This study aims to examine differences between outer regional (OR) and remote/very remote (RVR) patients in northern Queensland, Australia in the times taken to receive various aspects of head and neck cancer management. Our study prospectively recruited head and neck cancer patients presenting to three North Queensland regional hospitals from January 2009 to January 2011. Data on demographic and cancer-specific details, comorbidities and timing of presentation to various services, were collected using a self-administered questionnaire that included two questions in relation to possible reason for delays to health services. Multivariate linear regression analyses were conducted to assess the effects of various demographic characteristics on time delays. Survival and disease recurrence data were analysed in 2014. One hundred and fifty-eight patients participated. RVR patients had significantly longer median times between diagnosis and first treatment compared with OR patients (P = 0.015). Indigenous patients had significant delays from diagnosis to first treatment (P = 0.013) and visit to first specialist and treatment (P = 0.031) compared to non-Indigenous patients. Longer median times between symptoms and first treatment was associated with low income (P = 0.03) and lower education level (P = 0.04). Disease recurrence was higher for RVR patients compared with OR patients (P = 0.04), without significant differences in overall survival. Possible reasons for delays included patient and professional factors. Significant delays in various aspects of head and neck cancer management were associated with remoteness, Indigenous and socioeconomic status. While patient and professional factors could be addressed at local levels, sustainable improvement in outcomes requires a state and national level approach. © 2016 Royal Australasian College of Physicians.

In Situ Measurement of Seeking Speed and Seeking Induced Head-Disk Interface Instability in Hard Disk Drives

Directory of Open Access Journals (Sweden)

Yu Wang

2015-01-01

Full Text Available This paper investigated the instability of head-disk interface caused by the voice coil motor (VCM end crashing the crash stop during the seeking of magnetic head. To make the whole process of that clear, an in situ measurement method based on maximum likelihood estimation and extended Kalman filter for seeking speed at component level was developed first and was then calibrated by a high speed camera. Given a crash between VCM end and crash stop that may be a consequence of the continuous increasing seeking speed, the seeking speed was carefully controlled by using our developed method to find a critical value that may induce vigorous head-disk interface instability. Acoustic emission sensor and laser Doppler vibrometer were used to capture the transient dynamic behaviors of magnetic head when the crash is happening. Damage analysis and mode identification were carried out to reveal the relationship between the damage patterns on disk surface and head dynamics. The results of this study are helpful to optimize the track seeking profile during the HDD operation, as well as the design of components such as head and head arm.

Randomized, investigator-blinded, controlled clinical study with lice shampoo (Licener®) versus dimethicone (Jacutin® Pedicul Fluid) for the treatment of infestations with head lice.

Science.gov (United States)

Semmler, Margit; Abdel-Ghaffar, Fathy; Gestmann, Falk; Abdel-Aty, Mohammed; Rizk, Ibrahim; Al-Quraishy, Saleh; Lehmacher, Walter; Hoff, Norman-Philipp

2017-07-01

The present clinical trial was conducted to obtain additional data for the safety and efficacy of a head lice shampoo that is free of silicone compared with an anti-head lice product containing dimethicone. Both products act by a physical mode of action. This randomized, investigator-blinded, controlled clinical study was conducted between July and November 2016 in households of two villages (Abou Rawash and Shandalat) in Egypt. Children older than 2 years with an active head lice infestation were treated with either a shampoo-based head lice treatment containing neem extract (Licener®) or dimethicone (Jacutin® Pedicul Fluid) on day 1 and additionally on day 9. Assessment for living lice by combing was conducted before and 1-2 h after treatment and on days 5 and 13. The main objective was to demonstrate a cure rate of the test product of at least 85% after a single application (day 5 and 9). Secondary objectives were to scrutinize patient safety and satisfaction as well as cure rates on day 13 after two treatments and the evaluation of ovicidal and licicidal efficacies of the products. Sixty-one children in the test-group (Licener®) and 58 children in the reference group (Jacutin® Pedicul Fluid) were included in this study. The test product and the reference product were very well tolerated. Both products exceeded the objective of cure rates of over 85% after single treatment (test group 60/60 = 100%; 95% CI = 94.04-100.00%; reference group 54/57 = 94.74%; 95% CI = 85.38-98.90%; p = 0.112; CI by Clopper-Pearson) and after two treatments (test group 58/58 = 100%; 95% CI = 93.84-100.00%; reference group 52/54 = 96.30%; 95% CI = 87.25-99.55%; p = 0.230) with higher cure rates and non-inferiority for the test product. The combined success rate shows significant superiority of the test product against the reference product (test group 58/58 = 100%; 95% CI = 93.84-100.00%; reference group 49/54 = 90.7%; 95% CI = 79.70-96.92%; p = 0

Head and Neck Cancers in Developing Countries

Directory of Open Access Journals (Sweden)

Poonam Joshi

2014-04-01

Full Text Available Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC. HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care.

Head Lice: Treatment

Science.gov (United States)

... before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing ... does not imply endorsement by the Public Health Service or by the U.S. Department of Health and ...

Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for non-sinonasal neuroendocrine carcinoma of the upper airways

International Nuclear Information System (INIS)

Franco, Pierfrancesco; La Porta, Maria Rosa; Girelli, Giuseppe; Borca, Valeria Casanova; Pasquino, Massimo; Tofani, Santi; Ozzello, Franca; Ricardi, Umberto; Numico, Gianmauro; Migliaccio, Fernanda; Catuzzo, Paola; Cante, Domenico; Ceroni, Paola; Sciacero, Piera; Carassai, Pierpaolo; Canzi, Paolo

2012-01-01

Non-sinonasal neuroendocrine carcinomas (NSNECs) of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure. We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects. One year after the end of the whole combined modality approach, the patient achieved complete remission, with no treatment-related sub-acute and late effects. The present report highlights the importance of multidisciplinary management for NSNECs of the head and neck, as the possibility to achieve substantial cure rates with mild side effects with modern radiotherapy techniques

A screening algorithm for early detection of major depressive disorder in head and neck cancer patients post-treatment: Longitudinal study.

Science.gov (United States)

Henry, Melissa; Rosberger, Zeev; Ianovski, Lola E; Hier, Michael; Zeitouni, Anthony; Kost, Karen; Mlynarek, Alex; Black, Martin; MacDonald, Christina; Richardson, Keith; Zhang, Xun; Fuhrmann, Fabienne; Chartier, Gabrielle; Frenkiel, Saul

2018-03-13

The primary purpose of this study was to identify predictors of Major Depressive Disorder in head and neck cancer (HNC) patients in the immediate post-treatment period (ie, at 3 months post-diagnosis), with a focus on previously unexamined historical and contextual factors. Prospective longitudinal study of 223 consecutive adults (72% participation) newly diagnosed with a first occurrence of primary HNC, including validated psychometric measures, Structured Clinical Interviews for DSM Disorders, and medical chart reviews. The 3-month period prevalence of Major Depressive Disorder was 20.4%; with point prevalences of 6.8% upon HNC diagnosis, 14.2% at 3 months, and 22.6% lifetime. Patients most susceptible to developing Major Depressive Disorder in the immediate post-treatment period: were diagnosed with advanced-stage cancer rather than early-stage cancer (O.R. = 4.94, P = 0.04), received surgery only (O.R. = 8.73, P = 0.04), presented a lifetime history of Anxiety Disorder on SCID-I (O.R. = 6.62; P = 0.01), and indicated higher pre-treatment levels of anxiety on the HADS (O.R. = 0.45, P = 0.05). Our results outline the predominant role of anxiety upon diagnosis as a precursor to post-treatment Major Depressive Disorder, suggesting the need for identification and prophylactic treatment of anxiety upon diagnosis in head and neck cancer patients. Further investigation into pathways by which pre-treatment anxiety predisposes to post-treatment Major Depressive Disorder in this population is warranted. Copyright © 2018 John Wiley & Sons, Ltd.

A SURVEY OF PREVENTION AND TREATMENT REGIMENS FOR ORAL SEQUELAE RESULTING FROM HEAD AND NECK RADIOTHERAPY USED IN DUTCH RADIOTHERAPY INSTITUTES

NARCIS (Netherlands)

JANSMA, J; VISSINK, A; BOUMA, J; VERMEY, A; PANDERS, AK; SGRAVENMADE, EJ

1992-01-01

Radiation treatment plays an important role in the management of head and neck cancer. Unfortunately several radiation-induced side effects may occur including mucositis, hyposalivation, radiation caries, trismus and osteoradionecrosis. It is generally accepted that most side effects can be

Fractionation schedules for cancers of the head and neck

International Nuclear Information System (INIS)

Harari, Paul M.

1995-01-01

Purpose/Objective: This refresher course reviews current research activity and treatment results in the field of radiation therapy fractionation. The presentation emphasizes worldwide studies of altered fractionation, highlighting head and neck cancer as the primary teaching model. Basic radiobiological principles guiding the development of altered fractionation regimens, and advancing the understanding of fractionation effects on normal and tumor tissue are reviewed. A 'standard' prescription of 2 Gy x 35 fractions = 70 Gy may not provide the optimal balance between primary tumor control and late normal tissue effects for all patients with squamous cell carcinoma of the head and neck. The last decade has witnessed the treatment of thousands of head and neck cancer patients with curative radiotherapy using altered fractination schedules designed to improve overall treatment results. Although the number of different fractionation regimens currently being investigated continues to increase, the common guiding principles behind their design are relatively simple. Common fractionation terminology (i.e., accelerated hyperfractionation) will be reviewed, as well as a brief summary of radiobiological concepts pertaining to tumor potential doubling time, tumor proliferation kinetics, overall treatment time and fraction size-dependence of acute and late tissue effects. Several well known head and neck fractionation schedules from around the world (Manchester Christie Hospital-United Kingdom, Princess Margaret Hospital-Canada, Massachusetts General Hospital-USA, MD Anderson Hospital-USA, University of Florida-USA, Mount Vernon Hospital CHART-United Kingdom, RTOG and EORTC trials-USA and Europe) will be summarized with regard to design-rationale, treatment technique and results. The design of several current cooperative group trials investigating altered head and neck fractionation will be presented, as well as concepts prompting the pilot evaluation of several brand new

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

International Nuclear Information System (INIS)

Fortunati, Valerio; Niessen, Wiro J; Veenland, Jifke F; Van Walsum, Theo; Verhaart, René F; Paulides, Margarethus M

2015-01-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck.Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available.The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used.Using the proposed approach we improved the performance of the approach previously presented for H and N hyperthermia treatment planning, making the method suitable for clinical application. (paper)

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

Science.gov (United States)

Fortunati, Valerio; Verhaart, René F.; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; van Walsum, Theo

2015-08-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck. Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available. The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used. Using the proposed approach we improved the performance of the approach previously presented for H&N hyperthermia treatment planning, making the method suitable for clinical application.

[The role of core decompression for the treatment of femoral head avascular necrosis in renal transplant recipients].

Science.gov (United States)

Zivcić-Cosić, Stela; Stalekar, Hrvoje; Mamula, Mihaela; Miletić, Damir; Orlić, Lidija; Racki, Sanjin; Cicvarić, Tedi

2012-10-01

Avascular bone necrosis is a relatively rare but significant complication in renal transplant recipients because it causes progressive pain and invalidity. It can be the consequence of the action of numerous causative factors, but it is mostly connected to corticosteroid treatment.The underlying pathophysiologic mechanism is a diminished blood flow to the bone leading to necrosis and bone destruction. During the past 25-years period, 570 renal transplantations and five combined kidney and pancreas transplantations were performed in our centre. A part of the patients was lost to follow-up due to the separation of Croatia from the former Republic of Yugoslavia. After transplantation, we revealed aseptic necrosis of the femoral head in five female patients. All patients had a history of treatment with pulse doses of corticosteroids. At transplantation the average age of the patients was 52.2 yrs (range 46 to 62 yrs), and dialytic treatment before transplantation lasted in average 9.2 yrs (range 2.5 to 21.2 yrs). The period between renal transplantation and the development of clinical signs of avascular bone necrosis lasted in average 1.2 yrs (range 0.3 to 2.3 yrs). We will demonstrate our 62-year old female patient with terminal renal failure caused by post-streptococcal glomerulonephritis, who was treated with peritoneal dialysis 2.5 years before renal transplantation. Twenty months before renal transplantation the patient received pulse doses of corticosteroids, together with immunoglobulins and plasmapheresis, for the treatment of an acute polyradiculoneuritis Guillaine Barré. After transplantation a standard immunosuppressive protocol was applied which included tacrolimus, mycophenolate mofetil, corticosteroids and induction with basiliximab. Four months after transplantation the patient started to feel pain in the right hip after longer standing, in addition to the earlier long-lasting problems caused by bilateral coxarthrosis. The pelvic radiograph showed

A customized head and neck support system

International Nuclear Information System (INIS)

Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

1995-01-01

Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

Ulnar nerve entrapment complicating radial head excision

Directory of Open Access Journals (Sweden)

Kevin Parfait Bienvenu Bouhelo-Pam

Full Text Available Introduction: Several mechanisms are involved in ischemia or mechanical compression of ulnar nerve at the elbow. Presentation of case: We hereby present the case of a road accident victim, who received a radial head excision for an isolated fracture of the radial head and complicated by onset of cubital tunnel syndrome. This outcome could be the consequence of an iatrogenic valgus of the elbow due to excision of the radial head. Hitherto the surgical treatment of choice it is gradually been abandoned due to development of radial head implant arthroplasty. However, this management option is still being performed in some rural centers with low resources. Discussion: The radial head plays an important role in the stability of the elbow and his iatrogenic deformity can be complicated by cubital tunnel syndrome. Conclusion: An ulnar nerve release was performed with favorable outcome. Keywords: Cubital tunnel syndrome, Peripheral nerve palsy, Radial head excision, Elbow valgus

Intercomparison of two dynamic treatment techniques, ring scan and spot scan, for head and neck tumors with the Piotron

International Nuclear Information System (INIS)

Takai, M.; Blattmann, H.; Pedroni, E.

1988-01-01

An evaluation of the ring scan and the spot scan was made for the pion irradiation of head and neck tumors with the Piotron. For the geometry of the Piotron, with its 60 radially converging beams, two scanning techniques have been developed, ring scan and spot scan. They have different characteristics concerning achievable dose distributions and sensitivity to tissue inhomogenities. The optimized 3-dimensional dose distributions for the treatment with ring scan and spot scan techniques were calculated for two examples of the target volume. The comparison of the dose distributions has shown that the ring scan is better in sparing normal tissues than the spot scan for a simple shape target volume but not for an irregular shape target volume with the present status of the technique. The irradiation time needed for the ring scan is longer, for the present examples three times, than for the spot scan. From the practical view point the spot scan is preferable to the ring scan for the treatment of head and neck tumors with the Piotron

Biophysical stimulation in osteonecrosis of the femoral head

Directory of Open Access Journals (Sweden)

Massari Leo

2009-01-01

Full Text Available Osteonecrosis of the femoral head is the endpoint of a disease process that results from insufficient blood flow and bone-tissue necrosis, leading to joint instability, collapse of the femoral head, arthritis of the joint, and total hip replacement. Pain is the most frequent clinical symptom. Both bone tissue and cartilage suffer when osteonecrosis of the femoral head develops. Stimulation with pulsed electromagnetic fields (PEMFs has been shown to be useful for enhancing bone repair and for exerting a chondroprotective effect on articular cartilage. Two Italian studies on the treatment of avascular necrosis of the femoral head with PEMFs were presented in this review. In the first study, 68 patients suffering from avascular necrosis of the femoral head were treated with PEMFs in combination with core decompression and autologous bone grafts. The second one is a retrospective analysis of the results of treatment with PEMFs of 76 hips in 66 patients with osteonecrosis of the femoral head. In both studies clinical information and diagnostic imaging were collected at the beginning of the treatment and at the time of follow up. Statistical analysis was performed using chi-square test. Both authors hypothesize that the short-term effect of PEMF stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bone-marrow edema. The long-term effect of PEMF stimulation may be to promote osteogenic activity at the necrotic area and prevent trabecular fracture and subchondral bone collapse. PEMF stimulation represents an important therapeutic opportunity to resolve the Ficat stage-I or II disease or at least to delay the time until joint replacement becomes necessary.

One stage functional end-to-end stapled intestinal anastomosis and resection performed by nonexpert surgeons for the treatment of small intestinal obstruction in 30 dogs.

Science.gov (United States)

Jardel, Nicolas; Hidalgo, Antoine; Leperlier, Dimitri; Manassero, Mathieu; Gomes, Aymeric; Bedu, Anne Sophie; Moissonnier, Pierre; Fayolle, Pascal; Begon, Dominique; Riquois, Elisabeth; Viateau, Véronique

2011-02-01

To describe stapled 1-stage functional end-to-end intestinal anastomosis for treatment of small intestinal obstruction in dogs and evaluate outcome when the technique is performed by nonexpert surgeons after limited training in the technique. Case series. Dogs (n=30) with intestinal lesions requiring an enterectomy. Stapled 1-stage functional end-to-end anastomosis and resection using a GIA-60 and a TA-55 stapling devices were performed under supervision of senior residents and faculty surgeons by junior surgeons previously trained in the technique on pigs. Procedure duration and technical problems were recorded. Short-term results were collected during hospitalization and at suture removal. Long-term outcome was established by clinical and ultrasonographic examinations at least 2 months after surgery and from written questionnaires, completed by owners. Mean±SD procedure duration was 15±12 minutes. Postoperative recovery was uneventful in 25 dogs. One dog had anastomotic leakage, 1 had a localized abscess at the transverse staple line, and 3 dogs developed an incisional abdominal wall abscess. No long-term complications occurred (follow-up, 2-32 months). Stapled 1-stage functional end-to-end anastomosis and resection is a fast and safe procedure in the hand of nonexpert but trained surgeons. © Copyright 2011 by The American College of Veterinary Surgeons.

[End-of-life care and end-of-life medical decisions: the ITAELD study].

Science.gov (United States)

Miccinesi, Guido; Puliti, Donella; Paci, Eugenio

2011-01-01

To describe the attitudes towards end of life care and the practice of end-of-life medical decisions with possible life-shortening effect among Italian physicians. Cross sectional study (last death among the assisted patients in the last 12 months was considered). In the year 2007, 5,710 GPs and 8,950 hospital physicians were invited all over Italy to participate in the ITAELDstudy through anonymous mail questionnaire. Proportion of agreement with statements on end-of-life care issues. Proportion of deaths with an end-of-life medical decision. The response rate was 19.2%. The 65% of respondents agreed with the duty to respect any non-treatment request of the competent patient, the 55% agreed with the same duty in case of advanced directives, the 39% in case of proxy's request. The 53% of respondents agreed with the ethical acceptability of active euthanasia in selected cases. Among 1,850 deaths the 57.7% did not receive any end-of-life medical decision. For a further 21.0% no decision was possible, being sudden and unexpected deaths. In the remaining 21.3% at least one end-of-life medical decision was reported: 0.8% was classified as physician assisted death, 20.5% as non-treatment decision. Among all deceased the 19.6% were reported to have been deeply sedated. Being favourable to the use of opioids in terminal patients was associated to non-treatment decisions with possible but non-intentional life shortening effect; agreeing with the duty to fully respect any actual non-treatment request of the competent patient was associated to end-of life medical decisions with intentional life-shortening effect (adjusted OR>10 in both cases). The life stance and ethical beliefs of physicians determine their behaviour at the end of life wherever specific statements of law are lacking. Therefore education and debate are needed on these issues.

Hybrid life-cycle environmental and cost inventory of sewage sludge treatment and end-use scenarios: a case study from China.

Science.gov (United States)

Murray, Ashley; Horvath, Arpad; Nelson, Kara L

2008-05-01

Sewage sludge management poses environmental, economic, and political challenges for wastewater treatment plants and municipalities around the globe. To facilitate more informed and sustainable decision making, this study used life-cycle inventory (LCI) to expand upon previous process-based LCIs of sewage sludge treatmenttechnologies. Additionally, the study evaluated an array of productive end-use options for treated sewage sludge, such as fertilizer and as an input into construction materials, to determine how the sustainability of traditional manufacturing processes changes with sludge as a replacement for other raw inputs. The inclusion of the life-cycle of necessary inputs (such as lime) used in sludge treatment significantly impacts the sustainability profiles of different treatment and end-use schemes. Overall, anaerobic digestion is generally the optimal treatment technology whereas incineration, particularly if coal-fired, is the most environmentally and economically costly. With respect to sludge end use, offsets are greatest for the use of sludge as fertilizer, but all of the productive uses of sludge can improve the sustainability of conventional manufacturing practices. The results are intended to help inform and guide decisions about sludge handling for existing wastewater treatment plants and those that are still in the planning phase in cities around the world. Although additional factors must be considered when selecting a sludge treatment and end-use scheme, this study highlights how a systems approach to planning can contribute significantly to improving overall environmental sustainability.

Initial clinical experience with an interactive, video-based patient-positioning system for head and neck treatment

International Nuclear Information System (INIS)

Johnson, L.; Hadley, Scott W.; Milliken, Barrett D.; Pelizzari, Charles A.; Haraf, Daniel J.; Nguyen, Ai; Chen, George T.Y.

1996-01-01

Objective: To evaluate an interactive, video-based system for positioning head and neck patients. Materials and Methods: System hardware includes two B and W CCD cameras (mounted to provide left-lateral and AP-inferior views), zoom lenses, and a PC equipped with a frame grabber. Custom software is used to acquire and archive video images, as well as to display real-time subtraction images revealing patient misalignment in multiple views. Live subtraction images are obtained by subtracting a reference image (i.e., an image of the patient in the correct position) from real-time video. As seen in the figure, darker regions of the subtraction image indicate where the patient is currently, while lighter regions indicate where the patient should be. Adjustments in the patient's position are updated and displayed in less than 0.07s, allowing the therapist to interactively detect and correct setup discrepancies. Patients selected for study are treated BID and immobilized with conventional litecast straps attached to a baseframe which is registered to the treatment couch. Morning setups are performed by aligning litecast marks and patient anatomy to treatment room lasers. Afternoon setups begin with the same procedure, and then live subtraction images are used to fine-tune the setup. At morning and afternoon setups, video images and verification films are taken after positioning is complete. These are visually registered offline to determine the distribution of setup errors per patient, with and without video assistance. Results: Without video assistance, the standard deviation of setup errors typically ranged from 5 to 7mm and was patient-dependent. With video assistance, standard deviations are reduced to 1 to 4mm, with the result depending on patient coopertiveness and the length of time spent fine-tuning the setups. At current levels of experience, 3 to 4mm accuracy is easily achieved in about 30s, while 1 to 3mm accuracy is achieved in about 1 to 2 minutes. Studies

The impact of oral rehabilitation on oral health-related quality of life in patients receiving radiotherapy for the treatment of head and neck cancer.

Science.gov (United States)

Schweyen, Ramona; Kuhnt, Thomas; Wienke, Andreas; Eckert, Alexander; Hey, Jeremias

2017-05-01

To analyze the influence of dental treatment on oral health-related quality of life (OHRQoL) in head and neck cancer patients. This study included the data of 116 patients who underwent radiotherapy (RT) because of head and neck cancer. For each patient, the variables age, sex, tumor site, irradiation technique, dose on the spared parotid gland, concomitant chemotherapy, and denture status were documented. OHRQoL was determined using the OHIP-G14 questionnaire. Patients were divided into subgroups according to denture status: none or fixed partial dentures (none/FPD), removable partial dentures (RPD), and full dentures (CD). OHIP summary scores were determined and tested for clinical relevant differences with respect to the different variables. The association between OHRQol and the variables was assessed using linear regression. No clinically relevant influence on OHRQoL was found for gender, irradiation technique, and chemotherapy. Patients with tumors located in the oral cavity had a significantly higher OHIP score than patients with other tumor sites (p < 0.001). None/FPD and RPD patients had higher values than those found in a normal population, but did not differ significantly from each other (p = 0.387). In contrast to tumor site, teeth and type of denture seem to have a limited effect on OHRQoL in head and neck cancer patients. Prosthetic treatment in head and neck cancer patients do not lead to the same improvement in OHRQoL as found in the normal population. This might be taken into account especially if extensive dental treatment is intended.

Multiple squamous cell carcinomas within the head and neck region

International Nuclear Information System (INIS)

Sato, Katsuro; Hanazawa, Hideyuki; Sato, Yuichiro; Takahashi, Sugata

2004-01-01

Clinical features of multiple squamous cell carcinoma (SCC) cases within the head and neck that were treated in our department during the recent 10 years are discussed. Multiple SCCs arose in 6.6% of the cases with primary SCC; 67% of the cases had two carcinomas, and 33% had more than three carcinomas. The most common site of the multiple SCCs was the oral cavity (54%). The most frequent interval between treatment of previous carcinoma and diagnosis of subsequent carcinoma was simultaneous, but more than 5 years' interval was observed in 36% of the patients. The most common initial treatment of the carcinoma was irradiation, but the ratio of surgery increased for subsequent carcinomas. Prognosis of the patients with more than three carcinomas was not worse than that of patients with two carcinomas. Therefore, early diagnosis of the subsequent carcinomas based on careful long-term observation in the head and neck is necessary for follow-up of the patients with SCC of the head and neck. Treatment strategies considering the treatment of subsequent carcinomas are needed for the patients with primary head and neck SCC. (author)

The lived experience of dysphagia following non-surgical treatment for head and neck cancer.

Science.gov (United States)

Nund, Rebecca L; Ward, Elizabeth C; Scarinci, Nerina A; Cartmill, Bena; Kuipers, Pim; Porceddu, Sandro V

2014-06-01

The prevalence and severity of dysphagia in people treated non-surgically for primary head and neck cancer (HNC) is well documented. However, few studies have looked beyond the physiological impairment to explore the lived experience of dysphagia in the post-treatment period of HNC. The current study adopted a person-centred, qualitative approach to describe the experiences of people living with dysphagia in the months and years following non-surgical treatment for HNC. Using maximum variation sampling, 24 participants who had undergone radiotherapy treatment for HNC were recruited. Individual interviews were conducted to explore the impact of dysphagia on participants' everyday lives. The themes identified included: (1) physical changes related to swallowing; (2) emotions evoked by living with dysphagia; (3) altered perceptions and changes in appreciation of food; and (4) personal and lifestyle impacts. The data revealed the breadth and significance of the impact of dysphagia on the lives of people treated curatively for HNC. Assessment and management in the post-treatment period must be sufficiently holistic to address both the changing physical states and the psychosocial needs of people with dysphagia following HNC. Rehabilitation services which focus only on impairment-based management will fail to fully meet the support needs of this clinical population.

Computed Tomography (CT) -- Head

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Full Text Available ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Blood Clots CT Perfusion of the Head CT Angiography ( ...

Root resorption diagnosed with cone beam computed tomography after 6 months and at the end of orthodontic treatment with fixed appliances.

Science.gov (United States)

Makedonas, Dimitrios; Lund, Henrik; Hansen, Ken

2013-05-01

To investigate the prevalence of orthodontically induced root resorption after treatment and the correlation with resorption found after 6 months of treatment. One hundred fifty-six patients (11-18 years) treated with fixed appliances and extraction of four premolars were examined with cone beam computed tomography before treatment, after 6 months of treatment (n  =  97), and at the end of active treatment. The Malmgren Index was used to describe the degree of root resorption. Severe root resorption (>2 mm, score 3) was found in 25.6% of the patients at the end of treatment. Extreme root resorption was found in one patient. Root resorption was seen more frequently in the maxillary incisor region. There was no correlation between the severity of root resorption after 6 months and the amount observed at the end of treatment. Furthermore, no correlation was seen between treatment duration and the severity of root resorption. Clinically significant resorption was diagnosed in 25.6% of the patients, but no correlations, either with the resorption seen after 6 months or with the length of treatment, were found. Radiographic examination after 3 to 6 months of orthodontic treatment is too early and will not reduce the number of patients who will have teeth with severe root resorption.

Low-level laser therapy for the prevention of low salivary flow rate after radiotherapy and chemotherapy in patients with head and neck cancer

International Nuclear Information System (INIS)

Gonnelli, Fernanda Aurora Stabile; Palma, Luiz Felipe; Giordani, Adelmo Jose; Dias, Rodrigo Souza; Segreto, Roberto Araujo; Segreto, Helena Regina Comodo; Deboni, Aline Lima Silva

2016-01-01

Objective: to determine whether low-level laser therapy can prevent salivary hypofunction after radiotherapy and chemotherapy in head and neck cancer patients. Materials and methods: ee evaluated 23 head and neck cancer patients, of whom 13 received laser therapy and 10 received clinical care only. An InGaAlP laser was used intra-orally (at 660 nm and 40 mW) at a mean dose of 10.0 J/cm 2 and extra-orally (at 780 nm and 15 mW) at a mean dose of 3.7 J/cm 2 , three times per week, on alternate days. Stimulated and unstimulated sialometry tests were performed before the first radiotherapy and chemotherapy sessions (NO) and at 30 days after the end of treatment (N30). Results: At N30, the mean salivary flow rates were significantly higher among the laser therapy patients than among the patients who received clinical care only, in the stimulated and unstimulated sialometry tests (p = 0.0131 and p = 0.0143, respectively). Conclusion: low-level laser therapy, administered concomitantly with radiotherapy and chemotherapy, appears to mitigate treatment induced salivary hypofunction in patients with head and neck cancer. (author)

Low-level laser therapy for the prevention of low salivary flow rate after radiotherapy and chemotherapy in patients with head and neck cancer

Energy Technology Data Exchange (ETDEWEB)

Gonnelli, Fernanda Aurora Stabile [Faculdades Metropolitanas Unidas (FMU), Sao Paulo, SP (Brazil); Palma, Luiz Felipe; Giordani, Adelmo Jose; Dias, Rodrigo Souza; Segreto, Roberto Araujo; Segreto, Helena Regina Comodo [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Deboni, Aline Lima Silva

2016-03-15

Objective: to determine whether low-level laser therapy can prevent salivary hypofunction after radiotherapy and chemotherapy in head and neck cancer patients. Materials and methods: ee evaluated 23 head and neck cancer patients, of whom 13 received laser therapy and 10 received clinical care only. An InGaAlP laser was used intra-orally (at 660 nm and 40 mW) at a mean dose of 10.0 J/cm{sup 2} and extra-orally (at 780 nm and 15 mW) at a mean dose of 3.7 J/cm{sup 2} , three times per week, on alternate days. Stimulated and unstimulated sialometry tests were performed before the first radiotherapy and chemotherapy sessions (NO) and at 30 days after the end of treatment (N30). Results: At N30, the mean salivary flow rates were significantly higher among the laser therapy patients than among the patients who received clinical care only, in the stimulated and unstimulated sialometry tests (p = 0.0131 and p = 0.0143, respectively). Conclusion: low-level laser therapy, administered concomitantly with radiotherapy and chemotherapy, appears to mitigate treatment induced salivary hypofunction in patients with head and neck cancer. (author)

Impact of the prophylactic gastrostomy for unresectable squamous cell head and neck carcinomas treated with radio-chemotherapy on quality of life: Prospective randomized trial

International Nuclear Information System (INIS)

Salas, Sebastien; Baumstarck-Barrau, Karine; Alfonsi, Marc; Digue, Laurence; Bagarry, Danielle; Feham, Nasreddine; Bensadoun, Rene Jean; Pignon, Thierry; Loundon, Anderson; Deville, Jean-Laurent; Zanaret, Michel; Favre, Roger; Duffaud, Florence; Auquier, Pascal

2009-01-01

Background and purpose: Concomitant radio-chemotherapy is the gold standard treatment for unresectable head and neck carcinomas. Placement of prophylactic gastrostomy has been proposed to provide adequate nutrition during the therapeutic sequence. The objectives of this study were to assess the impact of prophylactic gastrostomy on the 6-month quality of life, and to determine the factors related to this quality of life. Materials and methods: Design. randomized, controlled, open study ('systematic percutaneous gastrostomy' versus 'no systematic gastrostomy'). Patients. squamous cell head and neck carcinoma (stages III and IV, UICC 1997). Setting. oncological departments of French university teaching hospitals. Treatment. optimal concomitant radio-chemotherapy. Evaluations. T0 baseline evaluation, T1 during the treatment, T2 end of the treatment, and T3 6-month post-inclusion. Primary endpoint. 6-month quality of life (Qol) assessed using SF36, EORTC QLQ-C30, EORTC QLQ H and N35 questionnaires. Results: The Qol changes from baseline included a decline (T1 and T2) followed by an improvement (T3). Qol at 6 months was significantly higher in the group receiving systematic prophylactic gastrostomy (p = 10 -3 ). Higher initial BMI and lower initial Karnofsky index were significant factors related to a higher 6-month Qol. Conclusions: The study results suggest that prophylactic gastrostomy improves post-treatment quality of life for unresectable head and neck cancer patients, after adjusting for other potential predictive quality of life factors.

Definitive radiation therapy - alone or combined with drug treatment for head and neck squamous cell carcinoma

International Nuclear Information System (INIS)

Katsarov, D.; Mihajlova, I.; Georgiev, D; Lyubomirov, V.; Gesheva, N.; Balabanova, A.; Klenova, A.; Pyrvanova, V.; Atanasov, T.

2017-01-01

Goal: To assess the effectiveness of three treatment methods in patients with squamous cell carcinoma of head and neck-ultimate radiotherapy (RT) up to 60 Gy, definitive radiation therapy simultaneously with chemotherapy (RT-CT) up to 60 Gy and definitive RT-CT greater than 60 Gy. Material and method: 154 patients with locally advanced head and neck carcinomas, at clinical stage T3-T4 N + M0 are included in the analysis for the period 2009-2016. Radical RT is carried out with a daily dose of 2-2.33 Gy on MV therapy equipment. There were treated as follows: in Group I - 37 patients with RT up to 60 Gy, in Group II - 58 patients with RT-CT up to 60 Gy and simultaneous radiosensitizing CT, weekly Cisplatin 50 mg i.v. or Cetuximab regimen, and Group III - 59 patients with RT-CT and a total dose over 60 Gy. The early dermatological and mucosal toxicity is assessed by the CTCAE v.3 scale. Results: RT in all patients was conducted without interruption. The mean total survival rate in the three groups with RT up to 60 Gy / RT-CT to 60 Gy / RT-CT over 60 Gy is 11 months, 21 months and 27 months respectively, with a statistically significant difference between I and III groups in favor of the latter (p = 0.049). The use of RT-CT with a dose increase above 60 Gy shows an advantage of III g over Group II, which is an extension of the mean overall survival by 61 months (p = 0.21). II-III degree toxicity was observed in II and III - dermatitis and mucositis - at the simultaneous RT-CT (Grade 3> 16%). Conclusions: The application of doses greater than 60 Gy with concurrent radiosensitizing drug treatment in advanced head and neck carcinoma is an effective method for more pronounced but reversible dermatological and mucosal toxicity. [bg

Image guided radiotherapy: equipment specifications and performance - an analysis of the dosimetric consequences of anatomic variations during head-and-neck radiotherapy treatment

International Nuclear Information System (INIS)

Marguet, Maud

2009-01-01

Anatomic variations during head-and-neck radiotherapy treatment may compromise the delivery of the planned dose distribution, particularly in the case of IMRT treatments. The aim of this thesis was to establish 'dosimetric indicators' to identify patients who delivered dose deviates from the planned dose, to allow an eventual re-optimisation of the patient's dosimetry, if necessary, during the course of their radiotherapy treatment. These anatomic variations were monitored by regular acquisition of 3D patient images using an onboard imaging system, for which a rigorous quality control program was implemented. The patient dose distribution analysis and comparison was performed using a modified gamma index technique which was named gammaLSC3D. This improved gamma index technique quantified and identified the location of changes in the dose distribution in a stack of 2D images, with particular reference to the target volume (PTV) or organs at risk (parotids). The changes observed in the dose distribution for the PTV or parotids were then analysed and presented in the form of gamma-volume histograms in order to facilitate the follow up of dosimetric changes during the radiotherapy treatment. This analysis method has been automated, and is applicable in clinical routine to follow dose variations during head and neck radiotherapy treatment. (author) [fr

Magnetic Resonance Imaging (MRI) -- Head

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Full Text Available ... by the interpreting radiologist. Frequently, the differentiation of abnormal (diseased) tissue from normal tissues is better with ... Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

Magnetic Resonance Imaging (MRI) -- Head

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Full Text Available ... the head (particularly the brain) in routine clinical practice. top of page What are some common uses ... gadolinium contrast material except when absolutely necessary for medical treatment. See the MRI Safety page for more ...

Diffusion-Weighted Magnetic Resonance Imaging Early After Chemoradiotherapy to Monitor Treatment Response in Head-and-Neck Squamous Cell Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Vandecaveye, Vincent, E-mail: Vincent.Vandecaveye@uzleuven.be [Department of Radiology, University Hospitals Leuven (Belgium); Dirix, Piet [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven (Belgium); De Keyzer, Frederik; Op de Beeck, Katya [Department of Radiology, University Hospitals Leuven (Belgium); Vander Poorten, Vincent [Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven (Belgium); Hauben, Esther [Department of Pathology, University Hospitals Leuven (Belgium); Lambrecht, Maarten; Nuyts, Sandra [Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven (Belgium); Hermans, Robert [Department of Radiology, University Hospitals Leuven (Belgium)

2012-03-01

Purpose: To evaluate diffusion-weighted imaging (DWI) for assessment of treatment response in head and neck squamous cell carcinoma (HNSCC) three weeks after the end of chemoradiotherapy (CRT). Methods and Materials: Twenty-nine patients with HNSCC underwent magnetic resonance imaging (MRI) prior to and 3 weeks after CRT, including T{sub 2}-weighted and pre- and postcontrast T{sub 1}-weighted sequences and an echo-planar DWI sequence with six b values (0 to 1,000 s/mm{sup 2}), from which the apparent diffusion coefficient (ADC) was calculated. ADC changes 3 weeks posttreatment compared to baseline ( Increment ADC) between responding and nonresponding primary lesions and adenopathies were correlated with 2 years locoregional control and compared with a Mann-Whitney test. In a blinded manner, the Increment ADC was compared to conventional MRI 3 weeks post-CRT and the routinely implemented CT, on average 3 months post-CRT, which used size-related and morphological criteria. Positive and negative predictive values (PPV and NPV, respectively) were compared between the Increment ADC and anatomical imaging. Results: The Increment ADC of lesions with later tumor recurrence was significantly lower than lesions with complete remission for both primary lesions (-2.3% {+-} 0.3% vs. 80% {+-} 41%; p < 0.0001) and adenopathies (19.9% {+-} 32% vs. 63% {+-} 36%; p = 0.003). The Increment ADC showed a PPV of 89% and an NPV of 100% for primary lesions and a PPV of 70% and an NPV of 96% for adenopathies per neck side. DWI improved PPV and NPV compared to anatomical imaging. Conclusion: DWI with the Increment ADC 3 weeks after concluding CRT for HNSCC allows for early assessment of treatment response.

Fuel cycle studies

International Nuclear Information System (INIS)

Anon.

1978-01-01

Programs are being conducted in the following areas: advanced solvent extraction techniques, accident consequences, fuel cycles for nonproliferation, pyrochemical and dry processes, waste encapsulation, radionuclide transport in geologic media, hull treatment, and analytical support for LWBR

Skin dose differences between intensity-modulated radiation therapy and volumetric-modulated arc therapy and between boost and integrated treatment regimens for treating head and neck and other cancer sites in patients

International Nuclear Information System (INIS)

Penoncello, Gregory P.; Ding, George X.

2016-01-01

The purpose of this study was (1) to evaluate dose to skin between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) treatment techniques for target sites in the head and neck, pelvis, and brain and (2) to determine if the treatment dose and fractionation regimen affect the skin dose between traditional sequential boost and integrated boost regimens for patients with head and neck cancer. A total of 19 patients and 48 plans were evaluated. The Eclipse (v11) treatment planning system was used to plan therapy in 9 patients with head and neck cancer, 5 patients with prostate cancer, and 5 patients with brain cancer with VMAT and static-field IMRT. The mean skin dose and the maximum dose to a contiguous volume of 2 cm"3 for head and neck plans and brain plans and a contiguous volume of 5 cm"3 for pelvis plans were compared for each treatment technique. Of the 9 patients with head and neck cancer, 3 underwent an integrated boost regimen. One integrated boost plan was replanned with IMRT and VMAT using a traditional boost regimen. For target sites located in the head and neck, VMAT reduced the mean dose and contiguous hot spot most noticeably in the shoulder region by 5.6% and 5.4%, respectively. When using an integrated boost regimen, the contiguous hot spot skin dose in the shoulder was larger on average than a traditional boost pattern by 26.5% and the mean skin dose was larger by 1.7%. VMAT techniques largely decrease the contiguous hot spot in the skin in the pelvis by an average of 36% compared with IMRT. For the same target coverage, VMAT can reduce the skin dose in all the regions of the body, but more noticeably in the shoulders in patients with head and neck and pelvis cancer. We also found that using integrated boost regimens in patients with head and neck cancer leads to higher shoulder skin doses compared with traditional boost regimens.

SU-F-T-303: Quantification of MLC Positioning Accuracy in VMAT Delivery of Head and Neck Cancer Treatment

Energy Technology Data Exchange (ETDEWEB)

Li, X; Yang, F [University Of Miami, Miami, FL (United States)

2016-06-15

Purpose: Knowing MLC leaf positioning error over the course of treatment would be valuable for treatment planning, QA design, and patient safety. The objective of the current study was to quantify the MLC positioning accuracy for VMAT delivery of head and neck treatment plans. Methods: A total of 837 MLC log files were collected from 14 head and neck cancer patients undergoing full arc VMAT treatment on one Varian Trilogy machine. The actual and planned leaf gaps were extracted from the retrieved MLC log files. For a given patient, the leaf gap error percentage (LGEP), defined as the ratio of the actual leaf gap over the planned, was evaluated for each leaf pair at all the gantry angles recorded over the course of the treatment. Statistics describing the distribution of the largest LGEP (LLGEP) of the 60 leaf pairs including the maximum, minimum, mean, Kurtosis, and skewness were evaluated. Results: For the 14 studied patients, their PTV located at tonsil, base of tongue, larynx, supraglottis, nasal cavity, and thyroid gland with volume ranging from 72.0 cm{sup 3} to 602.0 cm{sup 3}. The identified LLGEP differed between patients. It ranged from 183.9% to 457.7% with a mean of 368.6%. For the majority of the patients, the LLGEP distributions peaked at non-zero positions and showed no obvious dependence on gantry rotations. Kurtosis and skewness, with minimum/maximum of 66.6/217.9 and 6.5/12.6, respectively, suggested relatively more peaked while right-skewed leaf error distribution pattern. Conclusion: The results indicate pattern of MLC leaf gap error differs between patients of lesion located at similar anatomic site. Understanding the systemic mechanisms underlying these observed error patterns necessitates examining more patient-specific plan parameters in a large patient cohort setting.

Protective device for the head of a gushing well

Energy Technology Data Exchange (ETDEWEB)

Kutepov, A.I.; Prokopov, O.I.

1982-01-01

A protective device is proposed for the head of a gushing well. It includes a housing with assembly for attachment to the pipe string. It is distinguished by the fact that in order to simplify insulation of the device at the well head and to improve its reliable operation, the housing is made in the form of sections, each of which is made in the form of a crimped sleeve with upper and lower flanges on the ends. The lower flange is equipped with a guide bushing installed inside the sleeve and clamps for attaching it in relation to the upper flange.

Postoperative radiation for advanced head and neck cancers

International Nuclear Information System (INIS)

Ang, K. Kian; Garden, Adam S.

1995-01-01

Purpose: To discuss both general and specific indications for radiation following surgery for patients with cancers of the head and neck. Patients with advanced cancers of the head and neck are often not suitable candidates for treatment with definitive radiation, and are treated with surgery. Frequently these patients fail by recurring in either the primary sites or in the necks. Adjuvant radiation is therefore often a critical component in the management of these patients. While radiation can be done either prior to or after surgery, most centers prefer the postoperative setting. This refresher course will review general concepts of postoperative irradiation for the patient with head and neck cancer and apply these concepts to specific situations. The course will begin with a broad review of the indications for postoperative irradiation as not all patients undergoing surgery for cancers of the head and neck require additional treatment. We will also review the concept of using postoperative radiation to allow for more conservative surgery with preservation of function. The second portion of the course will focus on general techniques of postoperative irradiation. We will review concepts of patient setup and treatment portal design and describe how specific techniques are practiced at MDACC. Controversial topics, including field matching, total dose and fractionation, and the timing of postoperative radiation will be discussed. The final section of the course will review the results of postoperative irradiation as applied to the head and neck in general as well as to specific subsites. In addition to results for the common scenarios of squamous cell carcinomas of the oral cavity, pharynx and larynx, we will review results of postoperative irradiation for skin cancers of the head and neck, paranasal sinuses, and salivary glands

Effect of patient setup errors on simultaneously integrated boost head and neck IMRT treatment plans

International Nuclear Information System (INIS)

Siebers, Jeffrey V.; Keall, Paul J.; Wu Qiuwen; Williamson, Jeffrey F.; Schmidt-Ullrich, Rupert K.

2005-01-01

Purpose: The purpose of this study is to determine dose delivery errors that could result from random and systematic setup errors for head-and-neck patients treated using the simultaneous integrated boost (SIB)-intensity-modulated radiation therapy (IMRT) technique. Methods and Materials: Twenty-four patients who participated in an intramural Phase I/II parotid-sparing IMRT dose-escalation protocol using the SIB treatment technique had their dose distributions reevaluated to assess the impact of random and systematic setup errors. The dosimetric effect of random setup error was simulated by convolving the two-dimensional fluence distribution of each beam with the random setup error probability density distribution. Random setup errors of σ = 1, 3, and 5 mm were simulated. Systematic setup errors were simulated by randomly shifting the patient isocenter along each of the three Cartesian axes, with each shift selected from a normal distribution. Systematic setup error distributions with Σ = 1.5 and 3.0 mm along each axis were simulated. Combined systematic and random setup errors were simulated for σ = Σ = 1.5 and 3.0 mm along each axis. For each dose calculation, the gross tumor volume (GTV) received by 98% of the volume (D 98 ), clinical target volume (CTV) D 90 , nodes D 90 , cord D 2 , and parotid D 50 and parotid mean dose were evaluated with respect to the plan used for treatment for the structure dose and for an effective planning target volume (PTV) with a 3-mm margin. Results: Simultaneous integrated boost-IMRT head-and-neck treatment plans were found to be less sensitive to random setup errors than to systematic setup errors. For random-only errors, errors exceeded 3% only when the random setup error σ exceeded 3 mm. Simulated systematic setup errors with Σ = 1.5 mm resulted in approximately 10% of plan having more than a 3% dose error, whereas a Σ = 3.0 mm resulted in half of the plans having more than a 3% dose error and 28% with a 5% dose error

Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

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Deng Jie, E-mail: jie.deng@vanderbilt.edu [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Ridner, Sheila H. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Dietrich, Mary S. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee (United States); Wells, Nancy; Wallston, Kenneth A. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A. [Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States)

2012-11-01

Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients {>=}3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

International Nuclear Information System (INIS)

Deng Jie; Ridner, Sheila H.; Dietrich, Mary S.; Wells, Nancy; Wallston, Kenneth A.; Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A.

2012-01-01

Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

Factors associated with external and internal lymphedema in patients with head-and-neck cancer.

Science.gov (United States)

Deng, Jie; Ridner, Sheila H; Dietrich, Mary S; Wells, Nancy; Wallston, Kenneth A; Sinard, Robert J; Cmelak, Anthony J; Murphy, Barbara A

2012-11-01

The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC. Copyright © 2012 Elsevier Inc. All rights reserved.

Catalogue of tooth brush head designs.

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Voelker, Marsha A; Bayne, Stephen C; Liu, Ying; Walker, Mary P

2013-06-01

Manual toothbrushes (MTBs) and power toothbrushes (PTBs) are effective oral physiotherapy aids for plaque removal. End-rounded bristles are safer and reduce damage to oral tissues. Nylon bristles are more effective in plaque removal because the bristle is stiffer than natural bristles. In the last 10 years the number of options for MTBs and PTBs has expanded significantly and there is very little information providing a reference frame for the design characteristics of the heads. The present in vitro study characterized a variety of MTB and PTB heads to provide a reference library for other research comparisons which might be made. Various commercial MTB and PTB heads were used to characterize the following: bristle size, shape, diameter, number of tufts, number of bristles per tuft and surface characteristics. Photographs were collected from the side, at 45 degrees and the top of each toothbrush (TB) head using a scanning electron microscope and digital camera. Images were analyzed (Soft Imaging System) for bristle features and designs. One-way ANOVA (p ≤ 0.05) was performed to detect differences among TB types within MTB and PTB groups and between pooled values for MTB and PTB groups. There were significant differences (p ≤ 0.05) in toothbrush bristle diameter and bristle shape. In contrast, there were no significant differences between PTB vs. MTB in regards to bristle diameter, bristle count and tuft count. The results suggest that although there are wide variations in toothbrush head designs, significant differences were found only in relation to bristle diameter and shape.

A modification to the Gill-Thomas-Cosman (GTC) head frame for stereotactic radiosurgery of head and neck and cervical spine sites

International Nuclear Information System (INIS)

Qian, G.; Hasala, P.; Rashid, H.; Costantino, T.; Cangiane, L.; Lombardi, E.; Arbit, E; Lederman, G.

1996-01-01

PURPOSE/OBJECTIVE: Fractionated Stereotactic Radiosurgery (FSR) is used primarily to treat intracranial lesions. Many tumors which arise at or inferior to the base of skull and about the cervical spine area were not amenable to radiosurgery. Presented is a modification to the GTC head frame which permits stereotactic radiosurgery to be directed at head and neck tumors with accurate reproducible precision. MATERIALS AND METHODS: The original GTC head frame has two fixation points; an anterior individualized dental impression and a posterior occipital plate with a mold contoured to the occipital pertuberance. The height of the occipital plate is adjustable in its vertical plane. However, the position of the dental piece is fixed and, therefore, limits treatment to regions superior. Treatment of head and neck and cervical spine tumors has been accomplished with a modification of the dental apparatus. Presented is our new device; a bracket extension which attaches to the dental piece and allows the head frame to be lowered to multiple desired positions. The occipital plate is elevated accordingly to support the occipital pertuberance. The depth helmet is also modified for quality assurance. A Rando phantom was used to test the accuracy and reproducibility of the new equipment. Bracket extensions lowering the head frame by 3 cm and 8 cm, respectively, were tested for accuracy of relocation on the Rando Phantom. Each extension was tested 20 times and for each individual test 18 depth helmet positions were obtained. RESULTS: The standard deviation of the modified head frame for each depth helmet measurement ranged from 0.05 to 0.35mm (mean 0.20) as compared to the standard deviation for the original GTC head frame which was 0.13 to 0.34mm (mean 0.24). The new device maintains the accuracy and reproducibility of the original GTC head frame. CONCLUSION: The GTC relocatable head frame for FSR has been modified to treat tumors of the head and neck and cervical spine sites

Features of treatment of cervical dystonia associated with head tremor with botulinum toxin type A drugs under electro myographic control

Directory of Open Access Journals (Sweden)

A. N. Korenko

2016-01-01

Full Text Available The study was aimed to evaluate the efficacy and safety of injections of botulinum toxin typeA (BTA in the neck muscles under electromyographic control and without it to reduce head tremor, muscle tone and dystonic postures, as well as pain in patients with cervical dystonia (CD. 49 patients with CD and dystonic head tremor who received injections of BTA were examined. 33 (67 % patients received Dysport in an average dose of 695 (627; 762 units, 15 (31 % patients received Xeomin in an average dose of 262 (227; 297 units and 1 (2 % patient received 300 units of Botox. 16 (33 % patients received injections under EMGcontrol. The level of symptoms of CD and tremor before and 4 weeks after the treatment were measured by the TWSTRS and Tsui scales. Evaluation of the treatment efficacy was carried out using the patientreported Clinical Global Improvement (CGI scale, and the presence or absence of head tremor after injection was also recorded. The TWSTRS score decreased from 39 (36, 42 to 24 (21, 26, the TZUI score decreased from 9.8 (9, 10 to 4.9 (4, 6 in 4 weeks after injection (p <0.001. The level of tremor measured by Tsui scale decreased from 2.1 (1.7, 2.4 and 0.7 points (0,5; 0,9 (p <0.001. In 24 (49 % cases, complete disappearance of tremor was noted in 4 weeks after injection. Complete regression of tremor was observed significantly more frequently in patients with torticollis who received injections with EMG-control in 10(71 % cases vs. 8(32 % without it (p <0.05. 28(57 % patients noted moderate or significant improvement on the CGI scale. Pain decreased from 5.4 (3.9, 6.9 points to 2.4 (1.3, 3.6 (p <0.001 according to section 3 of TWSTRS scale, pain completely regressed in 15 (52 % patients. BTA injections are highly effective and safe treatment of CD symptoms such as dystonic posture, pain and dystonic tremor. BTA injections in the neck muscles under EMGcontrol can improve outcome in patients with torticollis associated with

Nonverbal synchrony of head- and body-movement in psychotherapy: different signals have different associations with outcome

Directory of Open Access Journals (Sweden)

Fabian eRamseyer

2014-09-01

Full Text Available Objective: The coordination of patient’s and therapist’s bodily movement – nonverbal synchrony – has been empirically shown to be associated with psychotherapy outcome. This finding was based on dynamic movement patterns of the whole body. The present paper is a new analysis of an existing dataset (Ramseyer & Tschacher, 2011, which extends previous findings by differentiating movements pertaining to head and upper-body regions. Method: In a sample of 70 patients (37 female, 33 male treated at an outpatient psychotherapy clinic, we quantified nonverbal synchrony with an automated objective video-analysis algorithm (Motion Energy Analysis, MEA. Head- and body-synchrony was quantified during the initial 15 minutes of video-recorded therapy sessions. Micro-outcome was assessed with self-report post-session questionnaires provided by patients and their therapists. Macro-outcome was measured with questionnaires that quantified attainment of treatment goals and changes in experiencing and behavior at the end of therapy. Results: The differentiation of head- and body-synchrony showed that these two facets of motor coordination were differentially associated with outcome. Head-synchrony predicted global outcome of therapy, while body-synchrony did not, and body-synchrony predicted session outcome, while head-synchrony did not. Conclusions: The results pose an important amendment to previous findings, which showed that nonverbal synchrony embodied both outcome and interpersonal variables of psychotherapy dyads. The separation of head- and body-synchrony suggested that distinct mechanisms may operate in these two regions: Head-synchrony embodied phenomena with a long temporal extension (overall therapy success, while body-synchrony embodied phenomena of a more immediate nature (session-level success. More explorations with fine-grained analyses of synchronized phenomena in nonverbal behavior may shed additional light on the embodiment of

Optimal feeding frequency of captive head-started green turtles (Chelonia mydas).

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Kanghae, H; Thongprajukaew, K; Yeetam, P; Jarit-Ngam, T; Hwan-Air, W; Rueangjeen, S; Kittiwattanawong, K

2017-08-01

Optimal feeding frequency was investigated to improve head-started propagation programme of juvenile green turtles (Chelonia mydas). The 15-day-old turtles (25-26 g body weight) were fed for ad libitum intake at one (1MD), two (2MD), three (3MD) or four (4MD) meals daily over a 3-month trial. Responses in growth, feed utilization, faecal characteristics, haematological parameters and carapace elemental composition were used to compare treatment effects. At the end of the feeding trial, no treatment had induced mortality. Growth performance in terms of weight gain and specific growth rate was similar in turtles fed 2MD, 3MD or 4MD (p > 0.05), but 1MD differed from these (p Turtles fed 2MD had significantly lower feed intake than in 3MD and 4MD groups, but the feed conversion ratios were similar. Faecal digestive enzyme analysis indicated higher catabolism of lipid and protein in the deprivation group (1MD), when compared with turtles fed at least twice daily. The feeding frequency did not affect the specific activities of carbohydrate-digesting enzymes. The results on enzymes activities were corroborated by the transition enthalpy characteristics of faeces, indicating nutrients remaining after digestion. The 2MD treatment also improved the haematological characteristics and the carapace quality, relative to low or excess feeding. Overall, the findings indicate that feeding juvenile green turtles twice a day is the preferred option in their head-started propagation. This promotes growth, reduces feed consumption, and improves health and carapace quality. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Cognitive Functioning After Radiotherapy or Chemoradiotherapy for Head-and-Neck Cancer

International Nuclear Information System (INIS)

Gan, Hui K.; Bernstein, Lori J.; Brown, Jennifer; Ringash, Jolie; Vakilha, Mehrdad; Wang, Lisa; Goldstein, David; Kim, John; Hope, Andrew; O'Sullivan, Brian; Waldron, John; Abdul Razak, Albiruni R.; Chen, Eric X.; Siu, Lillian L.

2011-01-01

Purpose: To perform a comprehensive cognitive function (CF) assessment in patients who were relapse free after curative intent radiotherapy (RT) or chemoradiotherapy for squamous cell carcinoma of the head and neck. Methods and Materials: Patients underwent neuropsychological tests to assess their objective CF; completed questionnaires to assess subjective CF, quality of life, and affect; and underwent blood tests to assess hematologic, biochemical, endocrine, and cytokine status. Retrospectively, the dosimetry of incidental radiation to the brain was determined for all patients, and the dose intensity of cisplatin was determined in those who had undergone chemoradiotherapy. Results: A total of 10 patients were enrolled (5 treated with radiotherapy only and 5 with radiotherapy and cisplatin). The mean time from the end of treatment was 20 months (range, 9-41). All patients were able to complete the assessment protocol. Of the 10 patients, 9 had impaired objective CF, with memory the most severely affected. The severity of memory impairment correlated significantly with the radiation dose to the temporal lobes, and impaired dexterity correlated significantly with the radiation dose to the cerebellum, suggesting that these deficits might be treatment related. Patients receiving cisplatin appeared to have poorer objective CF than patients receiving only RT, although this difference did not achieve statistical significance, likely owing to the small sample size. Consistent with the published data, objective CF did not correlate with subjective CF or quality of life. No association was found between objective CF and patients' affect, hematologic, biochemical, endocrine, and cytokine status. Conclusion: Neuropsychological testing is feasible in squamous cell carcinoma of the head-and-neck survivors. The findings were suggestive of treatment-related cognitive dysfunction. These results warrant additional investigation.

Curative and organ-preserving treatment with intra-arterial carboplatin induction followed by surgery and/or radiotherapy for advanced head and neck cancer: single-center five-year results

Directory of Open Access Journals (Sweden)

Tinelli Carmine

2007-04-01

Full Text Available Abstract Background This study evaluated the feasibility, toxicity, response rate and survival of neoadjuvant superselective intra-arterial infusion of high dose carboplatin in advanced head and neck cancer. Methods Forty-six patients with primary head and neck squamous cell carcinoma received 3 cycles of intra-arterial carboplatin (300 to 350 mg/m2 per cycle every 2 weeks, followed by radiotherapy or surgery plus radiotherapy. Results No complications or severe toxicity occurred. Sixteen patients (35% were complete responders, 20 (43% partial responders while 10 (22% did not respond to treatment. After completion of the multimodality treatment, 38/46 patients (83% were complete responders. After a 5-year follow-up period, 18/46 patients (39% are alive and disease-free, 3 (6,5% have died of a second primary tumor and 25 (54,5% have died of the disease. Conclusion Intra-arterial carboplatin induction chemotherapy is a safe, well-tolerated technique that discriminates between responders and non-responders and so may have prognostic significance in planning further integrated treatments aimed to organ preservation for advanced head and neck carcinomas.

Magnetic Resonance Imaging (MRI) -- Head

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Full Text Available ... structures of the brain and can also provide functional information (fMRI) in selected cases. MR images of ... Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain ...

Microbial diversity in firework chemical exposed soil and water samples collected in Virudhunagar district, Tamil Nadu, India.

Science.gov (United States)

Dhasarathan, P; Theriappan, P; Ashokraja, C

2010-03-01

Microbial diversity of soil and water samples collected from pyrochemicals exposed areas of Virdhunagar district (Tamil Nadu, India) was studied. Soil and water samples from cultivable area, waste land and city area of the same region were also studied for a comparative acount. There is a remarkable reduction in total heterotrophic bacterial population (THB) in pyrochemicals exposed soil and water samples (42 × 10(4) CFU/g and 5.6 × 10(4) CFU/ml respectively), compared to the THB of cultivable area soil and water samples (98 × 10(7) CFU/g and 38.6 × 10(7) CFU/ml). The generic composition the THB of the pyrochemicals exposed samples too exhibited considerable change compared to other samples. Pseudomonas sp. was the predominant one (41.6%) followed by Achromobacter sp. (25%) in pyrochemical exposed soil and Pseudomonas sp. was the predominant one (25%) in pyrochemical exposed water samples followed by Bacillus sp. (25%) and Micrococcus sp. (16.6%). It was observed that Cornybacterium sp. and Micrococcus sp. were absent completely in pyrochemical exposed soil and Achromobacter sp. was missing in the pyrochemical exposed water samples, which were present in the other samples. The outcome of this study clearly demonstrates that pollutants such as chemicals used in pyrotechniques affect the microbial biodiversity and suitable measures have to be taken to control the pollution level and to save biodiversity.

Consequences of radiotherapy on nutritional status, dietary intake, serum zinc and copper levels in patients with gastrointestinal tract and head and neck cancer

International Nuclear Information System (INIS)

Mahadavi, R.; Faramarzi, E.; Mohamed-Zadeh, M.; Ghaemmaghami, J.; Jabbari, Morteza V.

2007-01-01

Malnutrition occurs frequently in cancer patients and is multifactorial and can lead to negative outcomes. So we studied the effect of radiotherapy on nutritional status, weight changes, dietary intake, serum zinc and copper levels. During the period of October to March 2005, 45 cancer patients who referred to the Radiotherapy Center, Imam Khomeini Hospital, Iran were recruited. We assessed the nutritional status of patients using Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire. Patients on the basis of location of radiotherapy classified to mediastinum, head and neck pelvic groups. Changes in dietary intake (using 24 hour recall method) and body weight were evaluated prior to and during radiotherapy. At the onset and the end of radiotherapy, serum levels of Zinc, copper and albumin were determined. After treatment malnutrition increased significantly in all patients (p=0.01) and in head and neck (p=0.007) and pelvic groups (p=0.04). The decreased bodyweight of patients was significant in head and neck (p=0.02) and pelvic groups (p=0.05). The mean daily energy and protein intake of head and neck and pelvic groups decreased during radiotherapy while energy intake increased significantly in mediastinum group (p=0.01). After treatment, significant decreases also observed in mean serum zinc, copper and albumin levels (p<0.05). Because of negative effect of radiotherapy on oral feeding, nutritional assessment and intervention should be an integral part of treatment. Also, it would be worthwhile studying the effect of zinc supplementation on dietary intake and nutritional status of patients. (author)

Impact of weight loss on survival after chemoradiation for locally advanced head and neck Cancer: secondary results of a randomized phase III trial (SAKK 10/94)

International Nuclear Information System (INIS)

Ghadjar, Pirus; Hayoz, Stefanie; Zimmermann, Frank; Bodis, Stephan; Kaul, David; Badakhshi, Harun; Bernier, Jacques; Studer, Gabriela; Plasswilm, Ludwig; Budach, Volker; Aebersold, Daniel M

2015-01-01

To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer. From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end. The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 – 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes. Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival

Treatment outcome and prognostic factors for non-Hodgkin's lymphoma of head and neck

International Nuclear Information System (INIS)

Aoki, Yuki; Matsubayashi, Takashi

1999-01-01

A retrospective analysis was performed about the survivals of 188 patients with non-Hodgkin's lymphoma (NHL) of head and neck who had been treated from April 1975 to March 1997 in the department of radiology and otorhinolaryngology at Kitasato University Hospital. According to the mode of received treatment, they were classified into three categories of time, as the times of radiotherapy only from 1975 to 1985 (n=52), of transition from 1986 to 1989 (n=47), and of chemoradiotherapy from 1990 to 1997 (n=89). The survival was studied about the whole patients and patients' groups of the three times concerning the candidates of prognostic factors, as gender, age, clinical stage, histopathological type, site of origin and initial serum LDH-values, using Kaplan-Meier's method with logrank test. The cause-specific 5-year survival rates were 68.0% for the whole patients (n=188), 80.6% for the patients' group of the time of radiotherapy only, 64.7% for the time of transition (n=47), and 62.6% for the time of chemoradiotherapy. No survival difference of statistical significance was proved between these three times of therapy mode. Except for the clinical stage of the whole patients and of the two times of radiotherapy only and transition, and for the initial serum LDH-value of the whole patients, no survival difference of statistical significance was proved in any time of therapy mode concerning all other prognostic factors enumerated above. The time gap between the practice of biopsy and the start of either radiotherapy or chemotherapy proved to be significantly longer for the time of chemoradiotherapy (10.7±9.1 days) than for that of radiotherapy only (3.2±5.3 days), and also significantly longer in less than 3-year survivors than in more than 5-year ones. In conclusion, radiotherapy only resulted in a better or at least not worse outcome than chemoradiotherapy and the timing of starting treatment came out to be a noticeable prognostic factor for the patients with NHL of

Head-and-neck IMRT treatments assessed with a Monte Carlo dose calculation engine

International Nuclear Information System (INIS)

Seco, J; Adams, E; Bidmead, M; Partridge, M; Verhaegen, F

2005-01-01

IMRT is frequently used in the head-and-neck region, which contains materials of widely differing densities (soft tissue, bone, air-cavities). Conventional methods of dose computation for these complex, inhomogeneous IMRT cases involve significant approximations. In the present work, a methodology for the development, commissioning and implementation of a Monte Carlo (MC) dose calculation engine for intensity modulated radiotherapy (MC-IMRT) is proposed which can be used by radiotherapy centres interested in developing MC-IMRT capabilities for research or clinical evaluations. The method proposes three levels for developing, commissioning and maintaining a MC-IMRT dose calculation engine: (a) development of a MC model of the linear accelerator, (b) validation of MC model for IMRT and (c) periodic quality assurance (QA) of the MC-IMRT system. The first step, level (a), in developing an MC-IMRT system is to build a model of the linac that correctly predicts standard open field measurements for percentage depth-dose and off-axis ratios. Validation of MC-IMRT, level (b), can be performed in a rando phantom and in a homogeneous water equivalent phantom. Ultimately, periodic quality assurance of the MC-IMRT system is needed to verify the MC-IMRT dose calculation system, level (c). Once the MC-IMRT dose calculation system is commissioned it can be applied to more complex clinical IMRT treatments. The MC-IMRT system implemented at the Royal Marsden Hospital was used for IMRT calculations for a patient undergoing treatment for primary disease with nodal involvement in the head-and-neck region (primary treated to 65 Gy and nodes to 54 Gy), while sparing the spinal cord, brain stem and parotid glands. Preliminary MC results predict a decrease of approximately 1-2 Gy in the median dose of both the primary tumour and nodal volumes (compared with both pencil beam and collapsed cone). This is possibly due to the large air-cavity (the larynx of the patient) situated in the centre

Pre- and postirradiation care of the mouth in head and neck cancer patients

International Nuclear Information System (INIS)

Cohen, M.A.; Lownie, J.F.

1982-01-01

Radiotherapy plays an important role in the treatment of head and neck cancer. The effects of radiotherapy on the oral hard and soft tissues may range from a mild mucositis to severe caries and osteoradionecrosis. It is the responsibility of the dentist to treat and prevent the severe sequelae which may arise. This paper outlines the effects of radiotherapy on the oral structures and discusses the dental treatment of the patient during radiotherapy. Emphasis is placed on the prevention of complications. The head and neck cancer patient must be thoroughly examined by the dentist and treatment planning may then be divided into pre-irradiaton treatment, treatment during irradiation and post-irradiation treatment. The dentist thus forms an essential member of the team treating patients with head and neck cancer [af

Pre- and postirradiation care of the mouth in head and neck cancer patients

Energy Technology Data Exchange (ETDEWEB)

Cohen, M A; Lownie, J F [University of the Witwatersrand, Johannesburg (South Africa). Dept. of Surgery

1982-08-01

Radiotherapy plays an important role in the treatment of head and neck cancer. The effects of radiotherapy on the oral hard and soft tissues may range from a mild mucositis to severe caries and osteoradionecrosis. It is the responsibility of the dentist to treat and prevent the severe sequelae which may arise. This paper outlines the effects of radiotherapy on the oral structures and discusses the dental treatment of the patient during radiotherapy. Emphasis is placed on the prevention of complications. The head and neck cancer patient must be thoroughly examined by the dentist and treatment planning may then be divided into pre-irradiaton treatment, treatment during irradiation and post-irradiation treatment. The dentist thus forms an essential member of the team treating patients with head and neck cancer.

Heads Up

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... Connect with Us HEADS UP Apps Reshaping the Culture Around Concussion in Sports Get HEADS UP on Your Web Site Concussion ... HEADS UP on your web site! Create a culture of safety for young athletes Officials, learn how you can ... UP to Providers HEADS UP to Youth Sports HEADS UP to School Sports HEADS UP to ...

Correlations between the changes in patients' dental-facial morphology at the end of the orthodontic treatment and the psychological variables.

Science.gov (United States)

Vaida, Ligia; Pirte, Adriana; Corega, Claudia; Slăvescu, D; Muţiu, Gabriela

2009-01-01

The purpose of this research was to assess the impact that the improvement of patients' dental-facial morphology has at the end of the orthodontic treatment upon the following psychological variables: self-esteem, current self-related thoughts as well as upon the variables of social self-esteem and performance. The number of patients included in the study was of 168 (82 children and 86 adolescents) who carried out the orthodontic treatment. At the end of the active treatment, we applied to all patients the assessment instruments for the level of self- esteem and self-related current thoughts: the Rosenberg's Self-Esteem Scale and the Heatherton & Polivy Current Thoughts Scale. As far as the patients in the study are concerned, the improvement of their facial aspect at the end of the treatment showed a significantly positive correlation with the variables of global self-esteem, self-related current thoughts, social self-esteem and performance, with the exception of the girls in children study group who showed no correlations between physical aspect and the performance variable.

Prophylactic use of amifostine to prevent radiochemotherapy-induced mucositis and xerostomia in head-and-neck cancer

International Nuclear Information System (INIS)

Antonadou, Dosia; Pepelassi, Marizenia; Synodinou, Maria; Puglisi, Maria; Throuvalas, Nicolas

2002-01-01

Purpose: To determine the prophylactic properties of amifostine against acute and late toxicities from radiochemotherapy in patients with head-and-neck cancer. Methods and Materials: Fifty patients were randomized to receive conventional radiotherapy (RT) (2-Gy fractions, 5 days weekly, to a total of 60-74 Gy, depending on the tumor localization and TNM classification) and carboplatin (90 mg/m 2 infusion once per week before RT). Amifostine (300 mg/m 2 ) was administered in the study group only 15-30 min before RT for 6-7.5 weeks. The primary study end point was the grading of acute and late nonhematologic toxicities (mucositis, dysphagia, xerostomia) induced by radiochemotherapy. Secondary end points included treatment duration, hematologic toxicity, and clinical outcome. Results: The treatment duration was significantly shorter in the amifostine-treated group (p=0.013), because treatment interruptions were more frequent in the control group. Acute toxicities (mucositis and dysphagia) were less severe in the amifostine-treated group. By Week 3, all in the control group experienced Grade 2 mucositis compared with only 9% in the amifostine-treated group (p<0.0001). By Week 5, 52.2% of the patients in the control group experienced Grade 4 mucositis compared with 4.5% in the amifostine-treated group (p=0.0006). Similar results were obtained for dysphagia. At 3 months of follow-up, only 27% of patients in the study group experienced Grade 2 xerostomia compared with 73.9% in the control group (p=0.0001). Eighteen months after cessation of therapy, the proportion of patients with Grade 2 xerostomia was 4.5% vs. 30.4% for each respective treatment group (p=0.047). Cytoprotection with amifostine did not affect treatment outcome, with 90.9% complete responses in the amifostine-treated group compared with 78.3% in the control group (p=0.414). Conclusion: Amifostine was effective in reducing mucositis and dysphagia resulting from radiochemotherapy in patients with head

Prediction of critical weight loss during radiation treatment in head and neck cancer patients is dependent on BMI

DEFF Research Database (Denmark)

Lønbro, Simon; Petersen, Gry Bjerg; Andersen, Jens Rikardt

2016-01-01

PURPOSE: The aims of the present study were to explore pre-treatment predictors of weight loss during radiation treatment only in head and neck cancer (HNSCC) patients and investigate the weight loss in patients with or without a feeding tube. METHODS: Retrospectively, weight change during curative...... patients without (73.8 vs 78.3 kg) and feeding tube reduced, but did not prevent, weight loss which averaged 6.7 ± 4.7 kg (7.4 ± 4.7 %) compared with 4.7 ± 5.9 kg (5.5 ± 6.0 %) in patients without a feeding tube (P 

Utility of interim and end-of-treatment PET/CT in peripheral T-cell lymphomas

DEFF Research Database (Denmark)

El-Galaly, Tarec Christoffer; Pedersen, Martin Bjerregård; Hutchings, Martin

2015-01-01

According to the updated guidelines for imaging in lymphoma, 18F-FDG positron emission tomography/computed tomography (PET/CT) is recommended for staging and evaluation of treatment response in FDG-avid lymphomas. The purpose of the study was to evaluate the utility of PET/CT in nodal peripheral T....../CT. Medical records were reviewed for baseline clinical and follow-up information. Staging, interim (I-PET), and end-of-treatment PET/CT (E-PET) studies were centrally reviewed, and reported using the Deauville 5-point score (DS). A total of 124 patients fulfilled the inclusion criteria. The median age was 58...

Effect of fast neutrons and gamma rays treatments on heading date, plant height and tiller number in wheat

International Nuclear Information System (INIS)

Arain, M.A.

1978-01-01

Homogeneous seeds of six varieties of bread wheat, Triticum aestivum L. (2n = 6x = 42) were treated with fast neutrons and gamma rays. The irradiated seeds along with respective controls were grown in field plots during 1973-74 and heating date, plant height and tiller number studied. Varieties used in the present study varied significantly (P >=0.01) for all the characters. Treatment mean squares were highly significant for plant height and tillers per plant; whereas, the varieties x treatments interaction mean squares were significant only for plant height (P >= 0.05). Irradiated treatments exhibited significant reductions in plant height and tiller number than respective controls. However, heading was delayed among the irradiated material when compared with respective controls. Reduction in plant height was more pronounced after the treatments of gamma rays than the fast neutrons. The maximum and minimum shifts in mean values of these characters were observed in 20 kR (gamma rays) and Nf 300 RADS (fast neutrons) treatments, respectively. (author)

Role of taurine as a treatment for oxidative damage and sperm head abnormalities in irradiated mice and their male offspring

International Nuclear Information System (INIS)

El-Dawy, H.; Tawfik, S.S.; EI-Khafif, M.; Ragab, M.H.

2007-01-01

The efficiency of taurine therapy in treatment of male mice exposed to a dose of (3 Gy) whole body gamma irradiation and their male offspring was studied. Irradiated mice showed significant increase in plasma malonaldehyde (MDA) level and sperm head abnormality counts in all experiment interval times 1, 3 and 5 weeks. Administration of taurine (1% in drinking water) post-irradiation resulted in significant decrease in the effect of irradiation on MDA level and sperm head abnormalities count. The efficiency of taurine as radiotherapeutic agent is greatly dependent on its chemical properties as strong oxidants scavenger and biological activities as osmoregulator and membrane stabilizer. The probable mechanism of taurine was discussed, as it is a sulphydryl, heterocyclic-nitrogenous and pharmacological therapy

Evaluating the "Threshold Theory": Can Head Impact Indicators Help?

Science.gov (United States)

Mihalik, Jason P; Lynall, Robert C; Wasserman, Erin B; Guskiewicz, Kevin M; Marshall, Stephen W

2017-02-01

This study aimed to determine the clinical utility of biomechanical head impact indicators by measuring the sensitivity, specificity, positive predictive value (PV+), and negative predictive value (PV-) of multiple thresholds. Head impact biomechanics (n = 283,348) from 185 football players in one Division I program were collected. A multidisciplinary clinical team independently made concussion diagnoses (n = 24). We dichotomized each impact using diagnosis (yes = 24, no = 283,324) and across a range of plausible impact indicator thresholds (10g increments beginning with a resultant linear head acceleration of 50g and ending with 120g). Some thresholds had adequate sensitivity, specificity, and PV-. All thresholds had low PV+, with the best recorded PV+ less than 0.4% when accounting for all head impacts sustained by our sample. Even when conservatively adjusting the frequency of diagnosed concussions by a factor of 5 to account for unreported/undiagnosed injuries, the PV+ of head impact indicators at any threshold was no greater than 1.94%. Although specificity and PV- appear high, the low PV+ would generate many unnecessary evaluations if these indicators were the sole diagnostic criteria. The clinical diagnostic value of head impact indicators is considerably questioned by these data. Notwithstanding, valid sensor technologies continue to offer objective data that have been used to improve player safety and reduce injury risk.

Hydrometallurgical treatment of plutonium. Bearing salt baths waste

International Nuclear Information System (INIS)

Bros, P.; Gozlan, J.P.; Lecomte, M.; Bourges, J.

1993-01-01

The salt flux issuing from the electrorefining of plutonium metal alloy in salt baths (KCI + NaCI) poses a difficult problem of the back-end alpha waste management. An alternative to the salt process promoted by Los Alamos Laboratory is to develop a hydrometallurgical treatment. A new process based on the electrochemistry technique in aqueous solution has been defined and tested successfully in the CEA. The diagram of the process exhibits two principal steps: in the head-end, a dissolution in HNO 3 medium accompanied with an electrolytic dechlorination leading to a quantitative elimination of chloride as CI 2 gas followed by its trapping one soda lime cartridge, a complete oxidative dissolution of the refractory Pu residues by electrogenerated Ag(II), in the back-end: the Pu and Am recoveries by chromatographic extractions. (authors). 10 figs., 9 refs

Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial

International Nuclear Information System (INIS)

Duncan, W.; Arnott, S.J.; Orr, J.A.; Kerr, G.R.; Schmitt, G.

1984-01-01

The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group. (Auth.)

Bone properties of the humeral head and resistance to screw cutout

DEFF Research Database (Denmark)

Frich, L. H.; Jensen, N. C.

2014-01-01

Surgical treatment of fractures involving the proximal humeral head is hampered by complications. Screw cutout is the major pitfall seen in connection with rigid plating. We have exploited a bony explanation for this phenomenon. Materials and Methods: We examined the convex surface of the humeral...... sectioning technique. Results: The bone strength and bone density correlated well and revealed large regional variations across the humeral head. Bone strength and stiffness of the trabecular bone came to a maximum in the most medial anterior and central parts of the humeral head, where strong textural...... screw directions will predictably place screws in areas of the humeral head comprising low density and low strength cancellous bone. New concepts of plates and plating techniques for the surgical treatment of complex fractures of the proximal humerus should take bone distribution, strength...

Subchondral insufficiency fractures of the femoral head

Energy Technology Data Exchange (ETDEWEB)

Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

2004-02-01

The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

Preference Bias of Head Orientation in Choosing between Two Non-durables

Directory of Open Access Journals (Sweden)

Hiroyuki eFunaya

2015-06-01

Full Text Available The goal of this study is to investigate how customers’ gaze, head and body orientations reflect their choices. Although the relationship between human choice and gaze behavior has been well studied, other behaviors such as head and body are unknown. We conducted a two-alternatives-forced-choice task to examine (1 whether preference bias, i.e. a positional bias in gaze, head and body toward the item that was later chosen, exists in choice, (2 when preference bias is observed and when prediction of the resulting choice becomes possible (3 whether human choice is affected when the body orientations are manipulated. We used real non-durable products (cheap snacks and clothing on a shopping shelf. The results showed that there was a significant preference bias in head orientation at the beginning one second when the subjects stood straight toward the shelf, and that the head orientation was more biased toward the selected item than the gaze and the center of pressure at the ending one second. Manipulating body orientation did not affect the result of choice. The preference bias detected by observing the head orientation would be useful in marketing science for predicting customers’ choice.

Preference bias of head orientation in choosing between two non-durables.

Science.gov (United States)

Funaya, Hiroyuki; Shibata, Tomohiro

2015-01-01

The goal of this study is to investigate how customers' gaze, head and body orientations reflect their choices. Although the relationship between human choice and gaze behavior has been well-studied, other behaviors such as head and body are unknown. We conducted a two-alternatives-forced-choice task to examine (1) whether preference bias, i.e., a positional bias in gaze, head and body toward the item that was later chosen, exists in choice, (2) when preference bias is observed and when prediction of the resulting choice becomes possible (3) whether human choice is affected when the body orientations are manipulated. We used real non-durable products (cheap snacks and clothing) on a shopping shelf. The results showed that there was a significant preference bias in head orientation at the beginning 1 s when the subjects stood straight toward the shelf, and that the head orientation was more biased toward the selected item than the gaze and the center of pressure at the ending 1 s. Manipulating body orientation did not affect the result of choice. The preference bias detected by observing the head orientation would be useful in marketing science for predicting customers' choice.

Effect of pre- and post-heading waterlogging on growth and grain yield of four millets

Directory of Open Access Journals (Sweden)

Asana Matsuura

2016-07-01

Full Text Available Seeds of Panicum miliaceum, Panicum sumatrense, Setaria glauca, and Setaria italica were raised in polyvinylchloride tubes filled with soil to determine interspecific differences in waterlogging tolerance and the effect of pre- and post-heading waterlogging on growth and grain yield. Four treatments were conducted including control (no-waterlogging stress during growth. Pre-heading waterlogging treatment was initiated 17 days after sowing to heading (TC. Post-heading waterlogging treatment was initiated heading till harvest (CT. Waterlogging treatment was initiated 17 days after sowing to harvesting (TT. The grain yield of P. miliaceum, S. glauca, and S. italica decreased 16, 18, and 4%, while that of P. sumatrense increased 210% under TT treatment and this showed P. sumatrense had most waterlogging tolerance. The grain yield was more affected under TC treatment in S. italica and P. miliaceum. However, there was not significant differences the grain yield between TC and CT treatment in P. sumatrense and S. glauca. Total dry weight, total root dry weight, number of crown root, and the proportion of lysigenous aerenchyma of P. sumatrense were significantly higher than those of other millets at harvesting. Plant growth rate, total root dry weight, number of crown root, and the proportion of lysigenous aerenchyma of P. sumatrense were significantly higher than those of other millets at heading. These results suggest that P. sumatrense exhibits waterlogging tolerance by enhancing root growth characterized by a high proportion of lysigenous aerenchyma in the crown root.

Skin dose differences between intensity-modulated radiation therapy and volumetric-modulated arc therapy and between boost and integrated treatment regimens for treating head and neck and other cancer sites in patients.

Science.gov (United States)

Penoncello, Gregory P; Ding, George X

2016-01-01

The purpose of this study was (1) to evaluate dose to skin between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) treatment techniques for target sites in the head and neck, pelvis, and brain and (2) to determine if the treatment dose and fractionation regimen affect the skin dose between traditional sequential boost and integrated boost regimens for patients with head and neck cancer. A total of 19 patients and 48 plans were evaluated. The Eclipse (v11) treatment planning system was used to plan therapy in 9 patients with head and neck cancer, 5 patients with prostate cancer, and 5 patients with brain cancer with VMAT and static-field IMRT. The mean skin dose and the maximum dose to a contiguous volume of 2cm(3) for head and neck plans and brain plans and a contiguous volume of 5cm(3) for pelvis plans were compared for each treatment technique. Of the 9 patients with head and neck cancer, 3 underwent an integrated boost regimen. One integrated boost plan was replanned with IMRT and VMAT using a traditional boost regimen. For target sites located in the head and neck, VMAT reduced the mean dose and contiguous hot spot most noticeably in the shoulder region by 5.6% and 5.4%, respectively. When using an integrated boost regimen, the contiguous hot spot skin dose in the shoulder was larger on average than a traditional boost pattern by 26.5% and the mean skin dose was larger by 1.7%. VMAT techniques largely decrease the contiguous hot spot in the skin in the pelvis by an average of 36% compared with IMRT. For the same target coverage, VMAT can reduce the skin dose in all the regions of the body, but more noticeably in the shoulders in patients with head and neck and pelvis cancer. We also found that using integrated boost regimens in patients with head and neck cancer leads to higher shoulder skin doses compared with traditional boost regimens. Copyright © 2016 American Association of Medical Dosimetrists. Published by

Use of concentrated bone marrow aspirate and platelet rich plasma during minimally invasive decompression of the femoral head in the treatment of osteonecrosis.

Science.gov (United States)

Martin, John R; Houdek, Matthew T; Sierra, Rafael J

2013-06-01

The aim of this paper is to describe our surgical procedure for the treatment of osteonecrosis of the femoral head using a minimally invasive technique. We have limited the use of this procedure for patients with pre-collapse osteonecrosis of the femoral head (Ficat Stage I or II). To treat osteonecrosis of the femoral head at our institution we currently use a combination of outpatient, minimally invasive iliac crest bone marrow aspirations and blood draw combined with decompressions of the femoral head. Following the decompression of the femoral head, adult mesenchymal stem cells obtained from the iliac crest and platelet rich plasma are injected into the area of osteonecrosis. Patients are then discharged from the hospital using crutches to assist with ambulation. This novel technique was utilized on 77 hips. Sixteen hips (21%) progressed to further stages of osteonecrosis, ultimately requiring total hip replacement. Significant pain relief was reported in 86% of patients (n=60), while the rest of patients reported little or no pain relief. There were no significant complications in any patient. We found that the use of a minimally invasive decompression augmented with concentrated bone marrow and platelet rich plasma resulted in significant pain relief and halted the progression of disease in a majority of patients.

The head-regeneration transcriptome of the planarian Schmidtea mediterranea

Science.gov (United States)

2011-01-01

Background Planarian flatworms can regenerate their head, including a functional brain, within less than a week. Despite the enormous potential of these animals for medical research and regenerative medicine, the mechanisms of regeneration and the molecules involved remain largely unknown. Results To identify genes that are differentially expressed during early stages of planarian head regeneration, we generated a de novo transcriptome assembly from more than 300 million paired-end reads from planarian fragments regenerating the head at 16 different time points. The assembly yielded 26,018 putative transcripts, including very long transcripts spanning multiple genomic supercontigs, and thousands of isoforms. Using short-read data from two platforms, we analyzed dynamic gene regulation during the first three days of head regeneration. We identified at least five different temporal synexpression classes, including genes specifically induced within a few hours after injury. Furthermore, we characterized the role of a conserved Runx transcription factor, smed-runt-like1. RNA interference (RNAi) knockdown and immunofluorescence analysis of the regenerating visual system indicated that smed-runt-like1 encodes a transcriptional regulator of eye morphology and photoreceptor patterning. Conclusions Transcriptome sequencing of short reads allowed for the simultaneous de novo assembly and differential expression analysis of transcripts, demonstrating highly dynamic regulation during head regeneration in planarians. PMID:21846378

Timing of pilocarpine treatment during head and neck radiotherapy: concomitant administration reduces xerostomia better than post-radiation pilocarpine

International Nuclear Information System (INIS)

Zimmerman, Robert P.; Mark, Rufus J.; Juillard, Guy F.

1996-01-01

Purpose: To study whether oral pilocarpine administration during and three months after head and neck radiotherapy can prevent or reduce the expected post-radiation xerostomia. This regimen was compared to no treatment and to post-radiotherapy pilocarpine administration, which has previously been shown to reduce symptoms of xerostomia in several randomized trials. Methods: Xerostomia assessments were performed using a visual analog scale xerostomia questionnaire that measures oral dryness, oral comfort, difficulty with sleep, speech and eating. Higher scores indicate less xerostomia. All the patients had all major salivary glands in the initial field treated to ≥ 4,500 cGy. The concomitant pilocarpine group received 5 mg pilocarpine q.i.d. beginning on day one of radiotherapy and continuing for 3 months after completion of radiation. The control group had their baseline xerostomia measured prior to receiving pilocarpine. They subsequently took 5 mg pilocarpine t.i.d. for one month at which time they underwent a second xerostomia assessment. Xerostomia scores for each group were averaged and compared using the Student's t-test. Results: Seventeen patients who received pilocarpine during head and neck irradiation were compared to 12 post-radiotherapy patients who had not yet taken pilocarpine and the same patients after taking pilocarpine for one month. The mean intervals between completion of radiation and evaluation of xerostomia were 16 months for the control group and 17 months for the pilocarpine treated groups. The primary tumor sites treated as well as the total tumor doses were equivalent between the groups. Only one of the pilocarpine treated patients was still taking pilocarpine at the time of evaluation. Results are shown. For each component of xerostomia measured as well as the composite of all components, the group that had received pilocarpine during radiation had significantly less xerostomia than the no pilocarpine group (p<0.01 for each). Post

Quantifying Variation in Head Start Effects on Young Children's Cognitive and Socio-Emotional Skills Using Data from the National Head Start Impact Study

Science.gov (United States)

Bloom, Howard S.; Weiland, Christina

2015-01-01

This paper uses data from the Head Start Impact Study (HSIS), a nationally representative multisite randomized trial, to quantify variation in effects of Head Start during 2002-2003 on children's cognitive and socio-emotional outcomes relative to the effects of other local alternatives, including parent care. We find that (1) treatment and control…

The effectiveness of thyme honey for the management of treatment-induced xerostomia in head and neck cancer patients: A feasibility randomized control trial.

Science.gov (United States)

Charalambous, Andreas; Lambrinou, Ekaterini; Katodritis, Nicos; Vomvas, Dimitrios; Raftopoulos, Vasilios; Georgiou, Morpho; Paikousis, Lefkios; Charalambous, Melanie

2017-04-01

Radiation-induced xerostomia is one of the most common side effects that head and neck cancer patients experience during and after treatment. Despite the various methods for the prevention and treatment of radiation-induced xerostomia, it remains highly prevalent among patients treated for head and neck cancers negatively influencing their lives. The purpose of this study was to evaluate the effectiveness of thyme honey as a means for managing radiation-induced xerostomia. This was a parallel randomised controlled trial with two equal arms, the experimental arm (thyme honey) and the control arm (saline). 72 head and neck cancer patients receiving radiotherapy or/and chemotherapy or/and surgery were recruited in a specialised cancer centre. Patients in both arms followed the same administration protocol with thyme honey and saline respectively. Identical assessments at baseline, 1 month and 6 months following completion of the intervention were performed in both arms including the National Cancer Institute (NCI) xerostomia scale and the Xerostomia Questionnaire (XQ) additionally to weekly oral clinical assessments. The ClinicalTrials.gov Identifier for this study is NCT01465308. Linear Mixed Models revealed the statistically significant effect of the intervention on xerostomia (F = 8.474 p xerostomia. Copyright © 2017 Elsevier Ltd. All rights reserved.

CHIS – Services available during CERN’s end-of-year closure

CERN Multimedia

HR Department

2014-01-01

The UNIQA Helpdesk at CERN, which has been temporarily relocated to Building 510, will be closed during CERN's end-of-year closure (20 December 2014 to 4 January 2015).     During this period, UNIQA’s Head Office in Geneva will be open from 8 a.m. to 5 p.m. on 23, 24 (until 4 p.m.), 26, 27 and 30 December 2014 and on 2 and 3 January 2015. The UNIQA Helpdesk at CERN will open again on 5 January 2015 and its opening hours have been extended: Monday to Friday: from 9 a.m. to 1 p.m., and Tuesday and Thursday: from 2 p.m. to 4 p.m. During the end-of-year closure, the following services are also at your disposal: Until the end of 2014: the telephone numbers printed on your old insurance card: +41 (0)22 718 63 00 for UNIQA’s Head Office, available during office hours only (see above), +43 512 224 22 for Tyrolean Air Ambulance - urgent medical assistance 24/7.   From January 2015: the numbers printed on your new insura...

Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results

OpenAIRE

Žiak, Peter; Holm, Anders; Halička, Juraj; Mojzis, Peter; Piñero, David P.

2017-01-01

Background The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. Purpose To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample ...

Interstitial hyperthermia and iridium-192 treatment alone vs. interstitial iridium-192 treatment/hyperthermia and low dose cisplatinum infusion in the treatment of locally advanced head and neck malignancies

International Nuclear Information System (INIS)

Schreiber, David P.; Overett, Thomas K.

1995-01-01

Purpose: To determine whether the addition of low dose platinum infusional chemotherapy adds to the effectiveness of interstitial hyperthermia/iridium-192 management of locally advanced head and neck malignancies. Methods and Materials: From 1987 to 1993, 36 patients with locally advanced head and neck malignancies were treated locally with interstitial hyperthermia and iridium-192 as part or all of their management. Twenty-two of the above-mentioned patients also received low dose infusional cisplatinum chemotherapy at 20 mg/M 2 per day during the time of the implant. No patient received greater than 100 mg/M 2 total dose. Implant times ranged from 38.5 to 134 h and total doses delivered with the radiation implants ranged from 15 to 39.9 Gy. Average implant volume was 50 cc. Twenty-three patients received external beam irradiation supplementation in a dose range from 25.2 to 64 Gy. Results: Median follow-up for the entire group was 8, months with 7 months for the chemotherapy group vs. 12 months for the no-chemotherapy group. Freedom from relapse rates for the chemotherapy group vs. the no-chemotherapy group were 70% at 41 months vs. 63% at 60 months, p not significant (p = NS). Overall survival by Life Table Analysis was 28% for the chemotherapy group at 41 months vs. 31% for the no-chemotherapy group at 60 months (p = NS). Complete response (CR) rates were 93% for the chemotherapy group vs. 86% for the no-chemotherapy group. Seven patients in the chemotherapy group had recurrent disease and four patients in the no-chemotherapy group were being treated for recurrent disease. Complication rates were similar in both groups, with two patients in the chemotherapy arm requiring hyperbaric oxygen treatments and one patient in the no-chemotherapy arm requiring hyperbaric oxygen treatments (for soft tissue necrosis). Conclusion: It appears that low dose platinum infusional chemotherapy can be added safely to patients receiving interstitial iridium-192 implants along with

Changes in head and cervical-spine postures and EMG activities of masticatory muscles following treatment with complete upper and partial lower denture.

Science.gov (United States)

Salonen, M A; Raustia, A M; Huggare, J A

1994-10-01

A clinical stomatognathic, cephalometric and electromyographic (EMG) study was performed in relation to 14 subjects (10 women, 4 men), each with an edentulous maxilla and residual mandibular dentition before and six months after treatment with complete upper and partial lower dentures. The mean age of the subjects was 54.4 years (range 43-64 years). The mean period of edentulousness and age of dentures were 22.5 years (range 15-33 years) and 14.1 (range 1.5-30 years), respectively. Natural head position was recorded (using a fluid-level method) and measured from cephalograms. EMG activity was measured in relation to masseter and temporal muscles. A decrease in clinical dysfunction index was noted in 12 of 14 subjects (86%). There was no change in cervical inclination, but a slight extension of the head was noted after treatment. Rapid recovery of the masticatory muscles was reflected in increased EMG activity, especially when biting in the maximal intercuspal position. In cases of edentulous maxilla and residual mandibular anterior dentition, treatment with a complete upper and lower partial denture had a favorable effect on craniomandibular disorders and masticatory-muscle function.

Evaluation of Radiocapitellar Arthritis in Patients with a Second Radiograph at Least 2 Years after Nonoperative Treatment of an Isolated Radial Head Fracture

Directory of Open Access Journals (Sweden)

Amir R. Kachooei

2017-11-01

Full Text Available Background: To study if patients that have a second radiograph 2 or more years after nonoperative treatment of an isolated radial head fracture have radiocapitellar osteoarthritis (RC OA. Methods: We used the database of 3 academic hospitals in one health system from 1988 to 2013 to find patients with isolated radial head fractures (no associated ligament injury or fracture that had a second elbow radiograph after more than 2 years from the initial injury. Of 887 patients with isolated radial head fractures, 54 (6% had an accessible second radiograph for reasons of a second injury (57%, pain (30%, or follow-up visit (13%. Two orthopedic surgeons independently classified the radial head fractures on the initial radiographs using the Broberg and Morrey modified Mason classification, and assessed the development of RC OA on the final radiograph using a binary system (yes/no. Results: Four out of 54 (7.5% patients had RC OA, one with isolated RC arthrosis that seemed related to capitellar cartilage injury, and 3 that presented with pain and had global OA (likely primary osteoarthritis. Conclusion: With the caveat that some percentage of patients may have left our health system during the study period, about 1 in 887 patients (0.1% returns with isolated radiocapitellar arthritis after an isolated radial head fracture, and this may relate to capitellar injury rather than attrition. Patients with isolated radial head fractures can consider post-traumatic radiocapitellar arthritis a negligible risk.

Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies.

Science.gov (United States)

Tucker, Ross; Raftery, Martin; Kemp, Simon; Brown, James; Fuller, Gordon; Hester, Ben; Cross, Matthew; Quarrie, Ken

2017-08-01

The tackle is responsible for the majority of head injuries during rugby union. In order to address head injury risk, risk factors during the tackle must first be identified. This study analysed tackle characteristics in the professional game in order to inform potential interventions. 464 tackles resulting in a head injury assessment (HIA) were analysed in detail, with tackle type, direction, speed, acceleration, nature of head contact and player body position the characteristics of interest. Propensity to cause an HIA was significantly greater for active shoulder tackles, front-on tackles, high speeder tackles and an accelerating tackler. Head contact between a tackler's head and ball carrier's head or shoulder was significantly more likely to cause an HIA than contact below the level of the shoulder (incident rate ratio (IRR) 4.25, 95%-CI 3.38 to 5.35). The tackler experiences the majority (78%) of HIAs when head-to-head contact occurs. An upright tackler was 1.5 times more likely to experience an HIA than a bent at the waist tackler (IRR 1.44, 95% CI 1.18 to 1.76). This study confirms that energy transfer in the tackle is a risk factor for head injury, since direction, type and speed all influence HIA propensity. The study provides evidence that body position and the height of tackles should be a focus for interventions, since lowering height and adopting a bent at the waist body position is associated with reduced risk for both tacklers and ball carriers. To this end, World Rugby has implemented law change based on the present data. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exploding head syndrome: a case report.

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Ganguly, Gautam; Mridha, Banshari; Khan, Asif; Rison, Richard Alan

2013-01-01

Exploding head syndrome (EHS) is a rare parasomnia in which affected individuals awaken from sleep with the sensation of a loud bang. The etiology is unknown, but other conditions including primary and secondary headache disorders and nocturnal seizures need to be excluded. A 57-year-old Indian male presented with four separate episodes of awakening from sleep at night after hearing a flashing sound on the right side of his head over the last 2 years. These events were described 'as if there are explosions in my head'. A neurologic examination, imaging studies, and a polysomnogram ensued, and the results led to the diagnosis of EHS. EHS is a benign, uncommon, predominately nocturnal disorder that is self-limited. No treatment is generally required. Reassurance to the patient is often all that is needed.

Perceptions of support among Swedish parents of children after end of successful cancer treatment: a prospective, longitudinal study.

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Kukkola, Laura; Hovén, Emma; Cernvall, Martin; von Essen, Louise; Grönqvist, Helena

2017-12-01

Most children survive childhood cancer, however parenting a child diagnosed with cancer is a major challenge. The main aim of the current study was to describe Swedish parents' need, opportunity and benefit of support from healthcare professionals and significant others after end of a child's successful cancer treatment. Data was collected from approximately one week after end of successful treatment/six months after transplantation (T4, n = 212) up to five years thereafter (T7, n = 137). Parents answered questions via telephone about need, opportunity and benefit of talking to psychologists, social workers, partners and friends. The proportion reporting need of support from healthcare professionals varied between 73% (mothers' need of support from social workers, T4) and 7% (fathers' need of support from psychologists/social workers, T7). Need of support from significant others varied between 99% (mothers' and fathers' need of support from partners, T4) and 27% (fathers' need of support from friends, T7). The proportion reporting need of support decreased over time (p friends at T5 (p parent perceive support from healthcare professionals as beneficial. More parents should get access to psychosocial support services after end of a child's cancer treatment/transplantation.

The contribution of cetuximab in the treatment of recurrent and/or metastatic head and neck cancer

Directory of Open Access Journals (Sweden)

Mohamedtaki A Tejani

2010-06-01

Full Text Available Mohamedtaki A Tejani, Roger B Cohen, Ranee MehraDepartment of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USAAbstract: Recurrent and/or metastatic squamous cell carcinoma of the head and neck (HNSCC continues to be a source of significant morbidity and mortality worldwide. Agents that target the epidermal growth factor receptor (EGFR have demonstrated beneficial effects in this setting. Cetuximab, a monoclonal antibody against the EGFR, improves locoregional control and overall survival when used as a radiation sensitizer in patients with locoregionally advanced HNSCC undergoing definitive radiation therapy with curative intent. Cetuximab is also active as monotherapy in patients whose cancer has progressed on platinum-containing therapy. In the first-line setting for incurable HNSCC, cetuximab added to platinum-based chemotherapy significantly improves overall survival compared with standard chemotherapy alone. These positive results have had a significant impact on the standard of care for advanced HNSCC. In this review, we will discuss the mechanism of action, clinical data and common toxicities that pertain to the use of cetuximab in the treatment of advanced incurable HNSCC.Keywords: cetuximab, squamous cell carcinoma of the head and neck, epidermal growth factor receptor

The role of radiology in head and neck tumours in children

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McHugh, Kieran

2010-01-01

Abstract Head and neck malignancy is rare in children. However, distinguishing malignant tumours from the more common and numerous benign causes of neck masses in childhood is crucial as many malignant conditions have an excellent prognosis with appropriate oncological management. Ultrasound, computed tomography and magnetic resonance imaging all have crucial roles in the diagnosis of head and neck malignancy in children and there is an emerging role for positron emission tomography, particularly in the management and follow-up of lymphoma. We describe the imaging appearances of the common malignant tumours arising in the extracranial head and neck in children, focusing on lymphoma, rhabdomyosarcoma and nasopharyngeal carcinoma. The clinical presentation and radiological appearances of benign tumours in the head and neck in children may overlap with those seen in malignant disease. We describe the imaging appearances of juvenile angiofibroma, vascular abnormalities involving the extracranial head and neck and cervical teratomas. Advances in both imaging techniques and cancer staging systems, many of the latter aimed at avoiding over-treatment and treatment-related complications, will lead to an increasingly central role for imaging in childhood head and neck cancer. PMID:20199940

A project proposal for implementing intensity modulated radiotherapy (IMRT) for treatment of head and neck tumors

International Nuclear Information System (INIS)

Napoles Morales, Misleidy; Garcia Yip, Fernando; Rodriguez Machado, Jorge; Yanes Lopez, Yaima; Pomares Gomez, Yenes; Mena, Yailen

2009-01-01

Malignant tumors located in the structures of the head and neck, excluding the skull and its contents, constitute 10% of all cancers, remains the most frequent locations, which correspond to the oral cavity between 40 to 60%. Diagnosed between 60 to 80% in early stages and a 15 to 30% in more advanced forms of the disease. Radiotherapy and surgery are the essential therapeutic tools in the treatment of these tumors planning processes and administration of radiotherapy treatments currently in a situation of rapid and radical change. Since the beginning of radiotherapy to this day the greatest advances in treatment have been linked to a better definition of the tumor irradiation thus get a reduced dose in healthy tissue. The use of radiation, can be severe sequelae affecting quality of life of the patient, organs at risk receiving high dose and advanced technique of IMRT treatment planning and allows treatments shaped fields, especially when the target of radiation is irregular, with fewer side effects by limiting the dose in the tumor tissues and organs at risk and to allow us to increase the doses in the tumor. So we decided to develop a protocol for the implementation of IMRT, taking into account that we have the appropriate equipment, trained staff to develop this technique. (Author)

Clinical effectiveness of a Pilates treatment for forward head posture.

Science.gov (United States)

Lee, Sun-Myung; Lee, Chang-Hyung; O'Sullivan, David; Jung, Joo-Ha; Park, Jung-Jun

2016-07-01

[Purpose] This study compared the effects of pilates and an exercise program on the craniovertebral angle, cervical range of motion, pain, and muscle fatigue in subjects with a forward head posture (FHP). [Subjects and Methods] A total of 28 sedentary females (age 20 to 39 years) with FHP were randomly assigned to pilates (n=14) and combined (n=14) exercise groups. The study was a randomized, controlled, double-blind study with the two groups performing exercise 50 min/day, 3 days/week, with an intensity of 11-15 rating of perceived exertion (RPE) for ten weeks. The main outcome measures were craniovertebral angle, cervical range of motion (ROM), pain levels assessed by visual analog scale (VAS), and neck disability index (NDI). Surface electromyography was also used to measure muscle fatigue. [Results] There were significant increases in craniovertebral angle and cervical ROM in the pilates group, but none in the control group. The only significant differences in muscle activity were recorded in the sternocleidomastoid muscle in the pilates group. Both exercise programs had positive effects on pain measures, as VAS and NDI were significantly decreased. [Conclusion] The results suggest that pilates could be recommended as an appropriate exercise for treatment of FHP in sedentary individuals.

Impact of low-level laser therapy on hyposalivation, salivary pH, and quality of life in head and neck cancer patients post-radiotherapy.

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Palma, Luiz Felipe; Gonnelli, Fernanda Aurora Stabile; Marcucci, Marcelo; Dias, Rodrigo Souza; Giordani, Adelmo José; Segreto, Roberto Araújo; Segreto, Helena Regina Comodo

2017-05-01

Late effects of radiotherapy for head and neck cancer treatment have been increasingly investigated due to its impact on patients' quality of life. The purpose of this study was to evaluate the effect of low-level laser therapy on hyposalivation, low salivary pH, and quality of life in head and neck cancer patients post-radiotherapy. Twenty-nine patients with radiation-induced xerostomia received laser sessions twice a week, during 3 months (24 sessions). For this, a continuous wave Indium-Gallium-Aluminium-Phosphorus diode laser device was used punctually on the major salivary glands (808 nm, 0.75 W/cm 2 , 30 mW, illuminated area 0.04 cm 2 , 7.5 J/cm 2 , 10 s, 0.3 J). Six extraoral points were illuminated on each parotid gland and three on each submandibular gland, as well as two intraoral points on each sublingual gland. Stimulated and unstimulated salivary flow rate, pH (two scales with different gradations), and quality of life (University Of Washington Quality of Life Questionnaire for Patients with Head and Neck Cancer) were assessed at baseline and at the end of the treatment. There were significant increases in both mean salivary flow rates (unstimulated: p = 0.0012; stimulated: p quality of life questionnaire (p patients submitted to radiotherapy for head and neck cancer, thereby leading to an improvement in quality of life.

Management of osteonecrosis of the femoral head in children with sickle cell disease: results of conservative and operative treatments at skeletal maturity

OpenAIRE

Mallet, C.; Abitan, A.; Vidal, C.; Holvoet, L.; Mazda, K.; Simon, A.-L.; Ilharreborde, B.

2018-01-01

Abstract Purpose Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods All ...

Acupuncture treatment of patients with radiation-induced xerostomia

International Nuclear Information System (INIS)

Blom, M.; Dawidson, I.; Johnson, G.; Angmar-Maansson, B.; Fernberg, J.-O.

1996-01-01

Xerostomia is a common and usually irreversible side effect in patients receiving radiation therapy (>50 Gy) for head and neck cancer. Of 38 patients with radiation-induced xerostomia, 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo. Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment. In the experimental group 68% and in the control group 50% of the patients had increased salivary flow rates at the end of the observation period. Among those patients who had had all their salivary glands irradiated, 50% in both groups showed increased salivary flow rates (>20%) by the end of the observation period of 1 year. The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions, the majority had high probability of continual improvement after the completion of acupuncture treatment. (Author)

Acupuncture treatment of patients with radiation-induced xerostomia